20 मार्च 2013

we must change diabetes to truly reform health care in India

To truly reform health care in India  we must change diabetes.

As we work to change health care in INDIA  we must recognize the need to dramatically change diabetes.   Twenty-four million Indian  have diabetes at a cost to our nation of an estimated $218 billion for diabetes and pre-diabetes, according to a series of studies recently published in various papers.  Imagine the effects diabetes will have on our health and economy in the future if we don’t take action now. The prevalence and economic burden of undiagnosed and pre-diabetes make the case for the importance of policies that promote early diagnosis and prevention.  About 50 percent of Indian with diabetes aren’t even aware they have the disease.
The numbers associated with pre-diabetes, a precursor to type 2 diabetes, are equally as staggering.  Pre-diabetes affects an estimated 57 million Indian  . The costs stem from the fact that people with the condition have higher rates of medical visits than those with normal blood-sugar levels.  They also seek medical attention more often for issues associated with diabetes, including high blood pressure and metabolic and renal complications. While the rates of undiagnosed diabetes and pre-diabetes are alarming, studies show that type 2 diabetes can be significantly prevented, or at least delayed, by losing weight through diet and regular exercise.  But, even with evidence supporting prevention, our nation isn’t allocating adequate resources.  In 2005, a study by the National Diabetes Program found that the government spent much amount  more on those with diabetes than those without the disease, and only part of that was spent on prevention and health promotion.   Early diagnosis and prevention are good places to start, but we must also take measures to improve diabetes care and management.  The first step to care improvement is to measure the quality of care being delivered in a consistent way.  A recent study (to be published) documents tremendous variability of how care quality is now being measured. Aggressive treatment is another key component of changing diabetes.  Studies show that intensive treatment to reduce blood sugar levels can delay or prevent debilitating and costly complications of diabetes, such as heart disease, stroke, blindness, kidney failure and amputation. Changing diabetes is not a simple task and requires coordination.  Strategies and activities that impact diabetes need to be aligned in order for us to succeed in the fight against this disease.  We must also look at our budget process and make adjustments to more accurately assess the long-term impact of prevention programs.  The current 10-year budget window doesn’t take into account that the value of prevention and improved treatment needs to be assessed over a longer period of time.       To truly reform health care in India  we must change diabetes.

Discovery of insulin

 Discovery of insulin

In the fall of 1920 Dr. Frederick Banting had an idea that would unlock the mystery of the dreaded diabetes disorder. Before this, for thousands of years, a diabetes diagnosis meant wasting away to a certain death. Working at a University of Toronto laboratory in the very hot summer of 1921 Fred Banting and Charles Best were able to make a pancreatic extract which had anti diabetic characteristics.

 They were successful in testing their extract on diabetic dogs. Within months Professor J. J. R. MacLeod, who provided the lab space and general scientific direction to Banting and Best, put his entire research team to work on the production and purification of insulin. J.B. Collip joined the team and with his technical expertise the four discoverers were able to purify insulin for use on diabetic patients. The first tests were conducted on Leonard Thompson early in 1922. These were a spectacular success.

 Word of this spread quickly around the world giving immediate hope to many diabetic persons who were near death. A frenzied quest for insulin followed. Some patients in a diabetic coma made miraculous recoveries.

While insulin is not a cure, this medical discovery has and continues to save millions of lives world-wide. The production of insulin has changed a great deal since 1922. Modern science and technology has made high quality insulin and delivery systems available to diabetic persons.

significance of an eclipse?

What is the significance of an eclipse?

Eclipse  (grahan )are times of the year when the path of the Sun and the Moon intersect with the Nodes of the Moon, Rahu and Ketu. A Lunar eclipse (chandra  grahan )is during the full Moon and the Solar eclipse is during the new Moon.

What is the significance of an eclipse?
Let's first talk about the basic significance of the Sun, Moon and Rahu and Ketu. The Sun and the Moon are what can be called 'personal' planets because they represent our personality more than any of the other planets.
The Sun is the karaka or signficator of the body and our self-expression, while the Moon is the karaka of the mind (not intellect, which is Mercury) and emotions. The nodes of the Moon, Rahu and Ketu, are called chaya grahas or shadowy planets because they are invisible points in space and not actually planets with orbits around the Sun. They are given the full status of planets in Vedic astrology none the less. Their points in space which are always opposite one another travel through the zodiac in reverse direction in an approximately 19 year cycle.

Because the nodes of the Moon are so mysterious and unusual in nature their influences cause abnormal functioning to whatever they aspect. During the eclipse the nodes of the Moon are aspecting both of the personality planets, the Sun and Moon and are cutting off their normal functioning. They create an opening in our psyche for subtle energies to enter. It's therefore the best to only do spiritual practices during eclipses and not anything in the material world of signficance like having a surgery, or signing an important document. We should take a break and do extra spiritual practices and take advantage of the subtle influences of the eclipse time.

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SMBG OF DIABETES - A Doctor Who Understands

SMBG OF DIABETES  - A Doctor Who Understands

Over time I must admit to developing a certain degree of cynicism about researchers and doctors in the medical research field. I get a little jaded and dispirited about the entrenched attitudes in the fields of diabetes research, especially concerning diet.

Recently, in
 SMBG Research, Or the Lack of It, I wrote “There are so many areas of diabetes crying out for research. There are some that have never been studied at all, including those dealing with diet modified by structured testing or similar methods which can lead to minimal medication or insulin needs.”

The paper is written by Dr Lois Jovanovic and includes references to other studies in support. Not a lot of other studies, most are small and some are only obliquely relevant, but at least there is some research happening in the field. It is so pleasant, after years of reading so many doctors ignoring so many patients on this subject, to finally read a paper like this one. They can ignore diabetics like me and dismiss us as unqualified; but Lois Jovanovic is someone who may be harder to ignore.

