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Hello and Welcome. I'm Dr. George Lundberg and this is At Large at MedPage Today.
Providing and receiving needed health and medical care is morally right.
In a culture of capitalism, making a reasonable profit is morally acceptable.
Providing unnecessary and inappropriate medical and health care for the purpose of making a profit is morally wrong.
Both for-profit and not-for-profit health and medical care systems are capable of providing unneeded or inappropriate medical and health care -- such as tests, procedures, drugs, surgery, devices, repeated visits, readmissions, multiple prescribed consultations.
This may happen because of ignorance, habit, defensive fears, policies in place, and many other reasons. However, it is far more likely to occur in a system of incentives that produce more income by doing MORE.
The primary purpose of a business is to make money for its owners. To do so, it performs a service or builds and sells a product.
The primary purpose of a profession is to provide a service, for which it is paid money.
Hospitals, as functioning arms of the healthcare professions exist to benefit the population and thus should principally be service organizations, NOT businesses.
"Not-for-profit" hospitals can behave badly and act against the public interest. "For-profit" hospitals are virtually guaranteed to violate the public interest as much as they can without being caught, because it is their PURPOSE to make as large a profit as possible for their owners or shareholders.
Obviously, the way to manage this dilemma, other than the sensible but likely impractical approach of abolishing for-profit hospitals, is to align incentives that both drive appropriate patient care AND make money for the shareholders. Did I hear somebody say ... Accountable Care Organizations, ACOs?
OR, maybe merged hospitals and insurance companies working with physicians who use patient centered EBM algorithms designed to keep those dangerous hospitals empty, rather than fill their beds.
AND, maybe that whole approach could be used by for-profit and not-for-profit organizations?
Wow! An epiphany. Some potential solutions to the dilemma just appeared. Do it somebody, just do it.
But here is a big yellow caution flag. IF that same hospital also buys up physician practices and employs the physicians, GOODBYE physician autonomy; HELLO higher prices for patients and other payers.
The owners will decree whatever price increases those nefarious MBA types propose and that the market will bear.
And if you throw certain private equity firms at the blended, for-profit, hospital-physician concoction, forget about ethics, and the welfare of the locals, and watch the money get squeezed out for short term profit all the way to Switzerland and the Caymans.
That's my opinion. I'm Dr. George Lundberg, At Large for MedPage Today.


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5 Tips for Making a Small Bathroom Appear Larger
Dealing with a small bathroom can be difficult at times. Fortunately, while there may not be much you can do to physically expand the overall size of your bathroom, there are a few decorative steps that you can take to trick yourself into feeling like the space is larger than it actually is.
Tip #1: Get Creative with Mirrors
Mirrors are great assets to any bathroom. Not only do they help you with getting ready to start your day, but they can also help to create the illusion of more space. Rather than simply hanging one small mirror above your vanity, mirror an entire wall. The reflection of light will help to brighten up the space while also fooling your...

subset: commoncrawl


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Fulbright Nehru Fellowships 2016-2017: Apply by July 1 2015
The United States-India Educational Foundation (USIEF) invites applications for Fulbright-Nehru and other fellowships from Indian citizens residing in India, including students, college/university faculty, researchers, school teachers, policy planners, administrators, and professionals.
The Fulbright-Nehru Master's Fellowships are designed for outstanding Indians residing in India to pursue a master's degree program at selected U.S. colleges and universities in the areas of:
Arts and Culture Management including Heritage Conservation and Museum Studies; Environmental Science/Studies; Higher Education Administration; Public Health; Urban and Regional Planning; and Women's Studies/Gender Studies.
Join Lawctopus Law School, the law school you always wanted, online! Check courses.lawctopus.com
Due dates for submission of 2016-2017 Fulbright applications is July 1, 2015.
Timeline and Placement Process
July 1, 2015 Application due date for 2016-2017 awards
July-August 2015 Field-specific experts review applications to short-list candidates
Late August 2015 National interviews of short-listed candidates in Delhi
If you have questions, e-mail them to firstname.lastname@example.com
For more details please refer the Website HERE.
Disclaimer: We try to ensure that the information we post on Lawctopus is accurate. However, despite our best efforts, some of the content may contain errors. You can trust us, but please conduct your own checks too.


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The Fox network's struggling new comedy series Ben and Kate has been removed from the broadcast schedule leaving fans in limbo over when and if the remaining six episodes of the first season will be shown.
Although not officially canceled Fox has followed the lead of other networks in simply deciding not to broadcast the remaining episodes of the Tuesday night sitcom; in a similar move ABC decided not to show the remaining episodes of Don't Trust the B- in Apartment 23, which also aired on Tuesday nights, according to reports Thursday.
Ben and Kate was one of the major hopes for Fox to accompany the successful Raising Hope, which will have repeat episodes shown in the Tuesday time slot previously occupied by Ben and Kate. Tuesday night comedy series have struggled across the networks during the Fall season with NBC's Go On starring Matthew Perry and The New Normal also finding it difficult to maintain their number of viewers.
The show received an overall rating of 1.2 among viewers age 18-49, and a 2.1 rating in that demographic for its last aired episode, with only four million viewers tuning in on Jan. 22.
"My network and I just broke up. She is a great girl, and I'm glad she gave us a shot as long as she did. I'll miss you," Echo Kellum tweeted on Jan. 23. The actor played Tommy on the show.
While @bluthss tweeted, "Lesson in life: Don't get too attached to TV shows, cancellation may break your heart to million (i.e. Apt. 23, Ben and Kate)."
According to New York Times writer, Tuesday's comedy lineup across the networks is weak.
"Comedy on Tuesday appears to be nearing complete rejection," he wrote. "NBC's two new series, 'Go On' and 'The New Normal,' both sank to new lows this week, even though Tuesday's strongest network, CBS, was offering only repeats all night. Both new NBC comedies have had their ratings plunge since they were separated from the powerful lead-in of 'The Voice.' Their once-secure status as shows set to survive the season could now be threatened."
E! News Suggested FOX may air the remaining episodes after the March 28 finale of "Raising Hope."
On The Web:
'Ben and Kate' canceled? Fox takes its show off Tuesdays
Fox Shelves 'Ben and Kate' on Tuesdays
'Ben And Kate' Canceled, Fox Comedy Cut From Tuesday Lineup Midseason


