Podcasts about Acceptability

In dieser Folge spreche ich mit Florent Crépin, Geschäftsführer von Neurolite. Er stellt eine Depressions-Behandlung vor, die ohne Medikamente auskommt.Links :LinkedIn Instagram NeuroliteYoutube Instagram FlowFacebook FlowÜBER DEPRESSIONDepressionen.ch Stiftung Deutsche DepressionshilfeREFERENZENBarker et al. Non-invasive magnetic stimulation of human motor cortex. Lancet. 1985 May. Zur PublikationRush et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006 Nov. Zur PublikationFregni et al. Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders. Int J Neuropsychopharmacol. 2021 Apr. Zur PublikationWoodham et al. Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial. Nat Med. 2025 Jan. Zur PublikationCipriani et al. Comparative Efficacy and Acceptability of 21 Antidepressant Drugs for the Acute Treatment of Adults With Major Depressive Disorder: A Systematic Review and Network Meta-Analysis. Focus (Am Psychiatr Publ). 2018 Oct. Zur PublikationSaelens et al. Relative effectiveness of antidepressant treatments in treatment-resistant depression: a systematic review and network meta-analysis of randomized controlled trials. Neuropsychopharmacology. 2024 Dec. Zur PublikationGriffiths et al. Self-Administered “Flow” Transcranial Direct Current Stimulation (tDCS) Depression Treatment in a Crisis Resolution & Home Treatment (CRT) Service: Functioning, and Health-Related Quality of Life Outcomes. Open Journal of Psychiatry. 2024 Nov. Zur PublikationTomonaga et al. The economic burden of depression in Switzerland. Pharmacoeconomics. 2013 Mar. Zur PublikationDeutsche S3-Leitlinie und Nationale VersorgungsLeitlinie (NVL)  Kurzfassung – Lass mir Feedback da :)Hat dir die Folge gefallen? Ich würde mich über eine 5-Sterne-Bewertung sehr freuen! :)Webseite: https://www.psychologieunddenn.ch/Whatsapp-Gruppe (offen für alle): https://chat.whatsapp.com/JBcjpAaIaSeCRxmQMQWGXuMöchtest du Werbung schalten oder mit mir zusammenarbeiten. Dann schau hier vorbei.

In this episode of The Pet Food Science Podcast Show, Dr. Ricardo Vasconcellos from the State University of Maringá (Brazil) breaks down the complexities of feline palatability. He explains how cats' unique sensory traits affect their food preferences and the techniques used to measure palatability in pet food. Discover the science behind food selection, including the role additives and textures play in influencing what cats choose to eat. Tune in now on all major platforms!"Cats, despite having fewer taste buds than humans, are incredibly selective eaters, relying more on their sense of smell than taste to choose food."Meet the guest: Dr. Ricardo Souza Vasconcellos is an Associate Professor in the Animal Science Department at the State University of Maringá, Brazil. With a Ph.D. in Animal Nutrition focusing on cat and dog nutrition, Dr. Vasconcellos has extensive experience in both academia and the pet food industry. His research includes feline palatability, cat nutrition, and sustainability in pet food.What will you learn:(00:00) Highlight(01:20) Introduction(03:36) Feline food preferences(07:01) Role of sensory characteristics(10:27) Palatability testing methods(13:45) Acceptability vs. preference tests(33:20) Sustainability in pet food(41:10) Final QuestionsThe Pet Food Science Podcast Show is trusted and supported by innovative companies like:Biorigin* Trouw Nutrition* Kemin- ICC- Scoular- Symrise- EW Nutrition- Wilbur-Ellis Nutrition

This is the first episode of a series focused on the findings of the Horizon Europe project CAPABLE (ClimAte Policy AcceptaBiLity Economic framework). The aim of this podcast series is to provide an overview of the CAPABLE project and draw attention to some particularly relevant findings. In this first episode, we want to give a general overview of CAPABLE, highlighting the main topics we are going to touch on, focusing on its policy impacts and contribution. The guests are Silvia Pianta and Johannes Emmerling. Johannes is a Senior Scientist at the European Institute on Economics and Environment (EIEE). He co-leads its low-carbon pathways unit and he is the scientific coordinator of the Horizon Europe project CAPABLE. His main research areas include climate change and energy economics, risk and uncertainty, and welfare economics and development. Silvia is a Scientist at EIEE and the deputy coordinator of CAPABLE. Her research focuses on environmental policy and politics. She investigates the determinants of environmental attitudes and behaviours, climate policy preferences, public attention to climate change, and the impact of environmental change on political behaviour. CAPABLE is a research project funded by the Horizon Europe Programme under grant agreement No 101056891. It provides robust, resilient and actionable recommendations for the design of socially and economically acceptable climate policy measures for 2030 and beyond, examining experiences, policy design and implementation solutions to identify strategies that can enable a successful transition. Views and opinions expressed are those of the author(s) only and do not necessarily reflect those of the European Union. More info on CAPABLE: https://capableclimate.eu/

How does "quality" apply in all areas of an organization? In this final episode of the Misunderstanding Quality series, Bill Bellows and host Andrew Stotz discuss lessons from the first twelve episodes, and the big ah-ha moments that happen when we stop limiting our thinking. TRANSCRIPT 0:00:02.6 Andrew Stotz: My name is Andrew Stotz and I'll be your host as we dive deeper into the teachings of Dr. W. Edwards Deming. Today I'm continuing my discussion with Bill Bellows, who has spent 31 years helping people apply Dr. Deming's ideas to become aware of how their thinking is holding them back from their biggest opportunities. Today is episode 13 and the title is Quality Management: Don't be limited. Bill, take it away. 0:00:30.5 Bill Bellows: Hey, Andrew. So this is episode. What number did you say it was? 0:00:36.2 Andrew Stotz: 13. Lucky 13. 0:00:38.1 Bill Bellows: Lucky 13. So then for those who are concerned about the use of the number 13, this is episode 14. 0:00:51.0 Andrew Stotz: I thought you're gonna say episode 12A. 0:00:54.7 Bill Bellows: And for those who don't mind the number 13, this is episode 13. And as we talked earlier, if Dr. Deming was to title the episode it would be... It would not be "don't." It would be "do not", do not be limited. So at the start I wanted to go back to review the path we're on. We've been on episode one back in end of May, Quality, Back to the Start. All part of the Misunderstanding Quality series for The Deming Institute. Episode two, we got into the Eight Dimensions of Quality with David Garvin. One of those dimensions was acceptability. 0:01:49.8 Bill Bellows: Another was reliability. Another was I say dependability performance. Okay. And I think it's important in a series about misunderstanding quality to look at the work of David Garvin. Just realize I think it's fascinating to... You move out of the world of the American Society Quality and control charts and whatnot. And that's why I think Garvin's work paints a nice... Gives a nice perspective to not be limited.  And then we got into in the third episode Acceptability and Desirability. Episode four, Pay Attention to Choices and the choice of differentiating acceptability which is I'll take anything which meets requirements, and desirability. 0:02:42.3 Bill Bellows: I want that little doggy in the window. Not any doggy in the window. And then we followed that with episode five, the Red Bead Experiment which for many is their first exposure to Dr. Deming's work. I know when I worked for the Deming Institute for a few years the Red Bead Experiment website was one of one of the most popular pages. I believe another one was the 14 Points for Management. And, personally, I've presented the Red Bead Experiment think just once, just once. And I'm going to be doing it at the 2025 at, let me back up, the Bryce Canyon Deming... The Bryce Canyon...Bryce Canyon Forum. I can't remember the name. It's a partnership between Southern Utah University and The Deming Institute, and we're doing it at Southern Utah University. And on one of those days, I'll be doing the Red Bead Experiment, which takes a lot of time and then studying to present it a few years ago I was getting all the videos that I could find of it, many of them on The Deming Institute web page and none of them have the entire data collection. 0:04:18.5 Bill Bellows: They kind of fast forward through six people putting the... drawing the beads each four times and when you're up on stage trying to do that, I had four people that's, you gotta do a lot of work to make it that exciting. But the reason I present it, I say I present it for a number of reasons. One is to do the classic "The red beads are not caused by the workers are taken separately. They're caused by the system which includes the workers. It's an understanding of variation and introduction to control charts" and all of that is as exposed by Dr. Deming is classic. 0:05:00.7 Bill Bellows: But, I'd like to take it one step further, which is to go back into that desirability thinking and look at the concept that we've talked about of going through the doorway and going past the achievement of zero defects, zero red beads, and realize that there's further opportunities for improvement when you start to look at variation in the white beads. And, that then takes into account how the beads are used. And that gets us into the realm of looking at quality as a system.   Looking at quality with a systems view as opposed... That's good, that's good, that's good. With or without an appreciation on how the bead is used. So anyway, that was episode five. We explored that. Next we got into the differentiation of Category Thinking and Continuum Thinking. 0:05:55.5 Bill Bellows: And for those who haven't listened to it, maybe not in a while, the differentiation is category thinking. Putting things in categories such as red beads and white beads are the... It could be any categories, categories of fruit, categories of religion, categories of political systems. We have categories and then within a category we have variation. We have different. We have apples and oranges and then we have a given type of orange. And then there's variation in the juiciness, ripeness. That's called continuum thinking, which goes back to, if we go back to the red beads and the white beads is notion that the white beads are not uniformly white, not uniform in diameter or weight. 0:06:44.5 Bill Bellows: And, what are the implications there? Well, if we think in terms of categories, red beads and white beads, if all the beads are white have we stopped improving? And Dr. Deming and I believe it was Point 5 of the 14 Points stressed the need for continual improvement. And yes, you can continuously improve and reduce cost, you can continuously reduce cycle time, but can you continuously improve quality? Well, not if you're stuck in a category of good, then the role of that is to just to remind people that there's opportunities to go further when you begin to look at variation in white, which is the essence of looking at how what you're looking at is part of a system, which Dr. Deming was well, well aware of. 0:07:33.7 Bill Bellows: Next we got into the Paradigms of Variation and a big part there was differentiating acceptability. Well, going beyond acceptability was differentiating accuracy from precision. Precision is getting the same result shrinking the variation, otherwise known as getting achieving great piece-to-piece consistency. Metrics that begin with the letter C and sub P could be Cp, Cpk, are the two most popular. Those are measures of precision that we're getting small standard deviations that they are very, very close to each other. But in the paradigms of variation that was what I referred to as Paradigm B thinking we're looking for uniformity. Paradigm A thinking being acceptance, we'll take anything that meets requirements... Or academically called paradigm A. Paradigm C is what Dr. Taguchi was talking about with the desirability, where we're saying I want this value, I want uniformity around this specific value. 0:08:43.9 Bill Bellows: Here what we're looking at is uniformity around the target, around an ideal, otherwise known as piece-to-target variability. And, the idea there is that the closer we are to that ideal, the easier it is for others downstream to integrate what we're passing forward. Whether that's putting something into a hole or does this person we want to hire best integrate into our system. So, integration is not just a mechanical thing. In episode eight we then got into Beyond Looking Good which then shatters the Paradigm A acceptability thinking, going more deeply into the opportunities for continual improvement of quality. 0:09:29.1 Bill Bellows: If you shift to continuum thinking. Next, Worse than a thief coming from Dr. Taguchi. And that's the issue of achieving uniform. Part of what we looked at is the downside of looking at things in isolation and not looking at the greater system. Then episode 10 we look at Are you in favor of improvement of quality? 0:09:53.6 Andrew Stotz: I'm in favor. 