Psychological autopsy is a systematic methodology for comprehensive investigation of psychiatric and behavioral factors assumed to be causative or related to death of the deceased. In many countries, psychological autopsy is considered the most direct and valuable tool for determining the relationship between risk factors and suicide. The case of Finland revealed that successful psychological autopsy studies could greatly contribute to the national suicide prevention strategy, which consequently reduced the national suicide rate. Despite the strengths of psychological autopsy for identifying risk factors of suicide and consequently preventing suicide, it has not been successful in Korea. Implementation of psychological autopsy has been inconsistent and sporadic across the provinces. In addition, standardization of psychological autopsy protocol and qualification of interviewers are needed. With all of these methodological issues in mind, conduct of as many psychological autopsies as possible is important in order to build an evidence-based suicide prevention strategy. For successful implementation of psychological autopsy in Korea, it is necessary to improve attitudes toward suicide and psychiatric conditions. Legal, administrative, and institutional support are also important. Finally, multidisciplinary approach based on the financial and legal support should be employed.
Autopsy* ; Finland ; Korea ; Mental Health ; Risk Factors ; Suicide

The number of Korean people who are currently suffering from depressive disorders that require medical treatment is assumed to be more than 2 million. However, only around 15% of those with depressive disorder are actively receiving medical treatment, and this leads to an increasing suicide rate. Hence, the National Evidence-based Healthcare Collaborating Agency held a round-table conference to provide information on depression and suicide and suggested a reasonable policy through comprehensive discussion with experts. The prevalence of depression, which is closely related to suicide rates, is lower in Korea than in the U.S., but the rate of suicide is the highest among Organisation for Economic Co-operation and Development countries. It is thought that the underestimated prevalence of depression is owing to the inconsistency between the diagnostic criteria of depression and characteristics of depression in Korea. Therefore, it is necessary to develop Korean diagnostic criteria for depression reflecting cultural characteristics and conduct a regular and organized nationwide survey. Moreover, a term related to suicide officially used by Statistics Korea is 'intentional self-injury'. However, in a Korea-based community study, it was found that 60% to 72% of those attempting suicide had mental disorders; thus suicide is not merely an intentional self-injury but a medical condition that should be treated. To reduce suicide, both medical and social approaches are necessary. Furthermore, a strengthening of the public perception that a medical approach is important for suicide prevention is greatly needed. Moreover, it is necessary to prepare an effective national suicide prevention strategy through studies evaluating the suicide prevention policies currently implemented and psychological autopsy of suicide deaths similar to those practiced in Finland.
Autopsy ; Cultural Characteristics ; Delivery of Health Care ; Depression ; Depressive Disorder ; Finland ; Korea ; Prevalence ; Stress, Psychological ; Suicide

Finland ; Health Policy ; Humans ; Occupational Health Services ; organization & administration ; Safety Management

PURPOSE: Rebound tonometer has been used to measure the intraocular pressure (IOP) in the supine as well as normal upright positions. We investigated the reliability of IOP measurements using the rebound tonometer in the upright and supine positions. METHODS: IOP was measured in 30 patients (60 eyes) with open-angle glaucoma who had no history of ocular surgery and no anterior segment pathology, in both the upright and supine positions using rebound tonometer (IcarePRO; Icare Finland Oy, Finland). The average IOP value after 6 measurements was recorded. We measured IOP repeatedly until 3 reliable values within normal limits of the measurement's variation were obtained. We calculated the intraclass correlation coefficient (ICC), coefficient of variation, and number of repeated measurements necessary to obtain 3 reliable IOP values in each position as measured by one examiner. RESULTS: ICC values for IOP measurements were 0.852 (95% confidence interval [CI], 0.784-0.903; p < 0.001) in the upright position and 0.684 (95% CI, 0.563-0.784; p < 0.027) in the supine position. Coefficient of variation was 8.7 +/- 0.1% in the upright position and 24.0 +/- 0.1% in the supine position. An average of 3.3 times of repeated measurements in the upright position and 6.2 times in the supine position were necessary to obtain 3 reliable IOP values within the normal range of standard deviation. CONCLUSIONS: When measuring IOP using the IcarePRO rebound tonometer, the measurement reliability was different between the upright and supine positions. Reproducibility of IOP measurements was lower in the upright than the supine position.
Finland ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Iron-Dextran Complex ; Pathology ; Reference Values ; Supine Position*

