• The Korean Journal of Health Service Management
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• v.7 no.3
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• pp.287-296
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• 2013

The aim of this study was to compare the regional difference of death from intentional self-harm. The analysis was based on data of intentional self-harm deaths (31,450) from the 2010-2011 vital statistics of Korea. The suicide rate (per 100,000 population) was 46.2 in male and 22.3 in female. Gender ratio (male / female) of suicide rate was 2.07, and Jeju province had the lowest gender ratio (1.82), and Chungbuk province had the highest gender ratio (2.42). In the age-gender standardized death rate (per 100,000) of self-harm by region, the highest suicide rate was observed in Gangwon province (44.8) and Chungnam province (44.3), and the lowest in Seoul metropolitan city (28.9) and Ulsan metropolitan city (29.2). There was a significant increase in the rate of suicide in city areas (odds ratio: 1.11, 95% CI: 1.08-1.13), county areas (1.62, 1.56-1.67) as compared with the rate of suicide in metropolitan areas. The commonest methods of suicide were hanging (53.7 percent), self-poisoning by pesticides (16.8 percent) and jumping from a height (14.3 percent). The methods used for suicide differed between rural (county) and urban areas (metropolitan city and city). In county areas, 43 percent of suicides used pesticides as compared to only 7-18 percent of those in urban areas. In urban areas, jumping was more common (13-17 percent vs. 6 percent). There were no difference in hanging between urban and rural areas. The odds ratio of death by pesticides was 9.86 in rural areas compared with death rate of metropolitan areas. The odds ratio of death by jumping was 0.59 in rural compared with death rate of metropolitan areas.

• The Journal of the Korea Contents Association
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• v.22 no.5
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• pp.518-526
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• 2022

The extension of life expectancy due to modernization means an extension of the benefit time for elderly care and disease. However, compared to the increase in the elderly, the attitude of children toward parental responsibility is gradually weakening. These social phenomena bring alienation, hopelessness, and stress to life in old age, and the resulting sense of helplessness leads to suicidal thoughts or intentional death (suicide), becoming a social problem. The intentional death (suicide) of the elderly is a social phenomenon that often occurs around them, and the reality can be seen through the movie. In this study, the main character 'Soyoung' in the movie 'The Woman Who Kills' and the surrounding characters 'Song Old Man', 'Jongsu', and 'Jaewoo' in conversations with the elderly problem and death factors were analyzed in the Matrix. ), and then applied to the 'flow chart of problems in the elderly due to modernization' compiled by Byeong-Woo Lim (2019), to explore the factors of intentional death (suicide). As a result of the analysis, the four elderly were exposed to problems of the elderly such as disease, alienation and loneliness, poverty, and loss. (Suicide) was analyzed.

• Health Policy and Management
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• v.28 no.1
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• pp.87-90
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• 2018

Suicide has been a public health issue in many countries, and Korea has ranked highest suicide rate among Organization for Economic Cooperation and Development (OECD) countries over a decade. To address these issues, we updated the recent trends in suicidal ideation and suicide attempts among Korean adults followed by previous data observation. We used data from five sources: Korean National Health and Nutrition Examination (KNHANES, '07-12, '13, '15-16), Korean Community Health Survey (KCHS, '08-09, '13), Korean Wealth Panel Study (KOWEPS, '12-16), Korea Health Panel Survey (KHP, '10-13), and cause of death data from Statistics Korea ('07-16). We used weighted frequencies and trend tests. The rate of suicidal ideation as recent year was 5.10% (KNHANES, '15), 8.95% (KCHS, '13), 2.08% (KOWEPS, '16), and 5.39% (KHP, '13). That of suicide attempts as recent year was 0.59% (KNHANES, '16), 0.41% (KCHS, '13), and 0.08% (KOWEPS, '16). Annual percentage change of suicidal ideation was -2.80% (KNHANES, '07-12), 5.78% (KNHANES, '13-15), 0.62% (KCHS, '08-13), -8.50% (KOWEPS, '12-16), and -10.94% (KHP, '10-13). Annual percentage change of suicide attempts was -3.84% (KNHANES, '07-12), 2.26% (KNHANES, '13-16), -2.53% (KCHS, '08-13), and -20.22% (KOWEPS, '12-16). Annual percentage change of death by intentional self-harm was -0.49% (Statistics Korea, '07-16). Individuals who had lower income level were more likely to experience suicidal ideation and suicide attempts. According to these results, the rate of suicidal ideation and suicide attempts showed the decreasing tendency. However, the suicide rate of Korea has remained higher than that of OECD countries. Thus, continuous data observation and effective policies on suicide are needed.

