• Korean Journal of Social Welfare
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• v.57 no.1
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• pp.271-297
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• 2005

Since the 1980s, the western welfare states have experienced a wide spectrum of socio-economic changes; changes in population composition, the economic globalization, the post-industrialization, an increasing flexibility in the labor market. etc. This study examines the trend of poverty in welfare states, and analyzes how those socio-economic changes are related to it. For these purposes, this study first calculates the poverty indices for several years in 10 welfare states using the Luxembourg Income Study database, and then decomposes the index by subpopulation and income sources. Major findings of this study can be summarized as follows. First of all, the welfare state in general has experienced an increasing trend in the degree of poverty since the 1980s. In particular, poverty has greatly intensified in the United Kingdom and the Netherlands. Many other welfare states including Canada, Germany, Sweden, and Norway have also experienced substantial increases in poverty. The increasing trend of poverty is not wholly due to changes in population composition such as increases in the aging population and one-parent(mother) families. Contrary to the traditional belief, these population groups are not as much poor as the working-age population. In particular, the degree of poverty in the elderly is less severe than in the working-age group. Furthermore, since the 1980s the market income poverty in the aging population has shown a decreasing trend in many welfare states. The degree and trend of poverty in one-parent families vary greatly across countries, owing to the labor market and income transfer policies. The most important reason for the increasing poverty trend in the welfare state is that the degree of poverty has been deepening in the working-age population. Especially, the market income poverty of the working-age population has considerably increased in every country except the Netherlands. Structural changes in the economy and the labor market may drive the increasing trend of poverty. Further studies and deliberate anti-poverty policies are needed to tackle the factors relating to the increase in the market income poverty.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.311-329
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• 1996

This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3435-3441
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• 2014

Background: Axillary lymph node status at diagnosis remains the strongest predictor of long-term survival in breast cancer. Patients with more than ten axillary lymph nodes at diagnosis have a poor long-term survival. In this single institutional study, we set out to evaluate the prognosis of this high-risk group in the era of multimodality therapy. Materials and Methods: In this retrospective study, we looked at all breast cancer patients with greater than ten axillary lymph nodes diagnosed at Mount Sinai Medical Center (MSMC) from January 1st 1990 to December 31st 2007 (n=161). In the univariate analysis, descriptive frequencies, median survival, and 5- and 10-year survival rates were estimated for common prognostic factors. A multivariate prognostic analysis for time-to-event data, using the extended Cox regression model was carried out. Results: With a median and mean follow-up of 70 and 89.9 months, respectively, the overall median survival was estimated to be 99 months. The five-year disease-free survival (DFS) was 59.3% and the ten-year DFS was 37.9%, whereas the five- and ten-year overall survival (OS) was 66.6% and 43.9%, respectively. Multivariate analysis revealed a significant improvement in DFS among black patients compared to whites (p=0.05), improved DFS and OS among young patients (ages 21-45) compared to elderly patients (age greater than 70) (p=0.00176, p=0.0034, respectively), and improved DFS and OS among patients whose tumors were ER positive (p=0.049, p=0.0034). Conclusions: In this single institution study of patients with greater than 10 positive axillary nodes, black patients had a significantly improved DFS compared with white patients. Young age and ER tumor positivity was associated with improved outcomes. Using multivariate analysis, there were no other variables associated with statistically significant improvements in DFS or OS including date of diagnosis. Further work is needed to improve breast cancer survival in this subgroup of patients.

• KIPS Transactions on Software and Data Engineering
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• v.9 no.4
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• pp.137-144
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• 2020

Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.13-29
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• 2002

The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

• Korean Journal of Social Welfare
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• v.50
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• pp.61-85
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• 2002

Using the 2001 Family Income and Expenditure Survey micro-data, this study analyses the anti-poverty effectiveness of public and private income transfers. In this study, the anti-poverty effectiveness of income transfers is summarized in two ways; 1) the poverty reduction effect of the income transfers, and 2) the poverty reduction efficiency of the income transfers. The poverty reduction effects are measured with several poverty indices including the head-count ratio, poverty gap, and Sen index. Using Beckerman's model, this study also analyses the poverty reduction efficiency of income transfers. This analysis documents substantial differences in the anti-poverty effectiveness of public and private income transfers. Although the private income transfers contribute more to reduce the head-count poverty ratio and Sen index than public income transfers, their differences are significantly reduced after the enactment of National Basic Livelihood Security Act. The results also reveal that the anti-poverty effectiveness of public and private income transfers vary by the types of families. In families headed by elderly and working aged, private income transfers have more anti-poverty effectiveness. But, public income transfers contribute more to reduce poverty than private income transfers among families headed by single adults with children. The results of this study suggest that recent changes in anti-poverty policies in Korea have been strengthened the Government's responsibility. And more importantly, to effectively reduce poverty among the poor families, anti-poverty polices must be designed to consider different family types.