0:09:55.7 Bill Bellows: To which he would always say, but of course. That was a reference back to chapter one of The New Economics. And he said everyone's got an answer. Improving quality computers and gadgets. And what we spoke about is Quality 4.0, which is gadgets of the 21st century, tools and techniques. And again, what we said is, there's nothing wrong with tools and techniques. Tools and techniques are about efficiency, doing things well, but they lack what Russ Ackoff would say in asking, are we doing the right things well. And then episode 11 delved into what I've...amongst the things I've learned from Dr. Taguchi, To improve quality, don't measure quality. 0:10:42.5 Bill Bellows: If we have a problem with, we want to reduce scrap, we want to reduce rework, we want to eliminate the problems that the customer has experienced or that someone downstream is experiencing. And what Dr. Taguchi emphasized was start asking, what is the function of the thing we're trying to do? And the idea is that if you improve the function, then you're likely to improve the quality as measured by what the customer is looking for. If you focus on what the... If you focus your efforts on reducing what the customer is complaining about, you're likely to get something else the customer is complaining about. And for more on that, go to episode 11. 0:11:19.0 Bill Bellows: And then episode 12, Do specification limits limit improvement? Which again goes back to what I experienced on a regular basis is in my university courses with people I interact with and consulting is a very heavy emphasis on meeting requirements and moving on. And not a lot of thought of going beyond that or even that there's anything more to do, that's alive and well. And that's reinforced by Six Sigma Quality is filled with that mindset. If you pay attention closely to Lean Manufacturing, you'll see that mindset again, alive and well. So, what I wanted to get to tonight in episode 13, Quality. 0:12:04.3 Andrew Stotz: That was quite a review, by the way. 0:12:06.7 Bill Bellows: Yeah, Quality Management: don't be limited, as and I'm teaching for the sixth time a class in quality management at Cal State Northridge. The title used to be Seminar in Quality Management. The title this year is Engineering Quality Management and Analytics. One of the assignments I give them, essays, the quizzes, attending the lectures. 0:12:34.9 Bill Bellows: Learning Capacity Matrix that I learned about from David Langford. But what I was sharing with you earlier, Andrew, is one of the first things I thought about and designed in this course, back in 2019 was I could just imagine students going through the course. And, what I'm going to hear is, what I've heard before is professor, these are very, very interesting ideas, but I'm not sure how I would apply them where I work. Because where I work is different. It's different. And to avoid that question, I came up with an assignment I called the Application Proposal. And there's four parts to it. But part one is: imagine upon completion of this course. And I let them know about this in the first lecture and I say, imagine upon completion of the course, your boss, someone you work with, challenges you to find three things you can do within three to six months of the of the completion of the course. 0:13:34.6 Bill Bellows: And it must include something you learned in this course. I don't say what thing, I don't say two things, I don't say three things. I leave it to them. But all it comes down to is I'd like you to contemplate and within three to six months of the completion of the course, what could you do? And I call that the near-term application. Well, subtask one is come up with three. They have to meet your job, your role, not your boss's role, not another department's role. They have to fit your role because only you know then the method by which you would go about that. And, so for that near-term, I ask them to let me know what is the present state of that near term, the before, the current condition and what is the after. What is the future state of that near-term? So I assign that before the course begins, I give them until week five to submit and give me those three things. The reason I asked for three is if one, if the first one they give me, if they only asked for one and one didn't quite fit, then I say, well, okay, Andrew, go back and give me another one that same time. 0:14:49.7 Bill Bellows: So I said, give me three. And most often all three are fantastic. In which case I say they're all great. Which one would you like to do? But again, it has to fit their role because in Sub-Task 2, the next thing I want them to do is not so much tell me about the present state, tell me more about the future state. And again, the future state is how much can you accomplish within that three-to-six month period? And that's subtask two. Then they come back to me and tell me the plan. What is the plan by which you go from the near-term present state to the near-term future state, tell me about the plan. Tell me what some of the obstacles might be and how you plan to deal with the obstacles. And then I say now what I want you to do is imagine that is wildly successful, jump ahead a year and a half to two years and tell me what you would do next. How would you build upon this? And in that mid-term time frame, what is the present? What is the future of the mid-term? And then go a few years out and tell me how you're going to further expand on what you've learned. 0:16:03.4 Bill Bellows: I call that the far-term. And for the far-term, what's the present, what's the future? So when they submit that to me, then I come back with - it could be questions about some of the terminology.  It could be a suggestion that they look at something with the use of Production Viewed as a System. Or, I ask them to think about operational definitions or perhaps suggest a control chart and, or a book. So, part of the reason I wanted to bring that up is few of the title, few of the topics we are looking at are specifically quality related. They're all about improving how the organization operates. Which goes back to what Dr. Deming stressed is the importance of continual improvement. 0:16:50.9 Andrew Stotz: Can you explain that just for a second? Because that was interesting about quality versus improving the organization. What did you mean by that? 0:17:00.4 Bill Bellows: Well, I, they didn't come to me with this process I have, has lots, has a very high defect rate and I thought that's where I need to focus. Or this process has a lot of scrap and rework. That's where I want to focus. What I was excited by is that they were looking at how to take a bunch of things they already do and better integrate them. Just fundamentally what I found them thinking about is how can I spend time to organize these activities as a system and as a result spend a whole lot less time on this and move on to the next thing. And, what I found fascinating about that is if we keep our thinking to quality and quality's about good parts and bad parts, good things and bad things, and having less bad things and more good things, that could be a really narrow view of what Dr. Deming was proposing. Now another aspect of the assignment was not only do I want them to give me three ideas, we down-select to one. It could be they're writing a new piece of software. One of the applications has to do with a really fascinating use of artificial intelligence. 0:18:27.0 Bill Bellows: And what's that got to do with quality? Well, what's interesting is it has a lot to do with improving the functionality of a product or a service, having it be more reliable, more consistent, easier to integrate. But, the other thing I want to point out is not only do I ask them to come up with three things and then assuming all three things fit well with their job, their responsibilities, their experience.  What I'm also interested in is what from the course are you going to use in this application? And, two things came up that fit again and again.  One is the value proposition of a feedback loop. 0:19:12.9 Bill Bellows: And they would ask me, what do you mean by feedback? I said, well, you're going to come along and you're going to tie these things together based on a theory that's going to work better. Yes. Well, how will you know it's doing that? How will you know how well this is performing? And, I said when I see this is what people refer to as Plan-Do, but there's no Study. It's just... And, I saw that Rocketdyne, then people would come along and say, oh, I know what to do, I'm just gonna go off and change the requirements and do this. 0:19:44.6 Bill Bellows: But, there was no feedback loop. In fact, it was even hard to say that I saw it implemented. It just saw the planning and the doing. But, no study, no acting. 0:19:57.3 Andrew Stotz: Is that the Do-Do style? 0:20:01.3 Bill Bellows: Yes. But what was really exciting to share with them is I said in a non-Deming company, which we have referred to as a Red Pen Company or, or a Me Organization or a Last Straw. And I don't think we covered those terms all that much in this episode, in this series, we definitely covered it in our first series. But what I found is in a Deming or in a non -Deming company, there's not a lot of feedback. And even if I deliver to you something which barely meets requirements and we spoke about this, that in the world of acceptability, a D- letter grade is acceptable. Why is it acceptable? Because it's not enough. It's good parts and bad parts. And so even if I deliver to you, Andrew, something which barely met requirements, and you said to me, Bill, this barely meets requirements. And I say, Andrew, did you say barely meets requirements? And you say, yes. So, Andrew, it did meet requirements and you say, yes. So I say, "Why are you calling me Andrew?" 0:21:12.1 Andrew Stotz: By the way that just made me think about the difference between a pass fail course structure and a gradient course structure. 0:21:20.7 Bill Bellows: Exactly. 0:21:21.5 Andrew Stotz: Yeah. Okay. 0:21:22.5 Bill Bellows: Yeah. So even if you give me that feedback. I reject it. I'm just going to say, Andrew, move on. But I said, in a Deming organization, feedback is everything. The students were giving me feedback on the quizzes and some things that caused me to go off and modify some things I'm doing. And I told them, if I don't have that feedback, I cannot improve the course. So, I met with each of them last week for an hour, and the feedback I was getting is instrumental in improving the course for the remainder of the semester as well as for next year. And, so that's what I found is what really differentiates a Deming approach to improving a process or a service or a product is feedback, which goes then to watching how it's used. It is, I think I mentioned to you Gipsie Ranney, who was the first president of The Deming Institute, a Professor of Statistics at University of Tennessee, when she met Dr. Deming and later became a senior consultant, maybe advisor to General Motors Powertrain. And once she told me, she said to Dr. Deming "You know, Dr. Deming, what do people get out of your seminars?" And. he said, "I know what I told them. 0:22:42.0 Bill Bellows: I don't know what they heard." And, the challenge is without knowing what they heard, because we would also say, and I'm pretty sure we brought this up in one of our this series or the prior series, Deming would say the questions are more important than the answers because the questions provide them with feedback as to what is going on. So anyway, part of what I wanted to bring out today in this quality management, don't be limited, is whether or not you're focusing on quality per se, minimizing scrap, minimizing work. If you're trying to improve a process, again, you're not improving it necessarily because there's more I want to have less scrap. But if your improvement is, I want it to take less time, I want it to be easier to do. I want it to be cheaper to do. Well, while you're at it, think about a feedback loop.  And the role of the feedback is to give you a sense of is it achieving what you're hoping it would achieve? It would allow you over time to maybe find out it's getting better.  Maybe there's a special cause you want to take advantage of or a special cause you want to avoid.  But, without that feedback, how do you know how it's working and then beyond that? 0:23:55.7 Andrew Stotz: And where is the origin of the information coming from for the feedback loop? Is it a feedback loop within your area or is it feedback loop from the next process or what do you. 0:24:08.3 Bill Bellows: All of that. That's what I told her. I said one is, I said, when you're developing the process. I told them, I said, when you're. If in Sub-Ttask 1, your idea is to flowchart a process, come up with a template, a prototype. Part of the feedback is showing that to people. And part of the feedback is, does it make sense to them?  Do they have suggestions for improvement? Do they... Is there an issue with operational definitions?  There would be better clarity based on the words you're using.  You may say in there clean this thing, or early in the semester, one of the assignments I gave the students was to explain some aspect of the course within their organization. And then I thought, well, then now it will explain to who. And I thought, well, unless I say if I felt that without giving clarity to who they're explaining it to, they're going to get lost in the assignment. Am I explaining it to a co-worker? Am I explaining it to someone in management? Am I explaining it to the CEO? And, finally I just thought, well, that's kind of crazy. 