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The Achievements and limitations of the U. S. Welfare Reform (미국 복지개혁의 성과와 한계)

  • Kim, Hwan-Joon
    • Korean Journal of Social Welfare
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    • v.53
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    • pp.129-153
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    • 2003
  • This study examines the socio-economic impacts of recent welfare reform in the United States. Based on the neo-conservative critique to the traditional public assistance system for low-income families, the 1996 welfare reform has given greater emphases on reducing welfare dependency and increasing work effort and self-sufficiency among welfare recipients. In particular, the welfare reform legislation instituted 60-month lifetime limits on cash assistance, expanded mandatory work requirements, and placed financial penalties for noncompliance. With the well-timed economic boom in the second half of the 1990s, the welfare reform seems to achieve considerable progress; welfare caseload has declined sharply to reach less than 50% of its 1994 peak, single mothers' labor force participation has increased substantially, and child poverty has decreased. In spite of these good signals, the welfare reform also has several potential problems. Many welfare leavers participate in the labor market, but not all (or most) of them. The economic well being of working welfare leavers did not increased significantly, because earnings increase was canceled out by parallel decrease in welfare benefits. Furthermore, most of working welfare leavers are employed in jobs with poor employment stability and low wages, making them highly vulnerable to frequent layoff, long-time joblessness, persistent poverty, and welfare recidivism. Another serious problem of the welfare reform is that a substantial number of welfare recipients are faced with extreme difficulties in finding jobs, because they have severe barriers to employment. The new welfare system with 5-year time limit can severely threaten the livelihoods of these people. The welfare reform presupposes that welfare recipients can achieve self-reliance by increasing their labor market activities. However, empirical evidences suggest that many people are unable to respond to the new, work-oriented welfare strategy. It may be a very difficult task to achieve both objectives of the welfare reform((1) providing adequate income security for low-income families and (2) promoting self-sufficiency) at the same time, because sometimes they are conflicting each other. With this in mind, a possible solution can be to distinguish welfare recipients into "(Very)-Hard-to-Employ" group and "(Relatively)-Ready-to-Work" group, based on elaborate examinations of a wide range of personal conditions. For the former group, the primary objective of welfare policies should be the first one(providing income security). For the "Ready-to-Work" group, follow-up services to promote job retention and advancement, as well as skill-training and job-search services, are very important. The U. S. experiences of the welfare reform provide some useful implications for newly developing Korean public assistance policies for the able-bodied low-income population.

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Relationship between S-Phase Fraction and Survival Time in Patients with Primary Squamous Lung Cancer (편평상피성 폐암에 있어서 S-Phase Fraction과 생존기간과의 관계)

  • Jung, Byung-Hak;Kang, Jeong-Seong;Chang, Keun;Jeong, Eun-Taik;Chung, Hun-Taeg;Moon, Hyung-Bae
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.669-676
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    • 1993
  • Background: DNA content analysis of human solid tumor is now widely performed by flow cytometric study. One of the most interesting and potentially important observation in this field is that proliferative activity(S-Phase fraction of cell cycle) may profoundly affect prognosis. Method: S-Phase fraction(SPF) have been measured by flow cytometric method using tumor cells isolated from paraffin embedded tissue. To evaluate the prognostic significance, SPF of squamous lung cancer cell was assessed in 21 patients who died without any specific treatment. Results: 1) Mean survival time of squamous lung cancer patients was 225(${\pm}162$) days. Survival time were shortened, when TNM stage and PS scale were advanced. 2) Mean value of SPF of squamous lung cancer patients was 23.4(${\pm}11.3$)%. SPF had nothing to do with advance of TNM stage and PS scale. 3) Mean survival time of high SPF group(more than 20% of cell proliferation cycle) and low SPF group were 153(${\pm}99$) days and 342(${\pm}180$) days(p<0.01). In each identical TNM stage and PS scale, there were also statistic significant differences in mean survival time between high and low SPF group. Conclusion: On multivariate analysis including TNM stage and performance status, SPF was the significant and independent prognostic factor in the primary squamous lung cancer patients group.

