Earticle

The forest road feasibility evaluation is a key policy instrument aimed at ensuring the rational development of sustainable forest road networks by comprehensively assessing the appropriateness of road construction based on multidimensional criteria, including necessity, suitability, disaster safety, cost-efficiency, and environmental impact. This study aims to evaluate the effectiveness of the system by examining the extent to which its results are reflected in actual design and construction phases. To this end, we examined forest road projects evaluated and implemented by five regional forest services in South Korea between 2022 and 2023, focusing on key indicators such as average slope, maximum slope, and the proportion of steep-gradient sections. In addition, for routes assessed as "conditionally suitable," we reviewed the degree to which the recommended mitigation measures were incorporated into the final designs to evaluate the level of implementation. The analysis revealed that major technical recommendations—particularly the avoidance of steep slopes and the reinforcement of drainage infrastructure—were substantially reflected in the design and construction phases, contributing to disaster risk reduction. This study empirically demonstrates that the results of the forest road feasibility evaluations have been effectively applied in practice, thereby enhancing the safety and environmental performance of forest road infrastructure. The findings are expected to serve as a foundation for improving the credibility and policy applicability of the evaluation system in future forest road planning and management.

This study aimed to determine whether there is a significant difference in play properties in the case of media conversion through the combination of analog three-dimensional puzzles and immersive media in children's experience. Based on Roger Caillois' play theory and the contents of previous research, an experience was conducted on an experimental group and control group, and a questionnaire was prepared. The results of the correlation and paired t-test analysis showed that the play properties were higher and more evenly distributed in the media conversion immersive experience. This implies that an increase in children's fun during the immersive experience further increases their immersion, suggesting that the use of immersive media may have a positive effect on children who achieve holistic development through play and experience. We hope that this study will help recognize the difference in effectiveness through conversion into immersive media and will be referenced in various media studies that consider double-play properties.

The successful use of digital textbooks (DTs) in schools requires the development of various teaching and learning methods that are appropriate for DTs. However, recent DT studies have focused mainly on the implementation of DT features and formats. The objective of this study was to investigate a problem-based learning instructional model appropriate to DTs and to present the experimental results using the problem-based DT to demonstrate its educational effectiveness. Two learning-achievements tests were conducted to analyze the learning experience and effectiveness of the problem-based DT after it had been used in a high school for a certain period. The experimental results indicated that the students who used the DT, especially lower-level students, exhibited improved problem-solving ability and demonstrated a better practical understanding of the subject than students who used printed textbooks.

Purpose To test the impact of interpersonal caring theory empirically on six major psychosocial functioning outcomes of persons with serious mental illness. Methods This was a quasi-experimental pre- and post-test design with data collection from a total of 266 patients with long-term serious mental illness, who were diagnosed with schizophrenia spectrum disorder and followed at 6-month intervals over a 24-month period in three groups: a community psychiatric service group, a community service with interpersonal caring intervention group, and a control group. Three hypotheses between the intensity, specificity, and longitudinality of services were tested using growth curve analysis. Results Hierarchical linear modeling supported associations of hypotheses between the intensity, specificity, and longitudinality of services and improved patient outcomes. Conclusion This study suggests that the intensity, specificity, and longitudinality of interpersonal caring interventions in community psychiatric service programs deserve attention in order to improve and maintain patient functional outcomes.

Purpose: The purpose of this study was to test a predictive model that could predict and explain work effectiveness among staff nurses at local hospitals. Methods: Between April 1 and May 15, 2009, 340 nurses were recruited from two hospitals (one in Ulsan and one in Yangsan). Data were collected via self-administered questionnaires and analyzed using structural equation modeling. Results: A modified model was retained, as the final path model showed a very good fit with the data. Job characteristics and compensation justice were found to have direct and positive effects on empowerment. Job characteristics, transformational leadership, and empowerment were found to directly and positively affect work effectiveness. In addition, job characteristics were found to have a greater effect on empowerment and work effectiveness than other factors do. Conclusion: This structural equation model was used to test the relationships between these factors and work effectiveness. Empowerment mediated the relationship between job characteristics, transformational leadership, and work effectiveness. Findings from this study can be used to design the strategies for increasing work effectiveness in Korean nurses.