0:25:18.3 Bill Bellows: I just said, well, as if you're explaining it to a classmate. But, my concern was if I didn't provide clarity on who they're explaining it to, then they're going to be all over the place in terms of what I'm looking for versus what they're trying to do. And that being feedback and that also being what I told them is part of collecting, part of feedback is looking for how can I improve the operation, how can I improve? Or, what are the opportunities for paying closer attention to operational definitions, which means the words or the processes that we're asking people to follow. 0:25:58.3 Bill Bellows: But, I found in in joining Rocketdyne, I was in the TQM Office and then I began to see what engineering does. Oh, I had a sense of that when I worked in Connecticut, paid more attention to what manufacturing does. Well, then when I moved into a project management office. Well, project management is just like quality management. It's breaking things into parts, managing the parts in isolation. And, so when I talk about quality management, don't be limited. There's a lot Dr. Deming's offering that could be applied to project management, which is again, looking at how the efforts integrate, not looking at the actions taken separately. 0:26:45.4 Andrew Stotz: And, so how would you wrap up what you want to take away. What you want people to take away from this discussion? You went over a very great review of what we talked about, which was kind of the first half of this discussion. And what did you want people to get from that review? 0:27:05.2 Bill Bellows: The big thing, the big aha has been: this is so much more than quality. And, I've always felt that way, that when people look at Dr. Deming's work and talk about Dr. Deming is improving quality, and then when I work for The Deming Institute, the inquiries I would get it was part of my job to respond to people. And they want to know I work for a non-profit, do Dr. Deming's ideas apply. And, so for our target audience of people wanting to bring Dr. Deming's ideas to their respective organizations, even though the focus here is quality, we call this series Misunderstanding Quality. At this point, I'd like you to think more broadly that this is far more than how to improve quality.  This is improving management of resources, management of our time, management of our energy.  So this is a universal phenomenon. Not again, you can look at it as good parts and bad parts, and that's looking at things in isolation. That's what project managers do. That's what program managers do. That's what organizations do relentlessly. And this is what Ackoff would call the characteristic way of management. Break it into parts and manage the parts as well as possible. 0:28:21.5 Bill Bellows: So, I just wanted to bring that back as a reminder of this quality, quality, quality focuses. There's a lot more to this than improving quality when it comes to applying these ideas. 0:28:34.7 Andrew Stotz: And, I would just reiterate that from my first interactions with Dr. Deming when I was 24, and then I moved to Thailand and I did finance business and all that. So I wasn't, applying statistical tools in my business at the time. That just wasn't where I was at. But the message that I got from him about understanding variation and understanding to not be misled by variation, to see things as part of a system. Also to understand that if we really wanted to improve something, we had to go back to the beginning and think about how have we designed this? 0:29:20.3 Andrew Stotz: How do we reduce the final variability of it? And, so, it was those core principles that really turned me on. Where I could imagine, if I was an engineer or a statistician, that I would have latched on maybe more to the tools, but from where I was at, I was really excited about the message. And, I also really resonated with that message that stop blaming the worker. And, I saw that at Pepsi, that the worker just had very little control. I mean, we're told to take control, but the fact is that if we're not given the resources, we can only get to a certain level. 0:29:58.3 Andrew Stotz: Plus, also the thinking of senior management, you are shaped by their thinking. And, I always tell the story of the accumulation tables in between processes at a Pepsi production facility. And that basically allows two operators of these two different machines to, when one goes down, let's say the latest, the farthest along in the production process, let's say the bottling goes down, the bottle cleaning process behind it can keep cranking and build up that accumulation table until it's absolutely full. And, that gives time for the maintenance guys to go fix the bottling problem that you have and not stop the guy behind. And, that was a very natural thing from management perspective and from my perspective. But, when I came to Thailand, I did learn a lot more about the Japanese and the way they were doing thing at Toyota. 0:30:51.4 Andrew Stotz: I went out and looked at some factories here and I started realizing they don't do that. They have their string on the production line, that they stop the whole thing. But the point is the thing, if a worker can't go beyond that, you know what the senior management believe about it. So, that was another thing that I would say it goes way beyond just some tools and other things. So, I'll wrap it up there. And Bill, on behalf of everyone at The Deming Institute, I want to thank you again for this discussion and for listeners. Remember to go to deming.org to continue your journey. And if you want to keep in touch with Bill, just find him on LinkedIn. This is your host, Andrew Stotz, and I'll leave you with one of my favorite quotes from Dr. Deming and that is people are entitled to joy in work. 

Are your specification limits holding you back from improving your products and services? Should you throw out specifications? What does Stephen Hawking have to do with it? In this episode, Bill Bellows and host Andrew Stotz discuss specifications and variation. TRANSCRIPT 0:00:02.5 Andrew Stotz: My name is Andrew Stotz, and I'll be your host as we dive deeper into the teachings of Dr. W Edwards Deming. Today, I'm continuing my discussion with Bill Bellows, who has spent 31 years helping people apply Dr. Deming's ideas to become aware of how their thinking is holding them back from their biggest opportunities. Today is episode 12, and the title is Do Specification Limits Limit Improvement. Bill, take it away.   0:00:31.4 Bill Bellows: Hey, Andrew. How's it going? All right.   0:00:33.8 Andrew Stotz: Great. Great to have you back and great to see you. For those that are just listening, you can watch the video on DemingNEXT. But for those listening, Bill looks handsome, full of energy, ready to go, and it's my 8:30 in the morning in Bangkok, Thailand. So let's rock Bill.   0:00:56.3 Bill Bellows: So. I spoke recently to one of the folks I'd met on LinkedIn that have listened to our podcast and took the offer to reach out and we now talk regularly. And I just wanna say I've gotta, before we get to some, the story behind the title, I wanted to share, a heads up. And if anyone would like a copy of this article that I wanna, take some excerpts from, then just reach out to me on LinkedIn and ask for a copy of the article. The article's entitled 'A Brief History of Quality,' and there's three parts. So it's about 10 pages overall, and it was published in 2015 in the Lean Management Journal, which I don't believe still exists. I was writing articles at the end once a month for this journal, I think based out of the UK.   0:02:04.3 Bill Bellows: I think there was a manufacturing magazine that still exists and had this as a special topic and my interest was bringing Dr. Deming's ideas, to the Lean community, which is why it was a Lean Management Journal, so the article was entitled 'Brief History Equality.' And so I wanna get to those topics, but when I was reading the article, reminding myself of it, I thought, oh, I'll just share this story online with Andrew and our audience. And so here I'm just gonna read the opening paragraph. It says, "several years ago, I had the opportunity to attend an hour-long lecture by Stephen Hawking," right? So the article was written in 2015. So the presentation by Hawking would've been maybe 2012, 2013. And back to the article, it says, "he, Hawking, returns to Pasadena every summer for a one-month retreat, a ritual he started in the 1970s, several thousand attendees sitting in both a lecture hall and outdoors on a lawn area complete with a giant screen were treated to an evening of reflection of the legendary Cambridge physicist."   0:03:14.3 Bill Bellows: And I'll just pause. I have friends who work at JPL and they got me seats, and they got me an inside seat in the balcony, front row of the balcony, but they had big screens outside. I mean, it was like a rock concert for Stephen Hawking, right?   0:03:34.3 Andrew Stotz: That's amazing.   0:03:34.9 Bill Bellows: Oh, it was so cool. Oh, it was so cool. So anyway, "his focus was my brief history offering us a glimpse of his life through a twist on his treatise, A Brief History of Time. His introspective presentation revealed his genius, his humility, his search for black holes, his passion for life, not to mention his dry sense of humor. It ended with questions from three Caltech students, the last of which came from a postdoc student, an inquiry Hawking had likely tackled many times before."   0:04:06.6 Bill Bellows: So realize he's answering the questions through a voice activated thing. And it appeared that the questions were, his answers were prerecorded, but they're still coming through a device that is a synthesized voice. But I get the impression that he knew the questions were coming, so we in the audience were hearing the questions for the first time. But he had already answered the questions. So anyway, it ended with questions. There was an undergraduate student, a graduate student, then a postdoc, and I said, "the last of which came from a postdoc student, an inquiry Hawking had likely tackled many times before. And the student relayed the story of an unnamed physicist who once compared himself to both Isaac Newton and Albert Einstein." So this unnamed physicist compared himself to Einstein and Newton each placed on a scale of 1 lowest to 10 highest. "With this context, Hawking was asked where he would rank himself."   0:05:22.0 Bill Bellows: So this physicist said, oh, you know, Andrew, I see myself as this. And so the guy relays the story, and he says to Hawking, so given this other physicist said this, where would you rank yourself? "Well, I do not recall the relative rankings posed in the query. I'll never forget Hawking's abrupt reply. He says, “anyone who compares themselves to others is a loser." And I found online that he was, that commentary, this was not the first time he said that.   0:06:04.9 Andrew Stotz: Right.   0:06:06.5 Bill Bellows: And I just thought, oh, anyone who compares himself to others is a loser. And then the end of the paragraph is "in reference to Dr. Deming," Andrew, "variation, there will always be. So can't we just get used to variation?" So the title, are you in favor? No, no, no, no. That was last time. Are you in favor of improving the quality was number 10. Number 11 was to improve quality, don't measure quality. For 12, the specification limits limit improvement.   0:06:46.9 Andrew Stotz: Now, if that was true, first of all, that would be a little scary, 'cause we spend a lot of time working on specification limits. There's a lot of people working on that.   0:06:55.4 Bill Bellows: But here's what's behind the title. In 1995, I was invited to speak, not for the first time, but for the first time I ever spoke to an audience of the American Society of Quality. It was a San Fernando Valley chapter. I forget the number. I've spoken there many, many times over the years, but this is the first time I ever spoke to quality professionals as opposed to project managers or Society of Manufacturing Engineers. I was there with my wife. There's dinner, then after dinner in the next room, and the chairs were set up, theater style, that'd be 70, 80 people. And I was talking about what I would, I mean, things I still talk about, I talk about new things, to have new things done. But the big thing I was trying to get across the audience is, the difference between meeting requirements, which in this series, we call it acceptability versus desirability, which is, I want this value, I want this professor, I want to date this person. And so I was relaying that concept to that audience. And the question I asked that night was do specification limits limit improvement?   