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Patrons & Honorary Life President
We are proud to have such a dedicated selection of Patrons. They have all played a vital role, using their voice to raise awareness for Hope for Tomorrow.
Lord Ian MacLaurin, Honorary Life President
Ian MacLaurin joined our Founder, Christine, as a Trustee and Chairman when she started the Charity in 2003. Having served on the board for 13 years he stepped down and we are proud that he is now Honorary Life President. Ian is a British businessman who started his career at Tesco in 1959 as a management trainee and he rose through the ranks to become a hugely successful Chief Executive and Chairman. He subsequently became Chairman of Vodafone and has held numerous commercial and educational posts since, including Chancellor of the University of Hertfordshire. Knighted in 1989, he became Lord MacLaurin of Knebworth in 1996.
Sir Stirling Moss OBE and Lady Moss
Sir Stirling Moss OBE, British motor racing legend, became a professional driver at the age of 18 and enjoyed a career which spanned three decades. He won over 200 races, including 16 Formula 1 Grand Prix, and most notably won the Mille Miglia in 1955 in a record time of 10 hours, 7 minutes, 48 seconds (average speed 99.98mph) that still stands to this day. In 2000 he was made Knight Bachelor for his services to motor racing.
"Susie and I are so proud to be involved with Hope for Tomorrow, since its inception in 2003 supporting our dear friend Christine.
She had seen, at first hand, the stresses and strains associated with the disease, not least of all the uncomfortable, long journeys to and from their nearest Oncology Centre, and the often long waiting times for treatment that her husband David experienced.
Susie and I are especially honoured that Hope for Tomorrow's second Mobile Cancer Care Unit was named 'Bumble', when launched in December 2010, in memory of Susie's late mother, who also succumbed to cancer, and that the Unit continues to help patients throughout Somerset to this day."
Ross Brawn OBE
Ross Brawn began in Formula One in 1976 working for Frank Williams as a machinist. Ross worked for Frank for seven years, winning two World Championships and finishing as a Senior R&D Engineer.
Progress through various Teams in the eighties culminated in winning the World Sports Car Championships in 1990 where he met Michael Schumacher. With Michael, Ross won seven Drivers and Constructors F1 World Championships with Benetton and Ferrari. Ross formed his own eponymous F1 Brawn GP Team buying the defunct Honda F1 Team and won the F1 World Championships again with Jenson Button in 2009.
Ross Brawn was named Managing Director of Motor Sports, Formula 1® in January 2017.
Ross is one of the most successful and innovative Technical Directors in Formula 1 history. He has an unparalled technical knowledge of the industry thanks to his 40-year engineering and management experience.
"Most of us have been affected by cancer in one way or another, either directly or with loved ones. I lost my mother to cancer so I have always been very keen to support the team at Hope for Tomorrow because they are clearly making a difference to the lives of people battling against cancer.
In meeting the challenge of an illness such as cancer, the ability to receive the necessary treatment with the minimum of stress and in a positive and motivating environment can make all the difference.
I was delighted to be invited to become a Patron of the Charity and to be a small part of a really worthy cause – providing cancer sufferers with Mobile Cancer Care Units and the environment to beat cancer."
Gloria Hunniford OBE
"I was delighted to be invited to become a Patron of Hope for Tomorrow and to be a small part of this amazing charity.
I have a saying that 'people never die, if they live on the lips of the living'. So I am absolutely thrilled that the East Kent Mobile Cancer Care Unit will not only have Caron's name on it but will also be doing so much good for people going through cancer treatment in the region.
This Unit will make it easier for patients by bringing cancer care closer to their homes and I know that Caron would be very proud of it.
For everybody concerned, travelling for cancer treatment is difficult. Hope for Tomorrow has identified this problem, and it's just amazing to see how their Mobile Cancer Care Units make life easier for so many patients."
Photo Credited ©Edward Lloyd/Alpha
Dr David English CBE MBE OSCA
Former President of RSO Records and Manager of the Bee Gees, David is Vice President of the English Schools Cricket Association (ESCA) and Captain of the legendary charity celebrity 'Bunbury' cricket team, which he founded in 1986.
Each year David stages the Bunbury Festival, the most important week for under 15 cricketers in this Country.
As well as being Club Captain of Finchley Cricket Club, David has played for the M.C.C., Middlesex County Cricket Club and The Cross Arrows at Lords, and is the first President of Berkshire Youth Cricket, and a Lords Taverner.
David Richards CBE
David Richards is a former World Rally Champion and the Founder and Chairman of Prodrive, one of the world's leading motorsport and advanced technology businesses, headquartered in Banbury. In the past few years he has also ventured into the hotel business, and is now the owner of two hotels in the Cornish village of St Mawes, a place which has become his second home, and why he was so proud to launch the Hope for Tomorrow Mobile Cancer Care Unit for the Royal Cornwall Hospitals NHS Trust.
"I was really honoured when I was asked to launch the Mobile Cancer Care Unit for Cornwall, and chose to name it 'Dorothy', in memory of my grandmother, who sadly died of cancer, far too young, some 50 years ago. I am sure that had one of Hope for Tomorrow's Mobile Cancer Care Units existed in those days, she may well have lived for many years longer."
Derek Bell MBE
Derek raced in Formula 1, but more memorably in sports cars, winning 2 world championships, 5 times the Le Mans 24 hour race and 3 times at the Daytona 24 hours. He also took part in the filming of 'Le Mans' with Steve McQueen, and was awarded an MBE in 1986 for his services to motorsport.
"Back in the early 80's, I fortunately met David and Christine Mills who took me under their wing, and we had the most wonderful relationship as they guided me through some interesting times, and somehow convinced the world's press that Sportscar racing and winning the world's greatest race, Le Mans, was quite important!
Their guidance and friendship was invaluable throughout my career and following David's tragic passing in 2002, I truly admired Christine's commitment and selflessness in her passion to launch Hope for Tomorrow.
What Hope for Tomorrow has achieved is incredible, and I am more than proud to be a small cog in that dynamic wheel."
David Brabham
David Brabham was one of the world's elite sportscar racers – an outright and triple Le Mans 24 Hours class-winner, double American Le Mans Series Champion and former Formula 1 driver.
David has created his own powerful legacy befitting of the Brabham name in an illustrious career spanning the highest echelons of global motorsport.
"It is an honour to be asked to become Patron for Hope for Tomorrow and to support their vital work in bringing cancer treatment closer to patients' homes. My father, Sir Jack Brabham, was quick to support the charity when it was founded in 2003 and it is a pleasure to continue the association he established."
Geoffrey Bray
Geoffrey first met Hope for Tomorrow's Founder Christine Mills and her husband David in the early 1980's. His company at that time was launching a range of mobile workshops and needed their professional PR resource. A mutual friend effected an introduction and the rest, as they say, is history.
David and Christine played a significant part in promoting a business concept that ultimately led to Geoffrey and his wife Ina to found a successful nationwide fleet management company, Fleet Support Group, in 1987, which became the largest independent fleet management group in the UK. (Fleet Support Group was acquired by ARI in December 2011).
Geoffrey says that the invitation for him to become a Patron was very humbling and he feels very privileged to be a part of this dynamic organisation.
Martin Brundle
Martin Brundle started his racing career at 12 years old in a self built grass-track car in his native West Norfolk. He progressed up the motor racing ladder and after an epic season against Ayrton Senna in Formula 3, they were both elevated directly to Formula One in 1984.
Martin enjoyed 10 seasons of F1 racing and was also lucky enough to win the Le Mans and Daytona 24 hour races, along with the World Sportscar Championship. He was also a board member and then Chairman of the British Racing Drivers' Club, the owners of Silverstone.
In 1997 he moved to the commentary box working alongside the great Murray Walker, and after sixteen years with ITV and BBC he now works in commentary and presentation with Sky Sports F1, broadcasting to tens of millions of English speakers around the world.
"I was absolutely delighted when I was asked me to become a Patron of Hope for Tomorrow. I've been to several of the Charity's events and it's always been clear to me that the Charity is well organised and very efficient, and makes a significant difference to the lives of cancer sufferers and their families, at a most crucial time.
I lost my father to cancer and I know all too well what a miserable experience the chemotherapy is. The Hope for Tomorrow team clearly have no intention of resting on their considerable laurels, and no doubt such energy and determination will generate new Mobile Cancer Care Units and also keep the existing vehicles on the road to assist many other patients."
Nick Fry
Nick began his career with Ford Motor Company in 1977 as a graduate trainee. During his high performance career, he worked with Ford in the UK, Detroit and Germany. He soon moved to Aston Martin, where he was the youngest Managing Director in the marque's history and was responsible for their modernisation from a bespoke British car manufacturer to the brand you see today, synonymous with quality and high performance.
Nick was then recruited by Prodrive, where he was appointed CEO, leading their expansion into advanced engineering services as well as winning the World Rally & Le Mans Sports Car Championships and twice finishing second at Bathurst in the Australian V8 series.
Next, Nick Fry was appointed CEO of British American Racing (BAR), Honda F1 and led a management buyout of Honda F1 to create Brawn GP. As CEO he was responsible for building the commercial side of the Brawn GP team which won the 2009 Formula 1 Drivers and Constructors Championships followed by subsequent World Championships following the sale of Brawn GP to Mercedes.
After the sale to Mercedes he continued to successfully manage and grow the team by recruiting Lewis Hamilton. With his mission accomplished, Nick transitioned to a UK Business Ambassador role, consultant and venture capitalist. Nick continues to play a very active role in the world of Sport, Engineering and Business.


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We Build Websites Smart Enough to Increase your Revenue!
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- An Irresistible Headline.
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Say Something Nice
Everyone will feel warm and fuzzy after playing this simple icebreaker game.
Intensity level: Low
Preparations: None or not specified.
Equipment: a tennis ball, soft rubber ball, or Nurf ball.
This is a page showing you all our party games that have been tagged with 'circle'. We hope that this is what you're looking for, otherwise, feel free to browse around!
Everyone will feel warm and fuzzy after playing this simple icebreaker game.
Trusting the members of your group is the object of this noncompetitive game.
Can you remember names and try to think of new ones at the same time?
Work together and untie the mess that you created! Nothing is required except for some problem solving and fun.
This counting game will have everyone in the circle buzzing about the outcome.
"Fuzzy Duck" is a drinking game that can make the most well behaved people turn into sailors or at least talk like them. It sounds like it should be easy, but the more you drink, the harder it gets. The players will sit in a circle. One of the players is chosen to start the [...]
It is players against the clock in this wordy circle game.
This is a very traditional word game, played since Elizabethan times.
Can you figure out the secret of "Around the World"?
It is easier to pass a tissue using a soda straw when it becomes a group effort.


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Bozeman, MT -(Ammoland.com)- Two men were recently convicted in two separate poaching cases involving elk, deer and bighorn sheep in the Anaconda and Butte areas in 2012.
Montana Fish, Wildlife and Parks (FWP) game wardens investigated, and in the first case, uncovered evidence of three illegally taken bull elk, one white-tailed deer and a bighorn sheep at an Anaconda residence. The investigation began in April of 2013 when FWP wardens received information that Richard Bowen was in possession of a bighorn sheep skull as well as possible illegally taken elk and deer.
Game Wardens served a search warrant at Bowen's Anaconda residence where they recovered a trophy class bighorn sheep skull as well as other evidence of illegally taken wildlife. During the course of the investigation, wardens discovered several other violations that occurred during the 2012 hunting season.
Bowen pled no contest in District Court on June 11, 2014 to unlawful possession of bighorn sheep and deer and over-limit of elk. Bowen lost his hunting and fishing privileges for ten years, may not accompany anyone in the act of hunting, fishing or trapping during his 18 month suspended jail sentence, and must pay $1,500 in fines and $8,500 in restitution.
"This was blatant disregard for our resources and involved a complete lack of hunting ethics," said Game Warden Joe Kambic who led the investigation.
Two additional Anaconda men were cited for misdemeanor violations uncovered during the Bowen investigation. A photograph seized during the Bowen investigation also prompted a second case and conviction. Randy Nicholls of Butte lost hunting and trapping privileges for four years after he was convicted of over limit of elk and transfer of license related to a bull elk he poached on Fleecer Mountain south of Butte in November 2012. His fines total $870 and restitution is $2,000. Nichols was convicted on April 7, 2014.
FWP reminds anyone with information about hunting and fishing violations, or other outdoor crimes to call 1-800-TIP-MONT. Callers can remain anonymous and may be eligible for a reward up to $1,000 for providing information that leads to a conviction.
About Montana Fish, Wildlife & Parks (MFWP)
Montana Fish, Wildlife & Parks (MFWP) through its employees and citizen commission, provides for the stewardship of the fish, wildlife, parks, and recreational resources of Montana, while contributing to the quality of life for present and future generations.


