Navigation menu

Enhanced cooperation

IN ADDITION TO READING ONLINE, THIS TITLE IS AVAILABLE IN THESE FORMATS:.

 · bevorzugen (third-person singular simple present bevorzugt, past tense bevorzugte, past participle bevorzugt, auxiliary haben) to favor, to prefer Conjugation [ edit ]. English-German online dictionary developed to help you share your knowledge with others. More information! Contains translations by TU Chemnitz and Mr .

This is an efficiency gain, obviously, but it also allows modification of selected elements of an array in various ways. An important constraint on NumPy arrays is that for a given axis, all the elements must be spaced by the same number of bytes in memory. NumPy cannot use double-indirection to access array elements, so indexing modes that would require this must produce copies. NumPy arrays offer a number of other possibilities, including using a memory-mapped disk file as the storage space for an array, and record arrays , where each element can have a custom, compound data type.

However, they have certain limitations: This also means that very few list operations can be carried out by efficient C loops — each iteration would require type checks and other Python API bookkeeping. The short version is that Numeric was the original package that provided efficient homogeneous numeric arrays for Python, but some developers felt it lacked certain essential features, so they began developing an independent implementation called numarray.

Having two incompatible implementations of array was clearly a disaster in the making, so NumPy was designed to be an improvement on both. Neither Numeric nor numarray is currently supported.

NumPy has been the standard array package for a number of years now. If you use Numeric or numarray, you should upgrade; NumPy is explicitly designed to have all the capabilities of both and already boasts new features found in neither of its predecessor packages.

There are tools available to ease the upgrade process; only C code should require much modification. SciPy is freely available. It is distributed as open source software, meaning that you have complete access to the source code and can use it in any way allowed by its liberal BSD license. Actually, the time-critical loops are usually implemented in C or Fortran.

Much of SciPy is a thin layer of code on top of the scientific routines that are freely available at http: Netlib is a huge repository of incredibly valuable and robust scientific algorithms written in C and Fortran. It would be silly to rewrite these algorithms and would take years to debug them. Some wrappers were generated by hand coding them in C. The rest were generated using either SWIG or f2py.

Some of the newer contributions to SciPy are either written entirely or wrapped with Cython. A second answer is that for difficult problems, a better algorithm can make a tremendous difference in the time it takes to solve a problem. The SciPy development team works hard to make SciPy as reliable as possible, but, as in any software product, bugs do occur.

If you find bugs that affect your software, please tell us by entering a ticket in the SciPy bug tracker , or NumPy bug tracker , as appropriate. Drop us a mail on the mailing lists. We are keen for more people to help out writing code, unit tests, documentation including translations into other languages , and helping out with the website. Yes, commercial support is offered for SciPy by Enthought. Please contact eric enthought. In an ideal world, NumPy would contain nothing but the array data type and the most basic operations: All numerical code would reside in SciPy.

Thus NumPy contains some linear algebra functions, even though these more properly belong in SciPy. In any case, SciPy contains more fully-featured versions of the linear algebra modules, as well as many other numerical algorithms. If you are doing scientific computing with python, you should probably install both NumPy and SciPy. Most new features belong in SciPy rather than NumPy. Plotting functionality is beyond the scope of NumPy and SciPy, which focus on numerical objects and algorithms.

Several packages exist that integrate closely with NumPy to produce high quality plots, such as the immensely popular Matplotlib and the extensible, modular toolkit Chaco. Matplotlib provides basic 3D plotting in the mplot3d subpackage, whereas Mayavi provides a wide range of high-quality 3D visualization features, utilizing the powerful VTK engine.

This program currently reaches 16, employees who attend either a half-day, 1-day, or 2-day training session that teaches them how to expand their energy beyond their current status.

Isaac concluded his presentation by saying he wished to impart six key messages. First, success springs from a culture of health, which is built into the fabric of business, communities, and health systems. Second, phased approaches and pilots are critical to successful implementation. Third, there must be both short- and long-term goals and measurement of outcomes. Fourth, a focus on health risk factors can yield strong results. Fifth, increased productivity and engagement can generate significant cost savings and improved performance.