An interesting of desktop air-conditioning system is the Personal Environmental Module(PEM) System. The PEM system allows the occupant to choose the desired temperature, air volume and direction of the discharged air. In this study, the measurements on the age of air and the air change effectiveness, using the tracer gas method, are carried out to analyze the ventilation performance for provision of fresh air near the breathing zone by the PEM. The relations between the PEM for optimal control and other factors related to indoor air quality, and the ventilation for the PEM are examined. Also, three different supply diffuser types(desktop, floor and ceiling) are compared in view of their ability to distribute supply air to the workstation breathing zone. The desktop diffuser type could deliver air directly to the occupants breathing zone with a high degree of effectiveness. The minimum local age of air was measured in the breathing zone, which is directly supplied with air from the PEM diffusers, and the measured local air change effectiveness of the desktop diffuser in the breathing zone was about 1.13 to 1.23 times greater than that of the ceiling and floor diffusers. When the minimum outside air change rate as specified using ASHRAE Standard 62R is supplied with a desktop diffuser type, the volume of outside air can be reduced 13 to 23%, resulting in a commensurate in ventilation energy use.

Purpose : Sepsis and septic shock are life-threatening conditions associated with high mortality rates. CytoSorb is an extracorporeal cytokine adsorption device that has emerged as a potential adjunct therapy. However, its effectiveness remains controversial. To evaluate the effectiveness of CytoSorb hemoadsorption therapy in patients with sepsis and septic shock, we focused on the clinical outcomes and cytokine levels. Methods : A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, Web of Science, and CINAHL databases were searched from their inception to September 25, 2024. We included randomized controlled trials and observational studies comparing CytoSorb with standard care in adult patients with sepsis or septic shock. The primary outcomes were the 28-day and in-hospital mortality rates. The secondary outcomes included changes in cytokine levels and length of hospital stay. Results : We included 10 studies with 759 patients (517 patients treated with CytoSorb and 242 controls). The meta-analysis of mortality (481 CytoSorb and 335 controls) showed no significant differences between the groups (risk ratio: 0.99, 95% confidence interval [CI]: 0.75 to 1.30, p=0.93). The analysis of length of hospital stay (528 CytoSorb and 246 controls) showed a nonsignificant trend favoring the control group (SMD=0.06, 95% CI: -0.09 to 0.22, p=0.44) with no heterogeneity (I²=0%). CytoSorb significantly reduced IL-6 levels (SMD=-0.43, 95% CI: -0.83 to -0.03, p=0.04). Conclusion : Although CytoSorb can reduce cytokine levels, its effects on mortality and other clinical outcomes remain unclear. Several studies have suggested that optimal patient selection and intervention timing are crucial.

Background: An excessive pronated foot is defined as a flattening or complete loss of the medial longitudinal arch. Excessive foot pronation is considered to have high risk factors of overuse injuries in the lower limb. Various treatments have been investigated in attempts to control excessive pronation. Objects: This meta-analysis identifies the effects of an anti-pronation taping technique using different materials. Methods: The electronic databases used include MEDLINE, the Physiotherapy Evidence Database (PEDro), Science Direct, the Korean Studies Information Service System (KISS), the Research Information Sharing Service (RISS), the Korea National Library, and the Korean Medical Database (studies published up to July 31, 2019). The database search used the following keywords: "foot drop" OR "foot arch" OR "foot pronation" OR "flat foot (pes planus)" AND "taping" OR "support." Eight eligible studies were analyzed to determine the effectiveness of anti-pronation taping in study and control groups. Results: The overall random effect size (Hedges'g) of the anti-pronation taping technique was 0.147 (95% confidence interval [CI]: -.214 to .509). When the effect (Hedges' g) was compared by the type of tape material, rigid tape (RT; Lowdye taping) was .213 (95% CI: -.278 to .704) and kinesiotape (KT; arch support taping) was -.014 (95% CI: -.270 to .242). Based on this meta-analysis, it was not possible to identify the extent to which anti-pronation taping was effective in preventing navicular drop, improving balance, or changing foot pressure. Only three of the eight eligible studies applied KT on excessive pronated feet, and the outcome measure areas were different to those of the RT studies. The KT studies used EMG data, overall foot posture index (FPI) scores, and rear foot FPI scores. In contrast, the RT studies measured navicular heights, various foot angles, and foot pressure. Conclusion: This review could not find any conclusive evidence about the effectiveness of any taping method for patients with pronated feet. Future studies are needed to develop the anti-pronation taping technique based on the clinical scientific evidence.