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Clinical Investigation of Cervical Tuberculous Lymphadenitis (결핵성 경부 임파선염의 임상적 고찰)

  • Park, Mi-Ran;Kim, Chang-Sun;Seo, Jee-Young;Son, Hyung-Dae;Rheu, Nam-Soo;Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1225-1233
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    • 1997
  • Background : Cervical tuberculous lymphadenitis(CTL) is one of the most common extra-pulmonary tuberculosis. Recently overall incidence of pulmonary tuberculosis has decreased, but the incidence of tuberculous lymphadenitis has not decreased. Its duration of treatment is still controversial and the pathogenesis, prognosis and relationship with other site tuberculous are poorly published. So we did a retrograde study of 120 cases of confirmed CTL about its clinical manifestations. Method : All patients were applied fine needle aspiration(FNA) of palpable enlarged cervical lymph nodes and 114 patients were examined for AFB smear and 34 patients for TB culture with aspirated fluid. 57 patients were examined Mantoux test(5TU with PPD-S). With above methods, a total of 120 patients was diagnosed as having CTL. Results : 1) CTL is most prevalent in young women between the age of 20~30 years and the incidence of CTL in female is 2.5 times higher than that of male. It is located most commonly in the posterior cervical area. The most common presenting symptom is painless palpable enlarged cervical lymph nodes. 2) With FNA of enlarged cervical lymph nodes, the percentage of histopathological positivity is 82.3%. The percentage of AFB smear positivity is 38.6%, and that of TB culture positivity is 17.6%(p<0.001). 3) Pulmonary tuberculosis is noted in 79 cases(65.8%). And 42 cases(53.5%) of them had minimal pulmonary tuberculosis. In 14 cases(11.7%), other extrapulmonary tuberculosis coexsisted and pleural tuberculosis was most Common in the order. 4) CTL was treated with anti-tuberculous medication(first line drug) and median treatment duration was 18.5months. During treatment, the size of involved lymph nodes decreased gradually in 62 cases(75.8%), newly developed lymph nodes were found in 25 cases(30.4%), fluctuation formation in 22 cases(26.8%) and fistula formation in 14 cases(17.0%). Conclusion : CTL is prevalent in women between the age of 20~40 years and it involves posterior cervical area most commonly. CTL is treated with long-term anti-tuberculous chemotherapy. We think it is one manifestation of systemic disease and frequently coexisting with pulmonary tuberculosis. Despite anti-tuberculous chemotherapy, the size of involved lymph nodes was increased, new lymph nodes were developed or fluctuation and fistula formed in involved lymph nodes. After sufficient medication, when the patient felt pressure discomfort from enlarged lymph node or fistula was formed, we recommended total excision of involved lymph nodes.

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A Clinical Review of Mucoepidermoid Carcinoma of The Lung in Korea (점액상피암의 임상적 고찰)