I think two unique factors make this particular doctor more aware of the close relationship between carbohydrate input and post-prandial hyperglycemia than most doctors. First, she has
 a depth of experience especially in gestational diabetes and pregnancies in patients already diagnosed as type 2. That has led to experience in trying to attain and manage normoglycemia much tighter than the levels usually expected for most type 2s. Her bio, in part reads:

Dr. Jovanovic has authored over 240 articles, including 135 for refereed journals, and 25 books on the topic of diabetes and pregnancy and islet cell transplantation. She serves as an Associated Editor of Diabetes Care and is on the editorial boards of Clinical Pharmacology and Therapeutics and the American Journal of Perinatology and is a contributing editor for the Journal of the American College of Nutrition and special editor for Endocrine Practice, the official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. In addition, Dr. Jovanovic serves on the national board of directors of the Society for Experimental Biology and Medicine.

The purpose of this article is to describe how self-monitoring of blood glucose (SMBG) data is a useful tool for identifying and managing postprandial hyperglycemia (PPHG).

PPHG and postprandial glucose excursions occur frequently in patients with diabetes even when hemoglobin A1C is controlled below 7.0%, and convey increased risk of cardiovascular morbidity and mortality. Consequently, effective management of diabetes must include control of postprandial glucose levels. Postprandial plasma glucose (PPG) depends on the composition of meals, specifically the amount of carbohydrates.

Reduced-carbohydrate diets offer short-term improvements in glycemic control and other metabolic parameters, but await the support of long-term efficacy and safety studies. Glucose profiling and paired-meal SMBG are useful tools for detecting PPHG and glucose excursions. They provide immediate feedback to patients on the effect of foods and meals, thereby allowing appropriate food and medication adjustments to improve postprandial glycemic control.

But that abstract does not give an inkling of the specific recommendations in the full text or the pleasant shock I received when I read this marvellous “To Do” list for guiding dietary recommendations that is included as Table 1:

Educate your patients on the risks associated with high peak-postprandial glucose concentrations (≥150 mg/dL)

Ensure patients understand that postprandial glucose concentrations are determined by the total amount of carbohydrates consumed

•• Encourage patients to measure their carbohydrate consumption

•• Recommend that patients keep a food diary

Remind patients of the benefits of monitoring their blood glucose levels with SMBG and construct a testing plan that optimizes these benefits

•• Have patients determine the best time for postprandial SMBG by testing 45, 60, 75, 90, 105, and 120 minutes after a meal to detect their peak postprandial glucose concentration

•• Using preprandial and postprandial SMBG, together with a food diary, patients can understand how certain foods influence their glucose concentrations

•• If preprandial glucose concentrations are already high, there is no room for carbohydrates in the upcoming meal

Review recent SMBG and food diary data with your patients to help them recognize trends in out-of-target readings

•• Use this information to recommend a specific SMBG testing schedule including number of tests per day and appropriate testing times

•• Have patients meet with a nutrition specialist if they are having trouble identifying or controlling their carbohydrate consumption

19 मार्च 2013

The Tipping Point

The Tipping Point: How Little Things Can Make A Big Difference

By Malcolm Gladwell

If you want to read a bit about how word-of-mouth trends get started and grow, you'll like The Tipping Point: How Little Things Can Make A Big Difference by Malcolm Gladwell.
Gladwell says that things spread in popularity due to three factors.
Gladwell says that not all people are equally important in launching a new tread. Rather, there are a few key people called 'connectors' who tend to be very social and outgoing. These connectors have diverse social networks and a significant ability to spread information, trends, and products. Trends and epidemics spread when they are adopted by connectors.
Mavens are another type of people involved in spreading a trend. Mavens are people who like helping people and who take a particular interest in evaluating the quality of products or ideas. Because they are so well-informed about things, mavens are often the first to promote quality products. Mavens might also be the early adopters of trends. Often, Gladwell writes, some maven or connector must modify something to make it more acceptable to the larger population.
With connectors and mavens in place, the next ingredient for a trend to take off is for the message to be memorable or 'sticky.' Some messages don't stick in the minds of those who hear them while other messages do.
The best way to create a 'sticky' message is to test the message. Gladwell discusses children's TV--Sesame Street and a show called Blue's Clues, which were designed from the start to be 'sticky.'
For example, educators tested two skits designed to help children read. Both involved having children read (or see read) the word 'hug.' Each letter was uncovered and the sound it represented made.
Oscar the Grouch wasn't too effective in teaching kids the word. As Oscar read the word, Oscar was waving his hands around and making all sorts of fuss that distracted the children from the task at hand. They weren't concentrating on the word, they were concentrating on Oscar.
Another skit where a more subdued puppet slowly uncovered each letter as he read it proved to be much more effective.
How did Sesame Street producers know whether kids were paying attention to the word? Eye movement photography. The producers strapped little kids into chairs and photographed what part of the television screen they were watching. Gladwell tells us that they were watching Oscar, not the letters. But, with the subdued puppet, the children focused upon the letters.
Gladwell explains that we can only focus upon one thing at a time: "the receptors that process what we see--are clustered in a small region in the very middle of the retina called the fovea."
Gladwell says that eye movement photography is quite important in advertising. He writes: "If you can track where someone's fovea is moving and what they are fixating on... you can tell with extraordinary precision what they are actually looking at and what kind of information they are actually receiving. The people who make television commercials, not surprisingly, are obsessed with eye tracking. If you make a beer commercial with a beautiful model, it would be really important to know whether the average twenty-two-year old male in your target audience fixates only on the model or eventually moves to your can of beer."
So, in case you're wondering why Britney Spears is holding her Pepsi can in some particular location in her Super Bowl ad, now you know! It's based upon the location of the fovea! (How do they direct this stuff? "Hey Britney, move the can a bit lower. It's not quite aligned properly with the fovea." SLAP! Britney slaps the director.)
Do we really want people tracking the movement of our foveas? Remember, this was happening thirty years ago for the nefarious purpose of teaching kids to read. What about today?
We learn some other disturbing things. For example, Cookie Monster was a pitch man for Frito-Lay. If you can't trust the Cookie Monster, who can you trust?
This is what I found deeply disturbing about the attempt to try to create trends and 'social' epidemics. In particular, Gladwell discusses the failure of anti-smoking campaigns targeted to teenagers. Having adults tell teenagers not to smoke in TV commercials didn't work. Go figure!
But, by studying the nature of the mavens and connectors who unintentionally tend to encourage teenagers to smoke, Gladwell suggests that we can aim to prevent smoking from a more powerful position. I don’t really like this social engineering. Whose business is it, anyway? Why should taxpayers' money be spent to promote social policies that a small group decides is correct for us? I find this too politically correct and too meddlesome of individual freedoms.
And, this isn't the first time social engineers felt they knew what was better for the population and adopted such methods of trying to influence social behavior. For example, similar techniques were used in 1933 by the Nazis (read, for example, the academic book, Backing Hitler: Consent And Coercion In Nazi Germany by Robert Gellately).
Gladwell's third factor is context. Gladwell argues that the specific context of a situation will have a powerful impact upon whether or not a trend will spread.
It seems Gladwell draws heavily upon the work of Robert Cialdini and his book, "Influence." Many of the same studies are quoted. If you like this book, you'll like that book also.
Overall, I enjoyed reading The Tipping Point: How Little Things Make A Big Difference. But, I'm hesitant to recommend buying the book! How do we know what other little trend-setting tricks Gladwell knows or can bring to bear upon us? The Tipping Point is a bestseller. I say, "Just Say No To Social Engineering!" Get your book from the library. Then, order either Fight Club with Brad Pitt or else Josey And The Pussycats with Rachael Leigh Cook. We're on to the sneaky trend setters!

