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Assistance with the management of their illnesses or disease can also include assisting with cooperative purchases of health care materials. Establishing a network of contacts. Examples of contacts patient advocates can assist in connecting patients to include: in the public sector (political and regulatory), in public and private health insurance, in the sector of medical service providers, with medical practitioners, and with pharmaceutical and medical research to provide patients with help in the care and management of their diseases.
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Providing emotional support in dealing with their health concerns, illnesses, or chronic conditions. According to the National Institute of Mental Health, individuals with chronic illnesses are at a higher risk of depression of than patients with other mental health conditions. When managing their illnesses, patients and survivors experience the direct effect of the consequences their disease has on their quality of life, and may also go through difficult phases of adaptation of their daily routine and lifestyle to accommodate the disease.
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Part of the role of patient advocates can include providing emotional support for patients or connecting them to mental health resources. Attending appointments with a patient. Patients can find doctor's appointments intimidating, but also difficult to understand.
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Issues may stem from differences in language proficiency, educational background, or background in health literacy. A patient advocate's presence can ensure that patient's concerns are highlighted and adequately addressed by physicians.
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Patient advocates may also be responsible for assisting with scheduling additional appointments as well. Assisting with health insurance and other financial aspects of healthcare. The Institute of Medicine in the United States says fragmentation of the U.S.
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health care delivery and financing system is a barrier to accessing care. Within the financing system, health insurance plays a significant role. According to a United Health survey, only 9% of Americans surveyed understood health insurance terms, which presents a significant issue for patients, given the importance of health insurance in terms of providing access to healthcare. The patient advocate may help with researching or choosing health insurance plans.
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The American Nurses Association (ANA) includes advocacy in its definition of nursing: Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations. Advocacy in nursing finds its theoretical basis in nursing ethics. For instance, the ANA's Code of Ethics for Nurses includes language relating to patient advocacy: The nurse's primary commitment is to the patient, whether an individual, family, group, or community. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.Several factors can lead a patient to use nurses for advocacy, including impairments in their ability to express wishes such as die to speech impairments or limited consciousness, lack of independence due to illiteracy, sociocultural weakness, or separation from friends or family caused by hospitalization.
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Nurses are more able to advocate if they are independent, professionally committed, and have self-confidence as well as having legal and professional knowledge, as well as knowing a patient's wishes. The act of patient advocacy improved nurses' sense of professional well-being and self-concept, job motivation and job satisfaction, and enhances the public image of nurses; however, advocating for a patient could have social and professional consequences. : 146 Conflict of interests between a nurse's perceived professional responsibilities and their responsibilities to the patient can be a barrier to advocacy.
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: 174 Additionally, a nurse is concerned about all of the patients they care for rather any individual patient. : 190 Gadow and Curtis argue that the role of patient advocacy in nursing is to facilitate a patient's informed consent through decision-making, but in mental health nursing there is a conflict between the patient's right to autonomy and nurses' legal and professional duty to protect the patient and the community from harm, since patients may experience delusions or confusion which affect their decision-making. In such instances, the nurse may engage in persuasion and negotiation in order to prevent the risk that they perceive. : 192
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Private advocates (also known as independent patient/health/health care advocates) often work alongside the advocates that work for hospitals. As global healthcare systems started to become more complex, and as the role of the cost of care continues to place more of a burden on patients, a new profession of private professional advocacy began to take root in the mid-2000s. At that time, two organizations were founded to support the work of these new private practitioners, professional patient advocates. The National Association of Healthcare Advocacy Consultants was started to provide broad support for advocacy.
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The Alliance of Professional Health Advocates was started to support the business of being a private advocate. Some regions require that those detained for the treatment of mental health disorders are given access to independent mental health advocates who are not involved in the patient's treatment. : 20 Proponents of private advocacy, such as Australian advocate Dorothy Kamaker and L. Bradley Schwartz, have noted that the patient advocates employed by healthcare facilities have an inherent conflict of interest in situations where the needs of an individual patient are at odds with the business interests of an advocate's employer.
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Kamaker argues that hiring a private advocate eliminates this conflict because the private advocate "…has only one master and very clear priorities. "Kamaker founded patientadvocates.com.au in 2013 and followed with disabilityhealthsupport.com.au in 2021 when research revealed that vulnerable groups achieved sub-optimal outcomes and encountered barriers and prejudice in the mainstream health and hospital systems in Australia. "Based on the limited data available, we know that the overall health of people with disabilities is much worse than that of the general population", with "people with disabilities rarely identified as a priority population group in public health policy and practice".
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Patients supported by advocates have been shown to experience fewer treatment errors and require fewer readmissions post discharge. In Australia there has been some movement by private health insurers to engage private patient advocates to reduce costs, improve outcomes and expedite return to work for employees.
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Schwartz is the founder and president of GNANOW.org, where he states, "Everyone employed by a health care company is limited to what they can accomplish for patients and families. Hospital-employed patient advocates, navigators, social workers, and discharge planners are no different. They became health care professionals because they are passionate about helping people.
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But they have heavy caseloads and many work long hours with limited resources. Independent Patient Advocates work one-on-one with patients and loved ones to explore options, improve communication, and coordinate with overworked hospital staff. In fact, many Independent Patient Advocates used to work for hospitals and health care companies before they decided to work directly for patients."
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Patient advocacy organizations, PAO, or patient advocacy groups are organizations that exist to represent the interests of people with a particular disease. Patient advocacy organizations may fund research and influence national health policy through lobbying. : 5 Examples in the US include the American Cancer Society, American Heart Association, and National Organization for Rare Disorders. : 345 Some patient advocacy groups receive donations from pharmaceutical companies.
