• Journal of Hospice and Palliative Care
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• 제23권4호
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• pp.167-171
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• 2020

The finite nature of human existence leads many to search for meaning, which comes into sharper relief for those who are imminently facing death. Therefore, universal existential concerns such as the inevitability of death, existential isolation, loss of meaning, freedom, and dignity are inherent psychological issues in palliative care. Consequently, one of the critical challenges facing palliative care is how to address these issues effectively. This paper provides an overview of common themes of existential concerns and psychotherapeutic interventions to address existential distress among patients in palliative care.

• 한국철도학회논문집
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• 제9권3호
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• pp.313-318
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• 2006

In this paper, we propose an efficient Care of Address (CoA) configuration scheme for network mobility support in the railroad environment. Mobile routers in a train visit each access router in the fixed order. Such regular movement characteristic of a train enables a current subnet access router to inform the next subnet access router of the mobile routers' interface identifiers before the mobile routers move to the next subnet access router. So, the next subnet access router can make care of addresses for the mobile routers in advance. The numerical results show that the proposed scheme outperforms the stateless scheme with respect to CoA configuration time.

• 한국컴퓨터정보학회논문지
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• 제14권9호
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• pp.37-46
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• 2009

철도차량에 탑재된 이동 라우터(Mobile Router:MR)의 이동방향은 랜덤하게 이동하는 일반 무선단말기와 달리 선로를 따라 양방향 이동으로 제한된다. 따라서 이동라우터와 접속된 액세스 라우터 (Access Router:AR)은 인접한 이웃 AR의 주소정보를 이용하여 이동라우터의 2계층, 3계층 핸드오프 수행 전에 이동라우터 대신 미리 Care of Address(CoA)를 구성할 수 있다. 이동라우터는 현재 접속된 AR에서 어느 AR 영역으로 이동하더라도 이동검출과정 후 현지 AR로부터 새로운 CoA를 즉시 획득할 수 있게 된다. 성능분석결과, 제안한 방안은 Stateless 방식과 달리 별도의 CoA 과정과 주소중복확인절차(Duplicate Address Detection:DAD)를 수행하지 않아 Stateless 방식보다 최소 약 1.8(s), 최대 4.98(s) 빠르게 CoA를 획득할 수 있음을 확인할 수 있었다.

• 한국컴퓨터정보학회논문지
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• 제13권5호
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• pp.85-94
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• 2008

WLAN, WiBro, cdma2000, HSDPA와 같은 여러 이기종 무선 네트워크 서비스가 늘어나고 무선 서비스를 사용하기 위한 사용자의 선택의 폭도 점점 커짐에 따라 다양한 이기종 무선인터페이스를 동시에 사용하고자 하는 Multiple Care-of Address 방안이 IETF MONAMI6 WG에서 제안되었다. 이 방안을 통해 단말은 다중 인터페이스를 사용하여 동시에 여러 네트워크로의 접속이 가능하다 이처럼 다양한 무선 접속 기술은 All-IP 기반 핵심망에 연결되어 통합되는 형태로 발전하고 있으며 무선 접속 기술의 커버리지에 따라 이기종 무선망이 중첩되어 운영되고 있어, 이에 대한 고려가 요구되고 있다. 이에 따라 4G를 위한 차세대 네트워크와 현존하는 이기종 인터페이스를 지원하는 서비스 프레임워크가 요구되는 실정이다. 본 논문에서는 현재 서비스되고 있는 환경을 고려한 이기종 무선 서비스 프레임워크를 제안하고 여러 인터페이스 특성과 사용자 정의를 고려하여 효율적인 네트워크를 선택하는 수정된 MCoA (Multiple Care-of Address) 방안과 다중 인터페이스 핸드오버 상황에 따른 패킷 손실을 최소화하는 방안을 제안한다.

• 정보처리학회논문지C
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• 제10C권6호
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• pp.755-762
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• 2003

MIPv6에서는 경로 최적화를 위하여, 새로운 서브넷으로 이동한 MN(Mobile Node) 은 CN(Correspondent Node) 에게 자신의 HoA(Home Address) 와 새로운 CoA(Care-of Address)와의 바인딩을 통고하는 바인딩 갱신 패킷을 전송해야 한다. 하지만, 안전하지 않은 바인딩 갱신은 오히려 침입자로 하여금 다양한 공격을 가능하게 한다. 이에 따라 안전한 바인딩 갱신을 ?∏? 여러 프로토콜들이 제안되었다. 본 연구에서는 기존 프로토콜들을 비교하기 위해 공격에 대한 취약성을 포함한 보안 특성, 프로토콜의 관리 특성, 패킷 교환 횟수와 암호화 연산 시간의 성능 특성에 대한 비교 기준을 제시하였다. 또한, 제시된 기준에 따라 대표적인 4가지 바인딩 갱신 프로토콜들을 비교 분석하고, 안전한 바인딩 갱신을 위한 개선안을 제시하였다.

