• The Journal of the Korean life insurance medical association
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• v.24
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• pp.97-117
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• 2005

Internally Korean insurance market is that whole life products' growth are becoming slowdown that's why new insurance products have appeared on the market in consideration of consumer's needs recently. Externally domestic insurance market competitions has drifted from insurance industry to whole financial industry since bankasurance started. Life insurance companies should open up a new market to survive from severe competitions. Worksite marketing can be an alternative. An insurer make arrangements with an employer about an insurance terms which an insurer offers in Worksite marketing. Then eligible individuals enroll in the plans at their own discretion and pay 100 percent of the premium for coverage through payroll deductions. An employer doesn't need to pay extra money for additional benefit but can raise employee's loyalty and satisfaction of company through worksite marketing. An employee can be covered at discounted premium rate and less strict underwriting guidelines to an insurer compared to individual insurance. In developed countries specially U.S insurance market, Worksite marketing is getting very popular and growing rapidly due to the advantages. Worksite marketing has both individual insurance characters and group insurance characters. Individual insurance characters are that employees enroll in the plans at their own discretion and pay 100 percent of the premium for coverage. Group insurance characters are that actively at work and participation etc. An insurer have to reflect these two characters on Worksite marketing when an insurance company work out a plan for developing products and underwriting guidelines. When an insurer devise worksite products, one should consider participation level which means percentage of eligible employees participating. Participation is related to anti-selection. As we know underwriting is essential for every kind of insurance, especially underwriting plays major role in worksite marketing. We can see that in the below. Firstly, it has a function in calculation of premium rate. When calculate premium rate for worksite products underwriters have to estimate expected participation level and risk factors. So underwriters and acturies keep in close contact with each other. Secondly, underwriting methods are important. When an insurer underwrite worksite products, there are three kinds of underwriting methods. These are Simplified issue underwriting, Full underwriting and Guaranteed issue underwriting. Simplified issue underwriting typically requires no medical examination, but usually requires supplying satisfactory answers to one or several health and/or lifestyle questions. Full underwriting requires a complete medical history questionnaire that may further require an exam. Guaranteed issue underwriting means that coverage is issued without the employee having to provide evidence of insurability. When insurer set the GI limit are usually based on the type of industry, number of eligible employees, the average amount of coverage and participation level. In addition to insurer should have a clear definition of eligible employee on the insurance provision and application form. It will minimize possibility of trouble claims and anti-selection. An insurer also establish preexisting condition exclusion and special guidelines for late entrants. When an insurer introduce Worksite marketing to Korean insurance market, an insurer has to examine market research to analyze potential market and strategy of sales most of all. Also an insurer should review real situation of the U.S, England and Japanese market etc. There are a lot of new technologies about worksite marketing process that an insurer should learn. When an insurer consider many things which we explained it can be a real alternative.

• Korean Journal of Social Welfare
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• v.59 no.3
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• pp.59-73
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• 2007

The compensation system in industrial accident insurance is systemized with "either receiving all or no benefits at all" according to "admited or denied as an industrial accident". Therefore, they are centered on the decision as "industrial accident" or "non-industrial accident", but judging between the two is very complicated, and has inherent conflicting factors. In the early stage of industrialization, industrial accident compensation was based on the indemnity liability for employer's faults. In order to be compensated any damage, the injured worker should prove that the accident was not due to his or her faults. However it was very difficult for injured worker or his or her family to prove the employer's faults, so it was almost impossible to get compensation. Thereafter industrialization progress and improvement of workers' political status lead to conversion from principle of liability with employer's faults to principle of liability without employer's faults. In addition to that, coverage of industrial accident compensation was also expanded. This improvement strengthened the benefit payment principle of "All or Nothing". Even though the "All or Nothing" principle provokes tremendous criticism, the reason why it's difficult for industrialized countries to adopt partial compensation system, is that partial compensation system worsens the administrative hardship, therefore industrialized countries overcome the restrictions of the "All or Nothing" principle with making balance in provisions for any risk to some extent. However, in Korea because the general compensation system for covering medical cost and income loss from accidents, is not equipped, it could be possible to cause acute conflicts with regard to coverage of industrial accidents. Therefore it is required to improve the industrial accident insurance with the acceptance of the significance and logic of discriminated compensation, and create the integrated compensation system in the long run.