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In the US in 2015, 14 companies donated $116 million to patient advocacy groups. A database identifying more than 1,200 patient groups showed that six pharmaceutical companies contributed $1 million or more in 2015 to individual groups representing patients who use their drugs, and 594 groups in the database received donations from pharmaceutical companies. Fifteen patient groups relied on pharmaceutical companies for at least 20 percent of their revenue in the same year, and some received more than half of their revenue from pharmaceutical companies.
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Recipients of donations from pharmaceutical companies include the American Diabetes Association, Susan G. Komen, and the Caring Ambassadors Program.Patient opinion leaders, also sometimes called patient advocates, are individuals who are well versed in a disease, either as patients themselves or as caretakers, and share their knowledge on the particular disease with others. Such POLs can have an influence on health care providers and may help persuade them to use evidence-based therapies or medications in the management of other patients. Identifying such people and persuading them is one goal of market access groups at pharmaceutical and medical device companies.
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Solace Solace is an American professional organization where private advocates can list their business and allow consumers to book conversations with advocates directly. Alliance of Professional Health Advocates The Alliance of Professional Health Advocates (APHA) is an international membership organization for private, professional patient advocates, and those who are exploring the possibility of becoming private advocates. It provides business support such as legal, insurance and marketing. It also offers a public directory of member advocates called AdvoConnection.
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Following the 2011 death of Ken Schueler — a charter member of the APHA, described as "the Father of Private Patient Advocacy" — the organization established the H. Kenneth Schueler Patient Advocacy Compass Award. The award recognizes excellence in private practice including the use of best practices, community outreach, support of the profession and professional ethics. Dialysis Patient Citizens Dialysis Patient Citizens is an American patient-led, non-profit organization dedicated to improving dialysis citizens' quality of life by advocating for favorable public policy.
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One of DPC's goals is to provide dialysis patients with the education, access and confidence to be their own advocates. Through their grassroots advocacy campaigns, Patient Ambassador program; Washington, D.C.
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patient fly-ins; conference calls and briefings, DPC works to train effective advocates for dialysis-related issues. Membership is free. National Association of Healthcare Advocacy Consultants National Association of Healthcare Advocacy Consultants (NAHAC) is an American nonprofit organization located in Berkeley, California.
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Joanna Smith founded NAHAC on July 15, 2009, as a broad-based, grassroots organization for health care and patient advocacy. To that end, it is a multi-stakeholder organization, with membership open to the general public. National Patient Advocate Foundation The National Patient Advocate Foundation is a non-profit organization in the United States dedicated to "...improving access to, and reimbursement for, high-quality healthcare through regulatory and legislative reform at the state and federal levels."
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The National Patient Advocate Foundation was founded simultaneously with the non-profit Patient Advocate Foundation, "...which provides professional case management services to Americans with chronic, life-threatening and debilitating illnesses." Patient Advocates Australia Patient Advocates Australia, founded by Dorothy Kamaker, is a support option for consumers of aged, health and disability care in Australia. For the elderly, an emerging need has arisen for patient advocacy in residential aged facilities.
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The Aged Care Royal Commission Report published in 2021 has made recommendations regarding a need for vigilant advocacy for residents of nursing homes to protect them against rampant abuse and neglect, with one submission calling for the routine provision of independent patient advocates. For the disabled, funding for support to overcome healthcare barriers is available through the National Disability Insurance Scheme. Greater National Advocates (GNA) Greater National Advocates is a non-profit organization with the goal of raising Americans' awareness of the lifesaving benefits of independent patient advocacy and to provide patients and loved ones with immediate online access to a trusted network of qualified practitioners. GNA uses fact-based media to spread awareness and steer patients and their loved ones to GNANOW.org where they can learn more and find the professional support they need.
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Founded in 2000, the interprofessional Center for Patient Partnerships (CPP) at University of Wisconsin–Madison offers a health advocacy certificate with a focus on either patient advocacy or system-level health policy advocacy. The chapter "Educating for Health Advocacy in Settings of Higher Education" in Patient Advocacy for Health Care Quality: Strategies for Achieving Patient-Centered Care describes CPP's pedagogy and curriculum.
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In the United States, state governmental units have established ombudsmen to investigate and respond to patient complaints and to provide other consumer services. New York In New York, the Office of Patient Advocacy within the New York State Office of Alcoholism and Substance Abuse Services (OASAS) is responsible for protecting the rights of patients in OASAS-certified programs. The office answers questions from patients and their families; provides guidance for health care professionals on topics related to patient rights, state regulations, and treatment standards, and intervenes to resolve problems that cannot be handled within treatment programs themselves.
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California In California, the Office of the Patient Advocate (OPA), an independent state office established in July 2000 in conjunction with the Department of Managed Health Care, is responsible for the creation and distribution of educational materials for consumers, public outreach, evaluation and ranking of health care service plans, collaboration with patient assistance programs, and policy development for government health regulation.Such state government offices may also be responsible for intervening in disputes within the legal and insurance systems and in disciplinary actions against health care professionals. Some hospitals, health insurance companies, and other health care organizations also employ people specifically to assume the role of patient advocate. Within hospitals, the person may have the title of ombudsman or patient representative.
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Catherine Amanda Morgan is a New Zealand feminist psychology academic, as of 2019 is a full professor at the Massey University.
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After a 1992 PhD titled 'Strange attractions: discourse, narrative and subjectivity in social psychology' at Murdoch University, Morgan moved to the Massey University, rising to full professor in 2013.Morgan was an adviser to the Glenn Inquiry, but resigned from the troubled group in 2013.
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Kahu, Ella, and Mandy Morgan. "A critical discourse analysis of New Zealand government policy: Women as mothers and workers." In Women's Studies International Forum, vol. 30, no. 2, pp.