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Handy Cooler
The Handy Cooler is much more than a portable hand-held fan. In fact, it's one of the first mini air conditioners of this kind to arrive on the market. Featured in the acclaimed M.I.T technology review magazine, a breath of cool air using the patented air cooling technology can be utilized at the flick of a switch. It can be hand-held or adjusted to be used on a desktop.
Review Details
The manufacturer behind this little air conditioner has thought about how the human body naturally cools itself when it gets too hot. They have used this technology to produce one of the most effective and smallest portable air conditioners on the market.
Truly portable, the Handy Cooler mini air conditioner can be with you 24/7. It will run off a USB, batteries and can even be plugged into an 110V outlet. Using this unit couldn't be easier. Simply soak the cellulose cooling filter in water, switch the unit on and you'll receive advanced evaporative cooling on the go. It also has a hybrid design which means it will happily sit on a flat surface making it perfect for home or office.
What We Liked
- Truly Portable
The Handy Cooler mini air conditioner can be taken anywhere. If you are commuting, at a sporting event or even taking a walk in the park, you can stay cool no matter how warm the weather is. Doubling as a desk fan, this unit is also perfect for home or office.
- Whisper Quiet Operation
With a noise level of just 30dB the soft turbine will not disturb sleep or other times of the day when additional noise can be an issue.
- Patented Air Cooling Technology
The Handy Cooler uses 'evaporative technology' developed on a much smaller scale. The turbine draws in air through the cellulose filter and produces a cool breeze up to 30 degrees Fahrenheit lower than the ambient temperature.
- Functional/Stylish Design
With its ergonomic design this unit can comfortably be held all day. It also comes in three stylish colors – black – pink – blue.
What We Didn't Like
- Not Recommended for Humid Conditions
Because the Handy Cooler uses evaporative technology, it's not recommended for use in high humidity conditions.
- Pricey
You can expect to pay anything up to $50 for this unit. However, since the technology used isn't new to the market, it is new to units of this size which is why it costs that little bit extra.
If you're looking for a mini air conditioner that will cool you down in hot weather no matter where you are, the Handy Cooler is the answer. It's very easy to use and doesn't need a lot of maintenance. Design has also been thought about. With an ergonomic handle, comfort whilst holding for long periods is not an issue. You will pay a little more for this unit, but the Handy Cooler really is a true mini air conditioner.Review by AirReflect ©
Last modified: May 15, 2013 (Prices are updated daily)
5 Watt


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Implied Odds in Online Poker to Know your Possibility of Making Money
When you make a bet in online poker you want to understand the probability of making money in the consecutive betting rounds. You want to know what might add to the pot making your win a valuable one. When it comes to implied odds in online poker it is a reference made to what you are expecting to win versus the cost of making a call for a bet.
Consider a situation where you have a small pair in your pocket cards. You are playing a chance of 8:1 versus an option of hitting a three of a kind in the flop. However, even if the options are at 5:1 the hand with a small pair is worth playing considering the implied odds factor. However, when you call the hand with a small pair you need to know that you will not play the hand any beyond if you do not hit the trips and you should consider to not play the hand anymore.
In games where you are playing with a small ante, and a small initial bet, where the small is with reference to the increase in the betting stakes in further rounds, you might want to play loose you might do better playing looser than the small ante. This specifically is only for the small bets in the beginning rounds. As the rounds in the game proceed, you might want to play tight because the size of the bets might as well become big.
While you play you should ensure your hand is alive, which means your should not have probable opponents with a hand better than what you hold. If your hand is still alive you can expect decent number of actions from other hands in the table contributing to the increasing size of the pot you might win. Every time you make a call, try out a quick calculation of the pot odds and decide if the call you will make is worth the future profits you might get by winning the pot. If the pot odds are not favorable then you might probably not call or stop playing considering the disposition of your hand strength.
It makes sense to work out implied odds regardless of whether you are playing limit poker games, no-limit poker games or pot limit poker games. The estimation of the odds spoken here are paramount because it makes a great difference in poker betting rounds where the size of the bet you will make increases with the rounds numbers.


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Constant thoughts, constant distractions; wired on adrenaline. Some of us are driven to madness by the constant dopamine rush, the need for more. Alan Watts brings us a remedy to that via trains of thought like no other.
A man gifted with his words, the likes of which the world has never seen before: Alan brings us a refreshing perspective on the nature of life, the universe, and everything in his own signature humorous manner..
A small book, it could easily be read in a day. However Alan's words will undoubtedly take you to places that you have never been before. Revelation after revelation will take time to digest, and there is no better man to take on that journey than Mr Watts himself.
If you liked this post then check out the last book recommendation.


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Approaches to Organizational Strategic Alignment
In its simplest form, organizational strategic alignment is lining up a business' strategy with its culture. The approach to it is a process that requires management to change and align its vision for the company with that of its leadership goals, different departments, culture and individual staff members. Through organizational strategic alignment, a company makes sure that there is consistency between the tasks that need completion and the business completing them.
Developing a Supportive Culture
In order for a company to experience organizational strategic alignment, its management, processes and goals must be in alignment. To create a culture of support, a company must clearly define the competence of its resources by evaluating if its equipment, staff and processes can handle new changes. If employees do not possess the competence to handle a new strategy, a company should provide training to enhance the skills of its managers and employees. Without adequate training and support, the relationships between employees and managers will suffer and the organization will lack flexibility. In an effort to create a supportive culture, senior management should be involved in organizational strategic alignment from the start and secure the proper resources to help ensure the success of the employees and the company. Employees also must commit to supporting a company's strategic alignment, and management can help ensure this support by clearly defining the company's goals and providing incentive to help the staff accept new strategies.
Modifying the Factors Affecting Organizational Strategic Alignment
Trust, communication, transparency, quality of planning and decision-making techniques all affect a company's organizational strategic alignment. In order to for a company to experience successful alignment, it must strive to understand its stakeholders, particularly its customers, through marketing research. A company should use a critical path analysis, an algorithm that helps develop project management timelines, in order to predict the amount of time needed to implement change. Poor follow-through can negatively affect organizational strategic alignment, so a business must continue to follow plans for change after taking the initial steps, track progress and taking into account the consequences of not following through with plans for change. Additional considerations for companies to take into account regarding organizational strategic alignment include the reactions from competitors and the possibility of government intervention.
Aligning Management
In order to get the ball rolling on organizational strategic alignment, a company must create a performance and cultural management focus that leaders identify and agree upon during a time of strategic change. This focus is like a North Star for managers to follow that enables them to provide the appropriate employee motivations, cognitive support and resources. In order to align management, however, company leaders must know how to manage change by understanding reasons for internal resistance to organizational strategic alignment and make the relationship between a company's vision and its technology, organization and processes clear.
Promoting Individual and Team Efforts
Raising self-awareness and allowing teams and individuals to have more autonomy can help drive organizational strategic alignment and have employees centered on the company's goals. In order to promote team and individual efforts, a company must offer transparency and provide sufficient information for employees to complete tasks, as well as include other company stakeholders. By promoting efforts to individuals and teams, a company helps build trust, which can increase loyalty to its organizational strategic alignment goals.
- MIT; Strategic Alignment: A Model for Organizational Transformation Via Information Technology; John Henderson, et al.; November 1990
- "Blue Ocean Strategy"; W. Chan Kim, et al.; 2005
Photo Credits
- Michael Blann/Lifesize/Getty Images


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Touching amongst same gender colleagues is deemed appropriate but touching bodyparts of the opposite sex or to complain about it is a clear sign of lack of liberal attitude. After all, if Clegg had refused holding hands with Cameron we would not have advanced in same sex marriage legislation.
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I have struggled with finding the best holiday outfit but I have finally found it and wanted to share with you! Macy's is having a 30% off Friends and Family discount with code FRIEND Nov 30 – Dec. 11 Click HERE to shop my Macy finds.
When it comes to holiday attire I love to stand out without it look like I tried to stand out.. ya know haha I have found that jewel tones are the best for the holidays and stick to a monochromatic look. It is simple, clean and classy. The jewel tone will be loud enough that you don't want to distract from it by wearing an accent colored bag or shoes. Just keep it simple. However, you can break this rule with a bold lip but that's it! For my look I have gone with metallics, keeping it soft yet glam.
|| Dress || Shoes || Bag || Coat || Lipstick ||
This DRESS is the perfect soft look I am going for. It is feminine, chic, classy yet stands out in a stylish way.
I decided to go with a more detailed SHOE to compensate for the softness of the dress. Still keeping with the jewel toned, monochromatic theme.
If a HANDBAG is a must go with something light, like this crossbody bag.
Remember how I said BOLD LIP? Yep this is the one. A nice pink or red will compliment this look well. I am going to go on the darker red side to match my coat.
Speak of the devil, here she is! The classiest COAT of them all.
Now that you are dressed for the evening be back by midnight! XOXO your Holiday Fairy God Mother!
Click HERE to shop my favorite Macy Finds!