This study aimed to verify the effectiveness of Family Participation Intervention (FPI) for children with Autism Spectrum Disorders (ASD) by integrating and comparing effect sizes of single-subject studies published in Republic of Korea between 2000 and 2021. For this purpose, twenty-seven dissertations and journals were selected based on predefined criteria and were analyzed. Effect sizes were calculated according to various variables such as treatment approach, goals, subject group charac teristics, and session characteristics using a random effects model. The results are as follows. First, the overall effect size of FPI for children with ASD was Tau-U .88, indicating a medium effect. Additionally, the effect size for the maintenance phase was Tau-U .95, indicating a large effect. Second, this study found that for elementary school students, using a community-cen tered or play (activity)-centered approach with the goal of improving adaptive behavior, involving various family members, conducting at least 20 sessions, showed better effects than other condition. This study is meaningful in that it verifies the ef fectiveness and validity of FPI for children with ASD. Additionally, it provides detailed information on the factors improving the intervention effectiveness.

Purpose: Food Allergen Immunotherapy (Oral) is a form of immunotherapy administered to patients who are allergic to foods such as egg, milk, and peanut. The food allergen is orally administered to the patient in an escalating dose for desensitization or tolerance development. The safety and effectiveness of the therapy were assessed using a systematic literature review and meta-analysis. Methods: For a literature search, 8 national databases and a number of international databases including Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library were used; and 13 articles (all from international databases) were selected. The target of Food Allergen Immunotherapy (Oral) included patients with food allergy, and the intervention was food allergen immunotherapy without limiting the food type. The safety and effectiveness of Food Allergen Immunotherapy (Oral) were assessed by reviewing all the articles reporting on the therapy. The control group received standard therapies including aversion therapy, no treatment, anti-histamine treatment, and placebo. Safety was assessed through the incidence of complication and emergency medication. Effectiveness was assessed based on therapy success rate, symptomatic improvement, and quality of life. Results: Although Food Allergen Immunotherapy (Oral) was shown to have successful desensitization in patients with food allergy, the safety of the technique has not yet reached an acceptable level; the possible reason is due to the high rate of complication and frequency of emergency medication. Also, each study employed varying protocols while relying on a small number of participants and a short monitoring period. Conclusion: The results of assessment suggest that the level of evidence from current literature review is low and further research is necessitated for the verification of the safety and effectiveness of the therapy (Grade of Recommendation: A; Level of Technology: II-b).

Purpose: Advanced schistosomiasis, the most severe stage of Schistosoma japonicum infection, profoundlyimpairs patients’ quality of life (QoL) and increases vulnerability to anxiety and depression. Since 2004, China has launched a medical assistance program for the patients with access to medicaland/or surgical treatment, in which health workers have incorporated nursing interventions to addressthese challenges. This meta-analysis evaluated the effects of nursing interventions on QoL, anxiety,depression, and complications in advanced schistosomiasis patients. Methods: Seven databases [PubMed, Web of Science, the Cochrane Library, China Biology Medicine, ChinaNational Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang] weresystematically searched for randomized controlled trials up to August 1, 2024. Data were analyzed usingReview Manager 5.4 (Cochrane Collaboration) and R 4.2.3 (R Project, a free, open-source language andenvironment primarily used for statistical computing and graphics). Outcomes included QoL (WorldHealth Organization Quality of Life Brief scale and Karnofsky performance status), anxiety (Self-ratingAnxiety Scale), depression (Self-rating Depression Scale), and complications. The protocol was previouslyregistered with the International Prospective Register of Systematic Reviews (CRD42023406707). Results: A total of 23 studies with 2232 patients were included. Nursing interventions improved QoL withgreater benefits observed in longer intervention periods. Anxiety (standardized mean difference: -1.52,95% confidence interval (CI): -2.10 to ?? 0.94) and depression (standardized mean difference: -1.13, 95% CI:-1.43 to ?? 0.84) scores were markedly reduced. The risk of complications decreased by 64% (relative risk:0.36, 95% CI: 0.27 to 0.48). Subgroup analyses highlighted age as a key modifier of intervention efficacy. Conclusion: Nursing interventions effectively enhance QoL, alleviate psychological distress, and reducecomplications in advanced schistosomiasis patients. These findings advocate for integrating structurednursing protocols into China’s national healthcare programs and global schistosomiasis managementstrategies.