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134–146. Pergamon, 2007. Bürgelt, Petra T., Mandy Morgan, and Regina Pernice.
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"Staying or returning: Pre‐migration influences on the migration process of German migrants to New Zealand." Journal of Community & Applied Social Psychology 18, no. 4 (2008): 282–298. Kahu, Ella, and Mandy Morgan.
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"Weaving cohesive identities: New Zealand women talk as mothers and workers." Kōtuitui: New Zealand Journal of Social Sciences Online 2, no. 2 (2007): 55–73. Morgan, Mandy, and Leigh Coombes.
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"Subjectivities and silences, mother and woman: Theorizing an experience of silence as a speaking subject." Feminism & Psychology 11, no. 3 (2001): 361–375. O'Neill, Damian, and Mandy Morgan. "Pragmatic post‐structuralism (I): participant observation and discourse in evaluating violence intervention." Journal of Community & Applied Social Psychology 11, no. 4 (2001): 263–275.
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Autonomous pharmacy is an approach to medication management that seeks to create a more automated and data-driven process for medication inventory and dispensing. The main concept behind autonomous pharmacy is to use technology in place of manual medication processes in order to help healthcare providers reduce medication errors, decrease costs and save staff time. Autonomous pharmacy may use a combination of hardware, software and technology-enabled services to allow pharmacists to more effectively manage medication dispersal.
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When a physician prescribes a medication, they expect the correct medication to be administered to the patient; however, the medication management process depends on people, who are subject to human error. In a hospital or health system, a mistake in carrying out a medication order can put patient care at risk, and can even be fatal. According to the World Health Organization, medication errors cause at least one death every day and injure approximately 1.3 million people annually in the U.S.
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Global costs of medication errors are estimated at $42 billion annually. With better automation that includes technologies such as barcoding, there is less chance for human error. Health-system pharmacists spend only a quarter of their working hours on clinical activities.
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Automating medication distribution tasks would enable pharmacists to spend more time working with patients to address their medication-use issues and provide clinical support.The concept of an autonomous pharmacy is compatible with prior work to advance pharmacy practice, including the American Society of Health-System Pharmacists (ASHP)'s Practice Advancement Initiative 2030 (PAI 2030), whose themes include harnessing data and advancing pharmacy technician roles. Industry leaders, including pharmacy officers from notable hospitals and health systems, have joined to form the Autonomous Pharmacy Advisory Board. The board aims to transform the pharmacy care delivery model through the use of technology to achieve the fully autonomous pharmacy. It has established a five-level framework for achieving the autonomous pharmacy, similar to how levels of driving automation have been defined for autonomous vehicles. Another analog to the autonomous pharmacy framework is the eight-stage Electronic Medical Record Adoption Model developed by the Healthcare Information and Management Systems Society (HIMSS) to score hospitals regarding their electronic medical records (EMR) capabilities.
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Health systems are in various stages of progression along the autonomous pharmacy framework based on the medication management technology and data analytics they have implemented. Stanford Health Care uses robotic devices for storage, retrieval, and packaging of medications in the pharmacy. Texas Children's Hospital uses similar robotics technology in its central pharmacy and a robotic system for preparing intravenous (IV) drugs.
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This frees up time for the hospital's pharmacy technicians to prepare doses that require specialized attention such as those for chemotherapy. Similarly, Vanderbilt University Hospital & Clinics and Wake Forest Baptist Health have also adopted autonomous pharmacy technology in their respective organizations for better medication management. == References ==
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In the picture framing industry, a fillet (also referred to as a slip) is a small piece of moulding which fits inside a larger frame or, typically, underneath or in between matting, used for decorative purposes. The picture framing term is probably related to, though not necessarily derived from, the engineering term, which it is frequently pronounced similarly to; however, unlike the use of fillets in mechanical engineering, the use of "fillets" in picture frames is wholly decorative.
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Fillet can be pronounced in two ways. The other is similar to the French-derived culinary term. Either is acceptable in English, though most frame shops prefer one or the other pronunciation.
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Fillets are typically made of soft or hard wood, and feature a flat "lip" which can fit underneath a mat; the non-lip portion is what is displayed. Except for their shape and size (which is understandably small), fillets are constructed similarly to picture frames, usually from wood or polystyrene. One way is to pronounce it as if it were "fill-et" such as the cut of meat, as the similar term from mechanical engineering is pronounced. Metal fillets are very rare. Fillets are available in a number of styles and finishes, including gold and silver leaf finishes.
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The fillet is normally used as decoration in the lining of a picture frame or underneath a mat inside one; the intent is to help draw the eye inwards to the document being framed.However, one can also use inverted fillets as form of picture frame on small, flat objects, as seen below: In this case, the card was glued to the lip of the inverted fillet (which is thus hidden behind the back of the card). Objects such as this that have been framed using inverted fillets can be backed and then affixed to wire for hanging, displayed on an easel, or used inside of a larger shadowbox display. It is important to note that only very small, extremely flat objects can be framed using only an inverted fillet, as a fillet lacks the depth of a traditional picture frame, and due to its size, weight and construction, could not support a great amount of weight on its own.
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Deathcare (also death care, death-care or after-deathcare) is the planning, provision, and improvement of post-death services, products, policy, and governance. Here, deathcare functions to describe the industry of deathcare workers, the policy and politics surrounding deathcare provision, and as an interdisciplinary field of academic study.Deathcare, from the point of clinical death, has a diverse timeline. The first point of care often involves immediate healthcare professionals and responders closest to the person who has died, including doctors, nurses, palliative and end-of-life care workers. From here, the care of deceased individuals has a culturally, religious, and personal course. This can involve a range of people from religious figures, morticians, to grave keepers – all of these roles formulating to what can be known as deathcare workers.