Finally, investment in prevention and health innovation can yield significant economic and social returns. The same is true for patients, especially at critical moments such as when receiving a new diagnosis. Rosenblatt said company founder George Merck framed up its broad responsibilities to patients very well back in , when he said:. We cannot step aside and say that we have achieved our goal by inventing a new drug….

We cannot rest until a way has been found with our help to bring our finest achievement to everyone. Stories heard every day show that there is much opportunity to help create better understanding for patients. Rosenblatt said that as an endo-crinologist he has placed many patients on thyroid hormones and told them they must take it every day of their lives because it is substituting for a hormone that normally circulates in the body. But numerous times patients stop taking the medicine when they assumed it might interfere with a newly prescribed antibiotic, for example.

Similarly, he noted, patients placed on cholesterol medications sometimes abandon them as soon as their cholesterol reaches appropriate levels. The challenge is to communicate effectively, in a language that patients can understand, especially at critical times, such as when they are assimilating a new diagnosis.

There is a large emotional overlay and, even if the language used is quite right, the patients may not be in a position to accept or understand that language, Rosenblatt said. The significant challenges faced in health care today place more responsibility on us all to do better. When patients do not participate in their care, do not follow important lifestyle changes, and do not show up for appointments, bad things can happen.

And of course medicines do not work if people do not take them correctly. But there has been a shift—a true evolution—to a focus on the whole patient, and the whole ecosystem surrounding the patient. That is where efforts to improve health literacy come in. Research-focused companies like Merck are in a unique position to contribute, as they shepherd discoveries from the lab to the marketplace. It is a journey that involves multiple touchpoints with the patient and with others affecting the patient experience—providers, advocates, payers, and policy makers.

Each touchpoint is an opportunity for education and greater understanding. Unfortunately, many patients have a fundamental distrust of medicine, Rosenblatt said. They might be concerned because the medicine is a chemical, or because it was made by a for-profit company. One of the things the industry can do to build trust is spread the message about medications to help people better understand where a medicine comes from and that the industry does not work in a vacuum.

Rather, there is extensive research and clinical trials behind medicines and rigorous evaluations by health authorities such as the U. Food and Drug Administration. If people understand all this better, they might have fewer inner struggles, and more confidence in their medicines. And, said Rosenblatt, trust levels would go up considerably if patients also had an understanding not only of why they need to take a medicine for a particular disease but also about the risks of their medical condition alone.

Rosenblatt highlighted where Merck is on its journey to embed health literacy into its work across many aspects of its business. He said that while creating understanding about diseases and its medicines in patient prescribing information and medication guides is not new, the company has been helping advance health literacy through more formal initiatives in three main areas: Rosenblatt added that health literacy principles enable all to help patients better understand and weigh their choices—not only the risk—benefit of medicines but also the risk—risk ratio—as well as the possible risk of letting the disease take its natural course versus the possible risks of treatment.

There is the risk of the disease, the natural history of the disease, and the events associated with that disease. Then there is the risk of side effects of the medicine. If the balance among these factors is not in favor of the medicine, then the patient should not be taking the medicine, Rosenblatt said. But for many people, the concept of benefit means some-. That is not always the case, he said. It is usually that the patient will not get some sequelae of the disease.

He said the industry can work to apply health literacy principles and standards to efforts ranging from clinical trial recruitment to the packaging of medicines.

There are many avenues to take in addressing issues of health literacy. There will be a menu of opportunities, a menu of ways to communicate with different patients, Rosenblatt said. Certain things will work for some but not for others. And it is important to realize that there is no average patient. Rosenblatt said that the workshop under way has the potential to be a turning point in the field. It can have great impact for patients and can elevate things to the point that health care policy has health literacy as a priority.

Merck shares the goals of elevating patient health through patient literacy, he said, and his colleagues at Merck are fully committed to this field. The floor was opened for discussion.