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"My heart's passion and joy is to expand awareness and to help others have better lives."
At age 5 Brent's Gifts were documented by Duke University's Dr. J. B. Rhine the founder of ESP, in his pilot study. Ms. Atwater's unparalleled medical intuitive "look inside your body" diagnostic abilities have earned her the nickname of the "human MRI."
"Growing up I learned to follow "the voices in my Head" and I led my life by their Guidance and my Intuition." After law school and the death of her fiancé, Brent's Gifts exploded and couldn't be kept "on the sideline" any longer. So Brent refocused her life on helping people and their pets heal physically and from the loss of a loved one.
MEDICAL INTUITIVE page
For 20 years Ms. Atwater's highly respected and world renowned Medical Intuitive pioneering practice has published case studies that are documented and evidence based. Brent looks inside your body and can see the your organs, nerves, bones, tissue et. al, plus diagnose current health issues and predict future events.
Her Consultation's astounding accuracy and specific details amaze and comfort clients around the world by providing healing directions and health answers.
ANIMAL MEDICAL INTUITIVE Healthcare & Healing
Brent is also an Animal Medical Intuitive and Healer. Her energy healing work regenerating her dog's spinal cord nerves and vertebra has been documented by NC State University's School of Veterinary Medicine. She has been a speaker and teacher for the NC Veterinary Association and taught Energy work and How to be and Animal Veterinary Medical Intuitive at the New York Open Center.
Ms. Atwater pioneered and founded MIDI the field of Medical Intuitive Diagnostic Imaging™ and AIH Animal Intuitive Healthcare & Healing for Animals. Both books with healing techniques and descriptive energy pattern charts are groundbreaking resources for the science of Medical Intuition and Healing Animals with Integrative Energy Medicine.
WHY are Brent Atwater's Animal Medium Readings different from other Animal Communicators?
Because Brent actually sees, looks at and talks face to face with your Pet's Spirit no matter where you are located in the world! For almost 20 years, Brent's down to earth, sensitive life changing Readings are healing clients and audiences worldwide because they are filled with very personal information and specific OMG details that bring comfort, clarity and closure to heal your heart.
"My Life purpose is to
* provide clarity with answers,
* expand awareness with proof of after death communication,
* reduce the overwhelming grief and loneliness surrounding loss of a loved one.
* help others recognize, develop, and use their intuitive abilities."
Ms. Atwater is available for private Readings by Phone, Skype and on rare occasion in-person.
The ANIMAL MEDIUM page
Pet Loss, Afterlife, After Death Communication and Pet Reincarnation
Ms. Atwater, the Animal Medium is the world's authority on Pet Afterlife, Animal life after Death and Pet Reincarnation. Brent's decades of research produced numerous books on animal life beyond death. Those titles are translated into multiple languages and considered the worlds' #1 resource for animal afterlife and animal life beyond death information.
Brent's Animal Communication heals your Heart! Brent's ability to see Pet Spirits and talk with them, provides VERY specific details and personal information that comforts and brings you peace, closure and answers your heart's questions while expanding awareness about transition, afterlife and life after death.
In 1987 Brent founded the Just Plain Love® Charitable Trust to benefit children and other worthwhile causes.
and later
You're invited to Join Brent in making the world a better place for animals at her live audience shows Ms. Atwater communicates with audience member's live or dead pets. All show proceeds benefit animal welfare organizations.
MEET FRIEND, the DOG with a "B" on his BOTTOM
a Red tri colored Border collie who was born with a white fur "B" on his bottom that matches Brent's Signature.
Brent Took this as a "sign" to begin her research into expanding awareness about Pet reincarnation.


text: A series of cutters for making cork pads. They come in .5 mm steps from 6.5mm thru 16mm. The P30 cutters can be turned by hand, holding them perpendicular to the cork. Or, you can put a cutter in the drill press (to hold it more firmly) and turn the drill press by hand.


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im p*****.
it p***** me off that no matter what i do...you're always gonna love your mom more than me...i can be f****** perfect the exact replica of everything you've ever dreamed. and she still has priority....and she doesnt even want it...she wants you to grow up. its unnatural.......and i hate how you walk into a room where both of us are and you immediatly talk to her for an hour, while never acknowledging me....all the time she is talking to me...are you trying to tell me that you love her more than me...or do you just not realize that your that f****** clueless.....we certainly both notice..and were certainly both annoyed....
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He only wants you for s**. His mother takes care of the rest. So leave him and get the whole package
None of us care anymore. You have bitched a million times on here about this, just shut up and leave him already, or stay with him, I don't care.
The point of this isn't that he is still attached to his mom's apron, the point is I don't care.


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"The road through South Africa's energy landscape is beset with detours, crossroads and conflicting signposts," is a common assessment of the country's electrical power sector.
Struggling to find the right mix to tackle chronic capacity shortages, stubborn red tape holding up new projects and mounting pressure by consumers to tariff hikes which, according to some economists, will take South African electricity rates to amongst the highest in the world, and some industry mutterings about the proportioning of generation methods, CSP amongst them. At a few percent, reserve margins are low, compared to the global recommended level of 15%, due simply to energy supply not meeting energy demand.
South Africa is just two years into its IRP2010 (Integrated Resources Plan), a roadmap drawn up by the Ministry of Minerals and Energy to plot the energy sector's fortunes for a 30-year span.
Just under 1,500MW of clean energy will be installed over the next three years, the only look-in by independent power producers (IPPs) as South Africa struggles with its energy capacity deficit. Support is growing for the notion that the private sector should contribute to generation to a much greater extent, particularly as a means of steadying spiralling capital costs.
already five times the price
The contracted tariffs for renewable energy in the new build programme are already double Eskom's projected price five years from now.
In its application for a 16% tariff increase for each of the next five years from April 2013, Eskom says it will use 3% of that to fund its purchase of renewable electricity from independent power producers. If approved, it will double the price of electricity consumers now pay.
The load shedding debacle of 2007 and 2008 caused havoc to the South African economy, with losses estimated at R50bn ($6.5bn) – the government is understandably eager to broaden its energy supply base: renewables are one way of achieving this.
Can CSP fill this gap?
Whilst some analysts may criticise promoting CSP in South Africa due to high costs and relative lack of track record, others are more optimistic.
Ken Robinson, executive at management consultants Accenture, points out that the proportion of high-cost CSP in the IRP2010 – just 600MW in 20,000MW to 2020, or 1,000MW in 90,000MW to 2030 – is not enough to get excited about."In my view 1%-3% CSP is an experimental exercise in generation technology, which I would support."
It's no secret that Eskom and the government want more out of CSP than simply commercial wattage and that the big prize is industrial scale energy storage and heat transfer. So far, the quickest way to this particular golden fleece is the high temperatures only CSP (after nuclear) can provide.
Protagonists who see CSP as the best bet, in fact hardly a gamble, point out that much of the pioneering technical work has moved off the R&D drawing board and is proving its worth in Spain and the United States. What's more, Abengoa of Spain, South Africa's 51% stakeholder partner in its first CSP ventures, is a global leader in CSP technology. Their projects are a 100MW parabolic trough project at Upington and a 50MW tower facility at Pofadder, both in the Kalahari scrublands.
lots of sun & space available
Few regions in Africa – apart from the Sahara Desert – receive the intensity of solar radiation that bakes South Africa's Northern Cape Province for at least 350 days a year, and have as much free land to spare, bearing in mind the space that solar generation demands.
The strides PV are making technologically and in generation cost reduction is emerging as its most effective weapons its competition with CSP, if that is what it is. PV is also playing catch-up with CSP in heat generation with emerging CPV technology and an array of such cogenerators such as CSP-PV, for example. Perhaps the solution won't be found in individual technologies but in a melting pot of like-minded production methods.
Meanwhile, the European Investment Bank (EIB) has joined the funding portfolio of the joint Abengoa-SA Industrial Development Corporation's Khi Solar One project in South Africa's Northern Cape Province with a $63.5m contribution. It is the first large CSP project in sub-Saharan Africa and a milestone private sector renewable energy project in South Africa.
The EIB funding support came at the financial close of a slew of 28 renewable energy projects at the closing ceremony for REBID 1 projects. Electricity generated at the Khi Solar One plant will be sold to South Africa's state owned utility, Eskom, on a 20-year power purchase agreement. Some 600 construction jobs will be created during the build with about 35 full time plant operations employees. The project has a two-hour storage capacity and will prevent an annual 183,000mt of CO2 emissions. The Khi Solar One project consists of a 200m high tower with around 4,500 heliostat moving mirrors on a 600 hectare site.
By Tom Nevin. Source: CSP Today
The Khi Solar One plant, located close to Upington, will harness solar radiation by focusing it onto a small area to produce steam, which drives a turbine and produces electricity.