• Journal of Radiation Protection and Research
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• v.37 no.1
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• pp.1-9
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• 2012

A year has passed since the nuclear power plant accident in Fukushima on March 11, 2011, and a survey for public perception on radiation by Korean people has been made. The methodological design was based on a quantitative survey and a frequency analysis was done. The analysis objects were survey papers (n=2,754pcs) answered by random ordinary citizens chosen from all over the country. The questionnaires, and study tool, were directly distributed and collected. A total of 40 questionnaires using a coefficient of Cronbach's ${\alpha}$ per each area was 'self perception of radiation' (0.620), 'radiation risk' (0.830), 'benefit from radiation' (0.781), 'radiation controlled' (0.685), 'informative source of radiation' (0.831), 'influence degree from Fukushima accident' (0.763), showing rather high score from all areas. As the result of the questionnaires, the knowledge of radiation concept was 69.50 out of 100 points, which shows a rather significant difference from the result of 'know well about radiation' (53.7%) and 'just know about radiation' (37.40%). According to the survey, one of the main reasons why radiation seems risky was that once exposed to radiation, it may not have negative impacts presently but, the next generation could see negative impacts (66.1%). About 41% of our respondents showed a negative position against the government's report on radiation while 39.5% of respondents said that we should stop running nuclear power in light of Fukushima nuclear power plant accident. This study was done for the first time by Korean people's public perception on radiation after the Fukushima nuclear power plant accident. We expect this might have significant contributions to the establishment of the government's policy on radiation.

• Journal of Chest Surgery
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• v.49 no.4
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• pp.273-279
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• 2016

Background: The use of extracorporeal life support (ECLS) in the setting of cardiopulmonary resuscitation (CPR) has shown improved outcomes compared with conventional CPR. The aim of this study was to determine factors predictive of survival in extracorporeal CPR (E-CPR). Methods: Consecutive 85 adult patients (median age, 59 years; range, 18 to 85 years; 56 males) who underwent E-CPR from May 2005 to December 2012 were evaluated. Results: Causes of arrest were cardiogenic in 62 patients (72.9%), septic in 18 patients (21.2%), and hypovolemic in 3 patients (3.5%), while the etiology was not specified in 2 patients (2.4%). The survival rate in patients with septic etiology was significantly poorer compared with those with another etiology (0% vs. 24.6%, p=0.008). Septic etiology (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.49 to 5.44; p=0.002) and the interval between arrest and ECLS initiation (HR, 1.05 by 10 minutes increment; 95% CI, 1.02 to 1.09; p=0.005) were independent risk factors for mortality. When the predictive value of the E-CPR timing for in-hospital mortality was assessed using the receiver operating characteristic curve method, the greatest accuracy was obtained at a cutoff of 60.5 minutes (area under the curve, 0.67; 95% CI, 0.54 to 0.80; p=0.032) with 47.8% sensitivity and 88.9% specificity. The survival rate was significantly different according to the cutoff of 60.5 minutes (p=0.001). Conclusion: These results indicate that efforts should be made to minimize the time between arrest and ECLS application, optimally within 60 minutes. In addition, E-CPR in patients with septic etiology showed grave outcomes, suggesting it to be of questionable benefit in these patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.177-181
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• 2016