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The word deathcare is a compound term from the words death and care. It can also take the form of death care, however this is mostly used in the United States and Canada in the Anglosphere, where deathcare is a preferred variation elsewhere in the English speaking world reflecting on the preferred version of healthcare in places like the UK, Australia, India, etc.
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The provision of deathcare has historically and often continues to be a highly decentralized and diverse practice combining multiple actors and stages. Nonetheless, trends in providers and purveyors of deathcare do exist throughout different eras: in the time prior to the American Civil War, for instance, the majority of care for the deceased was performed by one's own family members. Specifically, women in the family were expected, as a part of their domestic duties, to oversee and execute the sanitization, dressing, and ultimately burial of their families' corpses. However, following the number of deaths during the Civil War, the practice of embalming became commonplace, as fallen soldiers had to be preserved before their bodies could be transported vast distances from the battlefield back to their hometowns.
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Following the war, it became the norm to have loved-ones bodies prepared and cared for by morticians, and spaces for services to be provided by funeral home directors. Coinciding with the professionalization of the funeral industry, the advances of the medical field changed expectations around an infectious disease course. That is, rather than comfort care, medical providers began to offer life-saving, and thus life-changing measures, e.g. antibiotics.
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This resulted in a change in the concentration of the placement of ill-people: rather than remaining at home, people began to rely increasingly on hospitals as a place of healing, especially in urban areas where hospitals were more accessible. In areas that allowed for access to hospital systems, this inevitably resulted in a greater proportion of deaths occurring in hospitals rather than at home, thus bolstering the change from home-based care to professional, funeral home-based care of the deceased in the urban West.In other countries, the social practices around deathcare vary compared to the U.S. For instance, in Hindu culture, women have been barred from attending cremation rituals, and even from touching the deceased. Before World War Two in Britain, women were "commonly responsible for laying-out the body", but following the war were barred from such a role given the expedient professionalization of the deathcare industry.
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Particularly with social phenomena like the growth of the welfare state and urbanisation of population centres, central government involvement with the deathcare process has risen as societal challenges present themselves to deathcare.
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Examples of government policy involvement include the impact of new burial methods like human composting to pressures like COVID-19 placing on those involved with deathcare as well as their families. In addition to government policy, the effects of COVID-19 have directly impacted those involved in deathcare: funeral directors were shown to have increased rates of burnout following the first wave of the pandemic.
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National and regional governments are often responsible for providing the legal framework for deathcare to operate within, including laws and guidance on what deathcare techniques, practices, and what individuals/ organisations are involved. However, this has a varying level of non-government organisations, third-sector, religious, and private organisations (such as funeral homes) take part in both providing and shaping deathcare policy and practice. However, most research on state interactions within deathcare is limited to the US, with further research needed elsewhere.Governments can also become a major focal point for deathcare services in specific situations, such as with deaths in the military, prisons, or in extraordinary events. COVID-19 is an example of global governmental intervention to provide mass fatality management to cope with high human fatality around the world. This also brought up issues of inequality and inequity within deathcare as some deaths throughout the pandemic were treated as "more tragic" compared to others, highlighted as a public values failure as economic productivity and social worth overruled public health and humanity.
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Analysts have stated that the deathcare industry can be divided into three portions: the ceremony and tribute (funeral or memorial service); the disposition of remains through cremation or burial (interment); and memorialization in the form of monuments, marker inscriptions or memorial art.Deathcare industry is a multifactorial sector including, but not limited to: companies and organizations that provide services related to death memorials, funerals, and burials. Theses types of ceremonies includes service use of coffins, headstones, crematoriums, and funeral homes. Most of the death service industry has consisted of small businesses that have been consolidated as time has gone on.There is a global marketplace for deathcare in the produces, services, and insurance that surrounds someone's death.
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This is a market that has shown expanding fiscal growth in years 2020 to 2021 supported by a compound annual growth rate of 5.6%. The market is expected to continue to grow to a compound annual growth rate of 8% by year 2025 expecting to reach a value of 147.38 billion dollars up from 103.93 billion dollars in 2020.The deathcare process comes with multiple costs to allow for certain rituals to take place. Including to removal/transfer of remains to funeral homes (est $340), embalming (est $740), Hearse use ($340), metal burial casket (est $2500). The estimated median cost of funeral with burial and funeral was estimated by an NFDA news release to be $7640.Deathcare industrial complex (DIC) has been outlined as a concept, mirroring the military-industrial complex concept, in at least the US and potentially Western countries as an industry: "profit-driven, medicalised, de-ritualized and patriarchal form, modern death care fundamentally distorts humans' relationship to mortality, and through it, nature". The death care industry in the United States is deemed controversial due to high costs and negative environmental impacts.Localized efforts to reform and offer innovative deathcare practices can be seen in the natural deathcare movements such as human composting to natural burials.
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Common funeral practices in Western society are associated with notable environmental impacts. Metal caskets can deteriorate and release harmful toxins when buried, leading to contamination of land and water. Cremation also uses a significant amount of fuel consumption, releasing chemicals and carbon emissions.With the threat of climate change, conversations about green death practices are becoming more prevalent. Natural burial methods are being developed to promote eco-sustainability in deathcare.
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The Studio Smart Agent Technologies (SAT) is part of the Research Studios Austria ForschungsgesmbH, a non-profit research organization. It aims to facilitate the transfer of academic research into commercial applications thus implementing an innovation pipeline from universities into markets. To this end, SAT cooperates with both, universities and other academic institutions, as well as innovative companies. The Studio SAT competes for national and European research grants and funding in research excellence. It does contract research for clients in the private and public sectors and it receives the funding for its independent research from the Austrian Federal Ministry for Science and Research.