• 한국노년학
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• v.39 no.4
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• pp.883-893
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• 2019

The purpose of this study is to analyze the characteristics of the elderly patients with depression who were admitted to the hospital with intentional self-harm. 3,280 patients were selected from KCDC database(2011-2015) using STATA 12.0. Analysis results show that gender(female), residence(micropolitan city), result of suicide(death), risk factors(financial problems, psychological problems, physical disease, conflicts with family, place(non-residence) method of suicide(poisoning) were statistically significant. The hospital should detect the elderly patient with depression when they admitted.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.131-139
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• 2017

Purpose: The purpose of this study was to investigate the epidemiologic characteristics of patients who visited emergency departments (EDs) after intentional poisoning in Korea. Methods: This study retrospectively analyzed the data of of 23 hospitals during a five-year period, between 2011 and 2015. We included patients who inflicted injury to themselves - attempt of suicide - by means of poisoning. Results: A total of 18,121 patients visited an ED after intentional poisoning. Among them, 58.3% were females; however, there were more males among those aged 60 years or older. The mortality rate for males was 8.6%, which was 3.1 times higher than that for females with 2.8%. The most common poison was pesticides (35.4%) in males and sedative-hypnotics (44.0%) in females. The most common causative agent of death was pesticide in both sexes (75.2% and 65.3%, respectively). Since the production of paraquat was discontinued in 2011, the number of deaths from pesticide poisoning has decreased. The mortality rate declined in both males and females, from 12.6% and 4.5% in 2011 to 7.1% and 2.1% in 2015, respectively. Conclusion: In this study, we analyzed the epidemiologic characteristics of intentional poisoning, especially the frequency of suicide attempts by gender and age group, the cause of suicide, and the causative agent. This can be used as basic data for establishing policies to reduce and prevent suicide attempts by poisoning.

• Health Policy and Management
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• v.31 no.2
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• pp.232-239
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• 2021

This study aimed to update suicide-related indicators including suicidal ideation, suicide attempts, and the number of suicidal deaths. Based on up-to-date information, we observed the trends of suicide-related indicators. In this study, five data sources were used to observe the trends of suicide-related indicators: Statistics Korea (1983-2019), Korean National Health and Nutrition Examination (KNHANES, '07-13, '15-19), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-19), and Korea Health Panel Survey (KHP, '10-13, '16-17). The suicide rate, which peaked in 2011, declined until 2017 and then started to rise again from 2018, recording a suicide rate of 26.9 per 100,000 people in 2019. The rate of suicidal ideation estimated based on the recently available data was 4.62% (KNHANES, '19), 3.51% (KHP, '16), 2.87% (KHP, '17), and 1.70% (KOWEPS, '19). That of suicide attempt as recent year was 0.43% (KNHANES, '19), 0.07% (KOWEPS, '19). Annual percentage change of death by intentional self-harm was -2.11% (Statistics Korea), and that of suicidal ideation was -14.7% (KNHANES), -2.5% (KCHS), -10.6% (KOWEPS), and -11.3% (KHP). Annual percentage change of suicide attempt was -5.0% (KNHANES), -4.4% (KCHS), and -11.3% (KOWEPS). The lower the income level, the higher the probability of experiencing suicide ideation and suicide attempts. Considering the recent increase in suicide rate in contrast to the continuing decline in suicidal ideation and suicide attempts, continuous data observation and appropriate policies regarding suicide prevention are needed.

• Health Policy and Management
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• v.30 no.1
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• pp.112-119
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• 2020

