Why Contemporary Medicine Is Failing

Berliner, Howard S.,Salmon, J. Warren 慶熙大學校 東西醫學硏究所 1986 國際東西醫學硏究論文集 Vol.1986 No.-

Beyond problems in the organization of health care are serious flaws in the paradigm and orientation of Western scientific medicine. After a brief historical review of how these problems arose, four related issues to the nature and content of conventional medicine are examined to point out the need for an new formulation. HEALTH CARE practitioners often see the U.S. health care system as immutable to progressive change. Indeed, health policy makers and planners seem unable to satisfactorily address spiraling costs, inadequate and unequal access to care, unresponsive practitioners and bureaucracies, and lack of comprehensive services. But beyond these problems of medical care organization and delivery lie problems with the actual content of medicine, which practitioners, if medicine, which practitioners, if they choose, can greatly affect. Whether it is called Western medicine, Flexnerian medicine, or technological medicine, the underlying essence of the predominant form of medical care in the united States remains the "medical model". This model emphasizes the detection and treatment of physical signs and symptoms to th exclusion or downplay of psycho-social and spiritual factors. The medical model results in a disease-focused medicine, which has little to say about health. Thus the system of medical care delivery in the united States that has followed from the premises of this orientation in medicine generates episodic, illness-oriented utilization of services by consumers. Medical care is provided chiefly by physicians specializing in a technological and invasive treatment of different parts of the body. The hospital-medical center ― a site for the already sick ― concentrates funds, personnel, and technology, to the detriment of an adequate system of preventive and primary care across the country. The fee-for-service system of medical practice, the cost reimbursement of hospital care, and uncoordinated and discontinuous patient services are also reasons that have traditionally been used to explain the absence of an effective and efficient health care system in the united States.

Current Drug Therapy in Chronic Heart Failure: the New Guidelines of the European Society of Cardiology (ESC)

Dominik Berliner,Johann Bauersachs 대한심장학회 2017 Korean Circulation Journal Vol.47 No.5

Congestive heart failure (HF) is a morbidity that is increasing worldwide due to the aging population and improvement in (acute) care for patients with cardiovascular diseases. The prognosis for patients with HF is very poor without treatment. Furthermore, (repeated) hospitalizations for cardiac decompensation cause an increasing economic burden. Modern drugs and the consequent implementation of therapeutic recommendations have substantially improved the morbidity and mortality of HF patients. This paper provides an overview of the current pharmacological management of HF patients, based on the 2016 guidelines of the European Society of Cardiology (ESC).

Change of spatiotemporal scale in dynamic models

Kim, Y.,Berliner, L.M. North-Holland Pub. Co ; Elsevier Science Ltd 2016 Computational statistics & data analysis Vol.101 No.-

<P>Spatiotemporal processes show complicated and different patterns across different space-time scales. Each process that we attempt to model must be considered in the context of its own spatial and temporal resolution. Both scientific understanding and observed data vary in form and content across scale. Such information sources can be combined through Bayesian hierarchical framework. This approach restricts a few essential scales. However, it is common in the trade-off view between simple modeling and analysis strategy with complicate modeling. Wikle and Berliner (2005) suggested a specialized, though useful, approach to the change of support (COS) problem within hierarchical framework. We extended their strategy by adding temporal modeling in their style and allowing discretized time-varying parameters. We apply a Bayesian inference based on combining information across spatiotemporal scale to some climate temperature data, which are point-referenced data and areal unit data. The inference focuses on the temperature process on specific prediction grid scale and maybe different time scale. (C) 2016 Elsevier B.V. All rights reserved.</P>

Chinese international students in the United States: demographic trends, motivations, acculturation features and adjustment challenges

Kun Yan,David C. Berliner 서울대학교 교육연구소 2011 Asia Pacific Education Review Vol.12 No.2

To date, few studies have focused solely upon understanding the unique characteristics of Chinese international students in the United States. This inquiry examines what Chinese international students' demographic trends are over decades, what their motivations are for studying in the United States, what the unique features of their group acculturation process are, and what special challenges they face in U.S. universities that are different from what they might face in Chinese universities? This study reveals that the life of Chinese students in the United States is not easy and they have to endure multifaceted life-stresses. These results can be used to help Chinese international students adapt to the American educational environment and improve the services and programs American universities deliver to their foreign students.

Approximated sensitivity analysis in posterior predictive distribution

김용구,L. Mark Berliner,김달호 한국통계학회 2015 Journal of the Korean Statistical Society Vol.44 No.2

In Bayesian statistics, a model can be assessed by checking that the model fits the data, which is addressed by using the posterior predictive distribution for a discrepancy, an extension of classical test statistics to allow dependence on unknown (nuisance) parameters. Posterior predictive assessment of model fitness allows more direct assessment of the discrepancy between data and the posited model. The sensitivity analysis revealed that the effect of priors on parameter inferences is different from their effect on marginal density and predictive posterior distribution. In this paper, we explore the effect of the prior (or posterior) distribution on the corresponding posterior predictive distribution. The approximate sensitivity of the posterior predictive distribution is studied in terms of information measure including the Kullback–Leibler divergence. As an illustration, we applied these results to the simple spatial model settings.