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The Studio Smart Agent Technologies has been founded in 2003 as one of the first research units of the Research Studios Austria, a division of the Austrian Institute of Technology (AIT) formerly known as Austrian Research Centers (ARC). In April 2008 the Research Studios Austria were spun out into a new company and the Research Studios Austria Forschungsgesellschaft mbH was founded.During the years 2004 and 2005 SAT accompanied the development of a mobile content download platform by 3united and Ericsson as a research partner concerning personalization. From 2006 to 2008 SAT guided research activities concerning semantic systems and recommender systems for Verisign Communications GmbH, the Viennese branch of VeriSign. With its flagship project easyrec, an open source recommender engine, SAT launched an incubator for spreading the ideas and usage of personalization in early 2010.
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The main research areas of SAT include: Recommender Systems Personalization Semantic Systems Data Mining and Visualization Intelligent Agent Solutions
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To classify postoperative outcomes for epilepsy surgery, Jerome Engel proposed the following scheme, the Engel Epilepsy Surgery Outcome Scale, which has become the de facto standard when reporting results in the medical literature: Class I: Free of disabling seizures Class II: Rare disabling seizures ("almost seizure-free") Class III: Worthwhile improvement Class IV: No worthwhile improvement
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Surgery for epilepsy patients has been used for over a century, but due to technological restrictions and insufficient knowledge of brain surgery, this treatment approach was relatively rare until the 1980s and 90s. Prior to the 1980s, no classification system existed due to the lack of operations performed up until the time. As surgery as a treatment grew more prevalent, a classification system became a necessity.
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The appropriate evaluation of patients following epilepsy surgery is extremely important, as medical professionals must know the appropriate course of action to follow in order to achieve seizure freedom for patients. Accordingly, the Engel classification guidelines were devised by UCLA neurologist Jerome Engel Jr. in 1987 and made public at the 1992 Palm Desert Conference on Epilepsy Surgery. The Engel classification system has since become the standard in reporting postoperative outcomes of epilepsy surgery.
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In Engel's 1993 summary of the 1992 Palm Desert Conference on Epilepsy Surgery, he annotated his classification system with more detail. The annotation was as follows: Class I: Seizure free or no more than a few early, nondisabling seizures; or seizures upon drug withdrawal only Class II: Disabling seizures occur rarely during a period of at least 2 years; disabling seizures may have been more frequent soon after surgery; nocturnal seizures Class III: Worthwhile improvement; seizure reduction for prolonged periods but less than 2 years Class IV: No worthwhile improvement; some reduction, no reduction, or worsening are possible
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The subjectivity of the Engel system leaves much of the postoperative class assignment process to the patients. While many have noted the disadvantages of a classification system where the patients are involved in determining the evaluation, others have praised it. Proponents of the Engel classification guidelines argue that the patients are best able to perceive the worth of the operation because they are the ones experiencing the seizures before and after the treatment.
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As is the case for all current methods of reviewing epilepsy surgery outcomes, the Engel classification system has subjective components. A "disabling seizure" is subjective and can vary in definition from person to person. While one epileptic experiencing a seizure when driving a car may find the seizure "disabling", the same magnitude of seizure may be interpreted as mild, and thus "nondisabling", by an epileptic resting in bed. Every class other than class I is also subjective because there is no quantitative definition of what determines a rare occurrence or method to measure worthwhileness.
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One doctor and patient may consider two seizures in a year as a rare occurrence while another doctor may consider ten in a year as rarely occurring. The worthwhileness of the operation is ambiguous because worth can be interpreted differently by various patients and healthcare professionals. Keeping those caveats in mind, most neurologists and neurosurgeons who specialize in epilepsy would most likely agree, as would many persons with epilepsy and even laypeople, that any seizure that leads to a period of status epilepticus (seizure activity, especially of the tonic-clonic, or grand mal, type, for longer than about five to ten minutes, or more – some now say it should be as little as two – without an intervening return to normal, or any repeat seizures without a return to consciousness) is a medical emergency, objectively a major problem, and cannot be considered a satisfactory outcome (unless perhaps if the person had a fatal or very severe form of a neurodegenerative syndrome or other disease where such severe repeat seizures are not unusual, and there are a number of these diseases; even then, such an outcome is usually still not a cure, just an amelioration of a fatal condition or a very disabling condition).