Also, he said, the data show that level of health literacy is related to perceived health. The participant asked if an analysis will be conducted of whether or not health literacy acts as some kind of mediator that might help those who come from more socially disadvantaged backgrounds—that it might protect them somewhat in relation to their health.

If it were identified that those having higher health literacy, even when poor, experienced a protective effect on their health, that would be a profound finding on a population basis, he said. The data do show a strong social gradient, and there are additional burdens related to age, low education, or social deprivation. Pelikan also responded to the question and said the analysis is examining the distribution of health literacy across the population and looking at determinants of health literacy.

Health literacy is not a dichotomous concept, he said; rather, it is a more-or-less concept, and the data from the survey show very interesting social gradients.

The data also show that health literacy. There are also correlations with body mass index. But the evidence concerning alcohol use and smoking is very different in different countries. Another finding is that health literacy is second only to age as an important predictor for health. There is also an interesting relationship between health literacy and use of health care services, that is, people with higher health literacy have less use of health care services than people with low health literacy.

That, Pelikan said, is a very interesting finding and has implications for costs. In the United States, she said, there has been a rise in ethnic media, not just Hispanic but also Asian and African American media, including television, newspapers, and magazines. How, she asked, can one measure the impact of ethnic media as well as how it interconnects with mainstream media at the national level?

Apfel responded that this is a tough question. One component relates to how populations are segmented; another relates to how to develop audience-centered communication strategies that address the needs of the users. At the core is finding out where those you want to reach are getting their information, he said. Apfel said that a recent study on immunization programs had, as a major focus, the Roma populations because there is concern that these populations are either not immunized or underimmunized.

In many instances, they were labeled as hard-to-reach populations. Apfel said that his organization conducts media audits that examine who the spokespeople are. Those are the individuals one wants to involve in planning whatever effort is under way because the influence of the local media is very important, he said. Local spokespeople also need to be involved in the implementation and evaluation of the program.

People from the community one is trying to reach are critical to the effort, he said. At this stage, the project is sharing results and discussing tools to use to measure policy frameworks and activity plans, and how to develop curriculums. The question is one of how to involve a broader group. Questions to consider, she said, include how formal such a federation should be; what kind of networks should be involved, or should it be an organization that individuals could join; should it focus on policy, practice, research, or all three; should membership be free, should membership cost something, or is there another way to fund the effort; and what should be the goals of the organization.

Apfel said that he hoped a certain kind of credential would not be needed to become involved in health literacy, and that a network seems like a great way to expand and develop a global consciousness.

Isham pointed out that the IOM Roundtable on Health Literacy does not have any requirement for credentials for members, sponsors, or participants in its meetings. Furthermore, the Roundtable appreciates the opportunity to draw upon the expertise of the field, and the strength of the dialogue comes from the mix of backgrounds and people joining together in the conversation.

Jennifer Cabe addressed her remarks to Isaac and Rosenblatt. She asked how employees influence internal policy. Isaac said that part of the engagement and participation strategy has to do with the entry point, which is the health risk assessment process that includes an online survey and response to a number of questions about modifiable risk factors and behaviors.

The company also has health targets, as discussed earlier. Promotional materials are placed everywhere—from the cafeterias to bulletin boards to restrooms. Representatives from the employee population are asked what they like and what they do not like about various programs. For example, employees who smoke were involved in putting a tobacco-free policy in place. Results of that survey vary from company to company and reflect company leadership. These results help identify where additional effort is needed.

They have moved health literacy. What messages do these companies have to take to the other companies that do not have a health-related product, she asked. Once resources are available, a participant said, employees take more and more advantage of them, and the early indicators are that they are having an impact. In the United States, most of the message is centered around health care. When discussions are held with senior management, health care cost is emphasized.

However, when one travels outside the United States, what is discussed is engagement, using health programs as a method for recruitment and retention, especially in emerging markets. Can these findings be replicated? Can the same insights and the same findings emerge from different methods and different perspectives?