OBJECTIVE: To explore the genetic basis for a fetus suspected for congenital nephrotic syndrome of Finland (CNF). METHODS: Genomic DNA was extracted from peripheral and umbilical cord blood samples derived from both parents and the fetus. Potential variants were detected by using next-generation sequencing. Suspected variants were confirmed by Sanger sequencing. RESULTS: The fetus was found to carry compound heterozygous variants c.1440+1G>A and c.925G>T of the NPHS1 gene, which were respectively inherited from its mother and father. CONCLUSION Identification of the compound heterozygous NPHS1 variants has enabled diagnosis of CNF in the fetus and genetic counseling for the affected family.
Female ; Fetus ; Finland ; Heterozygote ; Humans ; Membrane Proteins ; genetics ; Nephrotic Syndrome ; congenital ; diagnosis ; Pregnancy ; Prenatal Diagnosis

This research was carried out to determine the relationship between worker's health status and work ability index in small scale factories. The data were gathered from 330 workers of Gumi industrial complex, from February to March, 1996. In this study, as questionnaire for the assessment of work ability, We used the work ability index which was developed by Institute of Occupational Health in Finland. The results of the study were summarized as follows; 1) Work ability index was poor in shift work group, more than 9 hours work group, irregular diet group, and stress sensitive group (p<0.01). There were no evident trends of work ability index in sex, marital status, educational level, obesity index, exercise, alcohol drinking and smoking. 2) As comparing work ability index with worker's health status, work ability index was poor in visual correction needed group, urine sugar positive group, and abnormal ALT & AST group (p<0.01) There were no evident trends of work ability index in hearing capacity, blood pressure, hematocrit and urine protein. 3) In the ANOVA was performed to examine the relationship between work ability index and significant factors above 1) and 2). shift work, work hours, diet, stress sensitive and health status were still statistically significant (p<0.05) on work ability index.
Alcohol Drinking ; Blood Pressure ; Diet ; Finland ; Gyeongsangbuk-do ; Hearing ; Hematocrit ; Marital Status ; Obesity ; Occupational Health ; Questionnaires ; Smoke ; Smoking

This study was carried out to assess work ability of manufacturing workers and managerial workers. Subjects were 446 manufacturing workers and 278 managerial workers employed in Gumi industrial complex and the observation period was for 1 month(February to March), 1995. In this study, as a questionnaire for the assessment of work ability, we used the work Ability Index(WAI) which was developed by Institute of Occupational Health in Finland. Major findings obtained from this study were as follows; WAI was poor in lower economic condition, shift work, irregular diet group(p < 0.05). There were no evident trends of WAI in sex, educational level, obesity index, exercise, smoking, and alcohol drinking. In the groups of sensitive to perception of stress, other industrial classification except textile and electronics, the more than 9 hours work, the evident trends of poor WAl were observed(p<0.01). In the groups of 30-39 years old, 40-49 years old, unmarried, high school, shift work, standard body weight, and regular diet, WAl between manufacturing workers and managerial workers was significantly different(p<0.01) and WAI of managerial worker was worse than that of manufacturing worker.
Alcohol Drinking ; Body Weight ; Classification ; Diet ; Finland ; Gyeongsangbuk-do ; Humans ; Obesity ; Occupational Health ; Pilot Projects* ; Surveys and Questionnaires ; Single Person ; Smoke ; Smoking ; Textiles

OBJECTIVES: Season of birth, an exogenous indicator of early life environment, has been related to higher risk of adverse psychiatric outcomes but the findings for Alzheimer's disease (AD) have been inconsistent. We investigated whether the month or season of birth are associated with AD. METHODS: A nationwide nested case-control study including all community-dwellers with clinically verified AD diagnosed in 2005 to 2012 (n=70 719) and up to four age- sex- and region of residence-matched controls (n=282 862) residing in Finland. Associations between month and season of birth and AD were studied with conditional logistic regression. RESULTS: Month of birth was not associated with AD (p=0.09). No strong associations were observed with season (p=0.13), although in comparison to winter births (December-February) summer births (June-August) were associated with higher odds of AD (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.05). However, the absolute difference in prevalence in winter births was only 0.5% (prevalence of those born in winter were 31.7% and 32.2% for cases and controls, respectively). CONCLUSIONS: Although our findings do not support the hypothesis that season of birth is related to AD/dementia risk, they do not invalidate the developmental origins of health and disease hypothesis in late-life cognition. It is possible that season does not adequately capture the early life circumstances, or that other (postnatal) risk factors such as lifestyle or socioeconomic factors overrule the impact of prenatal and perinatal factors.
Adult ; Aged ; Aged, 80 and over ; Alzheimer Disease/*diagnosis/epidemiology ; Case-Control Studies ; Finland ; Humans ; Logistic Models ; Middle Aged ; Odds Ratio ; Risk Factors ; Seasons

