South Korea Research Articles

Sleep quality according to chronotype in nurses working 8-hour shifts.

To date, studies have been focused on sleep disturbances of nurses working during night shifts. There is a lack of understanding regarding the sleep quality of nurses working in the rapid rotation system for each type of shift work. To determine the relationship between chronotype and sleep quality according to shift type (i.e. day, evening and night shifts) in nurses working 8-hour rotating shifts. A cross-sectional, descriptive study was conducted from two tertiary hospitals in South Korea from December 2021 to September 2022, including nurses working 8-hour rotating shifts (N = 74). They completed questionnaires to measure general, occupational and sleep-related characteristics, chronotype, insomnia severity and daytime sleepiness. Additionally, sleep parameters were collected from actigraphy and sleep diaries for 7 days. A total of 64% of nurses had an evening chronotype and 37% of nurses had an intermediate chronotype. Nurses had significantly less total sleep time and worsened sleep latency and efficiency during the day shift compared to other shift types. Compared to nurses with an intermediate chronotype, those with an evening chronotype had poorer sleep quality during day shift work. Strategies to enhance nurses' sleep quality during day shifts should consider a two-level approach: individual approaches, such as improving sleep hygiene, and administrative approaches, such as establishing a chronotype-based shift system for scheduling.

For whom does the dawn bell toll? The factors of effectiveness of spatial development projects using the example of South Korea's Saemaul movement

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Cost-effectiveness of the adjuvanted quadrivalent influenza vaccine for older adults in South Korea

ABSTRACT South Korea’s National Immunization Program administers the quadrivalent influenza vaccine (QIV) to manage seasonal influenza, with a particular focus on the elderly. After reviewing the safety and immune response triggered by the adjuvanted QIV (aQIV) in individuals aged 65 and older, the Ministry of Food and Drug Safety in Korea approved its use. However, the extensive impact of aQIV on public health is yet to be fully understood. This study assessed the cost-effectiveness of replacing QIV with aQIV in South Korean adults aged 65 years and older. A dynamic transmission model, calibrated with national influenza data, was applied to compare the influence of aQIV and QIV on older adults and the broader population throughout a single influenza season. This study considered both the direct and indirect effects of vaccination on the elderly. We derived the incremental cost-effectiveness ratios (ICERs) from quality-adjusted life-years (QALYs) and costs incurred, validated through a probabilistic sensitivity analysis with 5,000 simulations. Findings suggest that transitioning to aQIV from QIV in the elderly would be cost-effective, particularly if aQIV’s efficacy reaches or exceeds 56.1%. With an ICER of $29,267/QALY, considerably lower than the $34,998/QALY willingness-to-pay threshold, aQIV presents as a cost-effective option. Thus, implementing aQIV with at least 56.1% efficacy is beneficial from both financial and public health perspectives in mitigating seasonal influenza in South Korea.

Social network analysis for medical narcotics in South Korea: focusing on patients and healthcare organizations

BackgroundMedical narcotics must be administered under medical supervision because of their potential for misuse and abuse, leading to more dangerous and addictive substances. The control of medical narcotics requires close monitoring to ensure that they remain safe and effective. This study proposes a methodology that can effectively identify the overprescription of medical narcotics in hospitals and patients.MethodsSocial network analysis (SNA) was applied to prescription networks for medical narcotics. Prescription data were obtained from the Narcotics Information Management System in South Korea, which contains all data on narcotic usage nationwide. Two-mode networks comprising hospitals and patients were constructed based on prescription data from 2019 to 2021 for the three most significant narcotics: appetite suppressants, zolpidem, and propofol. Two-mode networks were then converted into one-mode networks for hospitals. Network structures and characteristics were analyzed to identify hospitals suspected of overprescribing.ResultsThe SNA identified hospitals that overprescribed medical narcotics. Patients suspected of experiencing narcotic addiction seek treatment in such hospitals. The structure of the network was different for the three narcotics. While appetite suppressants and propofol networks had a more centralized structure, zolpidem networks showed a less centralized but more fragmented structure. During the analysis, two types of hospitals caught our attention: one with a high degree, meaning that potential abusers have frequently visited the hospital, and the other with a high weighted degree, meaning that the hospital may overprescribe. For appetite suppressants, these two types of hospitals matched 84.6%, compared with 30.0% for propofol. In all three narcotics, clinics accounted for the largest share of the network. Patients using appetite suppressants were most likely to visit multiple locations, whereas those using zolpidem and propofol tended to form communities around their neighborhoods.ConclusionsThe significance of this study lies in its analysis of nationwide narcotic use reports and the differences observed across different types of narcotics. The social network structure between hospitals and patients varies depending on the composition of the medical narcotics. Therefore, these characteristics should be considered when controlling medication with narcotics. The results of this study provide guidelines for controlling narcotic use in other countries.