source :

The Torrance Tests of Creative Thinking is a test of creativity.

Torrance Tests of Creative Thinking

The Torrance Tests of Creative Thinking is a test of creativity.

I have came across a novel test of creativity  devised by great psycologist Trrance which i want to share with my friends.


Building on J.P. Guilford's work and created by Ellis Paul Torrance, the Torrance Tests of Creative Thinking (TTCT), a test of creativity, originally involved simple tests of divergent thinking and other problem-solving skills, which were scored on four scales:
  • Fluency. The total number of interpretable, meaningful, and relevant ideas generated in response to the stimulus.
  • Flexibility. The number of different categories of relevant responses.
  • Originality. The statistical rarity of the responses.
  • Elaboration. The amount of detail in the responses.
The third edition of the TTCT in 1984 eliminated the Flexibility scale from the figural test, but added Resistance to Premature Closure (based on Gestalt Psychology) and Abstractness of Titles as two new criterion-referenced scores on the figural. Torrance called the new scoring procedure Streamlined Scoring. With the five norm-referenced measures that he now had (fluency, originality, abstractness of titles, elaboration and resistance to premature closure), he added 13 criterion-referenced measures which include: emotional expressiveness, story-telling articulateness, movement or actions, expressiveness of titles, syntheses of incomplete figures, synthesis of lines, of circles, unusual visualization, extending or breaking boundaries, humor, richness of imagery, colourfulness of imagery, and fantasy.
According to Arasteh and Arasteh (1976) the most systematic assessment of creativity in elementary school children has been conducted by Torrance and his associates (1960a,1960b, 1960c, 1961,1962,1962a,1963a 1964), who have developed and administered the Minnesota Tests of Creative Thinking (MTCT), which was later renamed as the TTCT, to several thousands of school children. Although they have used many of Guilfords concepts in their test construction, the Minnesota group, in contrast to Guilford, has devised tasks which can be scored for several factors, involving both verbal and non-verbal aspects and relying on senses other than vision. These tests represent a fairly sharp departure from the factor type tests developed by Guilford and his associates (Guilford, Merrifield and Cox, 1961; Merrifield, Guilford and Gershan,1963), and they also differ from the battery developed by Wallach and Kogan (1965), which contains measures representing creative tendencies that are similar in nature (Torrance, 1968).
To date, several longitudinal studies have been conducted to follow up the elementary school-aged students who were first administered the Torrance Tests in 1958 in Minnesota. There was a 22-year follow-up, a 40-year follow-up, and a 50 year follow-up 
Torrance (1962) grouped the different subtests of the Minnesota Tests of Creative Thinking (MTCT) into three categories.
  1. Verbal tasks using verbal stimuli
  2. Verbal tasks using non-verbal stimuli
  3. Non-verbal task


A brief description of the tasks used by Torrance is given below:

