國人自殺死亡自1997年起已經連續10年進入國人十大死因之列，且其排名及自殺率有逐年上升的趨勢。國防部相當重視自殺防治工作1977年起國軍即設置有「趙老師」負責心理諮商與輔導工作，1994年更推廣設立心輔官制度，其主要目的就是要在部隊中從事心理衛生的防治工作，以避免自殺事件的發生。但從1997至2008年統計數據分析，軍中自我傷害死亡自1997年起逐年上升，至2002年達最高峰，2003年後雖有降低，但各年度因自我傷害死亡仍在20人以上。從數據來看，軍中自我傷害事件並未因國防部大力推動自我傷害防治工作下降。因此，本文的目的在於找出影響官兵自我傷害的原因，提供國防部在自我傷害防治策略上有更為周全的決策考量，以降低國軍官兵自我傷害事件的發生。 / Suicide has been one of the top ten reasons behind the deaths of our countrymen since 1997. In addition, its ranking and suicide rate are both climbing over the years. The Ministry of Defense puts a lot of efforts into suicide prevention. Since 1977, the military has set up ‘Teacher Zhao’ to be in charge of psychological consultations and counseling work. In addition, ‘counseling officers’ system has been set up and its main purpose is to do prevention work about mental health in the military in order to prevent the occurrence of suicides. However, analyzing the statistics from 1997 to 2008, deaths due to self-mutilations in the military are increasing since 1997 and peaked in 2002. Although the number decreases since 2003 but there are still over 20 deaths due to self-mutilations every year. Looking at the statistics, self-mutilations in the military did not decrease even though the Military of Defense pushes for prevention of self-mutilations. Therefore, the purpose of this paper is to find out the reasons affecting self-mutilations, provide the Ministry of Defense a well-rounded decision making mechanism on how to prevent self-mutilations in order to decrease the occurrence of self-mutilations in the military.

京都大学 / 0048 / 新制・課程博士 / 博士(薬科学) / 甲第21711号 / 薬科博第102号 / 新制||薬科||11(附属図書館) / 京都大学大学院薬学研究科薬科学専攻 / (主査)教授 二木 史朗, 教授 松﨑 勝巳, 教授 中山 和久 / 学位規則第4条第1項該当 / Doctor of Pharmaceutical Sciences / Kyoto University / DFAM

本文共一冊約五、六萬字，計分五章。 首章概述個人醫療費用保險之內容及形態，分為五節，分別介紹住院費用保險，外科 手術費用保險，基本醫療費用保險、高額醫療費用保險及綜合醫療費用保險。 第二章說明保險費之計算，分為二節，一為影響保險費計算之因素，二為公式之介紹 。 第三章論及醫療費用保險成本上升之問題，分別述明原因及因應措施。 第四章分析我國個人醫療費用保險之狀況，分為三節，分別說明健康保險特約、傷害 保險特約及人壽保險及意外險中之醫療給付部份。 第五章提出改進之建議，以資參考。

經研讀相關文獻後，本文試以勞工於職災真實案例中，所得主張之各種請求權出發，探討相關法制內涵之規範目的及給付之性質。全文之章節安排如下： 第一章 緒論 闡述本文之研究動機與目的、研究方法、研究範圍與限制及研究架構。 第二章 職業災害補償內容概要 本章從憲法基礎出發，探討職業災害定義、職業災害認定之成立要件、職業災害補償制度之沿革及職業災害補償制度之本質。 第三章 我國職業災害救濟制度之內涵 本章臚列職災之勞工各種救濟制度內涵，有民法中之侵權行為之損害賠償責任、債務不履行之損害賠償責任、勞動基準法之補償責任、勞工保險條例之給付規定、職業災害勞工保護法中得請領之津貼及補助。 第四章 承攬關係中職業災害補償相關問題 本章探討勞基法第六十二條連帶補償責任所衍生之各種爭議。 第五章 職業災害補償抵充關係之適用 本章以抵充規定之意涵及先決要件出發，探討與勞工保險抵充之疑義、與民法賠償金抵充、與商業保險抵充、與其他商業險、與撫卹金或其他殮葬補助費抵充之各項疑義。 第六章 職業災害補償相關問題之探討 本章探討勞基法中職災補償之和解低於勞基法標準、受領權之拋棄及禁止扣押之規定。其次，第三人之加害行為可否認定為職業災害、而雇主或保險人得否代位向第三人求償。再者，討論通勤災害補償問題法規之明確化、與有過失原則之適用問題及職業災害勞工保護法之定位。最後，職業災害醫療期間禁止解僱及例外規定。而勞保中身故受益人加了「專受撫養」之限制，致雇主無法抵充補償責任之罕見現象。 第七章 派遣勞工職業災害補償與賠償相關問題 討論現行法中對派遣勞工之職災補償及賠償問題，並提出我國於勞動派遣尚未立法通過前，派遣關係下職災救濟制度的解決方式。 第八章 結論與建議 總結前述各章節之重點，檢討現行制度內涵，並對其缺點及疏漏提出具體建議以供日後修法之參考，以保障職災勞工權益。

