• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.128-144
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• 2023

Objectives: The health system reform process is highly political and controversial, and in most cases, it fails to realize its intended goals. This study was conducted to synthesize factors underlying the failure of health system reforms. Methods: In this systematic review and meta-synthesis, we searched 9 international and regional databases to identify qualitative and mixed-methods studies published up to December 2019. Using thematic synthesis, we analyzed the data. We utilized the Standards for Reporting Qualitative Research checklist for quality assessment. Results: After application of the inclusion and exclusion criteria, 40 of 1837 articles were included in the content analysis. The identified factors were organized into 7 main themes and 32 sub-themes. The main themes included: (1) reforms initiators' attitudes and knowledge; (2) weakness of political support; (3) lack of interest group support; (4) insufficient comprehensiveness of the reform; (5) problems related to the implementation of the reform; (6) harmful consequences of reform implementation; and (7) the political, economic, cultural, and social conditions of the society in which the reform takes place. Conclusions: Health system reform is a deep and extensive process, and shortcomings and weaknesses in each step have overcome health reform attempts in many countries. Awareness of these failure factors and appropriate responses to these issues can help policymakers properly plan and implement future reform programs and achieve the ultimate goals of reform: to improve the quantity and quality of health services and the health of society.

• Tuberculosis and Respiratory Diseases
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• v.86 no.3
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• pp.216-225
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• 2023

Background: Tuberculosis (TB)-related stigma has been well-documented. Since the emergence of the coronavirus disease 2019 (COVID-19), different organizations have been alerted to the fact that stigma could arise again. Due to stigma's negative effects, this qualitative study aimed to explore the stigma felt by patients by evaluating the following: COVID-19 stigma and its temporal progression through the pandemic; stigma perceived by different patients with TB before and during COVID-19 pandemic; and difference perceived by individuals who contracted both diseases. Methods: A semi-structured interview was developed according to the available literature on the theme. It was performed individually in 2022 upon receiving signed informed consent. Participants were recruited with a purposive sampling approach by searching medical records. Those who currently or previously had pulmonary TB and/or COVID-19 were included. Data were subjected to thematic analysis. Results: Nine patients were interviewed, including six (66.7%) females. The median age of patients was 51±14.7 years. Four participants (44.4%) had completed high school and four (44.4%) were never smokers. Three had both TB and COVID-19. Four only had TB and two only had COVID-19. Interviews identified eight main themes: knowledge and beliefs, with several misconceptions identified; attitudes towards the disease, varying from social support to exclusion; knowledge and education, assumed as of extreme importance; internalized stigma, with self-rejection; experienced stigma, with discrimination episodes; anticipated stigma, modifying actions for avoiding stigma; perceived stigma, with judgment by others prevailed; and temporal evolution of stigma. Conclusion: Individuals expressed strong stigma for both diseases. De-stigmatization of respiratory infectious diseases is crucial for limiting stigma's negative impact.

• 한국노년학
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• v.30 no.4
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• pp.1045-1058
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• 2010

Based on Rawl's Justice Theory, the author examines the rationales for educating older adults and advocates for their needs for just distributions of educational resources and opportunities. The author also seeks policy implications for establishing just educational systems for older citizens. On the basis of Rawl's Justice Theory, the essential principles for realizing social justice are presented. The author points out the Veil of Ignorance and Rational Indifference. As the practical methods for achieving social justice, the author presents Exclusion of Coincidence, Difference Principle, Democratic Equality, and Common Asset. Implications for establishing just education systems for older adults include: 1) The least advantaged groups such as older adults, females, and the disabled should not be discriminated in the distribution of educational resources; 2) People with higher capacities are obliged to serve less capable people; and 3) Older adults should mobilize all resources to empower themselves and to develop their potentials. The author concludes that Rawl's Justice Theory can be tapped into as a useful ideological framework in order to expand educational resources and opportunities for older adults.