0:08:31.0 Bill Bellows: And there was a guy about seven rows back, and I built up to that. That wasn't the opening thing, but what I was really pushing on was a focus on Phil Crosby's goal of striving for zero defects. And, then what? Once you achieve that, then what? And we've talked about the doorway and that's like the door is closed, we get up to the doorway and we've achieved zero defects. And, what we've talked about is going through the doorway and the attitude is, well, why open the door? I mean, don't open the door, Andrew. There's a wall on the other side of that door, Andrew. So it might be a door, but everybody knows there's a wall behind it, and I was poking at that with this audience, and prepared to show them the value proposition of going through that.   0:09:34.0 Bill Bellows: So anyway, I remember I got to the point of asking, do specification limits limit thinking about improvement or something like that. And a more senior gentleman, about seven or eight rows back, and fortunately, he was seven or eight rows back, fortunately, because he stood up and he says, "Are you saying we don't need specification limits?" There's a lot more anger in his voice. And I said, "No," I said, "I'm saying I think they limit our thinking about improvement." And, but he was really upset with me, and I was deliberately provoking because again, you and I have talked about, how can we inspire through this podcast and other podcasts that you do with the others, to get people to think about the possibilities that Dr. Deming shared with us. And it's not believing that there's a door that you can't walk through. You open the door and there's an opening and you can go through. There's a lot more going on there. So anyway, so I had prepared them. The whole reason for being there was to share what we were doing at Rocketdyne, and not just talk about the possibilities, but show them the possibilities. But he got very upset with me. But if he was in the front row, he might've hit me.   0:11:08.9 Andrew Stotz: May have thrown a book at you.   0:11:11.5 Bill Bellows: Oh, he...   0:11:12.2 Andrew Stotz: May have thrown a Specification Limit at you.   0:11:17.0 Bill Bellows: Twice I've had people get, well, I've gotten a number of people upset with me over the years, but that night was, I'll never forget, and I'll never forget, because my wife was sitting in the front row and she asked me never to be that provocative again. It might be dangerous to my health. But I was doing another class, also for the American Society of Quality, I was a member of the local chapter, and there was a big movement within Rocketdyne that all Quality Engineers within Rocketdyne be Certified Quality Engineers. And so two or three of us from Rocketdyne got involved in helping the local chapter train people to prepare to take this one day exam. Very, very, very rigorous. And it's a valuable credential for quality professionals.   0:12:20.1 Bill Bellows: And so the company was pushing that every single quality engineer was certified. So we did the classes on site. So instead of going to the nearby Cal State Northridge and doing it over there, we wanted to do it onsite, make it easy for our employees to attend. And so I would do one and a half sessions. So a given session was three hours long, and then there'd be a half session. And my topics were Design of Experiments and Dr. Taguchi's work. And so as I got this group this one night for the very first time, I was the second half of that three-hour session, and there's 30 some people in the room at Rocketdyne. And the question I wanted to raise is, why run experiments? What would provoke you to run an experiments either, planned experimentation, Design of Experiments or Dr. Taguchi's approach to it.   0:13:15.1 Bill Bellows: So I was throwing that out and I said, in my experience, we're either applying it to make something better - that's improvement, Andrew, - or we're applying it to find out why something doesn't work, which is rearward looking. And I was saying that in my experience, I spend like a whole lot of time running experiments to solve a problem, to fix something that was broken, to get it back to where it was before the fire alarm, not as much time focusing on good to make it better. And so I was just playing in that space of, you know, I guess I was asking the audience are we running experiments to go from bad to good and stop, or from good to better? And I was playing with that 30 people in the room, and all of a sudden, four or five feet in front of me, this guy stands up, says this is BS, but he didn't use the initials, he actually said the word and walked out of the room. And all of us are looking at him like, and there was no provocation. Now, I admit for the ASQ meeting, I was poking to make sure they were paying attention. Here, I was just plain just, why do we run experiments? So, he stands up, he lets out that word, pretty high volume, storms out of the room.   0:14:42.1 Bill Bellows: Well, at Rocketdyne, you can't... You need a... You have to walk around with someone who works there. You just can't go walk around the place, so I had to quickly get one of my coworkers who was in the room to go escort him to the lobby or else, we're all gonna get fired for having somebody unescorted. So the specification limits limit thinking about improvement, I think they do. I am constantly working with university courses or in my consulting work and acceptability in terms of the quality goal, that this is acceptable, it meets requirements is alive and well and thriving, thriving. And, I think what goes on in organizations, I think there's such a focus on getting things done, that to be done is to be good and is to stop that I could pass my work on to you.   0:15:45.2 Bill Bellows: And, the challenge becomes, even if you're aware that you can walk through the doorway and move from acceptability to desirability, how do you sell that to an organization, which you, what I see in organizations, there's a lot of kicking the can down the road. There's a lot of, and even worse than that, there's a lot of toast scraping going on because there's not a lot of understanding that the person toasting it is over toasting it because all they do is put the toast into the oven. Somebody else takes it out, somebody else scrapes it, somebody else sends it back to a different toaster. And I see a lack of understanding of this because the heads are down. That's part of what I see. What I also see in organizations is, with students is this is their first drop.   0:16:51.0 Bill Bellows: Wherever they are, engineering, manufacturing, quality, they're new, they're excited, they're excited to be on their own, to have an income. And they're taking what they learned in universities, and now, they get to apply it. And I remember what that was like. I worked the summer after getting my bachelor's degree, my last semester, I took a class at heat transfer, the prior semester, took a class in jet engines, and I just fell in love with heat transfer and I fell in love with jet engines. And that summer, I was coming back in the fall to go to graduate school for my master's degree. That summer, I worked for a jet engine company as a heat transfer engineer, I was in heaven.   0:17:37.6 Andrew Stotz: Yeah. That's gotta be the coolest thing.   0:17:40.1 Bill Bellows: Just incredible. So I can imagine people coming out of college, going to work, and you get to apply what you learned. You get to use computers, you get to work with some really cool people, and you're doing what you're doing, and it's a blast. And I think it takes a few years before you start to listen to what the veterans are talking about. And you might hear that they're challenging how decisions are made, they're challenging how the company is run. I think prior to that, your heads are down and you're just the subject matter expert. It could be, you know, engineering and manufacturing, finance, and you're doing what you're doing. Their head is down, you're receiving, you're delivering. I still remember when I went to work with my Ph.D. at the same jet engine company, they hired me back. And, I remember walking down the hallway with a colleague and somebody says, that's the VP of Engineering.   0:18:42.7 Bill Bellows: And I thought, we have a VP of Engineering? I mean, I know we have a Vice President of the United States, but I didn't know anything about titles like that. And I think... And I don't think I'm the only one. I've shared those with some younger folks recently, and they agree, you come in, it's heads down, we don't know management, all I get to work on this great stuff. I go and I, and so what we're, but I think what happens is, I think at some point of time you start to look up and you're hearing what the more senior people that are there are saying you've had some experience. And, I know when people join Rocketdyne, and they would come to my class and I would share these stories that had some things that were, if your experience would be questionable, some other things that are pretty cool.   0:19:34.6 Bill Bellows: And, I just had the feeling and I found out people would walk outta there thinking what you mean that, I mean the things, the use of incentives, like why do we need incentives? But, and what I found was it took a couple of years and I would bump into these same people and they'd say, now I'm beginning to understand what you were talking about and what Dr. Deming was talking about. So I throw that out. For those listeners that are trying to, that are at that phase where you're starting to wonder how are decisions being made? You're wondering what you wanna do in your profession. You're wondering what this Deming stuff is about. A whole lot of this entire series has been targeted at people that are new to Deming's ideas. Or maybe they have some experience, they're getting some exposure through these podcasts either with me and the ones you're doing with John and the others. And so, but the other thing I wanna get into today is this quality thing. I go back to this article. And then I was thinking about this article, things I didn't know when I started researching this article is, this term quality, where does that come from? And the term quality comes from, I got to pull it, I have to scroll through the article. Let me get it, let me get it.   0:21:06.4 Bill Bellows: All right. Here we go. "The word quality," Andrew "has Latin roots, beginning with qualitas coined by Roman philosopher and statesman, Marcus Tullius Cicero, who later became an adversary of Mark Antony." You know, what happened to Cicero? Wasn't pretty.   0:21:32.8 Andrew Stotz: Yeah.   0:21:33.9 Bill Bellows: "Feared by Antony," I wrote, "his power of speech led to his eventual beheading. But long after he introduces fellow Romans to the vocabulary of qualitas, that's quality; quantitas, that's quantity; humanitas, that's humanity; and essentia, which is essential. He's also credited with an extensive list of expressions that translate into English, including difference, infinity, science, and morale. When Plato invented the phrase poiotes for use by his peers." So Plato would've been Greek, "Cicero spoke of qualitas with his peers when focusing on the property of an object, not its quantity." And, what I had in mind there is counting how many things we have, so you come in and you want five apples, five suits, whatever it is, there's the quantity thing. And then what Cicero was trying to do is say, quality is not the number, but quality is a differentiation of not just any suit, not just any...   0:22:53.1 Bill Bellows: And I think that becomes the challenge is, is that still important? So when Dr. Deming came on board in 1980, at the age of 79, when the NBC white paper was written, and people got excited by quality because quality was something that people identified with Japanese products, not with American products.   0:23:19.9 Andrew Stotz: Well, not in 1980.   0:23:21.1 Bill Bellows: Not in 1980...   [laughter]   0:23:22.2 Bill Bellows: I mean, at that time, the auto companies were making a lot of money in repair businesses. And Toyota comes along and says, and the words on the street, our products don't require all that repair. And I thought, yeah. And what was neat about that is when I thought, when you think about differentiation and like how do you sell quality? Because, again, I find it, for the longest time, beginning in 1980, quality was hot. Quality improvement. I mean, the American Society of Quality membership skyrocketed. Their membership has dropped like a rock since then because they don't have this Deming guy around that got them going.   0:24:12.1 Bill Bellows: Now, they're still big in the Six Sigma, but I don't believe their membership is anything like it was, but what I was thinking and getting ready for tonight is the economics of quality is from a consumer, what, at least, when my wife and I buy Toyota, it's a value proposition. It's the idea that if we buy Toyota, in our experience, we're getting a car that doesn't break down as often, is far more reliable. That becomes the differentiation. Also in the first... In the second series, second podcast of this series, we talked about the eight dimensions of quality and David Garvin's work.   0:25:03.2 Bill Bellows: And one of them was features, that a car with cup holders is quality 'cause... And there was a time, and the more cup holders, the better. And that was... And Garvin was saying lots of features is quality. He said, reliability could perceived it as a dimension of quality. Conformance was one of the dimensions, and he attributed that to the traditional thinking of Crosby. Reliability is a thing. And so when it comes to, how do you sell quality today? How do you get people within your organizations to go beyond, 'cause what I see right now is it's almost as if quality has gone back to quantity, that it's gone, that it's lost its appeal. Now, quantity doesn't lose its appeal 'cause we're selling, five of them, 20 of them, 30 of them.   0:26:09.2 Bill Bellows: But I don't get the impression from students and others that I interact with, that quality has big appeal. But, if we convert quality to the ability to do more with less, I mean the, when I'm delivering a higher quality item to you within the organization, that it's easier for you to integrate, to do something with, that's money, that's savings of time. And the question is, well, I guess how can we help make people more aware that when you go through the door of good and go beyond looking good and start to think about opportunities for desirable? And again, what we've said in the past is there's nothing wrong with tools, nothing wrong with the techniques to use them, there's nothing wrong with acceptability, but desirability is a differentiator.   