• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.3
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• pp.146-157
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• 2024

Purpose: Celiac disease (CD) is one of the most prevalent food-related illnesses in children, with a global prevalence of approximately 1.4%. CD can create an emotional burden, particularly on mothers, who are mainly responsible for managing challenges related to adherence to a gluten-free diet, high food costs, and food problems in schools and social areas. There is a gap in the literature, and parental experiences of raising children with CD should be explicitly examined. This qualitative study sought to provide insights into the experiences of parents raising a child with CD in the Turkish context. Methods: This study used a descriptive qualitative research methodology and conducted individual semi-structured video-based dyadic interviews with 19 parents. Results: Participants experienced both challenges and motivators through management of their children's CD. Analyses of the interview transcripts through the data uncovered three main themes focusing primarily on parental concerns: (1) parental challenges in child's disease management, (2) supportive care needs, and (3) parental expectations. Conclusion: A multidisciplinary team should approach the child and family immediately after diagnosis, and facilities should support parents with continuing education and psychological, financial, and social assistance.

• Childhood Kidney Diseases
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• v.28 no.2
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• pp.51-58
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• 2024

Patients with chronic kidney disease (CKD) bear a significant financial burden and face numerous complications and higher mortality rates. The progression of CKD is associated with glomerular injury caused by glomerular hyperfiltration and oxidative stress. Factors such as uncontrolled hypertension, elevated urine protein levels, anemia, and underlying glomerular disease, contribute to CKD progression. In addition to conservative treatment, several medications are available to combat the progression of CKD to end-stage kidney disease. Renin-angiotensin-aldosterone system blockers could slow the progression of CKD by reducing glomerular hyperfiltration, lowering blood pressure, and decreasing inflammation. Mineralocorticoid receptor antagonists inhibit the mineralocorticoid receptor signaling pathway, thereby attenuating inflammation and fibrosis. Sodium-glucose cotransporter 2 inhibitors exhibit protective effects on the kidneys and against cardiovascular events. Tolvaptan, a selective vasopressin V2-receptor antagonist, decelerates the rate of increase in total kidney volume and deterioration of kidney function in patients with rapidly progressive autosomal dominant polycystic kidney disease. The protective effects of AST-120 remain controversial. Due to a lack of evidence regarding the efficacy and safety of these medications in children, it is imperative to weigh the benefits and adverse effects carefully. Further research is essential to establish the efficacy and safety profiles in pediatric populations.

• The Korean Journal of Applied Statistics
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• v.28 no.4
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• pp.643-661
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• 2015

Korea Teachers Pension (private school pension) is a mandatory pension and a social security system for private school teachers to ensure the stability of subscribers by a supplying pension when they (and their dependents) face future economic risk due to retirement or death. Therefore, the Teachers Pension must provide stability and sustainability in regards to adequacy of income and to function as a pension. However, the Government Employees Pension System (GEPS) of Korea (the most representative special occupation pension) recorded a fiscal deficit in 2001 and with an accumulated deficit that is expected to grow; subsequently, various plans for the reform of GEPS have been actively discussed. The Korea Teachers Pension system is based on the GEPS scheme and is not free from the GEPS discussions on reforms of national pension. The current system for the Teachers Pension needs to be improved because it is expected to be depleted within the next 30 years due to low fertility and an aging population in Korea. This study discusses existing Teachers Pension schemes problems and suggests a projection method and revised plans to improve it. We use long-term financial projections of the Teachers Pension to estimate the fund exhaustion point and the minus balance of the financial scale as well as analyze the supply-demand burden structure that reflects the future population structure to propose Teachers Pension reforms that will improve stability and adequacy.

• Land and Housing Review
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• v.6 no.3
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• pp.117-127
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• 2015

Korean government has launched a new public rental housing policy for younger generation suffering from instable housing conditions in CBD area. This paper is to analyze the financial feasibility of urban public rental housing projects, based on its cash flows. Urban rental housing projects should find out the way to reduce costs and to secure cheap land, because of the high land price in CBD area and complex relationship of legal rights. Project types are categorized by the land acquisition method and district characteristics. For 10 sample projects, financial feasibility was analyzed. Cash flows were calculated on the design plan and 16 scenarios were made by combining 4 important variables. The variables are increase rate of land price, increase rate of monthly rents, ratio of public and market rents, and the interest rate of National Housing Fund. The findings are as follows. Government land rent-type can reduce initial costs because it is not necessary to buy land. However, total NPV is lowered at the time of liquidation due to the land return. Private land acquisition-type require more initial costs. But the NPV at liquidation time increases with land disposal. To improve financial feasibility, acquisition-type should be preferred in high land-price area and rent-type should be preferred in low land-price area. Among influencing variables, the rate of increase in land price and the ratio of public and market rents turned out to be the most important. Although the ratio of public and market rents can be controllable, high ratio will cause the burden of tenants. Therefore, interest rate adjustment of National Housing Fund is more desirable.

• The Journal of the Convergence on Culture Technology
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• v.4 no.1
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• pp.67-73
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• 2018

Financial plight condition firms difficulties accessing external funding, these firms will arrange scarce funds using tax avoidance can be a way of improvement of internal cash flow and internal funds securement. This study is empirical evidence presented the association between free cash flow can be represented for financial condition of firms and using tax avoidance for Kosdaq listed firms. Empirical analysis result, presented plus (+) results the association between free cash flow and tax avoidance. these results are in the previous year free cash flow is large firms purpose of internal cash holdings that increase of tax avoidance in order to minimize of cash outflow are based on tax burden. also interaction effect of free cash flow and debt ratio is presented influence of plus(+) on tax avoidance.