  • Kim, Yeon-Jae;Park, Jae-Yong;Shin, Moo-Chul;Bae, Moon-Sup;Kim, Jeong-Seok;Chae, Sang-Cheol;Park, Tae-In;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.311-321
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    • 1998
  • Background: Mucoepidermoid carcinoma of the lung arises from submucosal gland of tracheobronchial tree. Histologically, the tumor is composed of mucin-secreting cells, squamous cells, and intermediated cells, which show no particular differentiating characteristics, in varying proportions. The tumor is divided into low grade and high grade depending on the proportion of cells, and the degree of the mitotic activity, cellular necrosis and nuclear pleomorphism. While favorable prognosis of low grade tumor, high grade tumor, which is very difficult to differentiate from adenosquamous carcinoma, has an aggressive clinical course. The tumor is rare, comprising 0.1 to 0.2% of primary lung cancers and 1 to 5% of bronchial adenomas. Method: A retrospective clinical study was done on 17 cases of mucoepidermoid carcinoma. The study investigated the clinical features, radiologic findings, bronchoscopic findings, histology and clinical courses. Results: Age ranged between second to seventh decade with a mean age of 42 years. Twelve out of 17 cases were male. Five out of 17 cases were smokers with a mean 11 pack-years. Common symptoms included dyspnea, cough, hemoptysis, and wheezing. Two out of 17 cases was asymptomatic. Atelectasis or mass was common radiologic finding. Plain chest radiography was normal in one patient whom the tumor was located in upper trachea. Bonchoscopy revealed exophytic mass in 12 cases and nodular infiltrations in 4 cases. One case having solitary pulmonary nodule in the right lower lung was normal on bronchoscopy. Histologically, ten out of 17 cases were low grade, and seven out of 17 cases were high grade. Among 10 patients with low grade tumor,9 patients were performed operation and have been alive without recurrence during a mean follow-up of 30 months. Two out of 7 patients with high grade tumor were performed pneumonectomy and have been alive during a follow-up of 3 and 8 months, respectively. Conclusion: Most of mucoepidermoid carcinoma is located at central airway and is presented symptoms by mucosal irirtation. Although atelectasis or mass is common radiologic finding. chest X -ray can be normal. The histologic grading and the extent of tumor are two most important factors for prognosis.

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Periodontal Management strategies for the future in Korea (2000년대 치주처치의 전략)

  • Chung, Hyun-Ju;Son, Sung-Hee
    • Journal of Periodontal and Implant Science
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    • v.27 no.3
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    • pp.533-547
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    • 1997
  • In periodontics, much progress was made in the understanding of periodontal disease from 1960s to 1980s and in prevention and management of periodontal disease since the end of 1980s. This presentation will discuss about the prevalence of periodontal disease, treatment need, and provision of periodontal treatment in Korea, and how we could manage the periodontal disease efficiently in the future. According to an epidemiological study in Korea, periodontal disease(including gingivitis) was present in 82% of general population and periodontitis in 30-40% in adult population over 30y and juvenile periodontitis in 0.1% of adolescents. If we consider that at least 17% of these patients may have recurrent or refractory forms, there is obviously an abundance of disease that needs treatment, As a result of increase in life expectancy, senile population over 65 y will be increased from 6% in 1996 to 6.9% in 2000, and tooth retention rate and periodontal treatment need are expected to increase. Periodontists need all the help they can get from the general dentists to control periodontal disease. As for provision, postgraduate course in periodontics started in 1957 in Korea and produced over 700 specialized dentists in periodontics. One report indicated that the periodontists as well as general practitioners did periodontal therapy on only a few periodontal patients, because of specific control by current medical insurance system in Korea. Comprehensive periodontal examination is rarely done in local dental clinic. Therefore, enhancement of periodontal care in medical insurance system and education of simplified periodontal examination such as Periodontal Screening & Recording will make dentists diagnose and manage the management of adult patients is based on the recognition that there are multiple diseases, including gingivitis, chronic adlt periodontitis, and other more aggressive forms of periodontitis, and requires the earliest possible recognition of these three disease categories. In this presentation, we discuss practical approach using PSR to diagnose, manage and refer the patients, to facilitate the separation of the simple from the complex and the predictable from the unpredictable form of periodontal diseases and to integrate diagnostic and therapeutic techniques into private practice today.