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Don't-Know Mind: A Path for Parenting
Don't-Know Mind, or Beginners Mind, is a Buddhist principle. It helps remind us that clinging to certainty, although natural, can cause us suffering. In parenting, it can interfere with our children's innate ability to learn from experience.
There aren't many jobs we sign up for in life where the stakes are as high as they are in parenting. We are suddenly required to be on call 24/7 without prior training, schooling, or mentoring. No matter how many books we have read, or how many children we have spent time with, we enter this job mostly ignorant of what it entails. Living outside of parenting and observing it is unfathomably different than living inside of it.
In our culture we like to "know" what we are doing. We read books, we do research, we seek control over our lives in myriad ways.
Good parenting, however, requires "don't-know mind." It is a letting go of preconceived ideas and a letting go of the notion that we have control over how things are.
While we might want to enter parenting with our answers in place, how can we know the answers before we have been "in" the experience? Parenting is a moment-to-moment dynamic relationship that involves environmental and situational variables as well as the child's and parent's ideas, thoughts, sensations and feelings.
As author Laura Davis put it:
As much as we might like to enter parenthood with all our answers, techniques, and strategies in place, doing so would mean building a system that fails to include the input of our children. Our ability to stay open, adaptable, and responsive necessitates that we don't start with all the answers but that we dedicate ourselves to figuring them out along the way. (p. 27)
When we come from a place of certainty, we are not receptive to what stands outside of our preconceived ideas. If we enter parenting with a rigid stance about how things should be, we not only leave out the variable of who our children are and who they are becoming, but we cloud our ability to allow our children and our experience to be our teachers.
In human development, stasis means something has gone awry. It is an undesirable state. Growth and development can be derailed both by certainty and by the anxiety that can accompany doubt. Don't be certain, don't be in doubt? Then what guidelines should we follow? Here is where the teaching of "don't-know mind" can be particularly useful. As the Buddhist teacher Suzuki Roshi said:
"Not-knowing does not mean you don't know." Not-knowing means not being limited by what we know, holding what we know lightly so that we are ready for it to be different. Maybe things are this way. But maybe they are not. (Quoted by Gil Fronsdale)
And as Fronsdale put it:
"The practice of not-knowing needs to be distinguished from confusion and debilitating doubt. Confusion is not a virtue: the confused person is somewhat lost and removed from life. With doubt, the mind is agitated or contracted with hesitation and indecision. These mind states tend to obscure rather than clarify."
Fronsdale adds that while doubt and uncertainty are involuntary states, "don't-know mind" is a conscious practice in which: "(We)…cultivate an ability to meet life without preconceived ideas, interpretations, or judgments."
The wish to know is a natural human tendency. Having a path in mind is helpful since it highlights when we have veered away from the things that are most important to us. But holding our beliefs lightly, being willing to sit with the discomfort of not knowing may be equally important.
Babies seek to learn and grow even in the absence of our "stimulating" them. They learn from experience and are constantly experimenting with different ways of making sense of the world. Perhaps our challenge is to be more childlike ourselves, letting each new moment be different from the last, full of surprise, wonder, and sometimes fogginess.
Try these exercises to help you with don't-know mind:
- Notice thoughts of certainty as they arise and see if you can soften the edges. Try to remain open to the possibility of things being different and allowing your beliefs to shift.
- Spend a few minutes observing a baby, witnessing their receptivity and openness to learning and growth.
Davis, L. (1997). Becoming the Parent You Want To Be: A Sourcebook of Strategies for the First Five Years.
Fronsdal, G. Not-Knowing – Adapted from a public talk February 2004
Hassan, G. (2018). Don't-Know Mind: A Path for Parenting. Psych Central. Retrieved on October 26, 2020, from https://psychcentral.com/blog/dont-know-mind-a-path-for-parenting/
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
Published on Psych Central.com. All rights reserved.


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Credential Limitations
The LHSAA has the right to limit the number of media credentials a media outlet can request for championship events depending upon the media outlets purpose and coverage.
Below are some general guidelines the LHSAA follows when approving media credentials.
Weekly Newspapers will be limited to two (2) media credentials, one (1) writer and one (1) photographer
Television News Stations will be limited to four (4) media credentials
Radio Stations will be limited to three (3) media credentials
Daily Newspapers will be limited to three (3) media credentials, two (2) writers and one (1) photographer
Websites/internet news outlets are considered on a case-by-case basis
Schools will be limited to two (2) school credentials


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Kate Moss parties with Courtney Love and Sadie Frost at fashion bash
The model was launching her new jewellery collection
KATE Moss partied with pals Sadie Frost and Courtney Love at the launch of her posh jewellery collection tonight.
The supermodel looked stylish in a floor length biscuit coloured shimmering dress with a black velvet jacket.
Along with Kate's old friend Sadie and rocker Courtney, Liv Tyler and model Karen Elson were also at the event, held at Isabel's in London's Mayfair.
Sadie wore a cowl-necked black dress and navy blue shrug while Courtney sported a light blue dress with gold collar.
Liv meanwhile, looked chic in a black top, blazer and slim fitting trousers.
Kate is launching her limited edition collection with Brazilian designer Ara Vartanian.
According to Vogue, the collection features diamond and Brazilian gemstone rings, pendants and earrings.
Kate told the fashion bible that the collection will feature "pieces that have meaning and that you can wear every day."
Prices range between £700 and £9,500.


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The Arkansas River Trail System's paved pathways offer an exhilarating experience for runners who prefer fresh air and natural surroundings to the monotony of an indoor treadmill.
Runners can sprint the towering Big Dam Bridge, the longest of its kind in the U.S. designed solely for foot and bike traffic, or tread past heavily forested parks, glistening green golf courses and expansive stretches of wilderness.
When it's time for a break from Arkansas trail running, food and water are available at many trail-side restaurants and shops downtown or in the Riverdale area.
Mile markers span the length of the trail, allowing runners to keep track of the distance they've traveled on this Arkansas running route. In addition, multiple marathons, 5Ks and other Arkansas running events make their way along the trail each year, from the River Trail 15K to the Little Rock Marathon.
Don't miss the Little Rock Marathon. This annual event features a 26.2 mile marathon run, 10K marathon run, 5K fun run/walk and a kids marathon. Click here for more information.
And check the Events page for other races you might be interested in.


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Briley Choke Tube Speed Wrench with aluminum fingers to accurately align the wrench inside the tube to hold the teeth in place.
Cranking the handle quickly then spins the tube in, or out.
Universal wrench fits all 4 factory style slot chokes offered by Henry.
Available in: 12GA, 20GA and .410 Bore.
Choose USPS Priority Mail today, and you'll receive your package between and .
*Priority Shipping not available for the following items: Henry Custom Picture Frame, Gift Cards, Gun Cabinet, Henry Big Boy Clock, and Personalized Engraved Covers. Please refer to those pages for specific shipping times.
Have any questions about our Henry Pride items? Email Allison using this form, or call toll free 844-451-1899