Roseateles agri sp. nov., a New Species Isolated from Fresh Soil in Uiwang, South Korea

Two isolates of Roseateles were discovered in soil samples collected from Uiwang-si, Gyeonggi-do, Republic of Korea. These isolates exhibited rod-shaped morphology and were facultatively anaerobic, non-motile, and tested positive for oxidase and catalase. Designated as strains R3-3T and R3-11, their growth was hindered by NaCl concentrations exceeding 0.5%, while their optimal growth conditions were observed at temperatures ranging from 25 °C to 30 °C and pH levels between 7.0 and 9.0. Both strains exhibited positive results for the hydrolysis of Tween 80 and DNA, but tested negative for starch, casein, chitin, and gelatin hydrolysis. Additionally, they assimilated L-Arabinose, D-mannitol, and D-Maltose, while exhibiting negative results for the fermentation of D-glucose, esculin ferric citrate, D-mannose, N-acetyl-glucosamine, potassium gluconate, capric acid, adipic acid, trisodium citrate, and phenylacetic acid. The DNA G+C content of strain R3-3T was measured at 67.5 mol%. Comparative analysis revealed that the average nucleotide identity (ANI) values between R3-3T and the Roseateles type strains ranged from 75.14% to 78.30% while the digital DNA-DNA hybridization (dDDH) values ranged from 20.70% to 22.70%. Consequently, based on comprehensive genomic, chemotaxonomic, phenotypic, and phylogenomic evaluations, the isolated strains have been designated as a new species within the genus Roseateles, named Roseateles agri sp. nov. (with type strain R3-3T = KACC 23678T = NBRC 116681T).

Sphingobacterium oryzagri sp. nov., isolated from rice paddy soil.

An aerobic, Gram-stain-negative and short rod-shaped bacterial strain, designated M6-31T, was isolated from rice paddy soil sampled in Miryang, Republic of Korea. Growth was observed at 4-35 °C (optimum, 28 °C), pH 6.0-9.0 (optimum, pH 7.0-8.0) and in the presence of 0-4 % (w/v) NaCl (optimum, 0 % w/v). Phylogenetic analysis based on 16S rRNA gene sequences grouped strain M6-31T with Sphingobacterium bambusae IBFC2009T, Sphingobacterium griseoflavum SCU-B140T and Sphingobacterium solani MLS-26-JM13-11T in the same clade, with the 16S rRNA gene sequence similarities ranging from 95.8 to 96.6 %. A genome-based phylogenetic tree reconstructed by using all publicly available Sphingobacterium genomes placed strain M6-31T with S. bambusae KACC 22910T, 'Sphingobacterium deserti' ACCC 05744T, S. griseoflavum CGMCC 1.12966T and Sphingobacterium paludis CGMCC 1.12801T. Orthologous average nucleotide identity and digital DNA-DNA hybridization values between strain M6-31T and its closely related strains were lower than 74.6 and 22.0 %, respectively. The respiratory quinone was menaquinone-7, and the major polar lipid was phosphatidylethanolamine. The major fatty acids (>10 %) were C15 : 0 iso, C17 : 0 iso 3OH and summed feature 3. The phenotypic, chemotaxonomic and genotypic data obtained in this study showed that strain M6-31T represents a novel species of the genus Sphingobacterium, for which the name Sphingobacterium oryzagri sp. nov. (type strain M6-31T=KACC 22765T=JCM 35893T) is proposed.

Spiritual nursing education programme for nursing students in Korea: a systematic review and meta-analysis

PurposeThis study conducts a systematic review and meta-analysis to understand the characteristics and contents of studies on spiritual nursing education programmes and their effects.MethodsThe literature search included five databases (RISS, KISS, DBpia, Science ON, and KmBase) published in South Korea until September 30, 2021. Nine studies were included in the final review, with six for the meta-analysis using the RevMan 5.4. 1 programme. The programmes targeted nursing students and nurses in the RN-BSN course and employed methods such as lecturing, discussions, and case presentations. The contents focused on self-spirituality awareness, spirituality-related concepts, understanding others’ spirituality, and the process and application of spiritual nursing.ResultsThe meta-analysis revealed statistically significant effects on spiritual nursing competencies, spirituality, spiritual well-being, existential well-being, and spiritual needs, except self-esteem. Spiritual nursing education was effective in enhancing spiritual nursing competencies.ConclusionThe study confirmed that spiritual nursing education effectively improves spiritual nursing competency, indicating a need for increased focus and administrative and financial support for such education in schools and hospitals. Furthermore, future studies should employ randomised experimental designs to examine the effects of online education programmes with short training time on clinical nurses in hospitals.