Objective: To evaluate the effectiveness of the National Health Screening Program for Infants and Children (NHSPIC) in the early diagnosis of neurodevelopmental disorders (NDDs) utilizing data from the National Health Insurance Database of South Korea.Methods: We enrolled children born between 2011 and 2018 who completed the first to fourth stages of the NHSPIC. A positive finding was defined as a recommendation for further evaluation during one or more stages. Participants were categorized into the positive and negative finding groups. Following 1:1 propensity score matching, 82,138 participants were assigned to each group.Results: Comparative analysis revealed that participants with positive findings exhibited a higher risk of developing all seven NDDs, particularly for autism spectrum disorder (hazard ratio [HR], 19.70; 95% confidence interval [CI], 17.48?22.20), intellectual disability (HR, 17.11; 95% CI, 14.69?19.93), developmental language disorder (HR, 11.74; 95% CI, 10.73? 12.84), and cerebral palsy (HR, 11.34; 95% CI, 8.67?14.84). The HR for learning disability was 4.31 (95% CI, 2.94?6.34), whereas attention-deficit hyperactivity disorder had an HR of 3.57 (95% CI, 3.37?3.78). Tic disorder had the lowest HR (HR, 1.64; 95% CI, 1.48?1.82). Additionally, HRs were calculated for each NHSPIC stage, demonstrating the utility of specific stages in the early detection of each NDD.Conclusion: Developmental screening tests in the NHSPIC contributed to the early diagnosis of NDDs. This study underscores the significance of the NHSPIC and provides foundational evidence to inform and enhance policies related to child health screenings.

To determine the effect of inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength (RMS), and functional capacity in patients undergoing cardiac surgery. The PubMed, PEDro, CINAHL, Web of Science, CENTRAL, and EMBASE databases were searched from inception to June 2020. Randomized controlled trials (RCTs) that evaluated patients who underwent cardiac surgery were included in this review. Meta-analysis performed using a random-effects model showed that the mean difference in forced vital capacity, forced expiratory volume in 1 second, 6-minute walk distance, and RMS was 3.47% (95% confidence interval [CI], 0.57 to 6.36), 5.80% (95% CI, 2.03 to 9.56), 78.05 m (95% CI, 60.92 to 95.18), and 4.8 cmH2O (95% CI, -4.00 to 13.4), respectively. There is strong evidence that IMT improves inspiratory muscle strength, pulmonary function, and functional capacity, and reduces the length of hospital stay in patients undergoing cardiac surgery.