Suicide has been a long-standing problem for global public health, along with almost 800,000 deaths from suicide worldwide in 2016, accounting for 1.4% of all deaths. South Korea was ranked first in suicide mortality in 2018 among countries in the Organization for Economic Cooperation and Development. This study aimed to suggest up-to-date information about suicide-related indicators such as the rate of suicidal ideation, suicide attempt, and suicide death, and its trends by applying sampling weight to make it nationally representative. In this study, we used the data sources: Korea National Health and Nutrition Examination (KNHANES, '07-13, '15-18), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-18), Korea Health Panel Survey (KHP, '10-13), and Statistics Korea (1983-2017). The rate of suicidal ideation as recent year was 4.73% (KNHANES, '17), 6.96% (KCHS, '17), 2.29% (KOWEPS, '18), and 5.39% (KHP, '13). That of suicide attempt as recent year was 0.51% (KNHANES, '18), 0.32% (KCHS, '17), and 0.15% (KOWEPS, '18). Annual percentage change (APC) of suicidal ideation was -15.4% (KNHANES, '07-13, '15, '17), -2.5% (KCHS, '08-09, '13, '17), -10.8% (KOWEPS, '12-18), and -10.9% (KHP, '10-13). APC of suicide attempt was -4.4% (KNHANES, '07-13, '15-18), -4.4% (KCHS, '08-09, '13, '17), and -13.6% (KOWEPS, '12-18). APC of death by intentional self-harm was -1.25% (Statistics Korea, '07-18). All suicide-related indicators were found to be decreasing in the overall from 2009. Individuals with lower income level were more likely to experience suicidal ideation and suicide attempts. Even though suicide rate had been continuously decreasing from its highest point in 2011 (suicide rate: 31.7 per 100,000 population) to 2017 (suicide rate: 24.3 per 100,000 population), it increased again in 2018 (suicide rate: 26.6 per 100,000 population). This information would be grounded on policy implementation for suicide prevention, thus continuous data observation is necessary.

• Journal of Preventive Medicine and Public Health
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• v.51 no.3
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• pp.163-168
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• 2018

Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.1
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• pp.47-53
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• 2016

Purpose: Intentional poisoning is a major public health issue in many parts of the world. This study was conducted to provide details regarding the epidemiology of intentional poisoning in a metropolitan emergency department and to identify the changing patterns and epidemiology of poisoning. Methods: A retrospective study was conducted to evaluate intentional poisoning of patients who visited the emergency department in a tertiary teaching hospital between 2001 and 2015. All intentional poisoning-related emergency department visits over three five year periods (2001-2005 (P1), 2006-2010 (P2) and 2011-2015 (P3)) were reviewed to investigate trends in intentional poisoning patients. Information regarding patient sex, age, time from episode to admission, psychiatric history, type of intoxicants, alcohol co-ingestion, gastric lavage, charcoal administration, any previous suicide attempts, need for hospitalization and death before discharge was reviewed. Results: A total of 1269 patients were enrolled in this study. The number of patients admitted during each period was P1=515, P2=439 and P3=315. Comparison of the three groups revealed significant differences according to age (p<0.001), psychiatric history (p<0.001), alcohol co-ingestion (p=0.013), gastric lavage (p<0.001), charcoal administration (p<0.001), need for hospitalization (p=0.044), repeated attempt (p<0.001) and type of intoxicants (p<0.001). Conclusion: The average age of intentional poisoning patients has increased. While the use of sedatives and multiple drugs increased, the use of pesticides and the antihistamine decreased.

• The Korean Journal of Air & Space Law and Policy
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• v.30 no.2
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• pp.279-310
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• 2015

The Montreal Convention is an agreement that governs the liability of air carriers for injury and death to passengers travelling internationally by air. The Montreal Convention serves as the exclusive legal framework for victims and survivors seeking compensation for injuries or death arising from accidents involving international air travel. The Montreal Convention sets monetary liability caps on damages in order to promote the financial stability of the international airline transport industry and protect the industry from exorbitant damages awards in courts that would inevitably bankrupt an airline. The Convention allows a litigant suing under the Convention to avoid the liability caps in instances where the airline's culpability for the injury or death is the direct result of negligence, another wrongful act, or an omission of the airline or its agents. The Montreal Convention identifies specific locations as appropriate venues to advance claims for litigants seeking compensation. These venues are closely tied to either the carrier's business operations or the passenger's domicile. In March 2015, in an act of suicide stemming from reactive depression, the co-pilot of Germanwings flight 9525 intentionally crashed the aircraft into the French Alps killing the passengers and the remaining crew. Subsequent to the crash, there were media reports that Lufthansa made varying settlement offers to families of the passengers who died aboard the flight ranging from $8,300 USD to $4.5 Million USD depending on the passengers' citizenship. The unverified offers by Lufthansa prompted outcries from the families of the decedent passengers that they would institute suit against the airline in a more plaintiff friendly jurisdiction such as the United States. The first part of this article accomplishes two goals. First, it examines the Montreal Convention's venue requirement along with an overview of the recoverable damages from countries comprising the citizenship of the passengers who were not American. The intentional crash of Germanwings flight 9525 by its First Officer encompasses the possibility that Lufthansa may be exposed to unlimited compensatory damages beyond the liability caps contained in the Convention. The second part of this article explores the application of the Convention's liability limits to the Germanwings flight to demonstrate that the likelihood of escaping the liability limits is slim.