Clinical characteristics and risk factors for right-sided infective endocarditis in Korea: a 12-year retrospective cohort study

Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (LSIE) and exhibits distinct epidemiological, clinical, and microbiological characteristics. Previous studies have focused primarily on RSIE in patients with intravenous drug use. We investigated the characteristics and risk factors for RSIE in an area where intravenous drug use is uncommon. A retrospective cohort study was conducted at a tertiary hospital in South Korea. Patients diagnosed with infective endocarditis between November 2005 and August 2017 were categorized into LSIE and RSIE groups. Of the 406 patients, 365 (89.9%) had LSIE and 41 (10.1%) had RSIE. The mortality rates were 31.7% in the RSIE group and 31.5% in the LSIE group (P = 0.860). Patients with RSIE had a higher prevalence of infection with Staphylococcus aureus (29.3% vs. 13.7%, P = 0.016), coagulase-negative staphylococci (17.1% vs. 6.0%, P = 0.022), and gram-negative bacilli other than HACEK (12.2% vs. 2.2%, P = 0.003). Younger age (adjusted odds ratio [aOR] 0.97, 95% confidence interval [CI] 0.95–0.99, P = 0.006), implanted cardiac devices (aOR 37.75, 95% CI 11.63–141.64, P ≤ 0.001), and central venous catheterization (aOR 4.25, 95% CI 1.14–15.55, P = 0.029) were independent risk factors for RSIE. Treatment strategies that consider the epidemiologic and microbiologic characteristics of RSIE are warranted.

Population decline and public attitudes toward multicultural immigration policies in South Korea

AbstractPopulation decline due to low fertility and aging causes socioeconomic challenges such as a shrinking labour force and regional decline. In response to these challenges, there is a growing discussion about accepting immigrants to mitigate the side effects of population decline. This implies the importance of analyzing local peoples' perceptions as a basis of policy and planning in anticipation of demographic transitions toward a multicultural society. While there are many studies on local problems caused by depopulation and perceptions of immigrants based on contact theory and group threat theory, there has been relatively little research on the relationship between depopulation and individual perceptions of immigrants. This study fills this gap by using survey data of Seoul, Korea, the city experiencing both population decline and an increase in immigrants. It employs the multilevel ordered logit model to explore how the decrease in local population associates with individuals' perception on the need for multicultural immigration policies. The results suggest that individuals are more likely to have a positive view of multicultural immigration policies if their region is experiencing a higher population decline. This finding is significant as it demonstrates that a shift to an unfavourable demographic structure can have a positive impact on perceptions of immigrant acceptance, offering a new perspective on the relationship between immigrants and native residents.

The Impact of Political Orientation and Government Change on Public Satisfaction with Food Policy in South Korea

This study investigates the relationship between political orientation, government change, and public satisfaction with food policies in the Republic of Korea. Utilizing data from the Consumer Behavior Survey for Foods (CBSF) conducted by the Korea Rural Economic Institute from 2020 to 2021, we employ fixed effects models to examine the impact of political orientation, the presence of a conservative government, and their interactions on satisfaction across various dimensions of food policy. We also analyze the change in satisfaction levels from 2020 to 2021 based on shifts in political orientation. The results reveal complex dynamics between political alignment, government performance, and public perceptions. While conservatives and liberals exhibit higher satisfaction with labeling policies, they show lower satisfaction with safety and redress policies. The presence of a conservative government is associated with higher satisfaction in specific policy areas but lower overall satisfaction. Changes in political orientation significantly influence policy satisfaction, with shifts away from conservatism and towards liberalism leading to decreased satisfaction. The findings highlight the importance of understanding the nuanced preferences of different political groups and the need for responsive and transparent food policy frameworks. This study advances the theoretical understanding of the political economy of policy satisfaction and provides novel policy implications for effective governance.