INTRODUCTION: Consumerism is prevailing value in Korean society, while there has been little concern about it especially in Korean nursing society even though there has been an increasing emphasis on patients' participation in decisions concerning health care and nursing as an ideal in the literature. OBJECTIVES AND METHODS: The study with survey method was carried out to examine the nature of collaboration between patient and nurse in nursing practice in Korea through a replication of the studies carried out in US, Norway, Finland, an Japan (Kim et al., 1993) and to revise and test Kim's explanatory model of collaborative decision making in nursing practice from the Korean perspectives. RESULTS & CONCLUSIONS: Both patients and nurses as groups exhibited pro-consumerist attitudes regarding collaboration in health care, while there were significant differences in attitudes and perceptions of patients and nurses. These findings are similar to those of Kim et al.' s study carried out in US, Norway, Finland, and Japan. Nurses as a group compared to patients held stronger health-care consumerist attitudes and beliefs in general. However, the Korean nurses seem to hold a weaker attitude for challenging professional authority. And the Korean patients compared to the nurses seem to hold stronger belief in the patient's right to information, as found in US, Finland, and Japan. Regarding the nurse patient collaborative attitude in decision making, it revealed that one third or more of the patients as a group believe in the patients' right to be informed of decisions that nurses make for their patients, while another one third or more of them believe in the patients' right for advisory role and joint role in nursing care decision making. This result for the patients is very similar as those found in US, Norway, Finland, and Japan. However, the attitude for the nurses held stronger agreement with patients' to be informed of decision making that nurses make than the patients' right for advisory and joint role. The nurses have weaker belief in patients' self determination on their care than the patients. The results of path analyses confirmed the explanatory models that tested two explanatory models examining the factors contributing to the differences in the attitudes of patients and nurses. The path model for nurses identified nurses' lengths of experience as the important factor explaining attitudes regarding challenging professional authority and the patient's rights for information. The path model for patients identified the level of education as the most significant factor that explains patients' attitudes regarding the rejection of general authority, challenging professional authority, and the patient's right for participation in decision making.
Cooperative Behavior* ; Surveys and Questionnaires ; Decision Making ; Delivery of Health Care ; Education ; Finland ; Humans ; Japan ; Joints ; Korea ; Norway ; Nursing Care ; Nursing* ; Patient Rights ; Personal Autonomy ; Societies, Nursing

BACKGROUND: In the mid-1970s and late 1980s, outbreaks of erythromycin-resistant streptococci in Japan and Finland were likely to be associated with the increased consumption of macrolides. Because of the lack of routine antibiotic sensitivity for Streptococcus pyogenes, the reported percentage of resistant strains was only 2% in 1994 in Korea. We tried to determine the rate of resistant strains considering the high occurrence of penicillin-resistant pneumococci and antibiotic purchase without prescription in our country. METHODS: Twenty-four strains of S. pyogenes were isolated from children with pharyngotonsillitis in Kyunghee University Hospital, Seoul, Korea from Feb. through Aug. 1998. Forty-four strains obtained from healthy school children living in Uljin, Kyongsang-bukdo and Hongreung, Seoul in 1998. All isolates were serotyped by T-agglutination (Sevapharma, Czech Rep) and minimal inhibitory concentrations were determined for penicillin, erythromycin, vancomycin, tetracycline, cefotaxime, and clindamycin by agar dilution method according to National Committee for Clinical Laboratory Standards. RESULTS: The carrier rates in Hongreung and Uljin were 4.1% and 13.3%, respectively. Twenty-two out of 24 (91.6%) strains from pharyngitis and 32 out of 44 (72.7%) strains from normal children were typed by T agglutination test. The most common T types were T12 (54.2%) and T4 (33.3%) in pharyngitis, whereas the most common T types were T12 (45.5%), non typable (27.3%), and T4 (15.9%) in healthy carriers. All of the strains from pharyngitis were susceptible to penicillin, vancomycin, and cefotaxime. However, 13 out of 24 (54.2%) strains were resistant to erythromycin, and 11 isolates (45.8%) were resistant to clindamycin and tetracycline. Ten out of 13 isolates of T12 and one isolate of T28 were multi-resistant to erythromycin, clindamycin, and tetracycline. Two isolates of T4 were resistant to erythromycin. CONCLUSION: Almost half of isolates obtained from a university hospital in Seoul are multidrug-resistant Streptococcus pyogenes. Serial monitoring of antibiotic susceptibility test and a nationwide survey accompanied by molecular epidemiologic studies are needed to determine the occurrence and spread of resistant strains from different geographic areas.
Agar ; Agglutination Tests ; Cefotaxime ; Child* ; Clindamycin ; Disease Outbreaks ; Erythromycin ; Finland ; Humans ; Japan ; Korea ; Macrolides ; Penicillins ; Pharyngitis ; Prescriptions ; Seoul ; Serotyping* ; Streptococcus pyogenes* ; Streptococcus* ; Tetracycline ; Vancomycin