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https://en.wikipedia.org/wiki/Engel_classification
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Continuing to have to endure a large number of tonic-clonic seizures (grand mal seizures) over a period of days, months, or even over the course of a year or two, would make it impossible to drive and very hard to hold a job away from home entailing much stress, and would pose limits on one's abilities to safely carry out the activities of daily living without at least some monitoring or assistance.The Engel classification system has been thought of as a cross-sectional grading system by medical professionals because it does not account for long term changes in patients. It has been proposed that it would be more beneficial to reevaluate patients on an annual basis, and the International League Against Epilepsy (ILAE) devised a separate rating scale in 2001 that reevaluates patients on every annual anniversary of their surgery. The ILAE also developed their system in hopes of avoiding many of the subjective components found in the Engel system. == References ==
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https://en.wikipedia.org/wiki/Engel_classification
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The Mechanical Bride: Folklore of Industrial Man (1951) is a study of popular culture by Marshall McLuhan, treating newspapers, comics, and advertisements as poetic texts.Like his later 1962 book The Gutenberg Galaxy, The Mechanical Bride is unique and composed of a number of short essays that can be read in any order – what he styled the "mosaic approach" to writing a book. Each essay begins with a newspaper or magazine article or an advertisement, followed by McLuhan's analysis thereof. The analyses bear on aesthetic considerations as well as on the implications behind the imagery and text. McLuhan chose the ads and articles included in his book not only to draw attention to their symbolism and their implications for the corporate entities that created and disseminated them, but also to mull over what such advertising implies about the wider society at which it is aimed.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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McLuhan is concerned by the size and the intentions of the North American culture industry. "Ours is the first age in which many thousands of the best-trained individual minds have made it a full-time business to get inside the collective public mind," McLuhan writes in his preface to the book. He believes the modern "helpless state engendered by prolonged mental rutting is the effect of many ads and much entertainment alike." McLuhan hopes Bride can reverse this process.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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By using artifacts of popular culture as a means to enlighten the public, McLuhan hopes the public can consciously observe the effects of popular culture on them.McLuhan compares his method to the sailor in Edgar Allan Poe's short-story "A Descent into the Maelstrom." The sailor, McLuhan writes, saves himself by studying the whirlpool and by co-operating with it. Likewise, the book is not interested in attacking the strong currents of advertising, radio, and the press.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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The book argues anger and outrage are not the proper responses to the culture industry. "The time for anger...is in the early stages of a new process," McLuhan says, "the present stage is extremely advanced." Amusement is the proper strategy.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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This is why McLuhan uses punning questions that border on silly or absurd after each visual example. On the technique of amusement McLuhan quotes Poe's sailor, when he's locked into the whirlpool's walls looking at floating objects: "I must have been delirious, for I even sought amusement in speculating upon the relative velocities of their several descents towards the foam below." This amusement, McLuhan argues, born "of his rational detachment as a spectator of his own situation," saved the sailor's life. By adopting the position of Poe's sailor, readers of Bride can escape from the whirlpool of popular culture.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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Marshall McLuhan's interest in the critical study of popular culture was influenced by the 1933 book Culture and Environment by F. R. Leavis (with Denys Thompson) and Wyndham Lewis' 1932 book Doom of Youth, which uses similar exhibits.During the 1940s, McLuhan regularly held lectures with slides of advertisements analysing them. He first referred to the present era as the Age of the Mechanical Bride in 1945, during a series of lectures in Windsor, Ontario. McLuhan had planned on publishing these lectures and slides since before 1945.During the thirties and forties, many "exposé" books critiquing the advertising industry were published but McLuhan's book was different. While critical, the tone of the essays was admiring at times, impressed with the skills of advertisers.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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Despite the influence, McLuhan was far more playful in The Mechanical Bride than Leavis was in Culture and Environment.In June 1948, McLuhan received an advance of $250 for the publication of The Folklore of Industrial Man from Vanguard Press. The tentative title would later become the subtitle. The title The Mechanical Bride comes from a piece by the French avant-garde artist, Marcel Duchamp, titled The Bride Stripped Bare By Her Bachelors, Even.The book underwent several title changes over four manuscripts before McLuhan settled on Bride.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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The first manuscript was titled Guide to Chaos. The following three manuscripts were titled Typhon in America, after the Ancient Greek mythological monster.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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The eventual title of the book reflects McLuhan's concern about the merging of sex and technology in advertising.McLuhan was frustrated by the editorial efforts of Vanguard Press. He resisted requests to cut entries, to expand on subjects, give examples, underline a point, or generally make the book easier for readers to understand. He would verbally abuse Vanguard Press staff, accusing editors of wearing him down with editorial requests.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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He began to suffer from severe headaches during this period, possibly products of the stress, anger, and frustration of his dealings with Vanguard.The Mechanical Bride was published in the fall of 1951. The book was well-reviewed but it was not a financial success, only selling a few hundred copies. Biographer Philip Marchand reports that after the publication, McLuhan complained of a vague "homosexual influence in the publishing world, that was horrified by the masculine vigor of his prose and trying to castrate his text." McLuhan bought one thousand copies and sold them individually to bookshops and students. By the 1970s, hardcover first editions of The Mechanical Bride became sought after items in the rare book business.
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https://en.wikipedia.org/wiki/The_Mechanical_Bride
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Hay's Galleria is a mixed use building in the London Borough of Southwark situated on the south bank of the River Thames featuring offices, restaurants, shops, and flats. Originally a warehouse and associated wharf (Hay's Wharf) for the port of London, it was redeveloped in the 1980s. It is a Grade II listed structure.
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https://en.wikipedia.org/wiki/Hay's_Galleria
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Hay's Galleria is named after its original owner, the merchant Alexander Hay, who acquired the property – then a brewhouse – in 1651. In around 1840 John Humphrey Jnr acquired a lease on the property. He asked William Cubitt (who was father-in-law to two of Humphrey's sons) to convert it into a 'wharf', in fact an enclosed dock, in 1856 and it was renamed Hay's Wharf.During the nineteenth century, the wharf was one of the chief delivery points for ships bringing tea to the Pool of London. At its height, 80% of the dry produce imported to London passed through the wharf, and on this account the wharf was nicknamed 'the Larder of London'. The wharf was largely rebuilt following the Great Fire of Southwark in June 1861 and then continued in use for nearly a century until it was badly bombed in September 1940 during the Second World War.In 1920, the owners of the wharf purchased the shares of Pickfords as part of their Hay's Wharf Cartage Company subsidiary. This subsidiary was sold to the Big Four railways in 1933.The progressive adoption of containerisation during the 1960s led to the shipping industry moving to deep water ports further down the Thames and the subsequent closure of Hay's Wharf in 1970.