意外事故之發生自古有之，但是在現代社會中，由於事故之數量及所造成的龐大損失，意外事故受害者需求的滿足，成為一項重要的社會問題。在面對這些意外事故所造成問題，國家莫不積極地介入社會生活中。其不但將相當可觀的資源投入事前的各種預防措施，對於各種危險型態從事行政管制。此外，國家基於社會國家的意旨，建立其他替代損害填補來源（Alternative Source of Compensation）以合理救濟受害者之需求，諸如社會保障制度、強制責任保險等機制。 然而．鑑於社會整體資源有限性之限制下，國家應考慮以何種手段方得以處理這些不幸的損害，以達到合理保障受害者權益的目標，因此國家對於補償制度建構，應有全盤理念,，否則將有流於不免有「頭痛醫頭，腳痛醫腳」之弊端。據此，本文將針對各類意外事故之特性，並考察其他先進國家，諸如德國、瑞典、荷蘭、紐西蘭、英國、美國及日本之發展歷程，從而檢討檢討我國現行意外事故社會保障制度之政策，及損害賠償與社會保障制度之協調關係。

國內保險經營，長久以來即是人身保險及財產保險分業經營方式，但兩者的經營規模差距很大，據統計資料顯示，壽險業這五年來的傷害險保費收入，平均每年約有580億元，健康險平均年約1260億元，對於產險業整體業界總保費收入約1100億元的市場規模而言，實在是塊誘人和商機無限的新市場，能加入傷害險或健康險的經營，將是產險業者突破經營瓶頸的關鍵，不僅保險市場會產生蛻變，更會對消費大眾帶來多元的選擇與影響。 在此背景下，本研究主要探討產險業經營傷害險的績效，並舉個案實例經營此單一險種的過程，就其在商品研發、行銷、核保和理賠等各項作業流程，進行探討分析。經本研究個案分析，歸納出幾點問題，一是在經營策略面，以業績成長為首要的考量，自然會選擇通路商的行銷方式，所謂「掌握通路，就是贏家」，兩年來通路業績佔了該險種的73%，而其賠款金額佔率，亦佔了76%左右，經營績效的結果顯示出「成也通路，敗也通路」，如何強化通路商之管理是經營重點。二是由理賠資料分析統計，並與壽險業資料比較，發現有相關性趨勢，但卻有相對惡化的現象，諸如平均死亡率，男性比女性多出5倍以上，比壽險業的3倍高；平均每件死亡賠款230萬元，比壽險業的120萬元，高出近一倍，且又以男性50~59歲的年齡層最高，此點顯示出其商品是否有「保費太低而保障過高」的問題。三是其面臨人力和經驗不足的問題，加上缺乏醫療、法務、徵信調查等相關專業人員及其運作經驗，無法在核保和理賠作業時，因應實際的作業需求。 我國保險法經過兩次修正後，現在已開放產險業者得以經營傷害險，再者，有關健康險是否可進一步開放予產險業者經營，相信很快會經立法院通過修法審議。故本研究的結果，即是找出經營問題和原因，並提出改善建議，期能提供產險業者經營傷害險或未來健康險的參酌。 關鍵字：個人傷害保險、綜合率、非比率再保險 / In our insurance market, there are two types of operation, that is, life insurance and non-life insurance, but the business scale of the two types has a long way to go. According to the data, the average premium income of whole life insurance market of the personal accident and health insurance is about NT$58 billion and NT$126 billion per year respectively among these five years. Relative to the non-life insurance which premium income is about NT$110 billion, it’s really a captivating and unlimited new market that the non-life insurance can take the risk about the personal accident and health insurance. From my point of view, it will be the main key to break through the bottleneck of operation of the non-life insurance market. Not only the whole insurance market will be changed but also it can bring multi-choice and influence to consumers. Under this background, the main task of this research is discussing the non-life insurance’s result of operation the personal accident insurance. It has a real case that also includes the product of development, marketing, underwriter and claim for further discussion and analysis. According to the research of this case, it can generalize some points as below. The first is about the tactic of operation: we will choice the way of marketing way of channel if we consider the growth of premium income as primary issue. What is called” Someone will be a winner if he controls the channel”. In our company, the business of channel was occupied about 73% of the personal accident insurance and the claim also in the same situation was about 76% over the past two years. Unfortunately, the result of operation is “Control the channel will make someone success and failure”, so the key point of operation is how to enhance the management of channel. The second is about the statistics of claim: we compared with the data of life and non-life insurance and find some related trends, but there is a phenomenon of related aggravation, such as rate of average death, men are five times more than women in non-life insurance but only three times in life insurance statistics; the average indemnity of death is about NT$2.3 million in non-life insurance which is one time higher than life insurance market and especially with men that age level among in 50~59 years old. On the basis of above mentioned, it shows the problem of this product have higher indemnification but lower premium income. The third is about the problem of lack of manpower and inadequate experience, in addition, it also lack such relevant professional personnel as medical, legal and investigative, etc. So it can’t offer the demand of real operation in the underwriting and claim process. The law of insurance has already opened that the non-life insurance can operate the personal accident insurance after revision two times in our country. Moreover, we believe that will be passed through about the non-life insurance also can operate the health insurance by the legislative rapidly. After the analysis, the conclusion of this research is finding out the question and reason of operation and offering the suggestion of improvement. I hope it can provide some recommendations for the non-life insurance that will operate the personal accident insurance or oncoming of the health insurance. Key words: Personal Accident Insurance、Combined Ratio、Excess of Loss

