• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.335-373
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• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.3
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• pp.75-85
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• 1996

Nursing Intervention Classification(NIC) includes the 433 intervention lists to standardize the nursing language. Efforts to standardize and classify nursing care are important because they make explicit what has previously been implicit, assumed and unknown. NIC is a standardized language of both nurse-initiated and physician-initiated nursing treatments. Each of the 433 interventions has a label, definition and set of activities that a nurse does to carry it out. It defines the interventions performed by all nurses no matter what their setting or specialty. Principles of label, definition and activity construction were established so there is consistency across the classification. NIC was developed for following reasons; 1. Standandization of the nomen clature of nursing treatments. 2. Expansion of nursing knowledge about the links between diagnoses, treatments and outcomes. 3. Devlopment of nursing and health care information systems. 4. Teaching decision making to nursing students. 5. Determination of the costs of service provided by nurses. 6. Planning for resources needed in nursing practice settings. 7. Language to communicate the unigue function of nursing. 8. Articulation with the classification systems of other health care providers. The process of NIC development ; 1. Develop implement and evaluate an expert review process to evaluate feedback on specific interventions in NIC and to refine the interventions and classification as feedback indicates. 2. Define and validate indirect care interventions. 3. Refine, validate and publish the taxonomic grouping for the interventions. 4. Translate the classification into a coding system that can be used for computerization for articulation with other classifications and for reimbursement. 5. Construct an electronic version of NIC to help agencies in corporate the classifiaction into nursing information systems. 6. Implement and evaluate the use of the classification in a nursing information system in five different agencies. 7. Establish mechanisms to build nursing knowledge through the analysis of electronically retrievable clinical data. 8. Publish a second edition of the nursing interventions classification with taxonomic groupings and results of field testing. It is suggested that the following researches are needed to develp NIC in Korea. 1. To idenilfy the intervention lists in Korea. 2. Nursing resources to perform the nursing interventions. 3. Comparative study between Korea and U.S.A. on NIC. 4. Linkage among nursing diagnosis, nursing interventions and nursing outcomes. 5. Linkage between NIC and other health care information systems. 6. determine nursing costs on NIC.

• Korean Security Journal
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• no.21
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• pp.75-94
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• 2009

Since mechanical security systems are mostly composed of electronic, information and communication devices, they have effects in the aspects of overall social environment and crime-oriented environment. Also, the importance is increasing for wireless recognition of RFID and tracing function, which will be usefully utilized in controlling the incomings and outgoings of people/vehicles or allowance, surveillance and control. This is resulting from the increase in the care for the elderly according to the overall social environment, namely, the aging society, and the number of women entering, as well as the increase in the number of heinous crimes. The purpose of this study is to examine the theoretical considerations on ubiquitous sensor network and present a direction for securities companies for their development by focusing on the technological and application areas. To present strategies of response to a new environment for security companies, First, a diversification strategy is needed for security companies. The survival of only high level of security companies in accordance with the principle of liberal market competition will bring forth qualitative growth and competitiveness of security market. Second, active promotion by security companies is needed. It is no exaggeration to say that we are living in the modern society in the sea of advertisements and propaganda. The promotional activities that emphasize the areas of activity or importance of security need to be actively carried out using the mass media to change the aware of people regarding security companies, and they need to come up with a plan to simultaneously carry out the promotional activities that emphasize the public aspect of security by well utilizing the recent trend that the activities of security agents are being used as a topic in movies or TV dramas. Third, technically complementary establishment of ubiquitous sensor network and electronic tag is needed. Since they are used in mobile electronic tag services such as U-Home and U-Health Care, they are used throughout our lives by forming electronic tag environment within safe ubiquitous sensor network based on the existing privacy guideline for the support of mobile electronic tag terminal commercialization, reduction in communication and information usage costs, continuous technical development and strengthening of privacy protection, and the system of cooperation of academic-industrial-research needs to be established among the academic world and private research institutes for these parts.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.9 no.6
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• pp.201-210
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• 2009

Studies on human-centered services are approaching their highest peak with the emergence of a new concept of the network environment, a ubiquitous environment. Among these ubiquitous service technologies, services related to health care are very closely related to the current social environment. In this paper, With social aging and changes in ubiquitous IT environment, studies on health care, which is among the essential application services and which has been defined as a key application technology, and studies related to it have been conducted. In addition, healthcare services, which are essentially applicable to the ubiquitous environment, were suggested by analyzing existing healthcare studies and drawing from them the requirements for such. This paper proposes management protocol for serious case except from health care research. This system is constructed database using RFID, it has location information. It provides procedures to consistently monitor the status of patients and process the outcome in real-time.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.11 no.6
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• pp.107-118
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• 2011

This paper shows a u-Health management system in user's Life environment, which is different from previous ones by enterprises. It's designed for users(citizens) and service provider(especially providing medical service). This paper is discussing on the proof on the service model being operated near the Tancheon stream in the city of Sung-nam. To maximize users' satisfaction, this service has been designed on four disciplines(so easy, so simple, well-customized, funny feedback) in the viewpoint for users. Its algorithm has 4 levels which are measurement, prescription, monitoring and feedback. In the system. there are HCBs(health check boothes) checking out status and assessment of users, customized health prescription customized a health management service prescription engine, exercise programs customized on exercise equipments near the stream and monitoring system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.3
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• pp.1972-1980
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• 2015