• Journal of Preventive Medicine and Public Health
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• v.57 no.4
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• pp.307-318
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• 2024

Objectives: Effective data collection and surveillance of epidemiological trends are essential in confronting the growing challenges associated with substance use (SU), especially in light of emerging trends and underreporting of cases. However, research and data are scarce regarding SU and substance use disorder (SUD) in Korea. Methods: We conducted a scoping review to identify data sources and surveillance methods used in SU research in Korea up to December 2023. This review was complemented by semi-structured consultations with experts in this area in Korea, whose feedback led to revisions of previously identified data sources and assessments. Results: Our review identified 32 publications conducting secondary analyses on existing data to examine the epidemiology of SU and SUD in Korea. Of these, 14 studies utilized clinical databases to explore the prescription patterns of addictive substances, particularly opioids. Eleven data sources showed promise for advancing SU research; however, they face substantial limitations, including a lack of available data, missing data, the absence of key variables, the exclusion of marginalized populations not captured within the clinical system, and complexities in matching individual-level data across time points and datasets. Conclusions: Current surveillance methods for SU in Korea face considerable challenges in accessibility, usability, and standardization. Moreover, existing data repositories may fail to capture information on populations not served by clinical or judicial systems. To systematically improve surveillance approaches, it is necessary to develop a robust and nationally representative survey, refine the use of existing clinical data, and ensure the availability of data on treatment facilities.

• 한국사회정책
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• v.25 no.4
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• pp.3-38
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• 2018

This study aims to analyse the redistributive impact of the welfare state growth in Korea after 2000s and establish whether there are people excluded from the benefits of the growth. The growth of the Korean welfare state has been achieved by universalizing welfare benefits under the social insurance-centered institutions which are the legacies of the productivist/developmental welfare regime. When it comes to redistribution impacts, the welfare state growth improved inequality among old age populations to a certain degree due to the introduction of the Basic Pension. On the other hand, welfare benefits for the working poor population has hardly been improved in spite of the growing welfare state. It can be said, therefore, that low-income working-age populations have been excluded from the growth of Korean welfare state. These groups are mostly in middle-old age, unemployed or precariously employed and half of them were female householders. The exclusion of these groups from the Korean welfare state shows that the growth of the Korean welfare state was unbalanced. To include the excluded into the Korean welfare state, it is necessary to increase non-insurance social provisions, extend the range of application of the social insurances, integrate income protection, employment service, and vocational training for the working poor, and combine universal and targeted welfare benefits.

• 한국사회정책
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• v.25 no.3
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• pp.37-71
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• 2018

Since 2016, public and political interest on basic income has been increased beyond academic interest. The recent debate on basic income has expanded on issues regarding to the concrete implementation of basic income moving further than the debate on conception of the basic income in the abstract level. This study examines major critiques of basic income which was raised from social policy area and makes a counter-argument on these critiques. Major points summarized as follows. First, the problem of jobs and social insurance exclusion is not serious enough to call for basic income. Second, existing social security systems will be crowded out by excessive financial burden if basic income is introduced. Third, policies to cultivate citizens' capacities to cope with a technological change should be given priority over basic income. This study disputes these critiques by counter arguing four points. First, it is necessary to reconstruct welfare state based on basic income, given the labor market changes, such as long-term trend of employment change, newly emerging employment of platform companies, and inconsistency of platform labor and social insurance. Second, hypothesis of crowding-out effect on social security system is just a criticism that can be applied to the basic income initiative of the right-wing. Also, it is unable to find a logical basis or evidence of this hypothesis from the historical process of welfare state development or previous studies. Third, it is necessary to discuss how to reconfigure existing social security system and basic income which are complementary to each other and also have consistency with labor market as a configuration, not as a matter of choosing between basic income and social security system. Fourth, de-laborization does not mean a refusal to labor but a free choice, and the basic principle of social security is not needs but right. In conclusion, in order to develop more productive debate on basic income, it requires more sophisticated discussion and criticism from the point of view of the distributive justice; the debate on the sustainability of social insurance-centered welfare states; and debates on the political realization of basic income.

• Korean Journal of Childcare and Education
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• v.9 no.5
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• pp.407-436
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• 2013

This study, based on understanding the play features of the participants, explores early children's peer-relation strategies of maintaining and altering play frame and understanding the meaning of the strategies. Free play of 5-year-old children's was observed. The child-care center was visited 1 or 2 days a week, from March to October, 2012. The data collected were based from field notes, interviews with participants, their workbooks and more. The participants used strategies such as 'refusing', 'incapacitating', 'interpreting in a way to sympathize', and 'changing the rules of play' to maintain the play, whilst 'tell-on', 'being on the same side', 'accepting 3rd party' features were used to alter play frame. Participants using these various play-frame strategies experienced life implications of 'dialectic of exclusion and selection' and 'quiver of boundary'. This study, specifying efforts of the children to maintain and alter the play frame, will provide an understanding of perception of "social exclusion" to children, which has been viewed negatively in the past. It will also benefit on-site teachers in helping them understand peer-relationship within children and provide a more in-depth intervention for peer-relationship issues.