Detection of Korean Phishing Messages Using Biased Discriminant Analysis under Extreme Class Imbalance Problem

In South Korea, the rapid proliferation of smartphones has led to an uptick in messenger phishing attacks associated with electronic communication financial scams. In response to this, various phishing detection algorithms have been proposed. However, collecting messenger phishing data poses challenges due to concerns about its potential use in criminal activities. Consequently, a Korean phishing dataset can be composed of imbalanced data, where the number of general messages might outnumber the phishing ones. This class imbalance problem and data scarcity can lead to overfitting issues, making it difficult to achieve high performance. To solve this problem, this paper proposes a phishing messages classification method using Biased Discriminant Analysis without resorting to data augmentation techniques. In this paper, by optimizing the parameters for BDA, we achieved exceptionally high performances in the phishing messages classification experiment, with 95.45% for Recall and 96.85% for the BA metric. Moreover, when compared with other algorithms, the proposed method demonstrated robustness against overfitting due to the class imbalance problem and exhibited minimal performance disparity between training and testing datasets.

Differentiating anthropogenic effects from natural metal(loid) levels in residential soil near a zinc smelter in South Korea.

Metal(loid)s pose a significant hazard due to inherent toxicity. Individuals are particularly exposed to metal(loid)s in soil through direct or indirect contact. Identifying metal(loid) sources in soil is required for exposure mitigation to anthropogenic metal(loid)s, while metal(loid)s are natural constitutes of soil. Metal(loid) concentrations and Pb isotopes were determined in residential soil profiles impacted by a Zn smelter to distinguish the anthropogenic effect from natural levels. One hundred sixty-nine core soil samples were collected from depths down to 5.5m below ground level at 19 sites and were divided into Zn-Cd-As- and As-contaminated groups based on the worrisome level (WL) of soil contamination. The Zn-Cd-As-contaminated group (n = 62) was observed at depths < 1m, showed high Zn levels (mean of 1168mg/kg) and Cd and As frequently exceeding WLs, and had low 206Pb/207Pb ratios close to the Zn smelter. In contrast, the As-contaminated group (n = 96) was observed at depths > 1m, did not have other metals exceeding WLs, and showed a wide range of 206Pb/207Pb ratios far away from the Zn smelter. The results indicated that the pollution sources of Zn-Cd-As- and As-contaminated soils were fugitive dust emissions from smelter stacks and geology, respectively. The metal(loid)s in host rock set geochemical baselines in soil profiles, while smelting activities affected the upper layers over 50years. This study demonstrated the effectiveness of utilizing the vertical distribution of metal(loid) concentrations and Pb isotopes in soil profiles for distinguishing between anthropogenic and geogenic origins, in combination with baseline assessment.

Comparative evaluation of the diagnostic accuracies of four different malaria rapid diagnostic test kits available in Ghana.

Malaria rapid diagnostic test (mRDT) kit is one of the techniques for diagnosing malaria. Due to its inherent advantages over the microscopy technique, several brands of the kit have flooded malaria endemic countries, without prior in-country evaluation. Two of such mRDT kits are Oscar (India) and Standard Q (Korea Republic). In this study, the performance of Oscar and Standard Q mRDT kits were compared to First Response (India) and CareStart (USA) mRDTs, which have been evaluated and deployed for use approved by the Ministry of Health (MOH). In this comparative study, whole blood samples were collected from patients suspected of malaria. Plasmodium falciparum was detected in each sample using nested polymerase chain reaction (nPCR), microscopy and the four mRDTs. The sensitivities, specificities, accuracies, positive and negative predictive values and accuracies of the mRDTs were determined using nPCR as a reference technique. Kappa statistic was used to determine the level of agreement among the techniques. Two hundred (200) blood samples were analyzed in this study. The overall detection rates of P. falciparum by microscopy, First Response, CareStart, Oscar-PfHRP2, Standard Q mRDT kits and nPCR were 31.5%, 34.5%, 33.5%, 32%, 31% and 43% (x2 = 6.1, p = 0.046), respectively. The accuracies of CareStart and First Response were comparable (90.5% vs. 89.5%). Further, comparing their sensitivities, Oscar-PfHRP2 was 74.4% (95% confidence interval (CI): 63.9-83.2) while that of Standard Q was 72.1% (95% CI: 61.4-81.2), with comparable accuracies (Oscar-PfHRP2-89% and Standard Q -88%). Apart from First Response that was 98.3% specific, the others were 100% specific. Kappa test revealed perfect diagnostic agreement (κ = 0.90-0.98) among the four mRDTs. That notwithstanding, Oscar-PfHRP2 agreed better with CareStart (κ = 0.94) and First Response (κ = 0.92) compared to the agreement between Standard Q and, CareStart (κ = 0.92) and First Response (κ = 0.90). Taken together, the diagnostic performance of the four mRDT kits were statistically similar. That notwithstanding, new mRDT kits should be evaluated prior to deployment for use.