No description available.

本研究主要目的在於探討在不同情緒經驗及反芻風格對男女性自傷行為的影響。回顧過去研究，情緒被認為是多數自傷者自傷的動機及原因之一。可惜的是，大多數研究聚焦在負向情緒經驗，而較少探討正向情緒及不同激發程度的影響力。Selby（2008）的情緒瀑布理論提出反芻風格能夠增加負面情緒強度的論點，也暗示了反芻風格也是另一個與自傷行為相關認知因子。因此本研究認為情緒經驗與反芻風格可能皆為自傷發生的關鍵。有鑑於許多文獻結果指出，男女性的自傷危險因子可能存在差異，本研究便把性別差異納入考量，欲了解男、女性是否在情緒經驗及反芻風格的自傷預測因子有所不同。 本研究對象為508位北部某私立高職部學生，請學生填寫包含基本資料、反芻風格、自傷狀況及情緒經驗的評估共四部份問卷。研究結果顯示，在預測過去一年自傷行為的因子上，的確有性別差異。對女性來說，預測過去一年是否自傷的有效因子分別為負向情緒及負向低激發情緒，男性則是負向情緒及正向低激發情緒。在自傷頻率方面，對男女性來說，沒有任何情緒經驗或反芻風格為有效預測因子。在自傷種類數方面，沒有任何情緒經驗或反芻風格為女性自傷頻率的有效預測因子；對男性來說，則是負向情緒及低激發情緒能夠有效預測過去一年自傷種類多寡。研究最後針對這樣的結果做進一步討論及提供實務上的意涵及應用。 / The purpose of the present study was to investigate the influence of emotion experiences and rumination styles on Non-suicidal self-injury behavior (NSSI) in males and females. According to past studies, emotion was considered a critical factor in motivating individuals to practice NSSI. However, most studies focused on negative emotion experiences, and ignored the role of positive emotions and the effect of emotion activation level. Moreover, Selby’s Emotional Cascade Model proposes that rumination style will increase the negative affect intensity, suggesting that rumination style may be another key factor to NSSI. In addition, due to several studies have shown gender differences in risk factors for NSSI, the gender difference will be also take into account in the present study. To sum up, the present study aimed to examine gender differences in predictors (i.e., emotion experiences and rumination styles) for NSSI. The participants were 508 high school students from one of the private vocational high school in Northern Taiwan. All participants were asked to fill out the questionnaire pack which included demographic questionnaire, short-form rumination style questionnaire, deliberate self- harm inventory, and affect valuation inventory. The results show that gender differences in predicting NSSI existed: First, in predicting the occurrence of NSSI in the past year, negative affect and low arousal negative emotion were the most effective factors for females; negative emotion and low arousal positive emotion were the most effective ones for males. Second, neither emotion experience nor rumination style can predict the frequency of NSSI in the past year for males and females. Third, in predicting the numbers of types of self-injury used in the past year, there was no effective predictor for females; negative emotion and low arousal emotion were the effective predictors for males. Finally, the results and the practical implication were discussed in the thesis.

京都大学 / 0048 / 新制・課程博士 / 博士(薬科学) / 甲第20307号 / 薬科博第76号 / 新制||薬科||8(附属図書館) / 京都大学大学院薬学研究科薬科学専攻 / (主査)教授 二木 史朗, 教授 松﨑 勝巳, 教授 中山 和久 / 学位規則第4条第1項該当 / Doctor of Pharmaceutical Sciences / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(薬学) / 甲第24564号 / 薬博第862号 / 新制||薬||243(附属図書館) / 京都大学大学院薬学研究科薬学専攻 / (主査)教授 金子 周司, 教授 竹島 浩, 教授 生田 宏一 / 学位規則第4条第1項該当 / Doctor of Pharmaceutical Sciences / Kyoto University / DFAM