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https://en.wikipedia.org/wiki/Hay's_Galleria
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In the 1980s, with the increasing urban regeneration of the Thames Corridor and nearby London Docklands, the majority of the area was acquired by the St Martin's Property Corporation, the real estate arm of the State of Kuwait. The easterly end of the site was developed as London Bridge City of which Hay's Galleria' forms part. The decision was made to retain the dock and to restore its tea and produce warehouses surrounding it to provide office accommodation and shops.
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https://en.wikipedia.org/wiki/Hay's_Galleria
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The dock gates were permanently closed, the 'impounded' area of the dock was covered with a floor to the sill of the wharf-sides and the entire space was enclosed with a glass roof designed by the young architect Arthur Timothy while he worked with Michael Twigg Brown Architects. This scheme was implemented by Twigg Brown Architects as part of their masterplan for the renewal strategy. In a fountain at the centre of the Galleria is a 60 ft moving bronze sculpture of a ship, called 'The Navigators' by sculptor David Kemp, unveiled in 1987 to commemorate the Galleria's shipping heritage.The development was supported by the London Docklands Development Corporation. After its completion and opening in 1987, Hays Galleria became the first new visitor attraction of that period on the south of the river.
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https://en.wikipedia.org/wiki/Hay's_Galleria
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Office tenants have included the UK social work regulator, the General Social Care Council, and the Social Care Institute for Excellence. The pub at the riverside entrance, 'The Horniman at Hay's', is named to commemorate one of the main tea-producing companies associated with the trade here.Due to its location on the southern Thames Path, its panoramic views over the City of London from the riverside, and the location between London City Hall and Southwark Cathedral, Hay's Galleria is visited by many tourists and local workers. For 20 years it housed a year-round market - the Hays Galleria Market, which operated seven days a week. It had a resident artist, and for more than 2 decades, it was home to several permanent independent traders, long-term tenants of St Martins Property Corporation selling souvenirs, touristic apparel, and jewellery from traditional barrows positioned in fixed locations in the Galleria. On 8 October 2010, on the orders of CBRE, the managing agents, the barrows were removed. The barrows were reinstated under the new managing agents post 2014, and as at 22 August 2017 there are 8 barrows operating in the Galleria.
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https://en.wikipedia.org/wiki/Hay's_Galleria
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River services: London Bridge City Pier (Commuter service) Tube/National Rail: London Bridge station
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https://en.wikipedia.org/wiki/Hay's_Galleria
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Romani studies (occasionally Gypsiology) is an interdisciplinary ethnic studies field concerned with the culture, history and political experiences of the Romani people. The discipline also focuses on the interactions between other peoples and Romas, and their mindset towards the Romas.Other terms for the academic field include Ziganology, Ciganology, Romology, Romalogy, and Romistics.Some of the notable scholars of Romani studies includes Colin Clark and Lev Cherenkov among others.
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https://en.wikipedia.org/wiki/Romani_studies
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In statistics, EM (expectation maximization) algorithm handles latent variables, while GMM is the Gaussian mixture model.
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https://en.wikipedia.org/wiki/EM_algorithm_and_GMM_model
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In the picture below, are shown the red blood cell hemoglobin concentration and the red blood cell volume data of two groups of people, the Anemia group and the Control Group (i.e. the group of people without Anemia). As expected, people with Anemia have lower red blood cell volume and lower red blood cell hemoglobin concentration than those without Anemia. x {\displaystyle x} is a random vector such as x := ( red blood cell volume , red blood cell hemoglobin concentration ) {\displaystyle x:={\big (}{\text{red blood cell volume}},{\text{red blood cell hemoglobin concentration}}{\big )}} , and from medical studies it is known that x {\displaystyle x} are normally distributed in each group, i.e. x ∼ N ( μ , Σ ) {\displaystyle x\sim {\mathcal {N}}(\mu ,\Sigma )} . z {\displaystyle z} is denoted as the group where x {\displaystyle x} belongs, with z i = 0 {\displaystyle z_{i}=0} when x i {\displaystyle x_{i}} belongs to Anemia Group and z i = 1 {\displaystyle z_{i}=1} when x i {\displaystyle x_{i}} belongs to Control Group.
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https://en.wikipedia.org/wiki/EM_algorithm_and_GMM_model
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Also z ∼ Categorical ( k , ϕ ) {\displaystyle z\sim \operatorname {Categorical} (k,\phi )} where k = 2 {\displaystyle k=2} , ϕ j ≥ 0 , {\displaystyle \phi _{j}\geq 0,} and ∑ j = 1 k ϕ j = 1 {\displaystyle \sum _{j=1}^{k}\phi _{j}=1} . See Categorical distribution. The following procedure can be used to estimate ϕ , μ , Σ {\displaystyle \phi ,\mu ,\Sigma } .
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https://en.wikipedia.org/wiki/EM_algorithm_and_GMM_model
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Generally, this problem is set as a GMM since the data in each group is normally distributed. In machine learning, the latent variable z {\displaystyle z} is considered as a latent pattern lying under the data, which the observer is not able to see very directly. x i {\displaystyle x_{i}} is the known data, while ϕ , μ , Σ {\displaystyle \phi ,\mu ,\Sigma } are the parameter of the model. With the EM algorithm, some underlying pattern z {\displaystyle z} in the data x i {\displaystyle x_{i}} can be found, along with the estimation of the parameters. The wide application of this circumstance in machine learning is what makes EM algorithm so important.
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https://en.wikipedia.org/wiki/EM_algorithm_and_GMM_model
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The EM algorithm consists of two steps: the E-step and the M-step. Firstly, the model parameters and the z ( i ) {\displaystyle z^{(i)}} can be randomly initialized. In the E-step, the algorithm tries to guess the value of z ( i ) {\displaystyle z^{(i)}} based on the parameters, while in the M-step, the algorithm updates the value of the model parameters based on the guess of z ( i ) {\displaystyle z^{(i)}} of the E-step. These two steps are repeated until convergence is reached.