• Journal of health informatics and statistics
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• 제43권4호
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• pp.274-281
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• 2018

Objectives: The purpose of this study is to comprehensively compare the trends of health administration and health policy in the field of health care using the semantic network analysis in the inaugural address of the Ministry of Health and Welfare of each regime in Korea. Methods: This study used a language network analysis method that uses Korean Key Words In Context (KrKwic) program and NetMiner program in sequence. The analysis was conducted by Minister Hwa-joong Kim during the Moo-hyun Roh government, Minister Jae-hee Jeon during the Myung-bak Lee government, Minister Young Jin of Geun-hye Park government and Government Jae-in Moon's inaugural address of Neung-Hoo Park Minister, respectively. Results: The key words differentiated by each regime are that the Moo-hyun Roh Government's Minister Hwa-joong Kim had high connection centrality values in the words 'balanced development', 'comprehensive' and 'reform'. Minister Jae-Hee Jeon of Myung-bak Lee Government had high connection centrality values in the words 'poverty' and 'return'. In the case of Minister Young Jin of Geun-hye Park Government had high connection centrality values in the words 'demand', 'Customized' and 'Life cycle'. In the case of Minister Neung-Hoo Park of Jae In Moon Government had high connection centrality values in the words 'Welfare state', 'Embracing' and 'Soundness'. Conclusions: If the role of health administration in the health care field and the health care policies are constantly changed according to the policies of each regime, it is inconsistent and it is difficult to approach from the long term perspective for public health promotion. In the future, health policy should be developed and implemented with a long-term perspective and consistency based on the consensus and participation of the people with less influence on the change and direction of each government's policies.

• 의학교육논단
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• 제21권2호
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• pp.80-91
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• 2019

The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

• 보건행정학회지
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• 제20권4호
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• pp.1-18
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• 2010

Much policy attention has been directed to the concentration of patients in large hospitals, especially in tertiary care hospitals. In order to address the problem, the government has enforced referral requirement for accessing care in tertiary care hospitals by denying insurance benefits to the patients who do not observe the requirement. This approach somehow has failed to produce expected effects although it still exists in theory. The concentration of patients in a certain type of providers results in the distortion of functional differentiation among various types of providers and vice versa. Thus the approaches for the alleviation of the problem should be directed to both patients and providers. However, policy approaches has so far focused on ways of directly affecting patients' choice of a provider neglecting the effects of providers. Based upon the observation, this paper has reviewed selected issues that should be considered in agenda setting for policies concerned with the concentration of patients in large hospitals or the distortion of functional differentiation among health care providers. A brief discussion of each of the issues suggests three general guidelines for the formulation and implementation of policies intended to address the problem. First, attention should be directed to both patients and providers. Secondly, it is necessary to employ diverse measures including regulation, incentives and administrative supports. Thirdly, some of the approaches should be planned from a long range perspective, for it often takes a long time to change some aspects of health care utilization and provision.

• 중환자간호학회지
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• 제15권1호
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• pp.13-23
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• 2022

Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.

• Journal of Hospice and Palliative Care
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• 제15권4호
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• pp.188-192
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• 2012

Palliative medicine has shown demonstrated benefit for patients with serious illness, their families, and hospital systems. As such, the demand for palliative care services is growing at a fast pace, and health care facilities frequently struggle to develop and implement effective and sustainable methods of providing this care. As with any new system, challenges and barriers naturally exist to instituting palliative care. Undertaking careful assessment, planning, and resource allocation can provide the greatest likelihood of success when developing these novel yet much needed models of care. This summary paper offers a qualitative overview of the potential benefits and the rationale to implement robust palliative care systems. We briefly review the history of palliative medicine in the broadest sense and address several seminal works from the US palliative care literature. Core practices to establish and advance palliative medicine are suggested. Commentary is provided on some of the particular barriers to palliative system development that may need to be addressed in the context of Korean medical culture. Collectively, we hope this overview can contribute to a framework within which such research and development can occur, leading to increasingly effective and sustainable palliative medicine in Korea.