Unusual Uses

The unusual uses tasks using verbal stimuli are direct modifications of Guilford’s Brick uses test. After preliminary tryouts, Torrance (1962) decided to substitute tin cans and books for bricks. It was believed the children would be able to handle tin cans and books more easily since both are more available to children than bricks.
Impossibilities task
It was used originally by Guilford and his associates (1951) as a measure of fluency involving complex restrictions and large potential. In a course in personality development and mental hygiene, Torrance has experimented with a number of modifications of the basic task, making the restrictions more specific. In this task the subjects are asked to list as many impossibilities as they can.
Consequences task
The consequences task was also used originally by Guilford and his associates (1951). Torrance has made several modifications in adapting it. He chose three improbable situations and the children were required to list out their consequences.
Just suppose task
It is an adaptation of the consequences type of test designed to elicit a higher degree of spontaneity and to be more effective with children. As in the consequence task, the subject is confronted with an improbable situation and asked to predict the possible outcomes from the introduction of a new or unknown variable.
Situations task
The situation task was modeled after Guilford’s (1951) test designed to assess the ability to see what needs to be done. Subjects were given three common problems and asked to think of as many solutions to these problems as they can. For example, if all schools were abolished, what would you do to try to become educated?
Common problems task
This task is an adoption of Guilford’s (1951) Test designed to assess the ability to see defects, needs and deficiencies and found to be one of the test of the factors termed sensitivity to problems. Subjects are instructed that they will be given common situations and that they will be asked to think of as many problems as they can that may arise in connection with these situations. For example, doing homework while going to school in the morning.
Improvement task
This test was adopted from Guilford’s (1952) apparatus test which was designed to assess ability to see defects and all aspects of sensitivity to problems. In this task the subjects are given a list of common objects and are asked to suggest as many ways as they can to improve each object. They are asked not to bother about whether or not it is possible to implement the change thought of.
Mother- Hubbard problem
This task was conceived as an adoption of the situations task for oral administration in the primary grades and also useful for older groups. This test has stimulated a number of ideas concerning factors which inhibit the development of ideas.
Imaginative stories task
In this task the child is told to write the most interesting and exciting story he can think of. Topics are suggested (e.g., the dog that did not bark); or the child may use his own ideas.
Cow jumping problems
The Cow jumping problem is a companion task for the Mother- Hubbard problem and has been administered to the same groups under the same conditions and scored according to the similar procedures. The task is to think of all possible things which might have happened when the cow jumped over the moon.

Verbal tasks using nonverbal stimuli

Ask and guess task
The ask and guess task requires the individual first to ask questions about a picture – questions which cannot be answered by just looking at the picture. Next he is asked to make guesses or formulate hypotheses about the possible causes of the event depicted, and then their consequences both immediate and remote.
Product improvement task
In this task common toys are used and children are asked to think of as many improvements as they can which would make the toy ‘more fun to play with’. Subjects are then asked to think of unusual uses of these toys other than 'something to play with’.
Unusual uses task
In this task, along with the product improvement task another task (unusual uses) is used. The child is asked to think of the cleverest, most interesting and most unusual uses of the given toy, other than as a plaything. These uses could be for the toy as it is, or for the toy as changed.

Non-verbal tasks

Incomplete figures task
It is an adaptation of the ‘Drawing completion test’ developed by Kate Franck and used by Barron (1958). On an ordinary white paper an area of fifty four square inches is divided into six squares each containing a different stimulus figure. The subjects are asked to sketch some novel objects or design by adding as many lines as they can to the six figures.
Picture construction task or shapes task
In this task the children are given shape of a triangle or a jelly bean and a sheet of white paper. The children are asked to think of a picture in which the given shape is an integral part. They should paste it wherever they want on the white sheet and add lines with pencil to make any novel picture. They have to think of a name for the picture and write it at the bottom.
Circles and squares task
It was originally designed as a nonverbal test of ideational fluency and flexibility, then modified in such a way as to stress originality and elaboration. Two printed forms are used in the test. In one form, the subject is confronted with a page of forty two circles and asked to sketch objects or pictures which have circles as a major part. In the alternate form, squares are used instead of circles.
Creative design task
Hendrickson has designed it which seems to be promising, but scoring procedures are being tested but have not been perfected yet. The materials consist of circles and strips of various sizes and colours, a four page booklet, scissors and glue. Subjects are instructed to construct pictures or designs, making use of all of the coloured circles and strips with a thirty minute time limit. Subjects may use one, two, three, or four pages; alter the circles and strips or use them as they are; add other symbols with pencil or crayon.


18 मार्च 2013

Researching the communication of emotions

 Researching the communication of emotions
Buddy's talk resonates with me because I spend my days researching the communication of emotions. Centered deeply within her work is the concept of emotion, particularly the emotion of power and how we communicate it to ourselves and to others.
Emotions are drivers for human and animal motivation. In the 19th century, Darwin wrote The Expression of the Emotions in Man and Animals, suggesting that the communication of emotions is extremely important to survival.

Today, advances in neurochemistry and neuroimaging have allowed social scientists to make great strides in understanding how emotions work, research that may help advance the understanding of disorders such as autism.
Cuddy talks about how nonverbal behaviors affect our dealings with others. Studies have shown how touch, for example, can create behaviors: A librarian accidently touches you and, as a result, you're more likely to return the borrowed book on time. We know that emotions are contagious. For instance, you visit a depressed friend, and within minutes, you, too, are feeling depressed.
An important topic exhibited and alluded to, but not necessarily stated, is that along with exuding power in evaluative situations you also need to make an emotional connection. Likeable doctors are less likely to be sued but share a systematic power over their patients with unlikeable ones, the difference being the emotional connection the likeable doctors achieve.
For me, the study of emotional connections has led to something of an obsession with charisma as a learned skill set. And while Cuddy talks about learning the body language of power to make yourself more powerful, I would suggest that Cuddy herself has done a terrific job of learning to exude charisma.
When Max Weber first described charisma in the early 1920s, he thought of it as a gift from god, a magical power that was bestowed to certain leaders. Now we understand charisma to be a process that creates a deep emotional connection through verbal and nonverbal communication. It is composed of specific emotional communication skills -- how we touch, the words we use (I vs. we), our facial display, empathy, vision, vulnerability and inspiration. Charisma is an adaptation to one's environment; you are not born with it. Oprah Winfrey, Bill Clinton, Adolf Hitler and John F. Kennedy (among others we consider naturally charismatic) all shared traumatic teenage experiences that taught them the importance of tuning in to the emotional communication of others to survive and flourish in their environments.
I think the strongest point Cuddy made in her talk wasn't about the research and discoveries made in the science, but her own inspiring story. The video becomes amazingly emotional as she strategically and masterfully makes herself vulnerable to the audience.
Cuddy spends the first 16 minutes talking about power -- how to feel more powerful, to be more powerful, to communicate the emotion of power. Then, choking back tears, she shares her personal story of how she faked it until she became it, and how she saw this same potential in one of her students.
Her vulnerability displayed a key component to charisma. She connected with her audience in a strong way prior to her personal testimony; she used great reason, humor, and examples. The talk, however, became something much more powerful when she majestically made her point by sharing such an inspiring and potent story. Her audience moves from listening to an expert to caring about this person. It happens when her face suddenly reveals an emotional memory. As a result, the audience is motivated to cheer her on, breaking out in spontaneous applause.
Cuddy makes this emotional connection with herself real for all who are willing to feel. It is a shining example of charisma