This study's purpose was to analyze the effect of the SmartCare obesity management pilot project, which was conducted between 09 March 2011 and 03 April 2013 in Korea (South). Of 212 subjects who were enrolled in the study, the final analysis was conducted with 147 subjects who completed their weight self-measurements and SmartCare services until the end of a 6-month service period. The self-measurement group for evaluation was classified into 3 groups (Low, Middle, and High) by evenly dividing the monthly average frequency of measurement for 6 months and the evaluation indices were weight, and BMI (Body Mass Index) transmitted from the SmartCare System. The monthly average weight and BMI were decreased more in the High Group than the Middle Group and Low Group (M5: High>Middle>Low), and they are showing statistically significant differences between groups (p< 0.05). In conclusion, analysis of the weight and BMI improvement effect showed a greater improvement effect when the self-measurement frequency level was higher.

• Journal of East-West Nursing Research
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• v.18 no.2
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• pp.111-119
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• 2012

Purpose: Recently, Neurofeedback training system that based on biofeedback of brain wave was introduced. This study was performed to identify the effects of the improvement of brain function by Neurofeedback training on elders(the 2nd or 3rd grade of long-term care insurance services). Methods: A quasi-experimental design using a nonequivalent control group, pre-post test was used. Total 11 elderly were enrolled in this study (experimental group 5, control group 6). The intervention was conducted 3 times a week for 30 minutes from January to June, 2012 (total 60 times). Chi-square test and Mann-Whitney U-test were used to analyze the data. Results: After the Neurofeedback intervention, attention quotient (AQ), anti-stress quotient (ASQ), emotion quotient (EQ) and brain quotient (BQ) of the experimental group were significantly better than those of the control group. Conclusion: The findings indicate that the Neurofeedback training program was effective in reducing fatigue by AQ, increasing the physical and mental stress resistance by ASQ, emotional balance by EQ and improving of total brain function by BQ. Therefore Neurofeedback training be used as an effective training intervention for the health of elderly in geriatric facility.

• Journal of the Institute of Electronics Engineers of Korea CI
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• v.45 no.1
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• pp.62-69
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• 2008

In this paper, we proposed the real-time bio-signals monitoring system that is based on the ZigBee wireless sensor network and SIP. This system makes medical team and user easily confirm user's medical state irrelative to their location and time. The communication between medical sensors and the user's end device uses the ZigBee wireless sensor network. The power consumption was decreased because wireless sensor network does not use the Ad-hoc routing protocol but routing protocol that is based on tree structure. Our proposed system includes a wireless user's end device, monitoring console, SIP server and database server. This real-time bio-signals monitoring system makes possible to implement the U-health care services and improving efficiency of medical treatment services.

• Journal of the Korea Society of Computer and Information
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• v.15 no.9
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• pp.129-136
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• 2010

With mobile computing, wireless sensor network and sensor technologies, ubiquitous computing services are being realized and could satisfy the feasibility of ubiquitous healthcare to everyone. This u-Healthcare service can improve life quality of human since medical service can be provided to anyone, anytime, and anywhere. To confirm the vision of u-Healthcare service, we've implemented a healthcare system for heart disease patient which is composed of two components. Front-end collects various signals such as temperature, blood pressure, SpO2, and electrocardiogram, etc. As a backend, medical information server accumulates sensing data and performs back-end processing. To simply transfer these sensing values to a medical team may be too trivial. So, we've designed a model based on context awareness for more improved medical service which is based on artificial neural network. Through rigid experiments, we could confirm that the proposed system can provide improved medical service.

• Journal of Biomedical Engineering Research
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• v.30 no.6
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• pp.503-509
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• 2009

The development of technology has led to ubiquitous health care service, which enables many patients to receive medical services anytime and anywhere. For the ubiquitous health care environment, real-time measurement of biomedical signals is very important, and the medical instruments must be small and portable or wearable. So, such devices have been developed to measure biomedical signals. In this study, we develop the biomedical monitoring device which is sensing the PPG signal, one of the useful signal in the field of ubiquitous healthcare. We design a watch-like biomedical signal monitoring system without a finger probe to prevent the user's inconvenience. This system obtains the PPG from the radial artery using a sensor in the wrist band. But, new device developed in this paper is easy to get the motion artifacts. So, we proposed new algorithm removing the motion artifacts from the PPG signal. The method detects motion artifacts by changing the degree of brightness of the light source. If the brightness of the light source is reduced, the PPG pulses will disappear. When the PPG pulses have disappeared completely, the remaining signal is not the signal that results from the changing blood flow. We believe that this signal is the motion artifact and call it the noise reference signal. The motion artifacts are removed by subtracting the noise reference signal from the input signal. We apply this algorithm to the system, so we can stabilize the biomedical monitoring system we designed.