The inverse association between obesity and education level has been demonstrated in many developed countries; however, few studies have investigated obesity in geriatric populations. This cross-sectional analysis explored the association between geriatric obesity and education level, along with other demographic characteristics in Taipei, Taiwan between 2013 and 2015. Taipei citizens ≥ 65 years (aborigines ≥ 55 years) were recruited to participate in the elderly health examination programme. Logistic regression was applied to analyse the relationship between obesity (defined as body mass index ≥ 27 kg/m² in Taiwan) and education level among men and women after controlling for age, race, income status, and smoking status. A total of 28,092 men and 31,835 women were included in the final analysis. Compared to those with education years ≥ 16, older men and women with education years ≤ 12 had higher odds of being obese. The odds ratios increase as years of education decrease, and the trend is more pronounced among women. Aborigines had much higher chances of being obese among men and women, while there were no differences by income status. The results clarified the factors related to obesity in the elderly, and will be useful for authorities working to improve health outcomes among this population.

This study aimed to identify knowledge gaps regarding coronavirus disease 2019 (COVID-19) and develop an integrated educational program for healthcare workers. First, we designed and validated ten multiple-choice questions to identify knowledge gaps among healthcare workers. Within one month of the online test and curriculum offering, 5533 staff had completed the test, with a completion rate of 84.97%. There were 2618 healthcare workers who answered the pre-test 100% correctly. Those who did not answer the pre-test 100% correctly took multiple tests after learning through the online teaching materials. Eventually, 5214 staff passed the test (pre-test or post-test with 100% correct answers). The result showed that all staff had a low correct rate for personal protective equipment (PPE) use recommendations. The Infection Control Center conducted training sessions for hospital staff on how to wear protective clothing. Information on the selection and use of PPE for infection prevention was provided, and participants were allowed time to practice and familiarize themselves with the correct way to wear PPE. Moreover, the Department of Education and Research continued updating the online learning materials based on the most important updated peer-reviewed published articles. The attending teaching physicians helped to search, translate, and take notes on articles in the local language (traditional Chinese) for other colleagues to read easily. We expect to increase learning opportunities for healthcare workers, even during uncertain times such as the current coronavirus pandemic through (1) the hospital-wide course announcements, (2) the continuous placement of test questions and learning files on the digital learning platform, (3) the placement of journal highlights in cloud folders, and (4) the use of the digital learning platform on mobile phones accessible outside the hospital.

Adolescent obesity has increased to alarming proportions globally. However, few studies have investigated the optimal waist circumference (WC) of Asian adolescents. This study sought to establish the optimal WC cutoff points that identify a cluster of cardiovascular risk factors (CVRFs) among 15-year-old ethnically Chinese adolescents. This study was a regional population-based study on the CVRFs among adolescents who enrolled in all the senior high schools in Taipei City, Taiwan, between 2011 and 2014. Four cross-sectional health examinations of first-year senior high school (grade 10) students were conducted from September to December of each year. A total of 124,643 adolescents aged 15 (boys: 63,654; girls: 60,989) were recruited. Participants who had at least three of five CVRFs were classified as the high-risk group. We used receiver-operating characteristic curves and the area under the curve (AUC) to determine the optimal WC cutoff points and the accuracy of WC in predicting high cardiovascular risk. WC was a good predictor for high cardiovascular risk for both boys (AUC: 0.845, 95% confidence interval [CI]: 0.833–0.857) and girls (AUC: 0.763, 95% CI: 0.731–0.795). The optimal WC cutoff points were ≥78.9 cm for boys (77th percentile) and ≥70.7 cm for girls (77th percentile). Adolescents with normal weight and an abnormal WC were more likely to be in the high cardiovascular risk group (odds ratio: 3.70, 95% CI: 2.65–5.17) compared to their peers with normal weight and normal WC. The optimal WC cutoff point of 15-year-old Taiwanese adolescents for identifying CVRFs should be the 77^th percentile; the 90^th percentile of the WC might be inadequate. The high WC criteria can help health professionals identify higher proportion of the adolescents with cardiovascular risks and refer them for further evaluations and interventions. Adolescents’ height, weight and WC should be measured as a standard practice in routine health checkups.