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Long-term Variation and Characteristics of Water Quality in the Yeoja Bay of South Sea, Korea (여자만 수질환경의 특성과 장기변동)

  • Park, Soung-Yun;Kim, Sang-Soo;Kim, Pyoung-Joong;Cho, Eun-Seob;Kim, Byong-Man;Jeon, Sang-Baek;Jang, Su-Jeng
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.17 no.3
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    • pp.203-218
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    • 2011
  • Long-term trends and distribution patterns of water quality were investigated in the Yeoja Bay of South Sea, Korea from 1976 to 2010. Water samples were collected at 3 stations and physicochemical parameters were analyzed including water temperature, salinity, hydrogen ion concentration (pH), dissolved oxygen (DO), chemical oxygen demand (COD), suspended solids (SS) and nutrients. Spatial distribution patterns of temperature, pH and DO were not clear among stations but the seasonal variations were distinct except ammonium. The trend analysis by principal component analysis (PCA) during 31 years revealed the significant variations in water quality in the study area. Spatial water qualities were discriminated into 2 clusters by PCA; station cluster 1 and 2~3. Annual water qualities were clearly discriminated into 4 clusters by PCA. By this multi-variate analysis, the annual trends were summarized as the followings; water temperature, COD and SS tended to increase from late 1970's, decreased salinity, and increased phosphate from 1991 to 2001 and increased dissolved inorganic nitrogen. Water quality was showed by the input of fresh water same as those of Kyoungin coastal area, Asan coastal area, Choensoo bay, Gunsan coastal and Mokpo coastal area in the Yeoja Bay.

An Analysis on Changing Pattern of Economic Active Population by Working Life Table for Korean Men (우리나라 노동생명표에 의한 노동력추이 분석)

  • 조진만
    • Korea journal of population studies
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    • v.13 no.2
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    • pp.1-18
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    • 1990
  • This is a study which attempt to analyze changing patierns of economic active popu-lation, t o estimato- future patterns, and exa- mine vartons problems arises by changing c ire u mst ances of t he labor force market in- clunging soici al, economic ic, heathl th and demoi-graph ic aspects. We have constructed series of wotking life table which are useful in syt uiolyioig the lirocess of growth and structural change of labor force. Work i ng life tables represent ihie life eyele of econrmic' activity in hi ypothetical cohorts, that is. gen-erat i on of men Sn bject at eat' b period ot f their lives th given ra to's o mor tali it y and of par-- tici pation in economic activities. The tabloes prot' ide measorues of the alvet'age he ng t able of economically aeti \- e life. and agespecific rates of en trannee' into and retirement from the hahn' force. In const routing working life tables, age-specific activity rates and life tabole popula- titoto which represents contemporary condi-tions of moortality in Korea au'e the basic' maltoerials. We have derived the age-specific rates foorm economically active population survey, whoich were conducted by the Bureau of Statistics, Economic Planning Borard of the Korean government. Working life tables are constructed for men wtable these materi- als in the year of 1970, 1980 and 1988 by a modified Wolfbein-Wool's method. Some of the findings may be summerized as follow : 1) A central part of constructing working life table is calculation of stationary' economic active population, which represents the number of men in the stationtary population extoected to be in the labor force at each age group in the life span. The stationary economic active population by age have generally a universal pattern, where they rise sharply in the early twenties, approach its' peak in the thirties decline thereafter. at first graolually and then more rapidly at an advanced age. Korean men show the same general pa ttern of age distribution of stationary eco-- nomic active population with sharp increase hegining from the age interval of 20 to 24, reaching to maximum level at older age. The population. however, presumably, increased substantially due to increaseing school atte endance rates. Another difference exiSts in the youngest age groups, that is the activity rate in the year of 1988 is lower than that of Japan. The table shows an analysis of changes in the age distrihution of labor force between 1970, 1980 and 1988. 2) It was shown an analysis of changes in the age distribution and cause of separation from labor force. The entrance rate to labor force has increased from 18~\5 persons to 299 persons per 1000 head of stationary population between that of 1980 than that of 1988 for Korean men in 20~24 age group. The entrace rate to labor force shows a rapid entrance appearance concentrated on the 15~24 age group. The separation rate from labor force by retirment in Korea in the year of 1988 shows a great difference of the about four times as much as that of Japan. 3) The functions of table illustrate the patterns of working life of males in Korea in 1970, 1980 and 1988. The average remaining number of economically active years, e at age 15 in 1988 is 46.39 which is 2.12 years of increase compared with that of at age 15 in 1970,1980 and 1988 are 43.90,44.27 and 46.39 respectively, showing steadily increase dur- ing the past double decade the increase in the length of economically active life various age may be considered to have come both from extention of general life expectancy and from increasing entrance rate to economic activity in high age that of working is far greater in 1988 than that of 1980. The gaps between expectation of life and average remaining years of economically active widened due to rapid improvement of mortality level in Ko- rea. This observation together with the population pressure by the appearance of a group of younger population implies that constant increase of economically inactive population among older age group.