17 मार्च 2013

Map your circles of creativity

Most valuable management skill was no longer "operations" or "marketing" but "creativity--- Harvard business review 

In 2010, IBM ran a survey of 1,500 CEOs and found that the most valuable management skill was no longer "operations" or "marketing" but "creativity." Since then BCG, Accenture and other consultancies have confirmed the global skill shift. Yet, only 9% of all public and private corporations in the US do any product or service innovation, according to the NSF's Business R&D and Innovation Surveys of 2010 and 2011. CEOs say that creativity is a crucial leadership skill, but few apparently have it.

And no wonder. Managers are trained in the values of efficiency and the skills of quantitative analytics. That's what most Americans believe in and what most business schools teach. So we now face a difficult transition. After decades of managing to squeeze out profits, how can executives quickly shift to amplifying the creative capacities of their people?
First, map your circles of creativity. Businesses are pyramids built to promote efficiency. But creativity is generated within circles — playgrounds — where a small number of highly talented people, usually in twos, threes or small teams, work. Many of these are formal — labs, product development, design. These are where "creatives" are supposed to work. But there are many more circles that are invisible. Most big corporations have hundreds of people who are sharing ideas, trying things out, connecting existing domains of knowledge in new ways, below the radar of supervision. This can happen as often on the assembly line as it does in a chemistry lab. But it's not always viewed as "creativity", and many people don't see themselves as "creative," even if they are. When you map your creativity circles, they almost always surprise.
But generating new ideas, even if they're original, is not enough. Creativity needs to scale in order to generate economic value. So you also need to identify your creativity brokers — people with good judgement and access to resources. Experienced executives are the ones who can better predict when new concepts have real potential; they're the "wise eyes" to complement the "fresh eyes" on a task. They're also the ones who can connect your creativity circles to the financial, prototyping, marketing they need. Finding these brokers can also lead to surprises. They have many official titles, from general manager to vice president to assistant to the CEO.

At the top, it's also important to move toward multi-generational leadership teams. In a period of cascading change, we are all immigrants to new technologies and new shifts in culture. As hard as we try to immerse ourselves, we simply cannot know as much as someone who embodies these changes. The young founders of Google and Facebook were wise enough to bring in more experienced talent as they scaled their start-ups. Older managers of established corporations should be wise enough to do the reverse: bringing in young talent to expand their capabilities.
You should also be ready to change your consumer frame. User experience (UX) was a bold concept in its day and moved us away from merely meeting "needs". But it is obsolete. People today participate with companies in the design and purchase of products. "Experience" is too passive a term to describe the relationship. User engagement (UE) is the new creative competence for the future. Think about aura — the things that beckon you and keep you interested — and design it into your products and services as Apple and Nike have done.
Most corporations with decades of building a culture of efficiency can't organically transform themselves into a den of creativity. They shouldn't try. The odds of success are pretty low. IBM did it. P&G is still trying. GE may make it. But most others won't. Established companies can, however,be a platform for creativity. They can learn to go outside their own walls to identify creativity they can leverage, buy and then scale.
Creative competence is like a sport. You can train for it and increase the capacities of yourself and your organization. If you get good at it, you can also transform it into real economic value on a massive scale.

community of practic :framework for thinking about learning in terms of communities, their practices, the meanings ,the identities

Communities of practice:learning, meaning, and identityBy Etienne Wenger
This is what we are doing whenever we made a group to do something . Wonderful to read this in a academic context .

Book summary
This book explores the concept of community of practice. It proposes a framework for thinking about learning in terms of communities, their practices, the meanings they make possible, and the identities they open. Finally, the book explores the implications of this framework for the design of organizations and educational systems. It consists of two Parts and an Epilogue.
Part I: Practice
Part I is a discussion of the concept of practice and of the kind of social communities that practice defines. Each chapter provides a specific characterization of the concept of community of practice, including:

