Purpose : Foot muscle strengthening exercises, including short-foot exercise, are effective in improving foot alignment and arch height in individuals with flexible flatfoot. However, given the limited methodological quality of domestic studies, these findings should be interpreted with caution, and further high-quality RCTs are needed to strengthen clinical evidence. Methods : A systematic search of domestic databases identified 92 studies, with 17 clinical trials meeting PICO-SD inclusion criteria (patient characteristics, intervention, comparison, outcome, and study design). Outcomes included foot arch height and foot alignment angle. First, quality was assessed by using the PEDro scale for 10 randomized controlled trials (RCTs) and RoBANS 2.0 for 7 non-RCTs. Second, effects were calculated as Hedges' g (standardized mean difference), with multiple intervention arms treated as separate units. Third, cluster-robust variance estimation (CRVE) addressed dependency violations. Fourth, a random-effects model was applied due to high heterogeneity. Fifth, publication bias was assessed with Egger's regression and trim-and-fill methods. Finally, sensitivity and meta-regression analyses explored sample size, treatment duration, and study design effects. Results : Foot muscle strengthening exercises showed sizeable effects in foot arch height (Hedges' g= -1.42, 95 % CI: -2.01 to -0.83, k= 18) and foot alignment angle (Hedges' g= -1.23, 95 % CI: -2.11 to -0.34, k= 15). The subgroup analysis indicated a significant effect on the study design (RCT vs. non-RCT) on foot alignment angle (p= .014), but not on foot arch height. The meta-regression identified treatment duration as a significant moderator in foot arch height (p= .028). Publication bias was detected (Egger's test: p= .000 for foot arch height, p= .000 for foot alignment angle), but trim-and-fill adjustments confirmed robust effects. Furthermore, high heterogeneity was observed (I²= 79.80 % for foot arch height, I²= 91.15 % for foot alignment angle). Conclusion : The findings in this study indicate that foot muscle strengthening exercise interventions have a positive effect on flexible flatfoot. However, due to the low quality of previous studies, the results of our study must be interpreted cautiously.

Purpose : This study aimed to examine the impact of nursing students' personality type and conflict coping style on their interpersonal relationship ability. Methods : Data collection was conducted from April 15 to April 23, 2024, targeting 260 first to fourth year nursing students at K University located in B City. The final sample comprised 184 students. Data analysis was performed using the SPSS 22.0 program. The analyses included frequency, percentage, t-test, analysis of variance. Pearsons correlation coefficient and hierarchical multiple regression. Results : Among the participants 54.3 % and 45.7 % were classified as personality type A and type B respectively. Further, personality type exhibited a weak positive correlation with interpersonal relationship ability (r= 0.21, p<.05), whereas conflict coping ability demonstrated a moderate positive correlation (r= 0.36, p<.001). Hierarchical multiple regression analysis revealed that grade level (β= 0.15, p=.022) significantly influenced interpersonal relationship ability, while the overall model was statistically significant (F= 0.01, p=.001). Conclusion : This study's findings suggest that nursing students' interpersonal relationship ability is more strongly affected by educational and situational factors including learning experience and conflict coping ability than by inherent personality type. Therefore, nursing education should prioritize developing practical programs aimed at strengthening conflict coping strategies and cooperative communication skills rather than emphasizing personality type differences. Future studies should validate causal relationships through longitudinal designs involving larger and more diverse samples.

Purpose : This study sought to determine whether therapy resources, products, and programs are effective. To help consumers select the optimal health products and services for their needs, and to help providers scientifically demonstrate and improve the effectiveness of their products and services, a therapy index was developed, and validation studies on it were conducted. Methods : The concept of therapy was first defined by analyzing laws related to the therapy industry. We secured content validity with a CVR value of 0.56 or higher by reflecting prior research and the opinions of 12 experts. Based on the definition of therapy, we established core areas and goals for the therapy index, which represents the level of self-therapy capacity. Considering the context in which the therapy index will be used, we established the scope of its application and evaluation areas, and we extracted dependent and independent variables accordingly. To calculate the therapy index, we collected data on these variables and analyzed them using regression analysis. Results : The analyses of the regression models of the dependent variables NK cells, limb muscle mass, and cognitive function on the levels of metabolic recovery, functional maintenance, and cognitive enhancement, respectively, resulted in adjusted R² values indicating that the models had 0.506, 0.932, and 0.572 explanatory power, respectively. These values confirmed that the independent variables explained 50.6 %, 93.2 %, and 57.2 % of the variance in NK cells, limb muscle mass, and cognitive function, respectively. Conclusion : The results of this study are significant in that they demonstrate that the therapy index is not simply the sum of individual health indicators but rather has the potential to comprehensively evaluate an individual's self-healing capacity in multidimensional areas, such as metabolism, physical function, and cognition. Therefore, the therapy index can be used to objectively verify the effectiveness of products and programs in various therapy industries, such as forest therapy, marine therapy, therapy agriculture, and therapy tourism, and to provide personalized services.