Purpose: Evidence on non-pharmacological interventions for adolescents with type 1 diabetes is unclear. This review aimed to evaluate the effectiveness of non-pharmacological intervention in adolescents with type 1 diabetes. Methods: We conducted a search on databases from November 11 to 19, 2022, for randomized controlled trials for the effects of non-pharmacological intervention in adolescents with type 1 diabetes. To identify recent research trends, we included studies published from 2017 to November 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0. To estimate the effect size, a meta-analysis was performed using RevMan 5.4 program and R Studio. Results: A total of 45 studies were included in the systematic review. Among those, 30 studies were included in the meta-analysis. Non-pharmacological interventions were significantly effective in improving Glycated hemoglobin (HbA1c) (standardized mean difference [SMD] = -0.26, 95% confidence interval [CI]: -0.42, -0.09), quality of life (SMD = 0.44, 95% CI: 0.13 to 0.76), and anxiety (SMD = -0.91, 95% CI: -1.26, -0.56). Subgroup analysis showed that duration of intervention was not a covariate related to HbA1c levels. Conclusions: Non-pharmacological interventions have shown effectiveness in improving the HbA1c, quality of life, and anxiety in adolescents with type 1 diabetes. Future studies with more rigorous methodology are needed to confirm and strengthen the validity of these findings. Additionally, attention to changes in the lipid profile and self-care motivation among adolescents with type 1 diabetes is warranted.

Purpose: This systematic review aimed to investigate the effectiveness of home visiting programs targeting parents who have maltreated their children on the prevention of child maltreatment recurrence. Methods: Major databases were searched (Ovid-Medline, PubMed, Cochrane Library, CINAHL, and RISS). The frequency of maltreatment was measured for the meta-analysis, which was conducted using Review Manager 5.2 software. The effect size was measured using odds ratios (ORs). Results: Six studies were included in the analysis, none of which were conducted in South Korea. The meta-analysis demonstrated that the risk of child maltreatment recurrence significantly decreased after a home visiting program was implemented (OR=0.45, 95% confidence interval [CI]=0.29-0.68). Nurses were the most common intervention providers. Conclusion: Home visiting programs should be provided for families in which maltreatment has already occurred to prevent the recurrence of maltreatment and foster a home environment in which children can live safely. Since the rate of child maltreatment in Korea is increasing, further research is needed to develop and implement home visiting programs in which nurses play a major role in preventing the recurrence of child maltreatment.

본 연구는 문헌연구를 통하여 먼저 세계 주요 국가들의 경찰항공대의 현황과 장비 등에 대해 살펴본 후, 무인항공시스템을 경찰항공대에 도입·활용하는 것에 대해서 미국의 사례 분석을 중심으로 비용효과분석(Cost-Effectiveness Analysis)의 측면에서 타당성을 검토해 보았다. 단위비행시간을 분석단위로 하여 추산한 결과, 경찰헬기는 노후화에 따른 감가상 가비(depreciation cost), 연료비(fuel cost), 관리비(maintenance cost)가 매우 큰 반면, 무인 항공시스템은 시간 당 운영비가 헬기의 10퍼센트에서 40퍼센트에 지나지 않는 것으로 분 석되었다. 경찰항공대에서 무인항공시스템이 활용된다면 관리주체가 명확해 지고, 타항공 기의 운항 일정을 알 수 있기 때문에 충돌가능성도 줄일 수 있는 등 여러 장점이 있다. 특히, 경찰 헬기가 비행할 수 없는 지역이나 테러나 인질 상황 등으로 피격·추락의 위험이 있는 곳에 무인항공시스템을 상호보완적으로 운영한다면 엄청난 시너지 효과를 얻을 수 있을 것으로 예상된다.

This study firstly looked at the mission and profile of the major police aviation units around the world and then reviewed the case study of a cost-effectiveness and feasibility analysis of implementing Unmanned Aerial Systems(UAS) into the police helicopter fleet in Los Angeles Police Department. The case study showed that the operating cost of the UAS is just 10 – 40 percent of that of helicopter fleet per every flight hour. The reason is that depreciation, fuel, and maintenance costs of helicopters are very expensive. If the police aviation unit employs UAS, the police accountability of using UAS will be clearer and the possibility of collision with other air crafts can be decreased. Furthermore, the synergy effect will be gained if the UAS is complimentarily applied to a hostage, terror, or any situation where the police helicopter cannot operate the mission due to limitation. The possibility and methods of implementing UAS in the Korean National Police helicopter fleets are discussed.