• 한국사회정책
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• v.25 no.3
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• pp.3-35
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• 2018

This article critically reviews the arguments that deny the financial feasbility and effectiveness of universal basic income as an alternative to existing social security systems and makes some suggestions to design effective and efficient basic income schemes. Regarding the financial feasibility of universal basic income, I argue that replacement of the existing regressive tax expenditures with universal basic income without raising tax rates can effectively reduce tax burden or provide income support to a majority of people except the rich. Addition of basic income to the tax base and reduction of the number of beneficiaries of public assistance and the amount of cash payment for them can further help save money. Regarding the redistributive effect, I note that the targeting ability of the existing social security systems is not good and that "the paradox of redistribution" that universal-type programs tend to be more redistributive than selective programs applies to universal basic income as well. I demonstrate significant redistributive effect of a hypothetical revenue-neutral basic income scheme and reviews several empirical studies done in Korea and abroad to show that basic income can be more effective in redistribution than social insurances or public assistance programs. Lastly, I emphasize the need to construct a reliable tax-benefit microsimulation model to help researchers to study redistributive effects of basic income schemes and other taxes and social policies.

• The Journal of the Korea Contents Association
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• v.19 no.5
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• pp.331-341
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• 2019

The purpose of this analysis is to examine the effects of health expenditure on income inequality on household income after the financial crisis by using the household income survey form 1996 to 2016. The main results are as follows. First, after the financial crisis, the gross income inequality of households has been changing steadily, though there has been a slight change in each year. Second, high-income earners spend more on health care expenditure by income level. Therefore, unequal levels are maintained. Third, the Gini coefficient of income excluding health care expenditure was calculated. The results of the analysis are larger than the Gini coefficient of total income. Income inequality is intensified by the expenditure of health care expenditure of households. The inequality of household income due to health care expenditure has been increasing steadily since the financial crisis. Efforts such as strengthening the protection of health insurance have been continuously carried out for the purpose of reducing the burden of the national medical expenses. However, it does not contribute to resolving income inequality. In the future, it will be necessary to provide a more selective medical support system to reduce the medical expenditure of the low income class.

• KDI Journal of Economic Policy
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• v.34 no.3
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• pp.31-65
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• 2012

We study the sustainability of the current fiscal policy of Korea, and the effects of the social welfare policy expansion, which has been recently discussed among the political circles, on the government budget and the generational equity, using generational accounting. We follow the generational accounting approach, considering the fact that most of the social welfare policies are the entitlement programs, which imposes the limitation of the policy maker's discretion to control the cost of their provision. The social welfare expenditure will change due to the change in the policy environments of the future, such as population aging. Therefore, we need to take into account the government cash flow of the future as well as of the present to investigate its effects on the fiscal sustainability, which implies that the national debt or the budget balance is not a proper index for the investigation. Our findings are as follows. The current fiscal policies are not sustainable, and the long-term budgetary imbalance is shown very serious. The required tax adjustment, which is defined as the percentage change of tax burden required to attain the long-term budgetary balance, is very large. Unless the level of the government expenditure is properly controlled, the tax burden and the social contribution level will rise to the untolerable level. Moreover, the expansion of the social welfare policies, which has been discussed among the political circles, will substantially increase the fiscal burden of the future generations. Even though the provision of the free lunch to the primary and the secondary school students, the free child care, and the discounted college tuition do not increase the fiscal burden much, because their magnitude at present is not large and will decrease due to the decrease in the number of the newborns and the students resulting from the fall in the fertility rate, that of the free health care service will increase tax burden of the future generations very much, because the magnitude of the government expenditure needed at present is very large and the population aging will further increase the magnitude of the health care expenditure. The findings indicate that the structural reforms, to prevent the explosive increase in the social welfare expenditure in the future, are necessary before the implementation of the welfare policy expansion. In particular, the cost control of the social transfers to the elderly needs to be made, because the speed of the population aging of Korea is among the highest in the world. The findings also indicate that the budget balance or the national debt can cause the fiscal illusion, which makes the Korean government budget look sound, even though the fiscal policy will rapidly increase the social welfare expenditure in the future, as the population ages. The generational accounting, which takes into account the cash flow of the future as well as of the present, unlike the budgetary balance and the national debt, which shows the results of the government financial activities of the past and the present, is a useful method to overcome the fiscal illusion.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• Korean Journal of Construction Engineering and Management
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• v.13 no.3
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• pp.152-159
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• 2012

Remodeling the existing building structure by recycling has great advantages compared with reconstruction in terms of environmentally contributions and reduced use of national resources. And no matter the existing floor area ratio, extension up to 30% of the exclusive using area and short project period have made remodeling a good alternative to reconstruction. However, the residents of aged housings that were being remodeled are either abandoning the remodeling project and turning to reconstruction. The main reason is remodeling project cannot increase the number of householders. In principal, it is prohibited to increase the number of floors during remodeling due to matters of safety. That is, all remodeling construction costs are borne by the residents, which leads to great financial pressure. Therefore, in order to improve these conditions, the residents' burden of remodeling charges should be reduced, and one of the ways to do so is to increase the number of householders. In this study, there will be suggestions of alternatives, including the story increase during remodeling, and compare the burden of remodeling charges on each of the residents, between proposed alternatives and the current remodeling plans by calculating the construction costs in order to prepare a foundation for a system that will promote remodeling.