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Analysis of Hydrological Impact Using Climate Change Scenarios and the CA-Markov Technique on Soyanggang-dam Watershed (CA-Markov 기법을 이용한 기후변화에 따른 소양강댐 유역의 수문분석)

  • Lim, Hyuk-Jin;Kwon, Hyung-Joong;Bae, Deg-Hyo;Kim, Seong-Joon
    • Journal of Korea Water Resources Association
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    • v.39 no.5 s.166
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    • pp.453-466
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    • 2006
  • The objective of this study was to analyze the changes in the hydrological environment in Soyanggang-dam watershed due to climate change results (in yews 2050 and 2100) which were simulated using CCCma CGCM2 based on SRES A2 and B2. The SRES A2 and B2 were used to estimate NDVI values for selected land use using the relation of NDVI-Temperature using linear regression of observed data (in years 1998$\sim$2002). Land use change based on SRES A2 and B2 was estimated every 5- and 10-year period using the CA-Markov technique based on the 1985, 1990, 1995 and 2000 land cover map classified by Landsat TM satellite images. As a result, the trend in land use change in each land class was reflected. When land use changes in years 2050 and 2100 were simulated using the CA-Markov method, the forest class area declined while the urban, bareground and grassland classes increased. When simulation was done further for future scenarios, the transition change converged and no increasing trend was reflected. The impact assessment of evapotranspiration was conducted by comparing the observed data with the computed results based on three cases supposition scenarios of meteorological data (temperature, global radiation and wind speed) using the FAO Penman-Monteith method. The results showed that the runoff was reduced by about 50% compared with the present hydrologic condition when each SRES and periods were compared. If there was no land use change, the runoff would decline further to about 3$\sim$5%.

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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Cultural practices of in vitro Tuber of Pinellia ternata(Thunb.) Breit II. Effects of Harvesting Time on Growth, Tuber Size and Yield (기내(器內) 대량(大量) 생산(生産) 반하(半夏) 종구(種球)의 포장(圃場) 재배기술(栽培技術) 연구(硏究) II. 수확시기별(收穫時期別) 생육특성(生育特性), 괴경(塊莖)크기 및 수량(收量))

  • Park, Moon-Soo;Park, Ho-Ki;Kim, Tai-Soo;Jang, Yeong-Seon;Park, Keun-Yong
    • Korean Journal of Medicinal Crop Science
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    • v.1 no.2
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    • pp.115-119
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    • 1993
  • This study was carried out to determine optimum harvest time of in vitro multiplied tuber Pinellia ternata(Thunb.)Breit from 1990 to 1992. Tuber yield and its related traits were observed with four harvest times. Plant height was 7.2cm at 6 months and 19.3cm at 24 months after planting. The number of tubers per unit area was significantly increased with the passage of growing time after planting$(78\;tubers/m^2)$, those were increased by 2.3 times in 6 months, 5.6 times in 12 months, 13.3 times in 18 months and 20.0 times in 24 months. The tuber sizes(length, width and weight) were highly enlarged during 12 to 18 months after planting compared with before or after this time. There were smaller tubers and lower tuber yields with shorter growing period, while large tubers above 7.1mm and higher yields with longer growing. It was suggested that the optimum harvest time was 18 months after planting, before over wintering rather than next year of spring, 24months after planting.

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