一部地域 特殊慰安婦의 淋菌(PPNG) 感染狀態에 關한 調査硏究

盧炳宜,BerlinerDanielS.,淋國煥,李順福 대한보건협회 1983 대한보건연구 Vol.9 No.2

The incidence of sexually transmitted disease (STD) has risen despite the progress made in it's diagnosis and treatment. High prevalence rates of STD have been reported among U.S. service members serving in Korea. Especially prevalence rates of PPNG were recently reported among U.S. service members. This study was conducted in order to determine the prevalence of PPNG among business women around U.S. military installation Euijeongbu city, Gyeonggi province. The results summarized are as follows; 1. The prevalence rate of gonorrhea was 13.9%. 2. The prevalence rate of PPNG of gonorrhea cases was 27.6%. 3. The prevalence rate of PPNG was higher in older age group than in young age group (p<0.01). 4. The prevalence rates of PPNG and gonorrhea were ower in the group with higher education than lower education.

Tensions in gifted college programs in China: the case of “Mount Everest Plan”

Kun Yan,David C. Berliner 서울대학교 교육연구소 2016 Asia Pacific Education Review Vol.17 No.2

To date, no empirical study has focused upon understanding the tensions in gifted college programs in China. This qualitative inquiry examines the tensions the “Mount Everest Plan” programs face while initiating gifted education reform in China, how the gifted college students characterize these tensions, and what conditions they believe tend to account for the tensions. The voices of 18 gifted college students were heard through individual semi-structured interviews and the transcripts of the interviews were analyzed using thematic coding to uncover the themes related to the tensions. This qualitative case study identifies multiple tensions arise surrounding the “Mount Everest Plan” programs which include program training needs versus students’ personal growth needs, program identification purposes versus students’ personal motives, identification of a person versus identification of a path to success, and high variance within the gifted class versus undifferentiated curriculum. These tensions involve competing arguments on the genesis and the development of gifted education and gifted students. The study also discusses possible ways of resolving and easing these tensions so that the services and programs can be enhanced.

Bayesian diffusion process models with time-varying parameters

김용구,강석복,L. Mark Berliner 한국통계학회 2012 Journal of the Korean Statistical Society Vol.41 No.1

The diffusion process is a widely used statistical model for many natural dynamic phenomena but its inference is very complicated because complete data describing the diffusion sample path is not necessarily available. In addition, data is often collected with substantial uncertainty and it is not uncommon to have missing observations. Thus, the observed process will be discrete over a finite time period and the marginal likelihood given by this discrete data is not always available. In this paper, we consider a class of nonstationary diffusion process models with not only the measurement error but also discretely timevarying parameters which are modeled via a state space model. Hierarchical Bayesian inference for such a diffusion process model with time-varying parameters is applied to financial data.

Modeling the sensitivity of hydrogeological parameters associated with leaching of uranium transport in an unsaturated porous medium

Berlin Mohanadhas,Suresh Kumar Govindarajan 대한환경공학회 2018 Environmental Engineering Research Vol.23 No.4

The uranium ore residues from the legacies of past uranium mining and milling activities that resulted from the less stringent environmental standards along with the uranium residues from the existing nuclear power plants continue to be a cause of concern as the final uranium residues are not made safe from radiological and general safety point of view. The deposition of uranium in ponds increases the risk of groundwater getting contaminated as these residues essentially leach through the upper unsaturated geological formation. In this context, a numerical model has been developed in order to forecast the 238U and its progenies concentration in an unsaturated soil. The developed numerical model is implemented in a hypothetical uranium tailing pond consisting of sandy soil and silty soil types. The numerical results show that the 238U and its progenies are migrating up to the depth of 90 m and 800 m after 10 y in silty and sandy soil, respectively. Essentially, silt may reduce the risk of contamination in the groundwater for longer time span and at the deeper depths. In general, a coupled effect of sorption and hydro-geological parameters (soil type, moisture context and hydraulic conductivity) decides the resultant uranium transport in subsurface environment.

Fuzzy statistics and computation on the lexical semantics: How much do you think? and how many?

( Berlin Wu ),( Ching Min Sun ) 한국언어정보학회 1996 국제 워크샵 Vol.1996 No.-

In this paper, we investigated the fuzzy statistics analysis in lexical semantics and apply the fuzzy logic to compute some uncertain and ambiguous problems. The fuzzy propositional computation for the cognitive semantics can account for the degree of typicality and similarity. Which provide a more precise expression in human thought and human cognition. Some essential definitions for fuzzy statistics are proposed to implement thses procedures. The empirical results by a sampling survey and fuzzy statistical analysis suggests that the fuzzy statistics and computation are potentially powerful heuristics in analyzing lexical semantics.