Purpose : This study aims to investigate the effects on body composition, knee joint range of motion, knee pain and daily activities of short-term (4-week) of participation in a complex hot spring aquatic exercise program on obese women, and providing complex hot spring aquatic effective exercise programs. Methods : This study was conducted on adult women living in A-si, Chungcheongnam-do, Korea, and the experiment was conducted by dividing into an obese women group (BMI>25, 21 people) and a control women group (BMI≦25, 30 people) based on BMI in a thermal hot spring facility. The effects on body composition, knee joint range of motion, and daily activities(assessed using K-WOMAC) before and after the complex hot spring aquatic exercise program and analyzed by mixed-design two-way ANOVA. Results : First, among the body composition variables, body weight (p<.01), body fat mass (p<.01), body fat percentage (p<.01), and waist circumference (p<.01) related to obesity significantly decreased between groups, and skeletal muscle mass (p<.01) significantly increased in the obese women group. Second, K-WOMAC scores for pain, stiffness, and impairment of daily activities decreased by approximately 50 %, but no significantly decreased. The range of motion of the knee joint (flexion) (p<.01) significantly increased in the obese women group, which had a positive effect on reducing knee pain, stiffness and impairment of daily activities. Conclusion : Complex hot spring aquatic exercise appears to be an effective program for improving body composition, enhancing knee joint mobility, reducing knee pain, and increasing daily vitality in obese women. This is significant as it provides a safe and enjoyable exercise program for obese women who struggle with long-term exercise participation, have limitations due to obesity, or suffer from knee pain.

Purpose : Vitamin D₃ plays a crucial role in calcium homeostasis, skeletal maintenance, immune modulation, and anti-inflammatory processes. However, its poor aqueous solubility and limited bioavailability pose significant challenges for effective oral administration. Liposomal encapsulation has become as a promising strategy for enhancing the physicochemical stability and intestinal absorption of lipophilic compounds. This study aimed to optimize the formulation of liposomal Vitamin D₃ by assessing the effects of lecithin concentration and preparation methods on key physicochemical parameters and storage stability. Methods : Liposomal Vitamin D₃ was prepared using sunflower-derived lecithin at four concentrations (0.0075, 0.0150, 0.0225, and 0.0300 wt %) and was fabricated through three techniques: the Bangham method, homogenization method, and diffusion method. Each formulation was evaluated over a 28-day storage period (days 1, 14, and 28) for particle size, zeta potential, encapsulation efficiency, and pH. The encapsulated Vitamin D₃ content was quantitatively analyzed using high-performance liquid chromatography. Results : Both the lecithin content and fabrication technique significantly influenced the physical stability of liposomal Vitamin D₃. The Bangham method with 0.0150 wt % lecithin yielded the most stable formulation, maintaining a particle size below 200 nm, zeta potential values lower than -45 ㎷, and an encapsulation efficiency exceeding 97 % throughout the study period. Liposomes prepared by homogenization exhibited substantial particle growth (>750 nm), reduced zeta potential (<-30 ㎷), and a marked decreases in encapsulation efficiency (<55 %). Diffusion-based liposomes demonstrated intermediate stability that improved with increasing lecithin concentration. All formulations maintained pH values within a stable range (5.5~5.9). Conclusion : Lecithin concentration and manufacturing method significantly influence the stability and encapsulation efficiency of liposomal vitamin D₃. The Bangham method, particularly at 0.0150 wt %, provides a highly effective approach to produce stable and bioavailable liposomal vitamin D₃. These findings provide a scientific basis for the development of advanced delivery systems for functional foods and targeted nutritional supplementation.