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Chapter 2: The Psychophysical Organism
and the Nervous System
James Rowland Angell
Table of Contents | Next | Previous
The Union of the Psychical and the Physical in the Organism. -- We shall now examine some of the evidence confirmatory of our assertion in the last chapter, that conscious processes and physiological processes are intimately connected in the organism. We shall in this way discover some of the reasons why it is desirable for us at the outset of our study of mental life to learn something about the nervous system, to which subject we shall then devote the remaining portion of the chapter.
Common observation informs us of at least two fundamental types of fact concerning these mind-body relations. We know in this manner (1) that our consciousness or knowledge of the world about us depends primarily upon the use of our senses. A person born blind and deaf has neither visual nor auditory sensations or ideas, and never can have so long as he remains destitute of eyes and ears. By means of the other senses he may be taught much about colours and sounds, as Helen Keller has been; but he never can have the experience which you or I have, when we see a colour or hear a sound, or when we permit a ' melody "to run through our 'heads," as we say, or when we call into our minds the appearance of a friend's face. Indeed, if a child becomes blind before he is five years old he commonly loses all his visual ideas and memories just as completely as though he had been born blind. There is every reason to believe that if we were deprived of all our senses from birth, we could never possess knowledge of any kind. The senses thus hold the keys which unlock the doors of intelligence to the mind, and the
(12) senses are physical, not mental, things. Apparently, therefore, the most simple and fundamental operations of consciousness are bound -up with the existence and activity of certain bodily organs.
Common observation also informs us (2) that the expressions of mind ordinarily take the form of muscular movements which we call acts. We hear a bell and our consciousness of the sound results in our going to open the door. We consider a course of action, and the outcome of our deliberation issues in the form of words or deeds, all of which consist primarily in muscular movements. Strange as it may appear, even keeping still involves muscular activity. It would accordingly seem as though the mind were hemmed in between the sense organs on the one hand and the muscles on the other. If would be a truer expression of the facts, however, to say that these are the tools with which the mind works. Through the sense organs it receives its raw material, and by its own operations this material is worked up and organised into the coherent product which we call intelligence. This intelligence is then made effective in practical ways through the rationally controlled action of the voluntary muscles.
There are other facts of a well-known kind whose precise purport is, perhaps, less evident, but whose general implication of intimate connections between mind and body is identical with that of the considerations which we have just mentioned. We know, for example, that blows and wounds may seriously disturb consciousness, or even destroy it. The similar effects of many drugs, such as alcohol, ether, and hashish, are matters of common knowledge. Even coffee and tea exercise a mild influence upon our psychical mood, and the change in general disposition which frequently follows indulgence in a satisfactory meal is a phenomenon familiar to every family circle. Bodily disease often produces a most marked effect upon the mind, and conversely
(13) different effect upon disease, of a cheerful or a depressed attitude, is a subject of frequent remark.
When we examine the less familiar evidence offered us by certain branches of modern science, we find our previous impressions strongly confirmed. Thus we learn from pathology, the science of disease, that disordered conditions of particular portions of the brain tissue are accompanied by disturbances of definite kinds in consciousness. In this way we learn, for example, that the destruction or disintegration of the tissue of one region in the brain is followed by the loss of one's visual memories, so that one cannot recall the appearance of familiar objects. A similar disorder in another region costs one the control of certain muscles in the hand, etc. The science of anatomy is able to demonstrate structural connections of nerves between these diseased parts of the brain and the sense organs and muscles over which consciousness has lost control, thus supporting the implication of the pathological evidence already cited. Experimental physiology shows us, that by stimulating (either mechanically or electrically) certain brain areas in animals, we can produce movements of definite muscles, whereas by extirpating these regions we can at least temporarily cripple the muscles and render the will powerless over them. By similar excisions of other brain areas we can cripple definite sense organs. Thus pathology, anatomy, and physiology all point to the same intimate relation of mind and body and indicate more specifically than the observations of every-day experience could do a fixed and positive relation between definite parts of the nervous system and such special phases of consciousness as the visual, the auditory, etc.
Moreover, comparative anatomy, comparative physiology, and comparative psychology all converge upon another cognate principle, i. e., that the development of consciousness among various genera and species of the organic world has run parallel with the development of the nervous system.
(14) Taking all these considerations into account, the deliverances of common sense as well as the teachings of science, it is easy to understand why the modern psychologist finds it judicious in his study of consciousness to learn all that he can about the nervous system, the sense organs, and the motor mechanism.
The Nervous System. -- It will assist us in gaining a working idea of the nervous system to bear in mind the fact that its fundamental function consists in "the conversion of incoming sensations into outgoing movements of a kind tending to preserve the creature." Creatures destitute of some form of nervous system are practically incapable of prompt and appropriate adaptation to their surroundings. Plants are thus in large measure the passive victims of their environments. Injury to one part commonly produces little or -no immediate effect upon the rest of the plant. But by means of its nervous system every part of an animal organism is brought into vital connection with every other part. Cooperation becomes the controlling principle in the life activities. This cooperation, or coordination, takes the form of movements made in response to sensory stimulations, and the most highly evolved form of nervous system, such as that of the human being, differs from the very -rudimentary forms, like that of the jelly fish, only in the complexity of the devices by which these stimulations and movements are connected. When we are studying the structure of this system, we should, then, always remember this fact about the coordination of sensations and movements, as the clue by which to interpret even its most intricate arrangements.
The Elementary Structures.-- The nervous system is made up of nerve cells, with their filamentous elongations which are called fibres. A sketch of certain common forms of nerve cells is shown in figures 1, 2, and 3. It will be seen that they are accumulations of granular protoplasmic masses containing a nucleus, and often within this nucleus smaller
(15) nucleoli, while from their edges are given off filaments of various forms and sizes. These filaments are outgrowths of the cell-body and constitute an organic part of the structure. The whole structure, including both fibre and cell-body, is nowadays called a neurone. The neurone is, therefore, the
real element of the nervous system. It has been estimated that in the nervous system of the adult human being there are about 11,000 millions of these neurones in various stages of development. Their average volume is probably about .00009 of a cubic millimetre.[1]
Certain of the fibrous protuberances are called axones or neurites , others are known as dendrites. The axones, as may be seen from figure 3, are generally smooth in their contours, and when they branch, the divisions commonly occur at right angles. Within the central system the dendrites are rougher and branch more gradually from one another, somewhat like the sticks of a fan. The fully developed axones have a peculiar structure, shown in figure 4. The central strand is known as the axis cylinder. This is a transparent mass
which apparently constitutes the true nerve, and conducts nervous impulses from sense organ to nerve centre, and back again from nerve centre to muscle. Outside the axis cylinder is a relatively thick covering known as the medullary sheath. This sheath generally disappears near the cell-bodies and also wherever the fibre terminus approaches other fibre ter
(17) minals. Outside of this again there is a thin membraneous sheath known as the neurilemma.
Although the cell-bodies and fibres are really parts of single organic cells -- the neurones -- their notable difference in appearance is accompanied by a distinct difference in function. Both cell-bodies and fibres are sensitive to stimulation,
are irritable, as the physiologists say, and both possess conductivity. But whereas this exhausts the fundamental functions of the fibres, the cell-bodies are ordinarily supposed to possess the further capacities of reinforcing or inhibiting
(18) the impulses sent to them. Moreover, the cell-bodies seem at times to send out nervous excitation along the fibres automatically, without any detectable external stimulation. It will be seen, therefore, that the cell-bodies are in a sense the
power centres of the nervous system, while the fibres are in the main merely interconnecting mechanisms, putting the several sense organs into relation (1) with the various centres and (2) through these with the muscles.
It is supposed that inside the central nervous system the axones are ordinarily employed to carry impulses away from the cell-bodies, whereas the dendrites probably carry impulses toward them. Outside the central system the afferent fibres leading to the spinal ganglia resemble axones in structure, and so offer apparent exceptions to this rule. In any event the whole nervous system is nothing but an aggregation of neurones with the supporting tissue, called neuroglia, which holds them in place. A nervous impulse originating in the sensory surface of the body, for example in the retina, may be transmitted from one group of neurones to another, until finally it issues, perhaps, from the nerves of the spinal cord, and produces a movement of the foot. This is what would occur if one should step aside upon seeing a heavy object about to fall. In this process of transmitting the
(19) impulse through the nervous system, it is not necessary that the groups of neurones should be actually in contact with one another, although this may occur. But they must at least be close together. Contiguity, if not anatomical continuity of groups of neurones, seems to be a sine qua non of neural conductivity.
The exact physical nature of neural excitement is not known. Various theories have been propounded in the effort to identify it with recognised forms of chemical or electrical activity, but thus far no hypothesis has been suggested which accords satisfactorily with all the facts. Meantime, we speak of the nervous current, the neural disturbance or excitement, in a purely metaphorical way, to cover the facts which we do know, i. e., that physiological activity of a certain kind occurs in the nervous structures, and is transmitted very rapidly from one point to another. In man the rate of this transmission is about 100 feet per second.
Various Forms of Nervous System.-- When we turn to the zoologist and the comparative anatomist, we are able to obtain certain interesting facts about the development of the nervous system throughout the organic kingdom. From such sources we learn that the simplest types of animal organism, e. g., such protozoans as the amoeba , possess no nervous system at all. Every part of the surface of the unicellular amoeba (figure 5) is capable of movement, of assimilating food and excreting the waste products. This animal's behaviour suggests that other forms of tissue besides nervous tissue are sensitive and capable of conducting impulses. Undoubtedly this is a fact, and we must accordingly think of the nerves as simply specialised
(20) forms of protoplasm in which these functions are more highly developed than elsewhere. In certain of the lower metazoans nerve cells appear with fibres extending toward the periphery of the body and possessing sensitive terminations. Among the coelenterates a very simple nervous system comes to light. In bydroids this is merely a kind of tissue of nerve cells. In echinoderms we meet with a structure like that shown in figure 6. But it is not till we get to such forms as the worms that we find a definite organised centre of control, like the brain or spinal cord. In the annulates of the worm forms there is not only a centre corresponding to a very rudimentary brain, but also one roughly corresponding to the spinal cord. (Figures 7 and 8.) In the molluscs the development is made more complex by the appearance of these groups of central cells clustered together in several directions about the brain. (Figure 9.) Even in the lowest forms of vertebrates, e. g., the acranial amphioxus, we find both a brain and cord. Passing from the lowest to the highest vertebrates up, for example, through the fishes, reptiles, and amphibians to the birds and mammals, we meet with every shade of variation in the development of the several parts of the nervous system. Everywhere, however, from the most primitive metazoan up to man, the general principle is one and the same mechanism for connecting sensitive surface organs with muscles.
