Medical Expenses of North Korean Defectors with Post-Traumatic Stress Disorder

Objective The purpose of this study was to establish the prevalence of PTSD among North Korean defectors who visited the National Medical Center, Seoul, South Korea over a period of approximately 10 years by examining their medical records and to examine differences in the medical service usage patterns of patients with and without PTSD. Methods Data from North Korean defectors who used outpatient services at the National Medical Center during a period of 10 years and 3 months (January 1 2006 to February 28, 2016) were analyzed. The general characteristics of the defectors were analyzed by frequency analyses, and descriptive statistics were generated. Additionally, independent t-tests and chi square analyses were performed to examine differences between PTSD patients and those without PTSD. Linear regression analysis was performed to examine factors affecting the mental health of North Korean defectors suffering from PTSD. Results This study assessed the correlations between PTSD, the average number of outpatient visits, and the total revenue. The regression analysis showed a relationship between PTSD and the average number of outpatient visits. There was also a correlation between PTSD and total revenue. The average number of outpatient visits was 41.8 for PTSD patients, whereas it was 33.2 for those without PTSD. The. total revenue visit was 953.6 USD for PTSD sufferers and 231.1 USD for those without PTSD. Conclusion This study found that the majority of North Korean defectors visit psychiatry departments, and that PTSD patients use outpatient services more frequently and have higher total revenue than those without PTSD. Additionally, patients with PTSD used a greater variety of medical services. Considering the high medical care expenses of North Korean defectors residing in South Korea, future investigations should examine the medical service usage patterns of such patients, especially those diagnosed with PTSD, in greater detail

Drought Analysis and Impact of Climate Change Effect on Drought

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Long-term risks of complicated grief and insomnia in student survivors of the Sewol ferry disaster in South Korea: A four-year observational follow-up study

Background: The Sewol ferry disaster in April 2014 resulted in the drowning of 304 people. Of the 325 students on board, 250 died and 75 were rescued. The measure of stress caused by bereavement and sleep problems is common and can be a chronic health concern for disaster survivors. The aim of this study was to determine longitudinal predictive factors of complicated grief and insomnia among student survivors of the disaster. Methods: This study centered on 67 student survivors who were enrolled in the disaster registry after graduating from high school. The self-report data as presented by the participants were collected at baseline (27 months after the disaster, T1) and again at two years later (51 months after the disaster, T2). Thirty-one participants completed both T1 and T2 surveys. The noted predictive variables, in this case, were event-related rumination, coping strategy, social support, attachment, meaning in life, and adverse childhood experiences. The outcome variables were complicated grief and insomnia. Results: Dysfunctional coping (T1) was positively associated with complicated grief (T2) (coefficient = 0.070; p<0.001). Intrusive rumination (T1) (coefficient = -0.114; p<0.001), social support (T1) (coefficient = -0.031; p<0.001), and meaning in life – search (T1) (coefficient = -0.082; p<0.001) were negatively associated with insomnia (T2). In contrast, dysfunctional coping (T1) (coefficient = 0.041; p = 0.012), adverse childhood experiences (T1) (coefficient = 0.280; p = 0.007), and insomnia (T1) (coefficient = 0.166; p<0.001) were positively associated with insomnia (T2). Conclusions: Dysfunctional coping influenced how student survivors of the Sewol ferry disaster suffered from complicated grief and insomnia over time. In this case, the findings from the current study indicate that interventions that target coping strategies should be provided to improve the resolution of grief and sleep among survivors. [Ethiop.J. Health Dev. 2020;34(Special issue-3):97-106] Keywords: Sewol ferry disaster, student survivors, coping strategy, complicated grief, insomni

Institutional Board Review for Clinical Investigations on Inflammatory Bowel Diseases: A Single-Center Study

Background/AimsThe growing volume and the diversity of clinical research has led to related laws and regulations as well as the Institutional Review Board (IRB) approval process becoming more stringent. To conduct clinical research efficiently and while following regulations, information about the IRB approval process and feedback is important for investigators. This has yet to be studied.MethodsWe included 381 gastrointestinal disease research proposals (79 with inflammatory bowel disease [IBD], and 302 with non-IBD) reviewed by the IRB of Severance Hospital between January 2009 and December 2013. We retrospectively analyzed research characteristics including research risk levels, results of initial reviews, frequencies of continuing review, numbers of IRB comments, frequencies of IRB comments, and durations from submission to approval.ResultsInvestigators' decisions on risk level were higher in the IBD group than in the non-IBD group (P<0.05). Results of initial reviews, frequencies of continuing reviews, the numbers of IRB review comments, and durations from submission to approval were not different between the two groups, but IRB decisions on risk level were higher in the IBD group (P<0.05). In subgroup analysis, the number of IRB comments from initial review on informed consent forms and procedures as well were quest of more information were significantly higher in the IBD group than in the non-IBD group (P<0.001 and 0.01, respectively).ConclusionsIn Korea, rare diseases such as IBD require more information for the IRB process due to their distinct characteristics. IBD researchers should develop research protocols more carefully and make their research as subject-friendly as possible

The impact of coping strategies and positive resources on post-traumatic stress symptoms among bereaved families of the Sewol ferry disaster

