Medical staff may have difficulties in using conventional medicine to manage symptoms among terminally ill patients, including adverse effects of the treatment. Traditional Chinese medicine (TCM) is regarded as a complementary or alternative medicine, and has been increasingly used in the field of palliative medicine in recent years. This study aimed to investigate the experiences of and attitudes toward using TCM among palliative care professionals, and to provide preliminary information about its use in palliative care. This was a cross-sectional survey study conducted in eight inpatient hospice wards in Taiwan between December 2014 and February 2016. The questionnaire was self-administered, and was analyzed with descriptive statistics including Pearson’s Chi-square test and Fisher’s exact test. A total of 251 palliative care professionals responded to the questionnaire, of whom 89.7% and 88.9% believed that the use of TCM could improve the physical symptoms and quality of life in terminally ill patients, respectively. Overall, 59.8%, of respondents suggested that TCM had rare side effects, and 58.2% were worried that TCM could affect the liver and kidney function of patients. In total, 89.7% and 88.0% of professionals agreed there were no suitable clinical practice guidelines and educational programs, respectively, for TCM use in palliative care. Most of the respondents agreed there was insufficient knowledge, skills-training, and continuing education on the use of TCM in terminally ill patients in Taiwan. These results show that to address patient safety considerations, guidelines about use of TCM in palliative care should be established.

In this paper, we aim to detect distributed denial of service (DDoS) attacks, and receive a notification of destination service, changing immediately, without the additional efforts of other modules. We designed a kernel-based mechanism to build a new Transmission Control Protocol/Internet Protocol (TCP/IP) connection smartly by the host while the users or clients not knowing the location of the next host. Moreover, we built a lightweight flooding attack detection mechanism in the user mode of an operating system. Given that reinstalling a modified operating system on each client is not realistic, we managed to replace the entry of the system call table with a customized sys_connect. An effective defense depends on fine detection and defensive procedures. In according with our experiments, this novel mechanism can detect flooding DDoS successfully, including SYN flood and ICMP flood. Furthermore, through cooperating with a specific low cost network architecture, the mechanism can help to defend DDoS attacks effectively.