  • the level of analysis at which the concept of practice is useful
  • the defining characteristics of communities of practice
  • the evolution of communities of practice over time
  • boundaries and relations among communities of practice
  • constellations formed by interrelated communities of practice
1. Practice as meaning:Chapter 1 sets the stage conceptually by arguing that the social production of meaning is the relevant level of analysis for talking about practice. In making that argument, I introduce three basic concepts-negotiation of meaning, participation, and reification-that serve as a foundation, not only for Part I, but for the whole book.
2. Practice as community:Chapter 2 defines the concept of community of practice by talking about practice as the source of coherence of a community. I introduce three dimensions of this relation between practice and community: mutual engagement, a joint enterprise, and a shared repertoire of ways of doing things.
3. Practice as learning:Chapter 3 addresses the development of communities of practice over time. I discuss the factors of continuity and discontinuity that constitute a community of practice over time. I argue that practice itself must be understood as a learning process and that a community of practice is therefore an emergent structure, neither inherently stable nor randomly changeable. I end by talking about the learning by which newcomers can join the community and thus further its practice.
4. Practice as boundary:Chapter 4 discusses the boundaries that practice creates. I describe the types of connections that create bridges across boundaries and link communities of practice with the rest of the world. I end by arguing that boundaries of practice are not simple lines of demarcation between inside and outside, but form a complex social landscape of boundaries and peripheries that open and close various forms of participation.
5. Practice as locality:Chapter 5 addresses the scope and limits of the concept of community of practice. I discuss when to view a social configuration as one community or as a constellation of communities of practice. Here I start talking about other levels of social structure, but still in terms of practice.
Knowing in practice:Coda I ends this discussion of practice with a brief essay on knowing in practice. Echoing the argument of Part I. I summarize the themes introduced in each chapter by using them to ponder what it means to know in practice. This results in a definition of learning as an interplay of experience and competence.
Part II: Identity
Part II focuses on identity. This shift of focus from practice to identity within the same analytic perspective has the following consequences:

  • It injects the notion of the person into the theory without having to posit an individual subject to start with.
  • It expands the domain of inquiry to social configurations other than those defined by practice and to mechanisms by which these configurations become contexts for identity formation.
  • It requires a theory of power by which to characterize the formation of identity in practice as the ability to negotiate an experience of meaning.
Part II thus complements Part I. It argues for a dual relation between practice and identity, and it addresses some limitations of the concept of community of practice by locating it within a broader framework. Our identities, even in the context of a specific practice, are not just a matter internal to that practice but also a matter of our position and the position of our communities in broader social structures.
6. Identity in practice:Chapter 6 shows the relation between identity and practice by rehearsing the argument of Part I. By revisiting the various characteristics of practice introduced in each chapter, I show how they can be construed as characteristics of identity. The result is a characterization of identity that inherits the richness and complexity of practice.
7. Identities of participation and non-participation:Chapter 7 introduces non-participation as a central aspect of the formation of identity. I argue that non-participation can take many forms-being an outsider, being a peripheral participant, or being marginalized-each with different implications for the resulting identities.
8. Modes of belonging:Chapter 8 extends the notion of belonging beyond local communities of practice. I distinguish between three modes of belonging: engagement, imagination, and alignment. I describe the basic features of each of these modes of belonging, the kind of work they require, and finally the various kinds of communities to which they give rise.
9. Identity as identification and negotiability:Chapter 9 discusses issues of belonging in terms of identification with certain communities and also in terms of negotiability-that is, in terms of our ability to shape the meanings produced in the context of these communities. I argue that the formation of communities inherently gives rise to "economies of meaning" in which various participants have various degrees of "ownership" of the meanings that define their communities. The dual processes of identification and negotiability make the notion of belonging a basis for talking at once about learning, identity, and power in social terms.
Learning communities:Coda II summarizes Part II by describing some basic features of what I call a learning community, whose practice it is to keep alive the creative tension between competence and experience.bbb
Epilogue: Design
By way of conclusion, I discuss issues of design and learning. First, I introduce a general framework to talk about design in terms of the kind of facilities it offers for learning. Then I apply this design framework in discussing two kinds of social design that involve learning in a crucial way: organizations and education.
10. A learning architecture:Chapter 10 outlines a skeletal "architecture" for learning derived from the argument of this book. It recasts the conceptual framework developed so far into a design framework, laying out basic questions that must be addressed and basic components that must be provided by a design for learning.
11. Organizations and their relation to practice:Chapter 12 argues that organizations can among other things be viewed as constellations of interconnected communities of practice. They form a learning architecture to the extent that the organizational design provides complementary facilities for engagement, imagination, and alignment.
12. Education and the formation of identities:Chapter 11 argues that education is about opening a field of possible identities that can be understood as actual trajectories of participation in practice. Again the infrastructures of engagement, imagination, and alignment are crucial in developing different aspects of identity formation.
There are many ways in which organizational and educational designs differ but both must provide institutional support for learning and, in this respect, they have much in common. In any discussion of design for learning, it is important to reiterate that communities of practice have been around for a very long time. They are as old as humankind, and existed long before we started to concern ourselves with systematic design for learning. Communities of practice already exist throughout our societies-inside and across organizations, schools, and families-in both realized and unrealized forms.
Communities of practice are thus not a novelty. They are not a new solution to existing problems; in fact, they are just as likely to have been involved in the development of these problems. In particular, they are not a design fad, a new kind of organizational unit or pedagogical device to be implemented.
Communities of practice are about content-about learning as a living experience of negotiating meaning -not about form. In this sense, they cannot be legislated into existence or defined by decree. They can be recognized, supported, encouraged, and nurtured, but they are not reified, designable units. Practice itself is not amenable to design. In other words, one can articulate patterns or define procedures, but neither the patterns nor the procedures produce the practice as it unfolds. One can design systems of accountability and policies for communities of practice to live by, but one cannot design the practices that will emerge in response to such institutional systems. One can design roles, but one cannot design the identities that will be constructed through these roles. One can design visions, but one cannot design the allegiance necessary to align energies behind those visions. One can produce affordances for the negotiation of meaning, but not meaning itself. One can design work processes but not work practices; one can design a curriculum but not learning. One can attempt to institutionalize a community of practice, but the community of practice itself will slip through the cracks and remain distinct from its institutionalization.
That does not meaning, however, that design is irrelevant. Communities of practice can be supported and they can be frustrated. Design is crucial, but it must be a dialogue among practices. It must be a design from the inside, not from the outside. Indeed, the relation of design to practice is always indirect. It takes place through the ongoing definition of their enterprise by the communities pursuing it. In other words, practice cannot be the result of design, but instead always constitutes a response to design.
The social perspective on learning presented in this book may be summarized succinctly by the following principles:
  • Learning is inherent in human nature:
    it is an ongoing and integral part of our lives, not a special kind of activity separable from the rest of our lives (Introduction).
  • Learning is first and foremost the ability to negotiate new meanings:
    it involves our whole person in a dynamic interplay of participation and reification. It is not reducible to its mechanics (information, skills, behavior) and focusing on the mechanics at the expense of meaning tends to render learning problematic (Chapter 1).
  • Learning creates emergent structures:
    it requires enough structure and continuity to accumulate experience and enough perturbation and discontinuity to continually renegotiate meaning. In this regard, communities of practice constitute elemental social learning structures (Chapter 3).
  • Learning is fundamentally experiential and fundamentally social:
    it involves our own experience of participation and reification as well as forms of competence defined in our communities (Chapter 2). In fact, learning can be defined as a realignment of experience and competence, whichever pulls the other. It is therefore impaired when the two are either too distant or too closely congruent to produce the necessary generative tension (Coda I).
  • Learning transforms our identities:
    it transforms our ability to participate in the world by changing all at once who we are, our practices, and our communities (Chapter 3).
  • Learning constitutes trajectories of participation:
    it builds personal histories in relation to the histories of our communities, thus connecting our past and our future in a process of individual and collective becoming (Chapters 3 and 6).
  • Learning means dealing with boundaries:
    it creates and bridges boundaries; it involves multimembership in the constitution of our identities, thus connecting-through the work of reconciliation-our multiple forms of participation as well as our various communities (Chapters 4 and 6).
  • Learning is a matter of social energy and power:it thrives on identification and depends on negotiability; it shapes and is shaped by evolving forms of membership and of ownership of meaning-structural relations that combine participation and non-participation in communities and economies of meaning (Chapters 7 and 9).
  • Learning is a matter of engagement:
    it depends on opportunities to contribute actively to the practices of communities that we value and that value us, to integrate their enterprise into our understanding of the world, and to make creative use of their respective repertoire (Chapters 2 and 8).
  • Learning is a matter of imagination:
    it depends on processes of orientation, reflection, and exploration to place our identities and practices in a broader context (Chapter 8).
  • Learning is a matter of alignment:
    it depends on our connection to frameworks of convergence, coordination, and conflict resolution that determine the social effectiveness of our actions (Chapter 8).
  • Learning involves an interplay between the local and the global:
    it takes place in practice, but it defines in a global context for its own locality. The creation of learning communities thus depends on a dynamic combination of engagement, imagination, and alignment to make this interplay between the local and the global an engine of new learning (Chapter 5, Coda II).
  • Learning cannot be designed:
    it can only be designed for. Its actual realization remains the property of the communities of practice that form in response to any design.                                                                                                                                                      [source http://www.ewenger.com/pub/pubCoPToC.html]

