Poverty in the Midst of Plenty: Unmet Needs and Distribution of Health Care Resources in South Korea

Background: The unmet needs for health care have been used as an alternative measurement to monitor equity in health services. We sought to examine contextual influences on unmet needs for health care whereas precedent studies have been focused on individual characteristics on them. Methods and Findings: The current study conducted multilevel logistic regression analysis to assess the effects of individual- and contextual-level predictors in meeting individual health care needs in South Korea. We sampled 7,200 individuals over the age of 19 in the Fourth Korea National Health and Nutrition Examination Survey in 2009. Included in the regression model were individual predictors such as demographic variables, socio-economic status, and self-rated health; the density of beds and physicians in public and private sectors within different regions were used as contextual-level predictors. This study showed the inverse association between unmet needs and regional resources in private sectors after controlling for the effects of individual-level predictors. Conclusion: Our findings suggest that increasing regional resources in private sectors might produce inefficiency in the health care system and inequity in access to health services, particularly where the competition in private health care sectors was highly stimulated under the fee-for-service reimbursement scheme. Policies for the reallocation of health care resources and for reduction of individual health care costs are needed in Korea

Effects of the Mental Health and Welfare Law revision on schizophrenia patients in Korea: an interrupted time series analysis

Background High rates of involuntary hospitalization and long lengths of stay have been problematic in Korea. To address these problems, the Mental Health and Welfare Law was revised in 2016, mainly to protect patient rights by managing involuntary admissions. The aim of this study was to evaluate the impact of the revised Mental Health and Welfare Law on deinstitutionalization by using routinely collected data from hospital admissions and continuity of mental health service use after hospital discharge as proxy measures of deinstitutionalization. Methods We used monthly-aggregated claims-based data with a principal or secondary diagnosis of schizophrenia from 2012 to 2019, collected by the National Health Insurance Service. Outcome variables included rates of first admission; discharges; re-admissions within 7, 30, and 90 days; outpatient visits after discharge within 7 and 30 days; and continuity of visits, at least once a month for 6 months after discharge. Using interrupted time series analysis, we estimated the change in levels and trends of the rates after revision, controlling for baseline level and trend. Results There was no significant change in first admission and discharge rates after the revision. Immediately after the revision, however, the rates of re-admission within 7 and 30 days dropped significantly, by 2.24% and 1.99%, respectively. The slopes of the re-admission rate decreased significantly, by 0.10% and 0.14%, respectively. The slopes of the re-admission rate within 90 days decreased (0.001%). The rates of outpatient visits within 7 and 30 days increased by 1.98% and 2.72%, respectively. The rate of continuous care showed an immediate 4.0% increase. Conclusions The revision had slight but significant effects on deinstitutionalization, especially decreasing short-term re-admission and increasing immediate outpatient service utilization.The study is funded by the Korean NeuroPsychiatric Association: 2018-001

Excitation functions of proton induced nuclear reactions on natW up to 40 MeV

Excitation functions for the production of the 181,182m,182g,183,184g,186Re and 183,184Ta radionuclides from proton bombardment on natural tungsten were measured using the stacked-foil activation technique for the proton energies up to 40 MeV. A new data set has been given for the formation of the investigated radionuclides. Results are in good agreement with the earlier reported experimental data and theoretical calculations based on the ALICE-IPPE code. The thick target integral yields were also deduced from the measured excitation functions. The deduced yield values were compared with the directly measured thick target yield (TTY), and found acceptable agreement. The investigated radionuclide 186Re has remarkable applications in the field of nuclear medicine, whereas the data of 183,184gRe and 183Ta have potential applications in thin layer activation analysis and biomedical tracer studies, respectively.Comment: 21papes, 14 figure

Measurements of neutron total cross-section of natural silver in the energy region from 0.01 to 10 eV