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https://en.wikipedia.org/wiki/EM_algorithm_and_GMM_model
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In political science, a multi-party system is a political system in which multiple political parties across the political spectrum run for national elections, and all have the capacity to gain control of government offices, separately or in coalition. Apart from one-party-dominant and two-party systems, multi-party systems tend to be more common in parliamentary systems than presidential systems and far more common in countries that use proportional representation compared to countries that use first-past-the-post elections. Several parties compete for power and all of them have a reasonable chance of forming government. In multi-party systems that use proportional representation, each party wins a number of legislative seats proportional to the number of votes it receives.
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https://en.wikipedia.org/wiki/Multi-party_system
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Under first-past-the-post, the electorate is divided into a number of districts, each of which selects one person to fill one seat by a plurality of the vote. First-past-the-post is not conducive to a proliferation of parties, and naturally gravitates toward a two-party system, in which only two parties have a real chance of electing their candidates to office. This gravitation is known as Duverger's law.
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https://en.wikipedia.org/wiki/Multi-party_system
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Proportional representation, on the other hand, does not have this tendency, and allows multiple major parties to arise. Proportional systems either has multi-member districts with more than one representative elected from a given district to the same legislative body or some other type of pooling of the votes, and thus there are a greater number of viable parties.
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https://en.wikipedia.org/wiki/Multi-party_system
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Duverger's law states that the number of viable political parties is one, plus the number of seats in a district. Argentina, Armenia, Belgium, Brazil, Denmark, Finland, France, Germany, Iceland, India, Indonesia, Ireland, the Netherlands, New Zealand, Norway, the Philippines, Poland, Sweden, Tunisia, Turkey and Ukraine are examples of nations that have used a multi-party system effectively in their democracies. In these countries, usually no single party has a parliamentary majority by itself (hung parliaments). Instead, multiple political parties are compelled to form compromised coalitions for the purpose of developing power blocks, usually majority control of the assembly, and attaining legitimate mandate.
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https://en.wikipedia.org/wiki/Multi-party_system
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Unlike a one-party system (or a dominant-party system), a multi-party system encourages the general constituency to form multiple distinct, officially recognized groups, generally called political parties. Each party competes for votes from the enfranchised constituents (those allowed to vote). A multi-party system prevents the leadership of a single party from controlling a single legislative chamber without challenge. A system where only two parties have the possibility of winning an election is called a two-party system.
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https://en.wikipedia.org/wiki/Multi-party_system
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A system where only three parties have a realistic possibility of winning an election or forming a coalition is sometimes called a "third-party system". But, in some cases the system is called a "Stalled Third-Party System," when there are three parties and all three parties win a large number of votes, but only two have a chance of winning an election. Usually, this is because the electoral system penalises the third party, e.g. as in Canadian or UK politics.
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https://en.wikipedia.org/wiki/Multi-party_system
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A two-party system requires voters to align themselves in large blocks, sometimes so large that they cannot agree on any overarching principles. Some theories argue that this allows centrists to gain control, though this is disputed. On the other hand, if there are multiple major parties, each with less than a majority of the vote, the parties are strongly motivated to work together to form working governments. This also promotes centrism, as well as promoting coalition-building skills while discouraging polarization.
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https://en.wikipedia.org/wiki/Multi-party_system
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The Global Media Monitoring Project (GMMP) is the largest international study of gender in the news media. It is also an advocacy organization that aims to change the representation of women in the news media. Every five years since 1995 the GMMP collects data on indicators of gender in the news, such as: the presence of women, gender bias, and stereotyping. The most recent study, conducted in 2015, encompassed 114 countries.
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https://en.wikipedia.org/wiki/The_Global_Media_Monitoring_Project
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The idea for a media monitoring project was created at the Women Empowering Communication international conference in Bangkok in 1994. The World Association for Christian Communication (WACC) along with MediaWatch (Canada) took up the project. They had several key goals: To map the representation and portrayal of women in the world’s mainstream news media To develop a grassroots research instrument To build solidarity among gender and communication groups worldwide To create media awareness To develop media monitoring skills on an international levelCoverage The 1995 Report covered 71 countries, and was conducted by volunteers over the span of one day. Consequent studies took place in 2000 and covered 70 countries, in 2005 covering 76 countries, in 2010 in 108 countries and in 2015 in 114 countries.
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https://en.wikipedia.org/wiki/The_Global_Media_Monitoring_Project
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All of the monitoring and compiling of reports is carried out by volunteers. GMMP reports have been presented at the Women’s NGO Forum in Beijing (1995), the UN Beijing + 5 (2000), a parallel-session at the Commission on the Status of Women 2010 session, and in 100 Women BBC series 2015 "Is News Failing Women? ".
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https://en.wikipedia.org/wiki/The_Global_Media_Monitoring_Project
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The 2015 Project covered 22,136 news items, 26,010 news personnel, and 45,402 total news subjects in newspaper, radio, television, internet news and news media tweets. The research discussed news subjects, personnel and content through the framework of media accountability to women .News Subjects The report discovered that progress towards gender parity in the news has almost ground to a halt over the period 2010 to 2015: Women make up only 24% of the persons heard, read about or seen in newspaper, television and radio news, exactly as they did in 2010. Over the past two decades, the gender gap in people in the news has narrowed most dramatically in Latin America by 13 percent. Women are three percent less visible in political news stories now than five years ago.
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https://en.wikipedia.org/wiki/The_Global_Media_Monitoring_Project
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