Purpose : This study aimed to identify factors associated with cirrhosis and to examine the antioxidant effect of vitamin E through correlation analysis. Methods : Data were obtained from the 7th National Health and Nutrition Survey conducted by the Korea Centers for Disease Control and Prevention. The dataset, accessed through the agency's official website, included 7,190 participants: 3,222 from 2016, 1,938 from 2017 and 2,030 from 2018. Results : Drinking frequency and body mass index (BMI) were used as variables representing lifestyle and environmental factors Analysis of variance showed that both drinking frequency (p<.01) and BMI (p<.01) significantly affected cirrhosis. Correlation analysis revealed that older age (p<.01), higher drinking frequency (p<.01), elevated cholesterol levels (p<.01), hyperlipidemia (p<.05), and higher BMI (p<.01) were associated with increased cirrhosis risk. These findings suggest that individuals with higher alcohol consumption or lower nutritional intake may be more susceptible to cirrhosis. In addition, exposure to hepatitis B (p<.01) and hepatitis C (p<.01) was significantly related to disease occurrence. Vitamin E levels (p<.01) were inversely associated with cirrhosis, indicating that lower concentrations increased disease risk. Regression analysis identified drinking frequency (p<.01), hepatitis B (p<.01), hepatitis C (p<.01), and vitamin E as the most significant predictors of cirrhosis. Conclusion : This study indicates that continued interdisciplinary research on the antioxidant efficacy of vitamin E is needed to support the prevention of liver disease, particularly liver cirrhosis-related conditions.

Purpose : The purpose of this study was to identify variables related to metabolic syndrome and to examine the positive physiological and functional effects of a short-term circuit training program in elderly individuals diagnosed with metabolic diseases Methods : Participants engaged in a structured circuit training program consisting of 40-minute circulation-based exercise sessions, performed twice per week over a 4-week period. The training protocol included alternating resistance and aerobic components designed to improve mmetabolic efficiency. All participants were older adults with clinically confirmed metabolic disorders. Preand post-intervention measurements were obtained for body composition, blood pressure, grip strength, and blood lipid profiles, including HDL-C. Results : The changes in body composition observed after a 4-week circuit training program in older adults with metabolic disorders showed no statistically significant interaction effects between time and group across all variables (p>.05). Regarding grip strength and health-related fitness, a significant increase in grip strength was observed in the exercise group after the 4-week program (p<.05). For metabolic syndrome-related variables, interaction effects between group and time were identified in systolic blood pressure and waist circumference, with post-hoc analysis confirming significant reductions in the exercise group. Furthermore, main effects were found in diastolic blood pressure and HDL-C; compared to the control group, the exercise group demonstrated significantly lower diastolic blood pressure (p<.05) and significantly higher HDL-C levels (p<.05). Conclusion : In conclusion, the 4-week circuit training program yielded beneficial outcomes on multiple metabolic and cardiovascular parameters, including improvements in grip strength, reductions in both systolic and diastolic blood pressure, increased HDL-C, and decreased waist circumference. These findings suggest that circuit training can serve as an effective, low-cost, and practical intervention strategy for managing and improving metabolic syndrome risk factors in older adults with metabolic disorders.

Purpose : This study aimed to compare and analyze changes in blood lactate and creatine kinase (CK) levels before and after practice matches, according to playing position, in high school soccer players. Understanding these position-specific physiological responses may provide important evidence for optimizing individualized training programs and scientific recovery strategies that reflect competition-specific metabolic and muscular demands. Methods : Twenty high school soccer players (aged 17-19 years; 4 forwards, 8 midfielders, 8 defenders) participated, with goalkeepers excluded. Venous blood samples were collected from the antecubital vein at rest before the match and immediately after. Lactate and CK concentrations were analyzed using standard enzymatic assays. Statistical analyses were performed using SPSS 25.0, applying two-way repeated-measures ANOVA, one-way ANOVA, and Tukey's post hoc test to examine the main and interaction effects between position and time. Results : Blood lactate concentrations differed significantly across sampling time points and in the interaction between position and time (p<.05). Post hoc comparisons revealed that defenders had significantly lower lactate levels than forwards and midfielders (p<.05). There was no significant difference between forwards and midfielders. CK levels also differed significantly by position, time, and their interaction (p<.05). CK levels were measured pre-match and 24 hours post-match, with midfielders exhibiting markedly higher post-match CK levels than forwards (p<.05) and defenders (p<.01), and no difference between forwards and defenders. CK values increased significantly after the match in all positions (p<.05). Conclusion : These findings indicate that both metabolic and muscle damage responses vary by playing position in adolescent soccer players. Coaches and practitioners should consider these physiological patterns when designing recovery protocols and periodized conditioning plans. Future studies should include heart rate, GPS-derived external load, sprint frequency, and technical actions to provide a comprehensive understanding of position-specific match demands.