The Gross Structures of the Human Nervous System. -- If we were to examine the human nervous system at one period of its development, we should find it a crude structure of tubular form, with one end enlarged, and slightly constricted at two zones, as shown in figures 10, 11, and 12. The walls of this enlarged portion thicken and spread out as they grow, and in one place dwindle away to a mere membrane. In this manner the various parts of the adult brain are formed, retaining to the end the old tubular contours. The remnant of the cavities in the embryonic brain and cord become respectively the ventricles of the developed brain and the canal of the spinal cord. These cavities remain connected with one another and are filled with the cerebrospinal fluid. The surfaces of the brain and cord are closely invested with a membrane, the pia mater, carrying blood-vessels. This membrane is bathed on its outer surfaces by fluids. A tough, thick membrane, the dura mater, separates the pia water from the bones of the skull and vertebrae. The portion of the embryonic brain known as the fore-
(22) -brain finally develops into the great masses of the cerebrum. The optic thalami, which are large collections of nerve cells with their fibrous connections, also belonged originally to this general region of the brain. The primitive mid-brain changes less in mass during growth than does the fore-brain, and becomes on its under or ventral surface the crura or peduncles of the brain, while on its upper or dorsal surface it C becomes the corpora quadrigemina. The hind-brain develops in its foremost part, dorsally into the cerebellum, and ventrally into the pons. In its lower portions it becomes the medulla oblongata, upon the dorsal surface of which appears the fourth ventricle, with its non-nervous membraneous covering. The spinal cord undergoes the least profound change, as regards its external contours, of any of the embryonic parts of the central system.
When we take the facts of development into account, therefore, it becomes evident that the various portions of the brain, which seem at first glance so hopelessly confused in their relations to one another, are nevertheless all outgrowths of a single relatively simple structure-the tubular embryonic nervous system, whose walls are everywhere made up of neurones and their supporting tissues, the neuroglia. The general form of the brain is complete some time before birth.
The number of neurones, the nervous element, is also com-
(23)-plete at birth. But the maturity of the brain in point of external size is not reached until about seven years of age, and development in the size and interconnections of the neurones goes on indefinitely, certainly with most persons up ito forty years of age.
Following Ebbinghaus and others we may classify the neurones of the central nervous system in three general groups, (1) the peripheral neurones, (2) the subcortical neurones, and (3) the cortical neurones.
Peripheral Neurones -- The peripheral neurones, whose cell-bodies lie outside the central system, consist of sensory cells and their fibrous prolongations of which a part extend inward toward the centres, and a part outward toward the sensory end-organs, such as the rods and cones of the retina, the hair cells of the cochlea in the internal ear, the touch corpuscles in the skin, etc. (See cuts in Chapter V.) The cell-bodies of these neurones are sometimes situated near the central structures, as in the case of The cells in the ganglia of the posterior roots of the spinal cord. These cells distribute their fibres to the skin, muscles, tendons, etc. Sometimes, however, they are in the neighbourhood of the sense organ, in the case of the auditory nerve, which arises from cell in the internal ear; the optic nerve, which has its cell-body in the retina, etc. The function of the peripheral neurones is evidently that of transmitting impulses from the
(24) sense organs in to the nervous centres, and we need discuss them no further at this point.
Subcortical Neurones. -- The subcortical group involves all the gross structures in the central system lying between the
cortices of the cerebrum and the cerebellum on the one hand and the peripheral neurones on the other. Their function is in general that of furnishing neural mechanisms for reflex acts and for connecting the various parts of the central system with one another. This can be best brought out by examining separately some of the more conspicuous gross structures of this group. After we have done this, we shall turn to the cortical groups, whose functions as general control centres we shall then discuss.
We may first consider the spinal cord (figure 13). If we take a cross section of this organ, cutting through at right angles to its long axis, we find a structure such as is shown in figures 14 and 15. In the central portion, grouped about the spinal canal in the general shape of the letter H, is a great mass of cell-bodies giving a peculiar greyish colour to the region. Outside of this is a thick layer of white nerve fibres. Close examination of the grey matter reveals fibres running out laterally to penetrate the white masses. The
(25) fibres from the cell-bodies in the ventral or anterior region of the grey mass pass out from the spinal cord in bundles at the general level of the several spinal vertebrae. Thence they may be traced principally to the voluntary muscles of the limbs and trunk. The fibres issuing from the dorsal or posterior region of the grey matter pass out in similar bundles from the posterior sides of the cord, and thence, after uniting with the bundles from the motor region, are distributed chiefly to the sense organs of the skin, joints, muscles, tendons, etc. It may be remarked at this point that the voluntary muscles, such as control the movements of the hand, are commonly striped muscles, whereas the involuntary muscles, e.g., those of the alimentary and circulatory systems, are generally unstriped. The unstriped muscles are mainly connected with the sympathetic nervous system, of which we shall speak briefly a little later. The striped muscles contract and relax more rapidly than the unstriped.
The arrangement of the elements in the spinal cord sug
(26) -gests at once two of its principal functions, and is so typical of the facts generally characterising nervous structure and function that it seems judicious to comment upon it briefly.
It will be observed in the first place, that in the cord cellbodies, connected through their fibres with the sense organs and the muscles respectively, are in very close proximity to one another. It should be relatively easy, therefore, for an incoming sensory impulse to find its way out over motor nerves and so to produce reflex movements, that is, movements made in immediate response to sensory stimulations, without the guiding action of consciousness. This is precisely what happens, and it is as a reflex mechanism that the spinal cord exercises one of its important functions. As in
(27)-stances of such reflexes we may mention the jerking of the foot when the sole is tickled, and the knee-jerk exhibited when one leg is crossed over the other and the region just below the knee-cap is smartly struck. Furthermore, we should find upon examination that the white fibrous tracts along the external surfaces of the cord connect it with both the higher and the lower parts of the system. (Figures 16 and 17.) It should thus be easy for impulses to pass upward and downward, between the brain on the one hand and the sense organs and muscles on the other. Such ready transmission actually occurs, and it is in this fact that we find the second great function of this organ. The spinal cord is accordingly typical of the central structures in general, in that
it provides (1) means for the immediate connection of sense organs and muscles and (2) devices for connecting various parts of its own and other nervous structures with one another.
If we were to examine the other subcortical masses lying between the cerebrum and the spinal cord, we should find that, in general, they consist of aggregations of neurones
(28) much like those in the cord, but on the whole less simply and regularly disposed. Thus, the medulla, the corpora, and the thalami all display ganglion groups with sensory and motor
connections. When we come to speak of their specific functions, we are obliged to indulge largely in speculation, because the facts are evidently extremely complex, and our knowledge of the details involved is notoriously incomplete. Moreover, the specialised functions which are sometimes attributed to them in the case of the lower animals are probably in the human being largely usurped by the cerebral cortex. In any event we must always remember that the nervous system is an organic unit, and no part of it ever acts wholly independently of the other parts, nor is any influence exercised upon one part entirely without significance for the other parts. Any mention of specific functions of different regions must always be made with this reservation in mind.
(29) Thus, the spinal cord undoubtedly contains the neurones whose innervation is immediately responsible for movements of the hand. But this innervation itself may originate almost anywhere throughout the rest of the nervous system, so that any portion of this system may in a particular case contrib ute to the production of the special motor consequences. To say that a region of the nervous system presides over any special function is, therefore, simply to say that it is the portion most immediately and most invariably responsible for it.
Speaking within such limitations, we may say that there
(30) are two functions of centres lying in the medullic region, about which considerable unanimity of opinion exists. The control of the automatic respiratory movements, and the control of the vaso-motor nerves which govern the calibre of the
arteries, are apparently the immediate possessions of neurones belonging in this neighbourhood. Needless to say,, all these regions are like the spinal cord in containing pathways for
(31) neural excitation to pass upward and downward, between the cerebrum on the one hand and the sense organs and muscles on the other.
It is in this region of the brain, too, that the cranial nerves are given off, e. g., the nerves of special sense, like the olfactory, the auditory, the optic, the gustatory and trigeminus; such motor nerves as those controlling the eyes, the tongue, the lips, etc. (Figure 18.) It is commonly maintained that the phylogenetic pattern from which the human nervous system has been developed is of a segmental character, each
part of it receiving sensory and motor nerves from relatively distinct regions, or segments, over which they exercise a definite and sometimes exclusive control, In the human being
(32) the motor nerves can, indeed, be classified in this segmental way in accordance with the special muscles which they innervate, e. g., those of the head, the upper trunk, the lower trunk, etc. But the connections of the sensory neurones in man make any such segmental divisions of them very hazardous, so that the application of the segmental idea to the interpretation of our human nervous action is somewhat uncertain.
The Cortical Neurones. -- The Cerebellum. -- So little is known about the operations of the cortex of the cerebellum, that it will not be profitable to discuss it. Suffice it to say that the cerebellum has a very rich connection, by means of both sensory and motor neurones, with the cerebrum and the lower brain centres.
The Cerebrum.-- For the psychologist the cerebral hemispheres are the most interesting and most important portions of the nervous system. From the various lines of evidence mentioned earlier in the chapter, we know that consciousness is connected with this part of the brain in an exceedingly intimate way, and we shall consequently devote some little space to its consideration.
The surface of the hemispheres, called the cortex, and shown in figures 19 to 22, is made up of layers of cell-bodies, with their delicate protoplasmic processes. The extraordinary richness of the dendritic development in the cortical neurones furnishes one of the most marked peculiarities of the human cerebrum, as contrasted with those of animals. This intricate dendritic structure apparently represents the bodily counterpart of those elaborate interrelations among ideational processes, which characterise in general the higher forms of intelligence.
Certain of the cortical areas are known to be in functional connection with sense organs from which they receive stimuli. Thus, the region marked H is in connection with the ear, and receives auditory impressions. (Compare figures 18 to 21.) The region marked V is similarly connected with the retina,