15 मार्च 2013


(Part - 4 of Motivation - Ken Shah & Prof. Param J. Shah)
[TYPES OF MOTIVATION (Part - 2)Theories of Motivation (Part - 3)BEING A MOTIVATING MANAGER (Part - 4) ]
(1) Treat staff well :
Subordinates have to be treated with diligence. The manager has to stay friendly as well as maintain a level of distance with his staff. It’s a tricky ground to tread. The staff looks up on the manager as their leader. They expect maturity, rationality and understanding from their superiors. Simple things like calling people by their first name, chatting about their families for a while or even a general inquiry about their well-being, brings in a feeling of belongingness. Small gestures of this type help in building up of a cordial relationship.
(2) Think like a winner :
A manager has to handle two situations, “The Winning” and “The loosing”. The crux is to think like a winner even when all the odds seem against you. It is necessary to equip yourself with all the tools of a winner. Always remember that winning and loosing rotate in a cycle. If you have been loosing from a long time you are very near the winning edge.
(3) Recognize the differences :
All the employees in the organization vibrate to a different pace. A treatment that motivates one may demotivation the other. Understanding the difference in temperament in between the individuals is important.
4) Set realistic goals :
Set moderate goals. Setting too high a task creates a feeling of non-achievement, right from the beginning itself. The goals set should be such which seem feasible to the employees to be achieved. A slightly higher target than expected provides a challenge
5) Prevent Demotivation :
A job of the manager is to motivate people. His task requires him to punish and penalize people. This might create resentment in the mind of the staff members, which may affect the productivity of the workforce. Henceforth, care should be taken, that punishment and penalties are used as a controlling technique and that they do not demotivation.
(6) Job-financial enrichment and small job changes are handy :
To make job more effective and to break the monotonous routine, small task additions and minor changes are always welcome. Even small suggestions of the manager seem valuable to the employees. A few challenges in the same job can enrich it.
(7) Non-financial rewards :
Monetary rewards have always had a high motivational capacity. But non-monetary rewards are equally helpful. A thank you note, a letter of appreciation or even few words of praise can help smoothen the creases between the different levels of management.