IntroductionThis study investigated the long-term prevalence of, and factors associated with, post-traumatic stress disorder (PTSD) among the bereaved families of the Sewol ferry disaster, in which 250 students lost their lives during a school excursion.MethodsEight years after the disaster, 181 family members were surveyed, and the prevalence of clinical PTSD symptoms was estimated. The Positive Resources Test (POREST), the Duke-UNC Functional Social Support Questionnaire, and the Brief COPE were evaluated using self-report measures. The multivariable binomial logistic regression was used to identify protective and risk factors for PTSD.ResultsPTSD symptoms were present in 49.7% of the family members 8 years after the incident. A one-point increase in the score on the optimism subscale of the POREST was associated with a 20.1% decreased likelihood of having clinical PTSD symptoms (OR = 0.799; p = 0.027; 95% CI = 0.655–0.975). Conversely, a one-point increase in the score on the avoidant subscale of Brief COPE was associated with a 13.2% increased likelihood of having clinical PTSD symptoms (OR = 1.132; p = 0.041; 95% CI = 1.005–1.274).DiscussionOur results provide evidence of the need for long-term mental health monitoring of bereaved families of disaster victims, along with valuable insights for the development of mental health intervention programs

Performance Analysis of Relative Positioning using GPS and BDS signals

In general, the satellite signal received by GNSS receivers has errors such as satellite clock error, orbit error, ionospheric delay and tropospheric delay. In environments where high positioning accuracy is required, these error factors can be eliminated by using relative positioning using code measurements with carrier phase measurements. If relative positioning is performed using carrier phase measurements, it is possible to have positioning accuracy of cm level. In this paper, we analyse the positioning accuracy of relative positioning using the L1 signal of GPS and BDS. For this study, we collect GPS and BDS signal using two low-cost receivers. We also designed a software-based platform to perform the relative positioning. Finally, we analyse relative positioning accuracy for GPS/BDS integrated system as well as relative positioning accuracy for GPS and BDS

Differential profiling of breast cancer plasma proteome by isotope-coded affinity tagging method reveals biotinidase as a breast cancer biomarker

<p>Abstract</p> <p>Background</p> <p>Breast cancer is one of the leading causes of women's death worldwide. It is important to discover a reliable biomarker for the detection of breast cancer. Plasma is the most ideal source for cancer biomarker discovery since many cells cross-communicate through the secretion of soluble proteins into blood.</p> <p>Methods</p> <p>Plasma proteomes obtained from 6 breast cancer patients and 6 normal healthy women were analyzed by using the isotope-coded affinity tag (ICAT) labeling approach and tandem mass spectrometry. All the plasma samples used were depleted of highly abundant 6 plasma proteins by immune-affinity column chromatography before ICAT labeling. Several proteins showing differential abundance level were selected based on literature searches and their specificity to the commercially available antibodies, and then verified by immunoblot assays.</p> <p>Results</p> <p>A total of 155 proteins were identified and quantified by ICAT method. Among them, 33 proteins showed abundance changes by more than 1.5-fold between the plasmas of breast cancer patients and healthy women. We chose 5 proteins for the follow-up confirmation in the individual plasma samples using immunoblot assay. Four proteins, α1-acid glycoprotein 2, monocyte differentiation antigen CD14, biotinidase (BTD), and glutathione peroxidase 3, showed similar abundance ratio to ICAT result. Using a blind set of plasmas obtained from 21 breast cancer patients and 21 normal healthy controls, we confirmed that BTD was significantly down-regulated in breast cancer plasma (Wilcoxon rank-sum test, <it>p </it>= 0.002). BTD levels were lowered in all cancer grades (I-IV) except cancer grade zero. The area under the receiver operating characteristic curve of BTD was 0.78. Estrogen receptor status (<it>p </it>= 0.940) and progesterone receptor status (<it>p </it>= 0.440) were not associated with the plasma BTD levels.</p> <p>Conclusions</p> <p>Our study suggests that BTD is a potential serological biomarker for the detection of breast cancer.</p

A GPS multipath mitigation technique using correlators with variable chip spacing

Various methods have been studied to mitigate the influence of multipath signals, representative methods focused the correlator structure are the Narrow Correlator and the Multipath Elimination Technique (MET). It is known that the MET has better performance than Narrow Correlator but it requires more complexity. In this paper, we propose a technique that has similar performance to the MET and it uses only three correlators like the Narrow Correlator. This technique switches the chip spacing of the correlators for each Predetection Integration Time (PIT) and applies it to the MET. For the performance analysis, we implemented a software platform and compared the code tracking error of the proposed technique with that of the Narrow Correlator and the MET

Dual Therapy with Cidofovir and Mirtazapine for Progressive Multifocal Leukoencephalopathy in a Sarcoidosis Patient

Background: Progressive multifocal leukoencephalopathy (PML) is a demyelinating central nervous system disease caused by JC virus (JCV) reactivation in immunocompromised patients. The disease course of PML is often progressive, fatal and at present, there are few reports on successful treatment outcomes. Case Report: A 45-year-old man with systemic sarcoidosis presented with rapidly progressive dementia and right hemiparesis. The patient was diagnosed with PML as confirmed via brain biopsy and JCV PCR. With a combination treatment of cidofovir and mirtazapine, there was significant improvement of neurological symptoms without measurable functional deficit. Conclusion: This case suggests that dual therapy with cidofovir and mirtazapine might be an effective treatment option in PML patients with sarcoidosis

Causes and effects of 2008 financial crisis

Beginning in the mid 2007’s the US financial market started to slide into the “worst financial crisis since the Great Depression of the early 1930’s” (Thakor, 2015: p.156). The domino effect of several events and occasions were leading first to a countrywide recession in the USA then later spreading globally. In the following this term paper will deal with the main causes and effects of 2008 financial crisis. Unlike other topics in literature there is no consensus about the question of guilt in this sense. Among economists there are different approaches to explain the main causes of the financial crisis