(33) and receives visual impressions. It is reasonably certain that areas marked O receive olfactory stimuli, while the region marked B is probably that immediately concerned with the reception of tactual and thermal stimuli. The centres for taste are not clearly made out. It seems probable, however, that they are in the neighbourhood of the olfactory terminals. There is reason to believe that ordinarily the peripheral sensory neurones are in connection with the side of the cortex opposite to that from which they originate For example, the touch nerves of the left hand find their cortical terminations in the right side of the hemispheres. The optic nerve, however, affords a curious modification of this plan. The neurones from the right side of each retina are connected with the right side of the brain, those from the left side, with the left hemisphere. (See figure 23.) In this particular, as in some others, the optic tract is peculiar. The retina itself differs from all the other sense organs in being a part of the brain, which has in the course of development been dislocated from its original position.
Another great group of these cortical cells in the region
(34) marked M, generally known as the region of Rolando, from its proximity to the fissure of that name, is well recognised as being in connection with voluntary muscles, which are controlled from this centre. The voluntary muscles of each half of the body appear as a rule to be controlled by cells situated in the opposite side of the brain. (See figure 24.) In view of such facts as we have just been rehearsing, the cerebral cortex has been described as a projection system, representing every sensitive point and every voluntary muscle
in the body. There are, however, other large areas in the cortex which are not in immediate control Of Muscles, nor do they represent the emergence point for neurones in connection with the sense organs.[2] These centres marked A are called by Flechsig, who has studied them most carefully, association centres. One of these centres, lying beneath the fissure of Sylvius, is not shown by our cuts. Their business seems to be that of uniting the several sensory regions, such as H and V, with one another and with the motor region.
(37) (Compare figure 25.) It appears to be true in a general way at these association centres are relatively larger and more highly developed in those animals possessing most intelligence. There is another extremely important connecting mechanism, made up, however, exclusively of fibres, and
known as the corpus callosum (figures 21, 25, and 26), by means of which the two sides of the hemispheres are brought into connection with one another. These various devices make it possible for cortical nervous impulses originating in
(38) the stimulation of some sense organ, like the ear, to pass into other cortical regions like that belonging to vision, and thence out through the Rolandic zone to some muscle, producing, perhaps, a voluntary movement. This is probably
what would occur, for example, were we to bear the words "Draw a horse," then to think how a horse looks, and then finally to make the -appropriate movements of our hands. This and similar relations are suggested by figure 27.
The Cerebral Cortex and Memory -- When we contrast the cerebral cortex with the other parts of the nervous system,. with reference to its significance for consciousness, we findthat it is in the memory processes that the most conspicuous differences first come to light. If one suffers the destruction of the retina by accident or disease, or if the pathways be interrupted anywhere between the retina and the cortex, one becomes blind, but that may be all. When, however, as occasionally happens, one loses the use of the occipital regions, one may not only become blind, but one's visual memory also
(39) is lost . It is not possible to remember how familiar objects look, and even if seen they may not be recognized. So-called word-blindness, or visual aphasia, is caused in this way, the patient being unable to recognise or understand written words. If the injury is confined to one side of the brain the comm on result is hemianopsia in more or less serious form, i. e., blindness to one-half of the field of view, owing to the destruction of the cortical centres receiving the fibres from the lateral half of each retina. Similarly. when the auditory region is injured, one loses the memory of auditory experiences. If in this case, as frequently happens, the disorder be confined to one side of the brain, and this be the side most highly developed (the left side in right-handed people), one cannot understand what is heard. This disease is known as sensory, or auditory, aphasia. The patient is not deaf, for the less developed and uninjured half of the cortes may serve for the production of vague auditory consciousness, but the associations which words and familiar sounds ordinarily evoke are wholly gone, because these were possessions of the now diseased side. The mental condition is not unlike that of a person hearing an unknown foreign language. He is not deaf to the words, but they mean nothing to him, for they have no associations.
A closely comparable condition is that of motor aphasia, a disease in which one cannot articulate coherently. One is
(40) not necessarily dumb, and there may be no true paralysis of the articulatory muscles. But one simply cannot make the enunciatory movements in their correct order. This disorder is often found connected in right-handed persons with disease of the left side of the motor region of the cerebral cortex, which is in control of these muscles. (Compare figure 19.) But it may be brought aboutand often is-as a secondary consequence of auditory or sensory aphasia. If, when we speak, we are in the habit of having in our minds just prior to enunciation the auditory image or thought of how the words are going to sound, any difficulty which prevents our securing these auditory images will effectually prevent our utterance. Now sensory aphasia involves precisely this difficulty in commanding auditory images. As most of us do actually employ auditory thoughts to innervate our speech muscles, for we learn to speak as children by imitating sounds, it is surely not unnatural that sensory aphasia should so often be accompanied by motor aphasia. Cases are on record of persons who employed visual instead of auditory imagery to innervate the speech muscles, and who, upon suffering from lesions in the visual regions of the brain, were seized with
(41) motor aphasia. The sensory-motor are, or circuit, as we have previously remarked, represents the unit of action, finding ,no exception in the activity of the complex cortical centres, and any stoppage of it in the sensory portion may be as fatal to its proper operation as a defect in the muscles themselves. This is brought out in the accompanying diagram, figure 28.
Such facts as these we have been describing show us that our memory is in a peculiar way dependent upon the integrity of the cortex. Visual ideas, tactual ideas, auditory ideas, and the like can apparently be recalled only when the several parts of the cortex with which these functions are connected are intact. In the first instance a visual consciousness involves not only a visual cortex, but also a retina, and more or less of the intermediate organs between the two. A similar thing is true of the relation of all the other sense organs to the various elementary forms of sensory experience, such as touch, sound, taste, etc. But once the sensory experience has occurred, the cortex instantly takes up the impress and memory becomes possible. Destroy any part of the nervous system save this, and conscious memory may escape destruction. Destroy any specific sensory region in this cerebral cortex, and the corresponding sensory memories are obliterated or seri-
(42) -ously deranged. Destroy a region in the motor zone, and the voluntary control of some muscle, or group of muscles, is affected. Destroy or injure the association centres, and our intelligent conjoining of ideas, impressions, and movements is likely to be impaired. The gravity and permanency of these Psychical disorders brought about in the way suggested, i.e., by destruction of certain areas, varies very greatly under different conditions, so that the statements as made must be understood as attempting to convey only the broad general facts.
When one remembers that our most important and significant acts of will are based -upon hopes and fears and beliefs which involve our calling upon the memory of our past experience, one begins to appreciate how immensely important for all our life history this memory function of the cortex must be. Thus we choose, for example, one course of action rather than another, because we remember that somebody will be benefited if we act in this way, or injured if we do not. Memory always operates whenever we deliberate, and anything which would deprive us of our memory would effectually destroy the will. The cortex of the cerebrum as the physiological substrate of our conscious memory is thus the unquestioned peer among the various gross structures in the nervous system.
In concluding this statement, two things should be emphasised. (1) The cortex is nowhere in direct connection with a sense organ, but receives all its sensory stimulations through the intermediation of the peripheral neurones and of some of the subcortical groups, like the medulla, and it is similarly in direct connection with no voluntary muscles, but communicates with them by means of the subcortical neurones. The shortest possible pathways which could, so far as is now known, be employed in the transmission of an auditory or visual stimulus to the cortex, and back from the cortex to voluntary muscles, is shown in figures 29 and 30. The anatomical arrangements peculiar to these illustrative cases
(43) may be regarded as typical for all sense organs and voluntary muscles, but undoubtedly the pathways generally traversed nervous impulses are much more complicated and indirect.
(2) The cortex seems always to act in an essentially unitary way. Consciousness is, then, the counterpart of the total mass of shifting tensions going on all over the cortex at any given mo ment. When this tension is greatest C in the occipital re gion, we are aware of visual qualities. When the temporal convolutions are under greatest strain, conscious ness is auditory, etc. Moreover, in this picture of con sciousness as the counterpart of a unified series of physiological ten sions all over the cortex, we must not forget that the whole nervous sys tem is in a measure involved. These tensions are of such a character as to require a constant escapement through the motor path ways, with a momentary establishment of equilibrium as a consequence of such escapement, and a fresh disturbance of equilibrium as a secondary consequence; this latter disturbance. being brought about
(45) through movements actually executed. Such a recurrent series of movements and sensations, illustrated by the accompanying diagram, is involved in every coherent, consecutive occupation of which we are capable. (Figure 31.) Sleep affords practically the only instance of cessation from these coordinated series of stimulations and movements. Ideational processes are often, of course, interpolated between the sensation and the movement, as is suggested by the diagram.
The Autonomic System.-- In addition to the central nervous system of which we have thus far spoken must be mentioned the autonomic system commonly known as the sympathetic system, and of which the true sympathetic is a highly important part. The autonomic system, about which our exact knowledge is lamentably defective, is apparently an outgrowth of the central system, and the two are intimately connected, both as regards their structure and their action. The striking peculiarity about the autonomic system is, as its name indicates, it, relatively self-directing or automatic activity.
The autonomic system of neurones may be conveniently, though roughly, described as made up of three great groups. One of these groups consists of a series of ganglia gathered into two long strands extending up and down each side of the spinal cord. This contains the sympathetic system in the narrower and more precise sense of the term. The second group consists of the great plexuses of ganglia found respectively in the thoracic, abdominal, and pelvic cavities. The third group consists of isolated ganglia scattered miscellaneously through the body, e. g., in the heart, in the walls of the arteries, in the eye cavity, etc. These neurone groups are made up of cell-bodies and fibres for the most part unmedullated. A portion of the impulses which affect their action apparently come from the central system. They certainly discharge impulses into the glands, the unstriped muscles, and, in the case of the heart, into striped muscle. Thus, for example, when an embarrassing announcement is made in our presence a sensory impulse passes over the auditory tract of the central system and thence, among other consequences, impulses are sent to the region in the medulla which controls the sympathetic ganglia connected with the muscular tissue of the blood-vessels, and straightway we find ourselves blushing. The sweat glands may also become active, causing us to perspire.
All the important vegetative and life sustaining processes, such as respiration, circulation, digestion, etc., are under the guidance, partial or entire, of the autonomic nerves. It is consequently to the activity of these parts that we owe our general sense of bodily well-being, as well as our feelings of distress and pain when any of these great life functions go astray. Our consciousness is undoubtedly toned, as it were, all the time, by the condition and activity of the autonomic system. This fact will become very evident when we come to study instinct and emotion. The entire nervous system, therefore, and not simply the central system, is concerned in the modifications of our consciousness.