The purpose of this analytic study is to design and examine an efficient hydrogen liquefaction cycle by using a pre-cooler. The liquefaction cycle is primarily comprised of a pre-cooler and a refrigerator. The fed hydrogen gas is cooled down from ambient temperature (300 K) to the pre-cooling coolant temperature (either 77 K or 120 K approximately) through the pre-cooler. There are two pre-cooling methods: a single pre-coolant pre-cooler and a cascade pre-cooler which uses two levels of pre-coolants. After heat exchanging with the pre-cooler, the hydrogen gas is further cooled and finally liquefied through the refrigerator. The working fluids of the potential pre-cooling cycle are selected as liquid nitrogen and liquefied natural gas. A commercial software Aspen HYSYS is utilized to perform the numerical simulation of the proposed liquefaction cycle. Efficiency is compared with respect to the various conditions of the heat exchanging part of the pre-cooler. The analysis results show that the cascade method is more efficient, and the heat exchanging part of the pre-coolers should have specific UA ratios to maximize both spatial and energy efficiencies. This paper presents the quantitative performance of the pre-cooler in the hydrogen liquefaction cycle in detail, which shall be useful for designing an energy-efficient liquefaction system.

The purpose of this analytic study is to design and examine an efficient hydrogen liquefaction cycle by using a pre-cooler. The liquefaction cycle is primarily comprised of a pre-cooler and a refrigerator. The fed hydrogen gas is cooled down from ambient temperature (300 K) to the pre-cooling coolant temperature (either 77 K or 120 K approximately) through the pre-cooler. There are two pre-cooling methods: a single pre-coolant pre-cooler and a cascade pre-cooler which uses two levels of pre-coolants. After heat exchanging with the pre-cooler, the hydrogen gas is further cooled and finally liquefied through the refrigerator. The working fluids of the potential pre-cooling cycle are selected as liquid nitrogen and liquefied natural gas. A commercial software Aspen HYSYS is utilized to perform the numerical simulation of the proposed liquefaction cycle. Efficiency is compared with respect to the various conditions of the heat exchanging part of the pre-cooler. The analysis results show that the cascade method is more efficient, and the heat exchanging part of the pre-coolers should have specific UA ratios to maximize both spatial and energy efficiencies. This paper presents the quantitative performance of the pre-cooler in the hydrogen liquefaction cycle in detail, which shall be useful for designing an energy-efficient liquefaction system.

배경: 당뇨병 환자에게 관상동맥심질환은 생존률, 건강 상태 유지 및 삶의 질에 주요한 영향을 미치는 합병증이며 적극적인 당뇨병 치료는 이러한 심혈관 합병증을 예방할 수 있으나 당뇨병의 적극적 치료와 관리에는 많은 비용이 소요된다. 목적: 제2형 당뇨병 환자를 대상으로 메트포르민과 글리메피리드 병합요법과 메트포르민과 피오글리타존 병합요법의 비용-효과성을 비교하고자 하였다. 연구방법: 마르코프 코호트 프로세스(Markov Cohort Process Model) 모형을 이용하여 비용-효과분석을 실시하였다. 연장된 수명 (life years gained, LYG)과 삶의 질(quality)을 보정하여 증가된 QALYs를 주요 효과 지표로 측정하였고, 총비용으로는 직접의료비용과, 환자와 가족의 교통비를 직접비의료비용으로 고려하였고 환자와 가족의 시간비용을 간접비용으로 포함하였다. 연구결과: 비용-효과분석 결과, 메트포르민과 글리메피리드 병합요법의 경우 총 비용은 5,962,288원, 효과는 7.94LYG, 6.43QALY이었다. 반면 메트포르민과 피오글리타존 병합요법은 총 비용 10,982,243원, 효과 8.62LYG, 6.99QALY으로, 점증적 비용-효과비(ICER)는 7,402,663원/LYG과 8,934,546원/QALY 이었다. 결론: 우리 사회의 연장된 수명(LYG)에 따른 지불의사가 700만원 이하인 경우는 메트포르민과 글리메피리드 병합요법이 비용-효과적인 대안이며 700만원 이상인 경우에는 메트포르민과 피오글리타존 병합요법이 비용-효과적인 대안이 될 수 있다.