0:27:15.2 Bill Bellows: And then the challenge becomes, if everyone's focused on acceptability, where it makes sense, then within your organization going beyond that, as we've explained, and this is where Dr. Taguchi's work is very critical. Dr. Deming learned about desirability from Dr. Taguchi in 1960. And that's what I think is, for all this interest in Toyota, I guess my question is, why is everybody excited by Toyota? Is it because they do single-minute exchange of dies? I don't think so. Is it because they do mixed model production? They can have, in one production line have a red car followed by a blue car, followed by a green car as opposed to mass production? Or is it because of the incredible reliability of the product? That's my answer, and I'm sticking to it. So...   0:28:14.3 Andrew Stotz: Yeah.   0:28:14.7 Bill Bellows: So what do you think Andrew?   0:28:17.2 Andrew Stotz: Yeah. There's two things that I was thinking about. One of the things I was thinking about is the idea if we're doing good with quality, and maybe we're satisfied with good, I was thinking about the book 'Good to Great,' and like how do you make this breakthrough? And then I was maybe it's good to groundbreaking or good to amazing or whatever. But like, when you really go beyond specification limits and take it to the next level, it's like you're moving from good to great. And one of the things that I see a lot is that, and I talk a lot in my corporate strategy courses with my clients and with my students is this idea that Deming really hit home about, about focusing on your customer, not your competitor.   0:29:06.6 Andrew Stotz: And I just feel like humans have a need to classify everything, to name everything, to label everything. And once they've got that label, that's the specification. That's what we want, they will fixate on that. And whether, I think, you think about all the kids that come out of the out of some meeting with a doctor and say, oh, I'm ADHD. Okay, we got a label now that's good and bad. And so that's where I think it, when I thought about the specification limits limit improvement, I think that, specification to me, when I think about quality, I think about setting a standard, moving to a, a new standard, and then maintaining that standard. And I can see the purpose of limits and controls and trying to understand how do we maintain that. But if we only stay on maintaining that and never move beyond that, then are we really, are we really in pursuit of quality?   0:30:12.0 Andrew Stotz: Now, on the other hand, when I think about the customers of my coffee factory, CoffeeWORKS and they want the exact same experience every single morning. Now, if we can make tests and do PDSAs to improve how we're doing that, less resources, better inputs and all that, great, but they do not want a difference. And I was just thinking about it also in relation to my evaluation masterclass bootcamp, where I still have a lot of variation coming out at the end of the bootcamp. Now, in the beginning, this is bootcamp number 19. So I've done this a lot. In the beginning, man, I would have, someone really terrible and someone really great, and I wasn't satisfied. So I kept trying to improve the content, the process, the feedback to make sure that by the time they get to the end, but I was just frustrated yesterday thinking there's still a lot of variation that, and I'm not talking about, the variation of a personality or something.   0:31:15.2 Andrew Stotz: I'm just talking about the variation of understanding and implementing what they're learning. And then I was thinking as I was at the park running this morning, I was thinking like, what makes Toyota so great is that there is very little variation of the 10 million cars that they've produced last year. And how impressive that is when all I'm trying to do is do it in a small little course. So I don't know, those are some things that were coming into my head when I thought about what you're talking about.   0:31:44.6 Bill Bellows: But no, you're right, in terms of the coffee, and I think you brought up a couple of good points. One is when the customer wants that flavor, whatever that level is, now, but that, I don't know how, anything about measuring taste, but there could be, within the range, within that, when they say they want that flavor, I mean, that could still have, could be a pretty broad spectrum. So maybe there's the ability to make it more consistent within that, if that's possible.   0:32:27.8 Andrew Stotz: Yeah, I think that, I think, like we have a blend we call Hunter's Brew, and I drink that every single morning and I can say, yeah, there's a variation, but it's a small enough variation that it doesn't bother me at all. And I think it doesn't bother our customer. Could we get more conformity to that? Yes, I think we could reduce that. Is it worth it? That's another question. We're looking at some automated equipment, some automated roasting equipment that would bring automation that would allow us to reduce that variation a bit. Will the customer notice that or not? Maybe. But the customer will definitely notice if we're outside of specification limits or if it's burnt...   0:33:12.7 Bill Bellows: Yes.   0:33:13.5 Andrew Stotz: As an example, and we're still shipping it, you know, they'll definitely notice that. And we have our mechanisms to try to measure that so that we are within those limits. So I do see, I see that the function of that to me is like, okay, in fact, in any business, you're constantly chasing and putting out fires. I mean, there's always things going on in every business owner's situation.   0:33:38.6 Bill Bellows: Right.   0:33:39.9 Andrew Stotz: And so there's at points where it's like, okay, can you just keep that in specification limit for right now while I get over to here and fix how we're gonna make sure that this is at another level where that is, I would consider it kind of an improvement versus maintaining. But I don't know, I'm just, I'm riffing here, but those are some things in my head.   0:34:00.0 Bill Bellows: No, what I hear you talking about is if we shift from quality management to, I mean, what desirability is about is looking at things as a system. Acceptability is about looking at things in isolation and saying, this is good, this is good, this is good, this is good. Not necessarily with a lot of focus of how is that used. So if we move away from quality and really what we're talking about is a better way to run an organization with a sense of connectedness that we're, we can talk about working together. Well, it's hard to work together if the fundamental mindset is: here, Andrew, my part is good and I wash my hands of it. When you come back and say, well, Bill, I'm having trouble integrating it, that's more like working separately.   0:35:07.2 Bill Bellows: So if we shift the focus from quality, which could be really narrow, it could be an entry point, but I think if we step back, I mean the title of Dr. Deming's last book was 'The New Economics,' the idea which has to be, which to me, which is about a resource. The better we manage the organization as a system, the more we can do with less. And relative to the quality of the taste and yeah, the customers want this and maybe we can make that even more consistent simultaneously. Can we use control charts to see special causes before they get too far downstream that allows us to maintain that consistency? That'd be nice. Then can we figure out ways to expand our capacity as we gain more? So there's a whole lot to do. So the organization is not static. And simultaneously the challenge becomes how do we stay ahead of others who might be trying to do the same thing? Dr. Deming would say, be thankful for a good competitor. Are we just gonna sit there and say, oh, we're the only coffee... We're the only ones in house that know how to do this. What is our differentiator? And I think having a workforce that thinks in terms of how the activities are connected, that are constantly involved in improvement activities.   0:36:45.1 Bill Bellows: Short of that, what you're hoping is that no one comes along in... Remember the book, it was required reading within Boeing, sadly, 'Who Moved My Cheese?'   0:36:58.2 Andrew Stotz: It was required reading at Pepsi when I was there, and I hated that book. We had another one called 'The Game of Work,' which I just was so annoyed with, but that 'Who Moved My Cheese?' I never, never really enjoyed that at all.   0:37:07.0 Bill Bellows: We used to laugh about, within Rocketdyne 'cause, and for those who aren't aware of the book, the storyline is that there's a bunch of mice and they're living in their little cubby holes and every day they go through the mouse hole, try to avoid the cat, find the cheese, bring the cheese back into their cubby hole, and that life is good. And then one day, somebody steals the cheese, moves the cheese and one's kind of frantic and the other's like, oh, not to worry, Andrew, I'm sure it was taken by a nice person and I'm sure they'll return it. So I wouldn't lose sleep over that. That's okay. That's okay. And then kind of the moral was another company is stealing your cheese and you're sitting there thinking everything's okay, and next thing you know, you're outta business because you weren't paying attention. And so the, and it was, this is written for adults with cartoons of cheese. That's how you appeal... That's how...   0:38:15.9 Andrew Stotz: Yeah. So that's what got me annoyed about it because it felt like, just tell me what you're trying to tell me, okay. Instead of telling me this story. But yeah, it was a used to create the burning platform concept that was used... I know at Pepsi when I was there, they talked about the burning platform, the level of urgency, we're gonna get, and, and there's, I kind of understand where they were coming from with it, but yeah.   0:38:44.7 Bill Bellows: But what is interesting is nowhere in the book was a strategy to be the ones moving the cheese. What it was more like is don't be in an environment where somebody else moves the cheese. Don't be that company. And I thought, no, you wanna be the company that's moving the cheese. But that was, maybe that's an advanced book that hasn't come out yet.   [laughter]   0:39:08.6 Bill Bellows: But really...   0:39:10.5 Andrew Stotz: There's some work for you, Bill.   0:39:12.6 Bill Bellows: But, but that's what... I mean what Dr. Deming is talking about is having an environment where you have that capacity on an ongoing basis. First of all, you're not sitting back stopping at good, thinking that what you're doing is always acceptable. It's trying to do more with that. Anyway, that's what I wanted to explore today. Again, there's nothing wrong with specification limits. I told the gentleman that night, specification limits are provided to allow for variation, to allow for commerce, to allow for suppliers to provide things that meet requirements. Then the question becomes, is there value in doing something with a variation within the specification limits? Is there value in moving that variation around? And that's the desirability focus. That is what Ford realized Toyota was doing a lot, is that then improves the functionality of the resulting product, it improves its reliability. All of that is the possibility of going beyond meeting requirements. So it's not that we shouldn't have, we need specifications. Why? Because there's variation. And if we didn't allow for variation, we couldn't have commerce because we can't deliver exactly anything. So I just want, just for some...   0:40:34.9 Andrew Stotz: Okay, all right. That's a good one.   0:40:37.4 Bill Bellows: All right.   0:40:38.2 Andrew Stotz: And I'll wrap it up with a little humor.   0:40:40.4 Bill Bellows: Go ahead.   0:40:40.5 Andrew Stotz: There were some parody books that came out, in relation to 'Who Moved My Cheese.' In 2002, the book 'Who Cut the Cheese' by Stilton Jarlsberg, which was good. And in 2011 was, 'I Moved Your Cheese' by Deepak Malhotra. So there you go. A little humor for the day. Bill, on behalf of everybody at The Deming Institute, I want to thank you again for this discussion. And for listeners, remember to go to deming.org to continue your journey. And if you want to keep in touch with Bill, just find him on LinkedIn. He responds. This is your host, Andrew Stotz, and I'll leave you with one of my favorite quotes from Dr. Deming. I just love this quote. I think about it all the time. "People are entitled to joy in work."  