Plantar fasciitis is a common and often disabling condition that affects both general and athletic populations, with chronic cases significantly impairing function and quality of life. Although a wide range of conservative and non-invasive, and minimally invasive treatments are available, the absence of direct comparative evidence has limited clarity about which interventions offer the most durable benefits. We conducted a systematic review and network meta-analysis of 63 randomized controlled trials including 4170 participants to evaluate extracorporeal shock wave therapy, prolotherapy, and injection-based therapies including platelet-rich plasma, botulinum toxin A, corticosteroids, autologous blood, and local anaesthetics. Across short-, mid-, and long-term follow- up, botulinum toxin A provided the greatest short-term improvements in pain and plantar fascia thickness, where prolotherapy was most effective for sustained pain relief. Corticosteroids injection yielded the largest short-term function gains, while platelet-rich plasma supported the long-term improvements in both function and plantar fascia thickness. Extracorporeal shock wave therapy demonstrated broad efficacy across all domains and timepoints. These findings provide updated comparative evidence to guide clinical decision-making, suggesting that treatment strategies for plantar fasciitis should be tailored to symptom duration and therapeutic goals rather than defaulting to one intervention alone. Systematic review registration: PROSPERO CRD420250641285.

Background: Osteoporosis is a global disease burden for aging society. The role of quantitative ultrasound (QUS) in the prediction for osteoporosis in a dose-response manner is hardly addressed. Aim: We aimed to show the dose-response of QUS measurement in the prediction for osteoporosis by a community-based study. Design: A prospective cohort study. Methods: Participants were recruited between 2000 and 2004. Demographic data and heel QUS measurement were collected at baseline. Diagnosis of osteoporosis was ascertained by the follow-up of this cohort over time. In order to reduce the imbalance of baseline characteristics in the observational study, we applied propensity score by using proportional odds regression analysis to match the quintiles of QUS T-score. Results: A total of 44 957 subjects composed of 17 678 men (39.3%) and 27 279 women (69.7%) were recruited. After adjustments for propensity score, an increase in one unit of QUB T-score led to 7% reduction in the risk for osteoporosis [adjusted odds ratio (OR) = 0.93, 95% confidence interval (CI): 0.89-0.96, P < 0.0001]. Higher quintile of QUS T-score yielded a lower risk of osteoporosis with a gradient relationship [OR: 0.82 (95% CI: 0.72-0.92); OR: 0.81 (95% CI: 0.71-0.91); OR: 0.77 (95% CI: 0.68-0.87) and OR: 0.76 (95% CI: 0.67-0.86)] from the second to highest quintile opposed to first quintile (P < 0.0001). The cumulative incidence of osteoporosis was higher in the lower quintile during follow-up (log-rank test, P < 0.001). Conclusion: QUS is an independent predictor for osteoporosis in a dose-response manner using a large population-based cohort. Due to the lower cost and portability of QUS measurement, the pre-screening for osteoporosis by QUS can be considered in the area with limited resources can be a feasible and alternative method.

Background/Objectives: A proper posture is essential for musculoskeletal health, and a poor posture can lead to low back pain. To address the limitations of traditional text-based questionnaires, this study developed and validated a visualized posture assessment questionnaire for evaluating daily postures related to low back pain. The questionnaire was administered in Taiwan and designed using Traditional Chinese language. Methods: The proposed questionnaire evaluates six categories of daily activities including lifting heavy objects, sitting, putting on shoes, face washing and tooth brushing, getting out of bed, and doing sit-ups, or similar actions. Each category comprises an ergonomic posture and a non-ergonomic posture with corresponding illustrations. The questionnaire was administered to 100 participants, and its internal consistency was evaluated using Cronbach’s α, while test–retest reliability was assessed using intraclass correlation coefficients (ICCs). An expert panel reviewed the content validity, and the item-level content validity index (I-CVI) was calculated for each item and illustration. Results: Testing revealed a Cronbach’s α of 0.808, indicating high internal consistency, and a test–retest reliability, as measured by ICCs, of 0.78, indicating high stability over time. The I-CVI scores were high across all items, with the illustrations unanimously rated by the experts as highly relevant, supporting the effectiveness of the questionnaire’s visualized format for enhanced comprehension. Conclusions: The proposed questionnaire exhibits high reliability and validity, rendering it effective in evaluating posture-related risks of low back pain. This questionnaire also offers a more accessible and intuitive alternative to text-based questionnaires, with potential applications in clinical and research settings.