This cross-sectional descriptive and qualitative study was aimed to study the people participation and their approaches toward the human carcinogenic liver fluke, Opisthorchis viverrini, prevention and control in Ban Chaun sub-district administrative organization (BCSAO) and Bamnet Narong sub-district municipality (BNSM), Bamnet Narong district, Chaiyaphum Province, Thailand between June 2013 and February 2014. Participants were purposive selected, included chiefs of sub-district administrative organizations, sub-district municipalities, sub-district health promotion hospitals (SHPHs), heads of village, and a further sample was selected with a multi-stage random sampling for public health volunteers, and villagers. The pre-designed questionnaire contained items for individualized status and the participatory steps of sharing ideas, decision-making, and planning, procession, evaluation, and mutual benefit, for the project O. viverrini prevention and control (POPC). In-depth interviews were used for collection of need approaches to POPC. With 375 participants who completed the questionnaire, it was found that people had a high level regarding to participate in the POPC, particularly in the process stage ($\bar{X}=3.78$, S.D. = 0.56), but the lowest level was found in sharing ideas, decision making, and planning step ($\bar{X}=3.65$, S.D. = 0.63). By comparison, participant status and organization did not significantly differ with people participation. In each step, Ban Chaun sub-district had a high level of participation in the step of sharing ideas, decision making, and planning toward POPC, more than Bamnet Narong sub-district municipality (t=2.20, p=0.028). Approaches for POPC in Ban Chaun sub-district and Bamnet Narong sub-district municipality included requirements for budget support, annual campaigns for liver fluke prevention and control, campaign promotion, risk group observation, home visiting, community rules regarding reducing raw fish consumption in their communities, and a professional public health officer for working in their communities, BCSAO, BNSM, and SHPH, for O. viverrini prevention and control. This study indicates that people realize that eradication of the liver fluke needs a continuous people participation for O. viverrini prevention and control in their communities.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3319-3322
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• 2013

Background: Helicobacter pylori (H. pylori) is one of the risk factors for gastric cancer (GC). Any prognostic effect of HER-2 status in gastric lymph node metastasis in H. pylori positive cases is unknown. Materials and Methods: A total of 74 patients, 47 (64%) male, and 27 (34%) female, who had subtotal or total gastrectomy and also positive lymph nodes, were included in the study. Age range was 29-87 years, and median age was 58 years. HER-2 expression was assessed in both gastric resection samples and lymph node material with carcinoma metastasis of the same patient by immunohistochemistry (IHC) and silver in situ hybridization (SISH) methods. H. pylori status was examined in gastric materials of all patients. Relationships between HER-2 status in gastric cancers and lymph nodes and H. pylori status were investigated. Results: H. pylori was positive in 40 cases (54%), and negative in 34 (46%). While in the primary tissues of H. pylori positive cases, SISH positivity for HER-2 was observed in 13 cases (86%), SISH negativity was observed in 2 (14%), in metastatic lymph nodes 21 cases (72%) were SISH positive and 8 cases (28%) were SISH negative (P=0.005 and P=0.019, respectively). Initial CEA values were high in 18 cases (78%) with positive H. pylori and in 5 cases (22%) with negative H. pylori (P=0.009). While SISH data of patients were negative in 59 cases (80%) and positive in 15 cases (20%) in primary tissues, they were negative in 56 cases (75%) and positive in 18 cases (25%) in lymph nodes. Discrepancy between primary tissue and lymph node results was detected in 3 cases, in which SISH was negative in the primary tissue and HER-2 expression was positive in the lymph nodes. Conclusions: Clinical progression was poor in H. pylori positive cases with HER-2 negativity in primary gastric tissue, but HER-2 positivity in the lymph nodes. SISH positivity can be expected in H. pylori positive cases, and it may be predicted that these cases can benefit from trastuzumab treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5095-5099
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• 2013

Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was $34.6{\pm}5.0$ years among younger patients compared to $54.1{\pm}9.9$ for those ${\geq}40$ years. The mean age at menarche was also significantly lower ($13.5{\pm}1.5$ vs $14.2{\pm}1.5$ years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women ($5.0{\pm}2.5$ vs $4.5{\pm}2.4cm$, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, $p{\leq}0.05$). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.