Purpose : This study aimed to analyze the effects of a 12-week combined exercise program on lactate and liver enzyme levels in middle-aged men, thereby providing basic information for developing exercise programs for managing metabolic and liver health in middle-aged men. Methods : The subjects of this study consisted of 24 middle-aged men living in South Chungcheong Province, County C. They were divided into an exercise group 12people and a control group 12 people. The combined exercise program comprised three sessions per week of approximately 60 minutes each, taking into account the subjects' physical fitness level and health status. Blood lactate concentrations were measured by collecting blood from fingertip capillaries at 15±1 minutes immediately after exercise, following the same standardized load after stable enzyme measurements. Then ALT and AST, used as indicators of liver enzymes, were collected from venous blood collected during stable fasting. Results : First, an interaction effect between group and period was observed for lactate changes (p<.01), and post-hoc analysis revealed a significant decrease across periods in the exercise group (p<.01). Second, an interaction effect between group and period was observed for liver enzyme changes for both ALT (p<.01) and AST (p<.05). Post-hoc analysis revealed significant decreases across periods in both ALT and AST in the exercise group (p<.05), while a significant increase in ALT was observed in the control group (p<.05). Conclusion : Our results suggest that a 12-week combined exercise program is an effective strategy for promoting metabolic health and improving liver health in middle-aged men. In particular, improvements in liver enzyme levels can contribute to the prevention of non-alcoholic fatty liver disease and the promotion of liver metabolic function, providing a scientific basis for the development of exercise programs for the health of middle-aged men.

Purpose : This study investigated the association between nutrient intake and dental caries treatment experience among Korean adults. The goal was to elucidate the relationship between nutritional factors and oral disease treatment, providing evidence to support the development of oral health management, preventive strategies, and nutrition-based public health policies. Methods : Data from the 8th and 9th Korea National Health and Nutrition Examination Surveys (KNHANES, 2019-2023) were combined for analysis of adults aged 19 years and older. To ensure representativeness, stratified sampling based on intrinsic stratification criteria was applied, and integrated weights-calculated by multiplying annual weights by integration ratios-were used in complex sample analyses. A total of 17,292 participants were included. Considering sociodemographic characteristics and nutrient intake, factors influencing dental caries treatment experience were analyzed using SPSS 21.0 for Windows, with a significance level of 0.05. Complex sample frequency analyses were used to determine overall distributions, and cross-tabulations assessed differences by sociodemographic factors. Variables showing statistical significance were further analyzed using complex sample logistic regression. Nutrient intake, measured by a 24-hour dietary recall, was examined using complex sample independent t-tests, followed by binary logistic regression to identify key influencing factors. Results : Dental caries treatment experience was more prevalent among younger adults, Seoul residents, individuals with higher income or education, private insurance subscribers, employed individuals, and those reporting poor perceived oral health or recent tooth pain (p < .05). Among nutrients, riboflavin intake showed the strongest negative association with treatment experience (OR = 0.894, p < .05), while energy, cholesterol, phosphorus, magnesium, retinol, and folate showed minimal effects. Conclusion : Both sociodemographic and nutritional factors significantly influenced dental caries treatment experience. Higher intakes of riboflavin, thiamine, vitamin E, niacin, and fatty acids were associated with fewer treatments, whereas greater dietary fiber intake was linked to more frequent treatment experience. These findings emphasize the importance of nutritional factors in oral health and support the need for nutrition-based preventive policies.