Have you ever had a quote or short essay completely change how you look at something? Whether it's gaining awareness about something new or looking at an old problem through a new lens, seeing and hearing other's perspectives can change our hearts and minds for better or for worse sometimes. In today's episode, I want to focus around a central subject about how you feel in your body and the many factors that can contribute to that feeling. I want to share one of my favorite books recently titled, "101 Essays That Will Change the Way You Think" by Breanna West and specifically share 18 short passages from this book and give you my interpretation of what they mean. Please let me know if you have a favorite one and Happy New Year! Time Stamps: (1:43) Favorite Thing About Christmas (4:44) The Relationship With Your Body (7:37) Your Kids Hear and Internalize Everything (8:52) Photoshop and The Distortion of Reality (12:57) Judging Others and Your Opinion Of Yourself (16:10) Your Friends and How They Treat Their Body (17:16) The Media You Consume (18:09) Your Heritage and Your Hometown (19:57) Relationships and Physical Expectations (21:16) The Journey vs A Destination (22:54) Genuine Friendships (24:00) Cat Calls (24:40) Your Body's Acceptability (27:07) The Sun and Vitality (28:24) Your Self-Worth (30:20) The Body of Celebrities (31:57) What Our Bodies Were Meant To Do---------------------Follow @vanessagfitness on Instagram for daily fitness tips & motivation. ---------------------Download Our FREE Metabolism-Boosting Workout Program---------------------Join the Women's Metabolism Secrets Facebook Community for 25+ videos teaching you how to start losing fat without hating your life!---------------------Click here to send me a message on Facebook and we'll see how I can help or what best free resources I can share!---------------------Interested in 1-on-1 Coaching with my team of Metabolism & Hormone Experts? Apply Here!---------------------Check out our Youtube Channel!---------------------Enjoyed the podcast? Let us know what you think and leave a 5⭐️ rating and review on iTunes!

In this episode, Bill Bellows and Andrew Stotz dive further into acceptability versus desirability in the quality world. Is it enough that something is "good" - meets requirements - or do you need to focus on degrees of "good"? How can you tell the difference? TRANSCRIPT 0:00:02.5 Andrew Stotz: My name is Andrew Stotz, and I'll be your host as we dive deeper into the teachings of Dr. W Edwards Deming. Today, I'm continuing my discussion with Bill Bellows, who has spent 31 years helping people apply Dr. Deming's ideas to become aware of how their thinking is holding them back from their biggest opportunities. Episode, today is episode eight, Beyond Looking Good. Bill, take it away.   0:00:25.4 Bill Bellows: Hi, Andrew. How are you doing?   0:00:29.1 AS: Beyond looking good. So beyond my good looks, that's what you're saying. Okay.   0:00:33.6 BB: No, but it's funny, this beyond looking good and so I could say, Andrew, how you feeling? Oh, I'm feeling good. Right? I'm feeling good. So we have this, and that's part of why I think is funny is how are things? Things are good, things are good.   0:00:49.3 AS: Looking good.   0:00:51.0 BB: And that's what I find is, I mean, and it's not that people are necessarily honest, but when somebody says how was your day? Good. Or it could be the extreme other, and we won't use any foul language, but it's like, but I find it's just a very common, how are you feeling? Oh, I'm feeling good. Or I could say, great, which is better than good. So anyway, so I'm gonna pick up on, well first say that a heavy focus of this series, Misunderstanding Quality, is for you, quality professionals out there around the world that are excited by Deming's work, learning about Deming's work, trying to bring Dr. Deming's ideas to your organization in your quality function.   0:01:41.6 BB: Or it could be, you're elsewhere in the organization and you believe that...you're inspired to realize that there's something about how quality is managed in your organization, whether you're in design or manufacturing, which is inhibiting what you might want otherwise to do. And what I'm hoping is that the examples and concepts presented here can help you, one, absorb the ideas yourself, begin to absorb them, eventually explain them to people at work. At least once a month I'm contacted by someone listening to the podcast who says, hey, they wanna connect with me on LinkedIn, and then quite often I reach out to them and ideally end up in a conversation with them to find out more about what they're trying to do.   0:02:38.7 BB: But what I'm hoping is that this fundamental information, knowledge, wisdom is useful to you and personally learning, but then depending on what you wanna do with it, you have to engage others. And that's why I've been encouraging, and this is what I do with people I mentor, is you have to develop the ability to explain it to others. 'Cause you can't be the only one talking about these differences. You're gonna drive your coworkers nuts. You might get in a jam where somebody's confused by what you're trying to do, and you need help, or you need help in implementation, help in explaining.   0:03:17.6 BB: So I'm gonna go back to acceptability and desirability. And I was in the Finland, the Netherlands and the Sweden about a month ago with friends in each of those countries. And what came up was, again, this acceptability/desirability and that contrast. So acceptability again, as a reminder is, there's no need to know where we are within the requirements. It is absolutely good. All we know is that it meets requirements for whatever the requirements are. It is you're comfortable with good versus bad. I was talking with somebody, some clients today and we were talking about, pass versus fail. And I said, 'cause it's really a pass. Acceptability is a pass-fail system. And what does passing mean?   0:04:17.5 BB: Passing means not failing. It's like, years ago when I was a summer student working for this jet engine company in Connecticut and got together for beers one Friday night with a couple of the executives, and there were a couple of us summer interns there with these directors. Yeah. Senior directors. And one of the senior directors says to us, says, so what's the difference between business and crime? And we're like, this and this and this and this. And I don't know what our answers were, but we. And finally one of them said, no, no, no, no, no, no. He said, the basic difference is crime's illegal.   0:05:03.0 BB: So you end up with what is bad, what is bad is what's not good. And what is good, good is what's not bad. And so what is passing? Passing is not failing. And so when I was explaining to somebody today I was asking him, what's the letter grade? What letter grade? In fact, I asked a very senior NASA executive this question once. What letter grade do they expect for everything they buy that put into their missions? And he said, A plus. And I said, A plus is not the requirement. He said, what's the requirement? I said, D minus. And he is like, nah, it's not D minus. I said, your procurement system is based on things being good or things being bad. He said, yep.   0:05:45.7 BB: I said, well, what is good but passing? Right. Good is not... Good is... To be good is to not be bad, to pass is to not fail. What is crime? What is crime is what's illegal versus legal. It's one or the other. We talked once on the previous podcast about Kepner-Tregoe problem solving, decision making. And part of decision making I mentioned is you come up with a bunch of characteristics of a decision. You're buying a house and you want it to be one story, three bedrooms, two bathrooms, whatever it is. And you put down all the requirements and then you ask for each of those requirements. Is it a must or a want? And a must is yes or no. It has it or it doesn't. So it must have three bedrooms, must be one story. The must could be must be under a million dollars or whatever the number is.   0:06:53.5 BB: And then you get into, well, is that really a must or is that a high weighted want? For our daughter, Allison, I remember taking her out to buy a bike for her birthday one year and she said, well, how much can we spend? And I said, $200. So, what did she say, Andrew? "What if it's 201?" Well, then you get into, well, is that a must or a high weighted want? You know what I say? Depends on how much money's in your wallet. If you don't have $201, it is a must if you're...   0:07:34.7 AS: I thought she was gonna say, if I can get it for 150, can I keep the 50 bucks?   0:07:41.3 BB: But that's it. So acceptability is like treating it as a must. It is absolute. It has to be three bedrooms. And then what is desirability? Desirability is the lower the cost, the better, the higher the performance, the better. And so acceptability is absolute, it is good versus bad. Desirability there's relativeness. And the next thing I wanna say is why should we be interested in desirability? Which also based on what we've talked about before, is to be appreciative of desirability in regard to the Dr. Deming's Red Bead Experiment. Deming Red Bead Experiment, we had red beads and white beads the customer wanted white beads. And then one of the things we looked at was, if all the red beads are gone, can we still improve?   0:08:46.1 BB: And then people would say, well, we can make the white beads faster, we can make them cheaper, but can we make the white beads better? And the huge blind spot and asking that question to audiences on a regular basis is, they get stuck. Well, then we got into, well, what if there's variation in the white beads? So part of desirability is that there's variation in good. And that allows us to go beyond just being good to better. But what is better than? Well, better than is, I mean, what would be better for the organization would be a better appreciation of the white bead variation. One, could prevent red beads from happening in the first place. And so why do we have a gas gauge that goes anywhere from E to full? It allows us to watch the gauge go down and go down and go down.   0:09:39.7 BB: What does that? It's watching variation in good and then getting gas before it runs out. So if we use a run chart and monitor vacuum level in a braze oven if we're monitoring something on a variable way, not just saying it's good or it's bad, that allows us to see trouble coming before it happens. We could use that information to create a control chart and go one step further. And so relative to a given characteristic, what we're doing is trying to prevent non-conformances, trying to prevent bad from happening by monitoring what is good. What we can also do and what I shared is with appreciation of Dr. Taguchi's insights, the idea that the closer we are to that ideal value so when we're at home cutting the piece of wood really close to that line, why do we do that?   0:10:33.7 BB: Because at home we have to get those pieces of wood together and they're not quite square or straight, then that's extra work over there. So those are two aspects of the value proposition for desirability. And then I wanted to mention is, our son is a handyman and a pet sitter. And he is self-employed in both. And the handyman stuff involves and sometimes it involves woodworking. And recently he's doing some work in our house and some really cool stuff. So he experiments in our house, which is great for us. He also experiments in our daughter's condo. So there's great opportunities for him to practice doing something. So he was cutting some long pieces of wood and they weren't, he was very frustrated. They weren't coming out straight. So we called a friend who's a master craftsman over, and he gave us both a lesson on how to, how desirability, how to get a really straight cut, not just anywhere within spec, but you need a really straight cut so they fit together well.   0:11:38.6 BB: Well, this carpenter friend, Alex, shared with me a while ago, years ago, what it's like in the construction industry. 