• Korean Journal of Social Welfare
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• v.69 no.2
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• pp.117-141
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• 2017

The purpose of this study is to investigate the differences of the factors affecting the entry of depression by generations and to present a practical strategy for preventing of depression by life-cycle. For this purpose, we analyzed the factors influencing the depression of adults, middle-aged and elderly people through the discrete-time hazard model. The results of this study are as follows: First, the lower the self-esteem, the lower the income satisfaction and the family satisfaction people have, the higher the likelihood of entering the depression they have. In addition, age, educational level, health status, presence of chronic diseases, employment status, regional area, and leisure life satisfaction were variables that showed difference by generation. In the case of adulthood(aged 20 ~ 39), unemployed persons are more likely to enter the depression than younger workers. On the other hand, the middle-aged(40 ~ 64 year olds) are more likely to enter the depression if they are older, have poor health status, have no chronic disease, and have low leisure satisfaction. Finally, older people(aged 65 and over) are more likely to enter the depression when the education level is higher, the health condition is worse, and the leisure satisfaction is lower. If they lived in an urban and rural complex, they are more likely to enter the depression. Based on these results, it is necessary to establish a support plan reflecting the characteristics revealed by generations in order to prevent the entry of depression.

• Journal of the Korean Society of Food Culture
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• v.11 no.3
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• pp.409-420
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• 1996

Consumer's perceptions of the qualities of food and food-related services were surveyed through questionnaires by 672 adults randomly selected from 20 industrial foodservice in Pusan and Kyeung Nam area. The results are as follows: 1) By age, the elderly group gaved the highest mean score not only for freshness and temperature among the food characteristics but also for cleanliness of dishes and materials of dishes among the food-related service. 2) By occupation, the white collar worker group gaved the highest mean score in all characteristics of food and food-related service than did the blue collar worker group. Especially for courtesy of employees, the mean rating given by the white collar worker group was 3.15/5.00, but by the blue collar worker group was 2.67/5.00. 3) Good appetitive group rated taste of food 3.15/5.00, quality of food vs. food price 3.17/5.00, and freshness 3.15/5.00. But poor appetitive group rated taste of food 2.44/5.00, quality of food vs. food price 2.65/5.00, and freshness 2.70/5.00. 4) Men agreed that the rice and soup were right in amount. And women responded that the rice was in a large amount and the soup was not enough. 5) The white collar worker group agreed that the rice, the soup, the side dish, and the kimchi were right in amount. However the blue collar worker group agreed that the rice was right in amount, the soup and the side dish were not enough, and the kimchi was in a large amount. For seasoning of food, the white collar worker group responded that the salty taste and the hotness were just right. But the blue collar worker group responded that the food was neither salty nor hot at all. 6) The taste of food was shown to be positively correlated (p<0.001) with various food item combinations, freshness of food, and the variety of cooking methods.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.20 no.2
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• pp.95-111
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• 2021

As the population decreases in an aging society, the average age of drivers increases. Accordingly, the elderly at high risk of being in an accident need autonomous-driving vehicles. In order to secure driving safety on the road, several technologies to respond to various obstacles are required in those vehicles. Among them, technology is required to recognize static obstacles, such as poor road conditions, as well as dynamic obstacles, such as vehicles, bicycles, and people, that may be encountered while driving. In this study, we propose a deep neural network algorithm capable of simultaneously detecting these two types of obstacle. For this algorithm, we used 1,418 road images and produced annotation data that marks seven categories of dynamic obstacles and labels images to indicate road damage. As a result of training, dynamic obstacles were detected with an average accuracy of 46.22%, and road surface damage was detected with a mean intersection over union of 74.71%. In addition, the average elapsed time required to process a single image is 89ms, and this algorithm is suitable for personal mobility vehicles that are slower than ordinary vehicles. In the future, it is expected that driving safety with personal mobility vehicles will be improved by utilizing technology that detects road obstacles.

• 한국노년학
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• v.38 no.4
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• pp.963-979
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• 2018

The purpose of this study was to identify frailty profiles based on physical, psychological, and social domains of functioning and to examine the associated factors showing the differences among frailty profiles. Respondents were 70 years and older(n=403) and latent class analysis was applied to determine the optimal subgroups based on Tilberg Frailty Indicators which comprised of three domains(the physical, psychological, and social domain). Also, we performed multinominal logistic regression analysis to find out factors making differences among frailty profiles. Latent class analysis(LCA) identified three distinct types: multi-frail type(27.0%), psychologically frail type(26.8%), inadequate support type(46.2%). All three types had common difficulties in dealing with daily life problems and did not receive enough help with theses difficulties. Based on the results of the LCA three-class models, people in multi-frail type accumulated problems in physical and psychological domains and had partially social domain. On the other hands, psychologically frail type showed a relatively high anxiety disorder and depression. Lastly, people in inadequate support type reported the lack of helps, but they were relatively healthy. Comparing these groups with inadequate support type, people with multi-frail had lower educational level, poor nutritional management status and were less likely to participate in labor market. People in psychologically frail type were more likely to be male, to live in big cities rather than middle and small cities, and less likely to smoke. Based on these results, our results showed the multifaceted concept of frailty among Korean elderly people and we suggested several implications for preventing frail process.