• Korean Journal of Social Welfare
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• v.53
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• pp.285-310
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• 2003

As National Pension Scheme for all nation complete in 1999 through expanding application in cities, the public pension including Public Occupational Pension became main axis of old-age income maintenance. After 4years since then, now, it is only half of total National Pension insured persons who have been qualified to receive pension through participate and contribution. The other half of National Pension insured is left the excluded from public pension. This paper is intended to identify scale and characteristics of the excluded from public pension and to analysis its cause, and to explore policy measures for solving the excluded's problem. for current recipients over 60 years old generation, the its excluded's scale is no less than 86% of the old over 60 years. The probability of getting in the excluded is high in case of old elderly and female for current elderly generation. For future recipients 18-59 years working generation, the its excluded's scale is no less than 61% of the 18-59 years total population. The probability of getting in the excluded is high in case of 18-29 years and female for current working generation. As logistic regression analysis determinant factor of paying or not pension contribution for future recipients, it appear that probability of getting in the excluded for current working generation is high in case of younger old, lower education attainment, irregular employee, working at agriculture forestry fishery sector, construction sector, wholesale retail trade restaurants hotels sector, financial institution and insurance real estate renting and leasing sector in comparison with manufacturing sector, occpaying at elementary occupation, professionals technicians and associate professionals, sale and service workers, plant machine operators and assemblers, legislators senior officials and managers in comparison with clerks. The Policy measures for the current recipient old generation have need to reinforce supplemental role of Senior's pension(non-contribution pension) until maturing of public pension, because of no having chance of public pension participants for them. And the Policy measures for the future recipient working generation have need to restructure social security fundamentally corresponding with social-economic change as labour market and family structure etc. The pension system has need to change from one earner one pension to one citizen one pension with citizenship rights. At this point, public pension have need to manage with combining insurance's contribution principle and citizenship principle financing by taxes. Then public pension will become substantially universal social network for old-age income maintenance and we can find real solution for the excluded from.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.34 no.4
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• pp.1307-1315
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• 2014

This study aims to analysis of determinants of the residents satisfaction of purchased rental housing and currently being implemented policy of supporting low-income families are empirically evaluated through the residential evaluation of purchased rental housing residents. Purchased rental housing users are possible to live in currently residing community consistently, have advantages for fewer problems of the phenomenon of social isolation, exclusion and preventing slumism of low-income families, are expected to increase in the future. First of all, the characteristics of residential environment, housing expenses and a head of household were examined for the residential environment evaluation of the residents of purchased rental housing, on the basis of this, the characteristics of internal and external house and residential location are examined each for the determinants of the residential environment satisfaction of purchased rental housing. The variables that affect residential satisfaction according to residential location are public facilities, educational facilities and welfare facilities respectively. In particular, the higher the satisfaction of access to welfare facilities, the higher the satisfaction of residential location of purchased rental housing was analyzed. The variables affecting the residential satisfaction according to the internal and external characteristics of house are significant in window status, cracking, heating facilities, housing scale and management.

• Korean Journal of Social Welfare
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• v.68 no.4
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• pp.143-167
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• 2016

While there have been numerous studies on various issues of aging of the individuals and the population, little is known about the process and consequences of aging of the disabled. Aging is irreversible for the disabled as well as for the not-disabled. With the advances of age, the disabled confront double jeopardy from disability and old age. This study aims to explore the meaning of aging and death for 40s and 50s living with disability for more than 20 years. It utilizes the data set collected through focus groups discussions of the disabled The cases in our analysis are composed of the disabled capable of articulating their feelings and thoughts. Thus, they are selected from the less privileged ones. The analysis shows that aging of the disabled, often involving secondary disability, overwhelms their current disability. Nonetheless, it does not necessary mean that they become an ordinary elderly person. Rather they still feel exclusion from the elderly for their disability. As getting older they turn to face social barrier for both disability and old age. Also, they are trying to live their present lives in full while accepting the presence of death Our findings are hoped to help to understand how the disabled get old and view their death in their own way.