We measured the neutron total cross-section of natural Ag in the energy region from 0.01 eV to 10 eV by the neutron time-of-flight method with a data acquisition system based on the flash analog to digital converter. The experiment was performed at Pohang Neutron Facility, which consists of a 100 MeV electron linac, a water-cooled Ta-target with a water moderator and a Li-6-ZnS(Ag) scintillator located at 11 m long time-of-flight path. The background level has been determined by using notch filters, which consist of Co, In, Dy and Cd plates. The present averaged neutron total cross-sections in the thermal neutron energy region are compared to those from the previous measurements and the evaluated data. The differences between the present and the evaluated averaged cross-sections were less than 2%.11Nsciescopuskc

Measurement of activation cross-sections for high-energy neutron-induced reactions of Bi and Pb

The cross-sections for 209Bi(n, 4n)206Bi, 209Bi(n, 5n)205Bi, natPb(n,xn)204mPb, natPb(n,xn)203Pb, natPb(n,xn)202mPb,natPb(n,xn)201Pb, natPb(n,xn)200Pb, natPb(n,αxn)203Hg and natPb(n, pxn)202Tl reactions were determined at the Korean Institute of Radiological and Medical Sciences (KIRAMS), Korea in the neutron energy range of 15.2 to 37.2 MeV. The above cross-sections were obtained by using the activation and off-line γ-ray spectrometric technique. The quasi-monoenergetic neutron used for the above reactions are based on the 9Be(p, n) reaction. Simulations of the spectral flux from the Be target were done using the MCNPX program. The cross-sections were estimated with the TALYS 1.6 code using the default parameter. The data from the present work and literature were compared with the data from the EAF-2010 and the TENDL-2013 libraries, and calculated values of TALYS 1.6 code. It shows that appropriate level density model, the γ-ray strength function, and the spin cut-off parameter are needed to obtain a good agreement between experimental data and theoretical values from TALYS 1.6 code

Measurement of activation cross sections for quasi-monoenergetic neutron induced reactions of

The neutron induced cross sections of the 89Y(n,2n)88Y, 89Y(n,3n)87Y and 89Y(n,4n)86Y reactions were measured in the neutron energy range of 15.2 to 37.2 MeV by using an activation and off-line $\gamma$-ray spectrometric technique. The quasi-monoenergetic neutrons used for the above reactions are based on a 9Be(p,n) reaction. Simulations of the neutron spectra from the Be target were done using the MCNPX 2.6.0 program. Theoretical calculations were performed for the 89Y(n,2n)88Y, 89Y(n,3n)87Y and 89Y(n,4n)86Y reaction cross sections using nuclear model code Talys 1.8. The measured and calculated cross sections were compared with the literature data given in EXFOR and the TENDL-2015 data libraries. The present data of the 89Y(n,xn) reaction were also compared with the similar data of the 89Y($\gamma$,xn) reaction to examine the effect of the entrance channel parameters as well as the role of projectiles and ejectiles

Localized Energy-Aware Broadcast Protocol for Wireless Networks with Directional Antennas

Abstract. We consider broadcast protocols in wireless networks that have limited energy and computation resources. The well-known algorithm, DBIP (Directional Broadcast Incremental Power), which exploits "Incremental Power" philosophy for wireless networks with directional antenna to construct broadcasting tree, provides very good results in terms of energy savings. Unfortunately, its computation is centralized, as the source node needs to know the entire topology of the network. Mobility of nodes or frequent changes in the node activity status (from "active" to "passive" and vice-versa) may cause global changes in topology which must be propagated throughout the network for any centralized solution. This may results in extreme and un-acceptable communication overhead. In this paper, we propose and evaluate a localized energyefficient broadcast protocol, Localized Directional Broadcast Incremental Power Protocol (LDBIP), which employs distributed location information and computation to construct broadcast trees. In the proposed method, a source node sets up spanning tree with its local neighborhood position information and includes certain hops relay information in packet. Directional antennas are used for transmitting broadcast packet, and the transmission power is adjusted for each transmission to the minimal necessary for reaching the particular neighbor. Relay nodes will consider relay instructions received to compute their own local neighborhood spanning tree and then rebroadcasts. Experimental results verify that this new protocol shows similar performance with DBIP in static wireless networks, and better performance in mobile scenarios.