'Cause I explained to him acceptability, desirability, focusing on the target. And in the world of construction, he gets involved, he'll be involved on a team building a multimillion dollar home for six months to a year. And it's not uncommon he's called in to have to deal with everybody else barely meeting requirements. And his job is to go in there and straighten things up because they're not quite right. And that's all this compensation stuff. And that's what with his insights trying to help our son get around that. All right, so, I do wanna share a couple anecdotes from Rocketdyne the world of acceptability and so it was a fun story.   0:12:41.2 BB: I was meeting with a small team and one of them was a senior quality manager and in the quality organization. And he says, you know what the problem is Bill? He says, what's, you know what the problem is? He said, "the problem is the executives VP of quality and as directors are not getting the quality data fast enough." So I said, "well, what data?" And he says, "scrap and rework data. He said, "they're just not getting it fast enough." So I said, "I don't care how fast they get it it's already happened."   [laughter]   0:13:18.9 BB: And I kept saying to him, the speed doesn't matter. And so how many red beads did we have today? Well, we gotta instantly report the number of red beads on a cell phone. No. If you monitor the white bead variation, then that's a means to do that. Also say, when I joined Rocketdyne in 1990, there was a big movement on the space shuttle main engine program. And I don't know what instigated this, but Rocketdyne developed, designed and developed and then produced for many years the space shuttle main engine. I mean the world's first reusable rocket engine. And there was a movement before I got there to change the drawings. And so a set of manufacturing drawings will have a nominal value, let's say 10. And then it might be something must be 10 plus or minus one.   0:14:19.4 BB: And what does that mean in terms of acceptability? It means anything between nine and 11. And then what I learned was they'll say that the number 10, that's the nominal value. And then we have 10 plus or minus one. Well, what matters to the person downstream is not the 10 plus or minus one. What matters to the person downstream is it's gotta be between nine and 11. So no matter what that nominal is, the nominal goes out the window. So there was a movement to get rid of the nominal value. 'Cause now the machinist has to do the math, 10 plus or minus one. Okay? Anything between nine and 11. So we're gonna save you all that trouble and just give you two numbers. The min and the max. And so what is that system? That is a system based on acceptability.   0:15:07.0 BB: And so that was the starting point when I joined. And so what I wanted to add for our listeners, if you're in an organization, this came up recently with one of my clients, and they're talking about the nominal value of that 10. The 10 plus or minus one, or it could be the nominal value is 11 and they'll say 11 plus nothing minus two. And so what does that mean? 11 plus nothing means eleven's the max minus two means nine and 11. So when I saw it doesn't really matter what the nominal value is, 'cause all that's gonna happen is gonna get translated to a minimum and max. And so in this client, they're talking about nominal values, nominal values. And I said, my recommendation is when it comes to desirability, don't say nominal.   0:16:00.3 BB: 'Cause I'm not convinced we use that term the same way. What I would suggest, again, this is for those listening to the podcast on a regular basis, is don't use the word nominal. It's confusing. Use the word target. Say that is the ideal. And the idea, by using the word target, which may not be part of the vocabulary, you can differentiate from nominal, which I find to be confusing and just say that's what we want. I'm gonna give you another fun story relative to acceptability. I was at a supplier conference, so in the room are a couple hundred Rocketdyne suppliers. And the person speaking before me says, and there was some very heavy duty brow beating.   0:16:48.0 BB: And the person ahead of me says, when we give a Rocketdyne employee a job and they sign that it's good, that's their personal warranty, Andrew. That's their personal warranty. So for you suppliers, when you tell us something is good, that's your personal warranty to us. And so that has to be transmitted to your organization. That's personal warranties. We take it seriously. This is the space business, Andrew. So that was going on and there was some heavy duty browbeating. And on the one hand I'm thinking, I wonder what happened recently where somebody said, Andrew, get up there on stage and go browbeat 'em, go browbeat 'em. And so this guy's up there, browbeating, browbeating.   0:17:42.7 AS: We need people to take this serious.   0:17:44.0 BB: Well, this is personal warranty, Andrew. When you say it's good, that's your warranty. So I got up and I told the story of the bowling ball being left in the doorway of the bedroom. And I said, the fact of the matter is, Wilson gave us his personal warranty that the bowling ball was in the bedroom. And just trying to say, 'cause the personal warranty is not a personal warranty of an A plus Andrew. It's not a personal warranty. It's a personal warranty that it's good and what is good, Andrew? Not bad. And so when I hear this talk of personal warranty, it's like it's not all that it's cracked up to be. When you start to look at what is good is what's not bad.   0:18:36.4 AS: By the way, I have a funny one to share in this one. And that is, every time I start my ethics in finance class with a new batch of fourth year finance students here in Thailand, class starts at 9:00 AM and the students think that the time to arrive is somewhere a little bit before or a little bit after nine. And when they arrive at the class at 9:01 or actually just after 9:00, they find the door is locked.   0:19:12.3 BB: Yeah.   0:19:13.3 AS: And then I leave them outside. And then after about five minutes, I go out after they've built up a group of people out there and I come out and I talk to them. I said just so you know I want you to be on time for my class. Don't tell me about traffic. Don't tell me you're busy. I got a full-time job and I'm working like crazy and I'm here for you. I'm not making much money out of this. So show me the respect and be here on time. They come in, they walk in shame, past all their classmates, and then they sit down and then I lock the door again, and of course another batch comes at about 9:05 or 9:10.   0:19:46.0 AS: And then I do the same. And then I bring them in, and then next week they come and they're all there at 8:58, let's say 8:59, but nobody arrives past 9:00. And then in the following weeks, I never locked a door anymore. Curious how things change. And of course, things start to shift back to that range around it, but it just made me think about what I do in trying to communicate that, whether it's right or wrong or whatever. But I like doing it because I want the students, I wanna set the parameters from the beginning. Like, take it seriously.   0:20:26.4 BB: Oh yeah. I go to a daily meeting and it starts exactly on the hour and it's done exactly. And everybody knows that. And the degree to which things are accomplished and 'cause the whole strategy was to develop a cadence that, yeah, no, that's...   0:20:56.8 AS: And I have a hard time. I want to, with my valuation masterclass bootcamp, which I do have classes at 6:00 PM. I'm generally pretty lenient letting students come in, but there's a part of me that has... I've started locking the room after 6:03 or so, and then I'll unlock it five minutes, 10 minutes later and let a few people that are... But I've had some questions in my mind as to whether I should just be hard line and say, it starts at 6:00, if you don't make it, see you next time. Now we also record it so they can watch it. But I don't know, I haven't really figured out whether I should be that tough or not.   0:21:35.0 BB: Yeah. And that's what it comes down to. I think depending on the environment, there could be, I mean, it's about synchronizing watches, right?   0:21:48.9 AS: Well, yeah. And the other thing that you could say is that, well, Andrew, come on if you understand variation, then you understand that there's gonna be some people that are gonna be late, and there's gonna be some people that are gonna be early. You set the target at 6:00 PM what else would you expect? But I guess what I'm thinking is, if for a student they should be thinking, I need to shift my target to be 8:00, sorry, 5:55 if the meeting's at 6:00, that way I could be a little bit late, you know?   0:22:16.2 BB: Exactly.   0:22:16.7 AS: And it's same concept, it's just that shifting that target. So maybe I need to start working on that one.   0:22:25.3 BB: No and it's respect for the other 15 people in the meeting that... you know, and this idea that we are... This meeting is designed for this reason, but it has to fit the work. And, yeah, I mean, so is that necessary for a college class? Again, I mean, if it depends on how much you wanna squeeze in. And five minutes if you're trying to get a whole bunch in and develop a cadence, then, yeah.   0:23:07.6 AS: Well, it also depends. What are you teaching.   0:23:11.4 BB: Exactly.   0:23:12.5 AS: In my Valuation Masterclass about valuing companies, I've decided I'm not teaching Excel. You can go somewhere else and get that, and people ask me for it, and I let them use my Excel model that I've created, but I've just decided that's not what I'm gonna teach. And so in this case, with being an ethics class, I think it is probably important to teach about the importance of time and understanding that. And so for that, but for the bootcamp, Valuation Masterclass Bootcamp, I am trying to teach discipline and helping young people realize you gotta deliver. And so that's it. By the way you're looking good, Bill. So let us summarize beyond looking good. How would you like people to... What would you like them to take away from our discussion on this topic?   