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

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*

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

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

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

BACKGROUND: A recent case-control study from Finland reported a strong relationship between high antibody titers to Chlamydia pneumoniae , strain TWAR, and both chronic heart disease and acute myocardial infarction. Other studies also suggested an association between C. pneumoniae infection and coronary atherosclerosis, based on the demonstration of increased serologic titers and the detection of bacteria within atherosclerotic tissue, but this association has not been yet regarded as an established theory. The objective of this study was to investigate the relationship between C. pneumoniae immnoglobulin G antibody titers and angiographically diagnosed coronary artery disease. METHOD: Coronary angiography was performed. Controls (n=89) were coronary angiographically normal cases and coronary artery disease (n=115) was diagnosed if coronary artery luminal diameter is obstructed more than 50% in more than one coronary artery. Micro-IF assay was used to measure C. pneumoniae TWAR antibodies. The sera were titrated in two-fold dilutions starting from 1 in 8, and a titre of 1 in 8 or more was judjed positive. RESULTS: The estimated risk of coronary artery disease, adjusted for age and gender, was greater among subjects with high (> or =1:128) antibody titers than with low (< or =1:8) antibody titers (relative risk, 7.9:95% confidence interval, 1.3-47.9). CONCLUSION: These results support an association between infection with >ENGLISH=Ptimes-i< C. pneumoniae and coronary artery disease only in high (> or =1:128) antibody titers.
Antibodies ; Bacteria ; Case-Control Studies ; Chlamydia* ; Chlamydophila pneumoniae* ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Finland ; Heart Diseases ; Myocardial Infarction ; Phenobarbital ; Pneumonia

BACKGROUND: A recent case-control study from Finland reported a strong relationship between high antibody titers to Chlamydia pneumoniae , strain TWAR, and both chronic heart disease and acute myocardial infarction. Other studies also suggested an association between C. pneumoniae infection and coronary atherosclerosis, based on the demonstration of increased serologic titers and the detection of bacteria within atherosclerotic tissue, but this association has not been yet regarded as an established theory. The objective of this study was to investigate the relationship between C. pneumoniae immnoglobulin G antibody titers and angiographically diagnosed coronary artery disease. METHOD: Coronary angiography was performed. Controls (n=89) were coronary angiographically normal cases and coronary artery disease (n=115) was diagnosed if coronary artery luminal diameter is obstructed more than 50% in more than one coronary artery. Micro-IF assay was used to measure C. pneumoniae TWAR antibodies. The sera were titrated in two-fold dilutions starting from 1 in 8, and a titre of 1 in 8 or more was judjed positive. RESULTS: The estimated risk of coronary artery disease, adjusted for age and gender, was greater among subjects with high (> or =1:128) antibody titers than with low (< or =1:8) antibody titers (relative risk, 7.9:95% confidence interval, 1.3-47.9). CONCLUSION: These results support an association between infection with >ENGLISH=Ptimes-i< C. pneumoniae and coronary artery disease only in high (> or =1:128) antibody titers.
Antibodies ; Bacteria ; Case-Control Studies ; Chlamydia* ; Chlamydophila pneumoniae* ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Finland ; Heart Diseases ; Myocardial Infarction ; Phenobarbital ; Pneumonia

PURPOSE: The aim of this study was 1) to confirm the reliability and validity of a Korean version of Washington Psychosocial Seizure Inventory (K-WPSI), 2) to investigate the psychosocial functioning of epilepsy patients from Korea, and 3) to compare with other countries. METHODS: The subjects were 302 patients with epilepsy (above 18years). They completed K-WPSI of 132 items including 11 subscales:family background, emotional adjustment, interpersonal adjustment, adjustment to seizures, medical management, overall psychological functioning, Blank, Lie and Rare. We assessed internal consistency, item-subscale correlations, and split-half reliability. Construct validity was assessed by correlating scales of Psychosocial Rating Sheet and K-WPSI. K-WPSI profiles were compared with those from the West Germany, Finland, Canada, the United States, Chile, Dutch, and Japan. RESULTS: The internal consistency estimated by cronbach's alpha coefficient was .934 and split-half reliability coefficient was .876 for adequate reliability (p<.01). Each of subscales in the K-WPSI were high correlated with theoretically similar scales but correlation between theoretically dissimilar subscales was not high. And K-WPSI subscales were significantly related to the PRS subscales. It showed that the Korea epilepsy patients had serious problems in emotional, interpersonal, vocational adjustment, financial status, adjustment to seizure, and overall psycho-social functioning. Comparing the outcomes of various countries, epilepsy patients from Korea and chile had the most serious problem in most areas of psychosocial functioning. CONCLUSIONS: K-WPSI could be a useful test in Korea for reliable determination of the various psychosocial problems of epilepsy patients but modifications of the limitation of the Lie scale may be needed. Comparing the results of other countries, Korea epilepsy patients have been experienced serious psychosocial problem. To solve this problem, social policy and medical and emotional supportive system for persons with epilepsy should need to be established.
Canada ; Chile ; Cross-Cultural Comparison* ; Epilepsy ; Finland ; Germany ; Humans ; Japan ; Korea ; Reproducibility of Results* ; Seizures* ; Social Problems ; United States ; Washington* ; Weights and Measures