Importance of small vessel disease as a possible cause of sudden sensorineural hearing loss.

Vascular disease like small-vessel disease (SVD) is the most likely cause among the potential causes of Sudden sensorineural hearing loss (SSNHL). Understanding the relationship between SVD and SSNHL is crucial for developing effective prevention and treatment strategies. To confirm the relationship between SVD and SSNHL, the effect of SVD is confirmed by focusing on the duration and recurrence of SSNHL. This article reports a retrospective observational study that investigated the relationship between SVD and SSNHL using the South Korea Health Insurance Review and Assessment Service (HIRA) database from 2010 to 2020. This retrospective observational study included 319,569 SSNHL patients between 2010 and 2020. Participant demographics were controlled using Propensity Score Matching. The hazard ratios (HR) for the effect of SVD on the duration of SSNHL were 1.045 for the group with SVD before the onset of SSNHL and 1.234 for the group with SVD after the onset of SSNHL. SVD was statistically significant for the recurrence of SSNHL, with an odds ratio of 1.312 in the group with SVD compared to the group without SVD. The HR for the period until a recurrence in the group with SVD was 1.062. The study identified SVD as a possible cause of SSNHL and found that the duration of SSNHL increased only in the presence of SVD. SVD also affected the recurrence of SSNHL, with the recurrence rate being 1.312 times higher in the group with SVD.

Totally laparoscopic versus laparoscopy-assisted distal gastrectomy: the KLASS-07, a randomized controlled trial.

Strong evidence is lacking as no confirmatory randomized controlled trials (RCTs) have compared the efficacy of totally laparoscopic distal gastrectomy (TLDG) with laparoscopy-assisted distal gastrectomy (LADG). We performed an RCT to confirm if TLDG is different from LADG. The XXXXX trial is a multicentre, open-label, parallel-group, phase III, RCT of 442 patients with clinical stage I gastric cancer. Patients were enrolled from 21 cancer care centers in South Korea between January 2018 and September 2020 and randomized to undergo TLDG or LADG using blocked randomization with a 1:1 allocation ratio, stratified by the participating investigators. Patients were treated through R0 resections by TLDG or LADG as the full analysis set of the XXXXX trial. The primary endpoint was morbidity within postoperative day 30, and the secondary endpoint was QoL for 1 year. This trial is registered at ClinicalTrials.gov (NCT XXXXXXXX). 442 patients were randomized (222 to TLDG, 220 to LADG), and 422 patients were included in the pure analysis (213 and 209, respectively). The overall complication rate did not differ between the two groups (TLDG vs. LADG: 12.2% vs. 17.2%). However, TLDG provided less postoperative ileus and pulmonary complications than LADG (0.9% vs. 5.7%, P=0.006; and 0.5% vs. 4.3%, P=0.035, respectively). The QoL was better after TLDG than after LADG regarding emotional functioning at 6 months, pain at 3 months, anxiety at 3 and 6 months, and body image at 3 and 6 months (all P<0.05). However, these QoL differences were resolved at 1 year. The XXXXX trial confirmed that TLDG is not different from LADG in terms of postoperative complication but has advantages to reduce ileus and pulmonary complications. TLDG can be a good option to offer better QoL in terms of pain, body image, emotion, and anxiety at 3-6 months.

Impact of intravenous accessibility and prehospital epinephrine use on survival outcomes of adult nontraumatic out-of-hospital cardiac arrest patients