  1. The enemy of the ‘best’ is the ‘good’
  2. Think Win – Win
  3. You have be very clever to do simple things
  4. There is always a better way
  5. The man who makes no mistakes does not usually make anything
  6. Allow yourself the permission to make mistakes
  7. The best are optimists having vision
  8. Never promise more than you can perform
  9. No pain no gain
  10. Get organized
  11. In action, be primitive; in foresight, a strategist
  12. All easy problems have already been solved
  13. Include the success of others in your dreams or your own success
  14. To be a winner, all you need to give is all you have
  15. Success means winning the war, not every battle
  16. Daring ideas are like chessman, moved forward, they may be beaten but they may start a winning a game
  17. A man is not paid for having a head and hands, but for using them
  18. Work half day but don’t care if it’s the first 12 hours or the second 12 hours source :http://www.laynetworks.com/BEING-MOTIVATING-MANAGER.html

Motivation -1

(Ken Shah & Prof. Param J. Shah)
Nearly all the conscious behavior of human being is motivated. The internal needs and drives lead to tensions, which in turn result into actions. The need for food results into hunger and hence a person is motivated to eat.
A manager requires to create and maintain an environment in which individuals work together in groups towards the accomplishment of common objectives. A manager cannot do a job without knowing what motivates people. The building of motivating factors into organizational roles, the staffing of these roles and the entire process of leading people must be built on a knowledge of motivation. It is necessary to remember that level of motivation varies both between individuals and within individuals at different times. Today in the increasingly competitive environment maintaining a highly motivated workforce is the most challenging task. The art of motivation starts by learning how to influence the behavior of the individual. This understanding helps to achieve both, the individual as well as organizational objectives.
Motivation is a powerful tool in the hands of leaders. It can persuade convince and propel. People to act.


Motivation is to inspire people to work, individually or in groups in the ways such as to produce best results. It is the will to act. It is the willingness to exert high levels of effort towards organizational goals, conditioned by the efforts and ability to satisfy some individual need.
Motivation is getting somebody to do something because they want to do it. It was once assumed that motivation had to be injected from outside, but it is now understood that everyone is motivated by several differing forces.
Motivation is a general term applied to the entire class of drives, desires, needs, wishes and similar forces. To say that managers motivate their subordinates is to say that they do those things which they hope will satisfy these drives and desires and induce the subordinates to act in a desired manner.
To motivate others is the most important of management tasks. It comprises the abilities to communicate, to set an example, to challenge, to encourage, to obtain feedback, to involve, to delegate, to develop and train, to inform, to brief and to provide a just reward.

In the initiation a person starts feeling lacknesses. There is an arousal of need so urgent, that the bearer has to venture in search to satisfy it. This leads to creation of tension, which urges the person to forget everything else and cater to the aroused need first. This tension also creates drives and attitudes regarding the type of satisfaction that is desired. This leads a person to venture into the search of information. This ultimately leads to evaluation of alternatives where the best alternative is chosen. After choosing the alternative, an action is taken. Because of the performance of the activity satisfaction is achieved which than relieves the tension in the individual.


(Part - 2 of Motivation - Ken Shah & Prof. Param J. Shah)
[TYPES OF MOTIVATION (Part - 2)Theories of Motivation (Part - 3)BEING A MOTIVATING MANAGER (Part - 4) ]
(1) Achievement Motivation
It is the drive to pursue and attain goals. An individual with achievement motivation wishes to achieve objectives and advance up on the ladder of success. Here, accomplishment is important for its own shake and not for the rewards that accompany it. It is similar to ‘Kaizen’ approach of Japanese Management.
    (2) Affiliation Motivation
    It is a drive to relate to people on a social basis. Persons with affiliation motivation perform work better when they are complimented for their favorable attitudes and co-operation.
    (3) Competence Motivation
    It is the drive to be good at something, allowing the individual to perform high quality work. Competence motivated people seek job mastery, take pride in developing and using their problem-solving skills and strive to be creative when confronted with obstacles. They learn from their experience.
    4) Power Motivation
    It is the drive to influence people and change situations. Power motivated people wish to create an impact on their organization and are willing to take risks to do so.
    (5) Attitude Motivation
    Attitude motivation is how people think and feel. It is their self confidence, their belief in themselves, their attitude to life. It is how they feel about the future and how they react to the past.
    (6) Incentive Motivation
    It is where a person or a team reaps a reward from an activity. It is “You do this and you get that”, attitude. It is the types of awards and prizes that drive people to work a little harder.
    (7) Fear Motivation
    Fear motivation coercions a person to act against will. It is instantaneous and gets the job done quickly. It is helpful in the short run.


    • We have to be Motivated to Motivate
    • Motivation requires a goal
    • Motivation once established, does not last if not repeated
    • Motivation requires Recognition
    • Participation has motivating effect
    • Seeing ourselves progressing Motivates us
    • Challenge only motivates if you can win
    • Everybody has a motivational fuse i.e. everybody can be motivated
    • Group belonging motivates
     MOTIVATING DIFFERENT PEOPLE IN DIFFERENT WAYSMotivation is not only in a single direction i.e. downwards. In the present scenario, where the workforce is more informed, more aware, more educated and more goal oriented, the role of motivation has left the boundries of the hierarchy of management. Apart from superior motivating a subordinate, encouragement and support to colleague as well as helpful suggestions on the right time, even to the superior, brings about a rapport at various work levels. Besides, where workforce is self motivated, just the acknowledgement of the same makes people feel important and wanted.
    Motivation refers to the drive and efforts to satisfy a want or goal, whereas satisfaction refers to the contentment experienced when a want is satisfied. In contrast, inspiration is bringing about a change in the thinking pattern. On the other hand Manipulation is getting the things done from others in a predetermined manner.

    Hence, manipulation or external stimulus as well as inspiration or internal stimulus acts as carriers of either demotivation or motivation which in turn either results into dissatisfaction or satisfaction depending upon.