Answering her own question, Rudd said that the answer is an enthusiastic yes because different measures of the health literacy of populations in the United States, Canada, Australia, New Zealand, and the Netherlands came to the same conclusions.

Literacy may not be a mediating factor, but it could well be a social determinant of health, she said. That question has not yet been answered. Is a respondent in the survey saying he or she does not have access to needed information because of his or her own lack of skills or because the information is so poorly constructed that it is not accessible?

The answer to that question has profound implications for action, Rudd said. Perhaps one needs to focus on the demand side of the equation—improving information, the accessibility of information, and on communication. But the shocking thing is that only 47 percent of individuals are doing well in terms of health literacy. Change must occur, but where that change should start has yet to be determined, she said. It is important to use the results of the comparative study to look at what are the best practices in different systems.

Who can we learn from? What is the best approach for different situations? Isham asked what the impact has been on the countries that participated in the survey in terms of engagement of those in policy and leadership positions. Activity has varied from country to county, however. Within each participating country there is a national advisory board. Those boards are very different from country to country. In Ireland, for example, they have created the health literacy award, which serves as an example for other countries.

Netherlands, there is also an active group of researchers that is developing a health literacy alliance that already has 60 organizations engaged.

For Bulgaria and Poland, however, there has been no established activity. In Austria, the results were quickly taken up, and health targets are being established. This alliance brought together 60 multinational companies to begin to share data and information on what works in worksite wellness programs.

Lower health spending, strong return on investment. Health Affairs 30 3: Comparative report of health literacy in eight EU member states. Measuring the information society. Health literacy in Israel: Policy, action, research and beyond. Some Melungeon communities in rural Appalachia have historically self-identified as "Portuguese", despite having no Portuguese origin.

Bilateral ties date from the earliest years of the United States. Portuguese people have had a very long history in the United States, since Navigators, like the Miguel Corte-Real family, may have visited the North American shores at the beginning of the 16th century.

There is a historic landmark, the Dighton Rock , in southeastern Massachusetts , that a small minority of scholars believe testifies their presence in the area. During the Colonial period , there was a small Portuguese emigration to the present-day U. In the late 19th century, many Portuguese, mainly Azoreans and Madeirans , emigrated to the eastern U.

A Portuguese community existed in the vicinity of the Carpenter Street Underpass in Springfield, Illinois , one of the earliest and largest Portuguese settlements in the Midwestern United States.

Many Portuguese settled in the Kingdom of Hawaii , before its overthrow by the United States in the late 19th century. In the s, whaling ships were the way to get to America, after a slow voyage of two to three years. By the early 19 th century, New Bedford had become the center of whaling in America. When whalers were out at sea, they would frequently stop in the Azores to recruit crew members for help. Today, one can visit the Whaling Museum in New Bedford, Massachusetts and encounter authentic Portuguese whaling history.

There are Portuguese clubs, principally in the larger cities of these states, which operate with the intention of promoting sociocultural preservation as venues for community events, athletics, etc. There were around 1 million Portuguese Americans in the United States by A general contribution the Portuguese people have made to American music is the ukulele , which originated in Madeira and was initially popularized in the Kingdom of Hawaii.

A large amount of mingling took place between Chinese and Portuguese in Hawaii. For two years to June 30, , 38 of these children were born; they were classified as pure Chinese because their fathers were Chinese. In —58, the Capelinhos volcano erupted on the Azorean island of Faial , causing massive destruction from lava and smoke.

President Dwight Eisenhower signed the Azorean Refugee Act in , making 1, visas available to the victims of the eruption. According to the United States Census from , there were 1,, Portuguese-Americans, the majority being of Azorean descent.

The single number makes it easier for people to keep track of their health risks and establishes simple goal ranges.

Closed On:

Promoting and sustaining a culture of health within an organization requires finding approaches that incorporate these five components in such a way that they become part of the fabric of the organization rather than an add-on, Isaac said.

Copyright © 2015 stc-comm.info

Powered By http://stc-comm.info/