BackgroundThis study compared out-of-hospital cardiac arrest (OHCA) patient outcomes based on intravenous (IV) access and prehospital epinephrine use.MethodsA retrospective study in Ulsan, South Korea, from January 2017 to December 2022, analyzed adult nontraumatic OHCA cases. Patients were grouped: Group 1 (no IV attempts), Group 2 (failed IV access), Group 3 (successful IV access without epinephrine), and Group 4 (successful IV access with epinephrine), with comparisons using logistic regression analysis.ResultsAmong 2,656 patients, Group 4 had significantly lower survival to hospital discharge (adjusted OR 0.520, 95% CI 0.346–0.782, p = 0.002) and favorable neurological outcomes (adjusted OR 0.292, 95% CI 0.140–0.611, p = 0.001) than Group 1. Groups 2 and 3 showed insignificant survival to hospital discharge (adjusted OR 0.814, 95% CI 0.566–1.171, p = 0.268) and (adjusted OR 1.069, 95% CI 0.810–1.412, p = 0.636) and favorable neurological outcomes (adjusted OR 0.585, 95% CI 0.299–1.144, p = 0.117) and (adjusted OR 1.075, 95% CI 0.689–1.677, p = 0.751). In the shockable rhythm group, Group 3 had better survival to hospital discharge (adjusted OR 1.700, 95% CI 1.044–2.770, p = 0.033).ConclusionsSuccessful IV access with epinephrine showed worse outcomes in both rhythm groups than no IV attempts. Outcomes for failed IV and successful IV access without epinephrine were inconclusive. Importantly, successful IV access without epinephrine showed favorable survival to hospital discharge in the shockable rhythm group, warranting further research into IV access for fluid resuscitation in shockable rhythm OHCA patients.

Clinical significance of the advanced lung cancer inflammation index in patients with limited-stage small cell lung cancer treated with chemoradiotherapy

The aim of the study was to investigate the prognostic significance of the advanced lung cancer inflammation index (ALI) in patients with limited-stage small-cell lung cancer (LS-SCLC) undergoing definite chemo-radiotherapy (CRT). We included 87 patients with LS-SCLC from South Korea, treated between 2005 and 2019 with definite CRT. ALI was calculated using body mass index, serum albumin, and neutrophil–lymphocyte ratio. We categorized 38 patients into the high ALI group (ALI ≥ 44.3) and 48 into the low ALI group (ALI < 44.3). Patients in the high ALI group exhibited longer overall survival (OS) than patients in the low ALI group. In multivariate analysis, prophylactic cranial irradiation (hazard ratio [HR] = 0.366, 95% confidence interval [CI] 0.20–0.66, P = 0.0008), and high ALI (HR = 0.475, 95% CI 0.27–0.84, P = 0.0103) were identified as independent prognostic factors for predicting better OS. Notably, a high ALI score was particularly indicative of longer survival in patients treated with the combination of etoposide and cisplatin. In conclusion, this study demonstrated that a high pretreatment ALI was significantly associated with better OS in patients with LS-SCLC undergoing definite CRT. This suggests that ALI could be a useful tool for predicting prognosis and guiding chemotherapy regimen selections in clinical practice for LS-SCLC.

Ecumenical Formation in the Context of World Christianity

AbstractThis article sets out the background to and the significance of the Global Ecumenical Theological Institute (GETI), an educational course for younger and emerging theologians, first organized by the World Council of Churches (WCC) to coincide with its 10th Assembly in Seoul, South Korea, in 2013. Further GETIs have taken place since then, most recently at the WCC's 11th Assembly in Karlsruhe, Germany, in 2022. The article finishes by setting out five statements about ecumenical education and formation.

“Yes, I Am More Confident with My Avatars”: Integrating EFL Students’ Speaking Practice into Metaverse

This article presents an innovative practice that demonstrates the use of the metaverse to enhance English speaking skills in an undergraduate English drama course in South Korea. The innovation stemmed from the common situation that English-language learners feel self-conscious when speaking in front of their peers. To overcome this problem, the metaverse was used to provide a virtual space for students to practice dialogues and speeches using avatars. The two-phase implementation involved practicing dialogues from the American sitcom Friends and celebrity speeches in the metaverse space. Surveys and reflections showed that this approach significantly improved students’ confidence, motivation and English speaking skills by reducing the anxiety associated with physical presence. Nevertheless, some technical limitations, such as connectivity issues and constraints on virtual expression, were observed. Based on the findings, this study suggests the metaverse as a powerful tool for overcoming affective barriers in language learning, providing a safe and engaging platform for students to practice speaking skills. Furthermore, the study underscores the importance of selecting appropriate metaverse platforms and considering technical factors such as device compatibility and internet stability.

Malaysia's Diplomatic Choices, Dynamics and Mechanisms Towards Northeast Asia - An Explanation Based on Neoclassical Realism

Malaysia's Diplomatic Choices, Dynamics and Mechanisms Towards Northeast Asia - An Explanation Based on Neoclassical Realism