• Journal of Acupuncture Research
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• v.34 no.2
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• pp.93-112
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• 2017

Objectives : To evaluate and summarize the efficacy and safety of acupuncture treatment (AT) in chronic fatigue syndrome (CFS). Methods : Fifteen databases (Pubmed, Cochrane, EMBASE, AMED, CINAHL, CNKI, Wanfang, and eight Korean databases) were searched up to September 2016. Only trials in which acupuncture was the sole treatment were included. Fatigue was used as the primary outcome measure, while the quality of life, pain, mood disorders, and adverse events were used as secondary outcome measures. We adopted three classifications: AT vs Sham AT, AT vs Wait-list, AT vs Western medication. The Cochrane risk of bias tool was used to assess the methodological quality. Results : A total of 11 randomized controlled trials involving 869 participants were identified. In comparison with Sham AT, AT significantly alleviated fatigue and pain, but no conclusions about the quality of life and mood disorders could be drawn. In the Wait-list group and Western medication groups, patients with CFS might feel less fatigued following acupuncture treatment, but the evidence was insufficient due to lack of study. Nine of 11 RCTs (81.8%) reported adverse events and there were two cases of mild subcutaneous hemorrhage, but no serious adverse cases. Conclusion : This review found evidence that patients with CFS may generally benefit from alleviation of symptoms by acupuncture treatment, and there is no evidence of worsening symptoms or causing of serious adverse events. A positive effect on fatigue and pain was observed, but no conclusion for improving quality of life and mood disorders.

• Journal of the Korean Society of Marine Environment & Safety
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• v.21 no.6
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• pp.790-797
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• 2015

This study tried to evaluate the safety and economical benefit of Nitrox-diving by comparing with Air diving. We used actual diving data which was recorded in construction site of the Busan-Geoje fixed link immersed tunnel in 2010. The study method was to assort and analyze the diving data by divers, depth, breathing air, and diving table. Furthermore, the study examined the possibility of outbreak decompression sickness by comparing Nitrox diving and Air diving in no-decompression limit time, decompression time, working time. As a result, this study confirms that if certain diver breathe Nitrox for diving and oxygen for decompression, not only the risk of decompression sickness could be minimized, but also duration of decompression could be shortened. Moreover, it was estimated that a remarkable difference(more than 3 times) between actual duration of underwater construction period and virtual construction period by using air. As a result, the study confirmed that Nitrox diving is more efficient and economical than Air diving in physically limited and hazardous diving environment.

• Safety and Health at Work
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• v.11 no.1
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• pp.33-40
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• 2020

Background: Exploratory study to investigate whether co-exposure to physical wrist stressors and chemicals is associated with carpal tunnel syndrome (CTS) in French male farmers and agricultural workers. Methods: Cross-sectional study of 711 men aged 30-65 years and working as either farmers or agricultural workers in 2009-2010 within a cohort covered by the French Agricultural Workers' and Farmers' Mutual Benefit Fund. CTS and exposure to physical wrist stressors and chemicals were assessed using a self-administered questionnaire. Associations between CTS and personal/medical factors, exposure to physical wrist stressors, exposure to chemicals, and co-exposure to physical wrist stressors and chemicals were studied using multivariate logistic regression models. Results: Forty-four men {5.6% [95% confidence interval (CI) 4.0-7.7]} reported that they had suffered from unilateral/bilateral CTS during the last 12 months. CTS was associated with age, current smoking [odds ratio (OR) = 2.1 (1.0-4.5)], and exposure to physical wrist stressors [OR = 2.6 (1.1-5.9)]. An association was found between CTS and co-exposure to physical wrist stressors and chemicals [OR = 3.3 (0.8-14.3), p = 0.044] in comparison with the no-exposure group. Conclusions: This exploratory study shows an association of CTS with exposure to biomechanical wrist stressors in male farmers and agricultural workers and suggests an association of CTS with co-exposure to physical wrist stressors and chemicals. Owing to the limitations of the study, this result must be confirmed by a prospective study with objective assessments of the outcome and exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemicals on the impairment of the median nerve.