0:24:07.3 BB: It goes, this is...I mean, we started off this whole series talking about quality and the eight dimensions of quality and the book and the article by David Garvin of the Harvard Business School. So to first introduce in this series called Misunderstanding Quality, that there are dimensions of quality. And amongst those dimensions were capacity and reliability and repairability. And one was aesthetics, and one was a sense of a reputation that through everything else, you're developing a reputation. Well, one of them was acceptability, and that then was the inspiration to get into the contrast between acceptability and desirability.   0:25:05.6 BB: And there's a lot to that. And so what I found in the beginning I had a little bit in mind based on some things I've seen. And then the more I researched it, the more I saw and what I wanna get into next time is, and these are questions I was asking people in the trip to Europe is, first is, can acceptability - a focus on acceptability explain the incredible reliability of Toyota products? At least that I have experienced. Can you explain that with acceptability? And I don't think so. Next, okay, I'll go back to my notes here.   0:25:57.7 BB: Next is, does your organization, again, for those calling in, the better you understand this distinction between acceptability and desirability. Does your organization distinguish those? Does your quality system... Is your quality system based on acceptability? Does it have acceptability and desirability? That is a question for our audience. What I want to get into next time is, and I think I've mentioned this before, I've read much a great deal about Lean. I've gone to Lean conferences. I've written plenty of articles for the Lean Management Journal involving reading articles and commenting on them. Everything I see within Lean is acceptability. I don't see any mention of desirability. Six Sigma quality is that we wanna have 3.4 defects per million. There's no mention in acceptability, either explicitly or implicitly to this difference between acceptability and desirability nor in Lean.   0:27:04.9 AS: Sorry, can you clarify that for just a second? Okay. So you said Lean was one and Six Sigma was the other, which was focused on which?   0:27:13.4 BB: Well, what I'm saying is that I don't see explicitly... I don't see a call out in the Lean literature a conversation about acceptability and desirability. What I see is plenty of evidence of an acceptability-based quality mindset in Lean, in Six Sigma quality, in Lean Six Sigma, in Operational Excellence, in the Toyota Production System is what I see is a heavy emphasis directly about things being good versus bad. I don't see any inference to desirability that there's something beyond good in that system.   0:28:06.4 BB: And that's what I've been wanting to point out, is I think Dr. Deming's work is unique in its appreciation of that distinction in explaining the difference and the value of understanding when acceptability makes sense, when desirability makes sense. And that's what this whole Misunderstanding Quality series, a big part that I'm trying to introduce through my experiences is, if you're interested in moving your organization or just your personal awareness beyond a good mindset into continual improvement, that's what I'm trying to bring about in this series.   0:28:50.5 AS: Fantastic.   0:28:50.9 BB: That's my story, Andrew, and I'm sticking to it.   0:28:53.7 AS: Yeah. Exciting. Exciting. Well, Bill on behalf...   0:28:58.9 BB: It'll be on my tombstone, acceptability is not desirability.   0:29:01.7 AS: Yeah, exactly. We have accepted the death. It is acceptable. It's not desirable, but... On behalf of everyone at The Deming Institute, I want to thank you, Bill, for this discussion. Again, it's a fun one to hear what you're thinking about. And for listeners, remember to go to Deming.org to continue your journey. Any final thoughts Bill?   0:29:31.4 BB: Keep looking good Andrew, keep looking good.   0:29:34.0 AS: I wanna go beyond looking good. If you wanna keep in touch with Bill, just find him on LinkedIn. He responds. This is your host, Andrew Stotz, and I'll leave you with one of my favorite quotes from Dr. Deming. People are entitled to joy in work.

Lester Kiewit speaks to Zachary Rudolph, Environmental Health Practitioner, with the City Health Department, about the increase in applications for Certificates of Acceptability, which is required if you intend to manufacture, store, distribute, prepare, transport or sell any kind of foodstuff intended for public consumption. They discuss whether all shops – including small informal house shops – are subject to regulations.See omnystudio.com/listener for privacy information.

In this week's episode, we speak with Dr John Pierce from the Centre for Research Excellence in Aphasia Rehabilitation and Recovery at La Trobe University. He discusses what multi-modal treatment is, how it can be used as an aphasia treatment, and how it is being adapted for telepractice. Resources: Aphasia Therapy Finder: https://aphasiatherapyfinder.com/therapyprofile/20 Aphasia CRE: https://www.latrobe.edu.au/research/centres/health/aphasia Information on M-MAT Tele: https://www.mmat.rehab | https://www.latrobe.edu.au/research/centres/health/aphasia/research/technology Dr John Pierce: https://johnepierce.github.io AI images: https://johnepierce.github.io/AI_images.html Pierce, J. E., Hill, A. J., Wong, D., Pitt, R., & Rose, M. L. (2024). Adapting a group-based, multimodal aphasia treatment for telehealth – co-design of M-MAT Tele. Disability and Rehabilitation: Assistive Technology, 1–8. https://doi.org/10.1080/17483107.2024.2366423 Pierce, J. E., OHalloran, R., Togher, L., Nickels, L., Copland, D., Godecke, E., … Rose, M. L. (2023). Acceptability, feasibility and preliminary efficacy of low-moderate intensity Constraint Induced Aphasia Therapy and Multi-Modality Aphasia Therapy in chronic aphasia after stroke. Topics in Stroke Rehabilitation, 31(1), 44–56. https://doi.org/10.1080/10749357.2023.2196765 Rose, M. L., Nickels, L., Copland, D., Togher, L., Godecke, E., Meinzer, M., Rai, T., Cadilhac, D. A., Kim, J., Hurley, M., Foster, A., Carragher, M., Wilcox, C., Pierce, J. E., & Steel, G. (2022). Results of the COMPARE trial of Constraint-induced or Multimodality Aphasia Therapy compared with usual care in chronic post-stroke aphasia. Journal of Neurology, Neurosurgery & Psychiatry, 93(6), 573–581. https://doi.org/10.1136/jnnp-2021-328422 Speech Pathology Australia acknowledge the Traditional Custodians of lands, seas and waters throughout Australia, and pay respect to Elders past and present. We recognise that the health and social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples are grounded in continued connection to culture, country, language and community and acknowledge that sovereignty was never ceded. Free access to transcripts for podcast episodes are available via the SPA Learning Hub (https://learninghub.speechpathologyaustralia.org.au/), you will need to sign in or create an account. For more information, please see our Bio or for further enquiries email speakuppodcast@speechpathologyaustralia.org.au Disclaimer: © (2024) The Speech Pathology Association of Australia Limited. All rights reserved. Important Notice, Please read: The views expressed in this presentation and reproduced in these materials are not necessarily the views of, or endorsed by, The Speech Pathology Association of Australia Limited (“the Association”). The Association makes no warranty or representation in relation to the content, currency or accuracy of any of the materials comprised in this recording. The Association expressly disclaims any and all liability (including liability for negligence) in respect of use of these materials and the information contained within them. The Association recommends you seek independent professional advice prior to making any decision involving matters outlined in this recording including in any of the materials referred to or otherwise incorporated into this recording. Except as otherwise stated, copyright and all other intellectual property rights comprised in the presentation and these materials, remain the exclusive property of the Association. Except with the Association's prior written approval you must not, in whole or part, reproduce, modify, adapt, distribute, publish or electronically communicate (including by online means) this recording or any of these materials.

Is quality simply a matter of two categories: good and bad? But then how do you get to "better"? In this episode, Bill Bellows and Andrew Stotz discuss categories and continuum thinking. TRANSCRIPT 0:00:02.4 Andrew Stotz: My name is Andrew Stotz and I'll be your host as we dive deeper into the teachings of Dr. W Edwards Deming. Today I'm continuing my discussion with Bill Bellows who has spent 31 years helping people apply Dr. Deming's ideas to become aware of how their thinking is holding them back from their biggest opportunities. And today is episode six, Category Thinking and Continuum Thinking. Bill, take it away.   0:00:27.9 Bill Bellows: Welcome Andrew great to see you again. All right, so in podcast five, I went back and it was just posted by The Deming Institute. And I just wanna clarify again on the topic of acceptability and desirability. Where we're going tonight is looking at acceptability and desirability in a little bit more detail, a little bit differently, but those are still the prevailing themes. And again, I just wanna reinforce that none of this is to imply that desirability is better than acceptability. What's important is to be aware of when I'm using acceptability thinking. And when I'm using desirability thinking and use the one that makes the most sense in that situation. We were talking earlier about companies whose products we enjoy using and we're loyal to them. And I mentioned that my wife and I have developed a loyalty to Toyota products.   0:01:40.4 BB: Going back to 1989 was our first Toyota product. And I knew I wanted a pickup truck. 'Cause I was borrowing a pickup truck from a number of friends and I thought, I really like a pickup truck. There's a lot you can do with a pickup truck. So, I knew I wanted a pickup truck. And I knew from having worked in my father's gas station, I had reason to believe I wanted a Japanese pickup truck and not an American pickup truck. So, I then it was a question of is it a Mazda, Toyota.   0:02:11.1 AS: Nissan.   0:02:13.2 BB: Sorry Nissan. And I looked at all of them and yeah I just all I knew is I was gonna be one of those. And I think the major reason I went with... My wife and I went with a Toyota... I don't think the prices were that different. But it just had a, it was the styling was a little bit better. But I did not... That's why I bought it.   0:02:46.5 AS: The loyalty wasn't built yet.   0:02:49.0 BB: No I knew to stay away... I knew I had seen plenty of examples of... Well, I had traded in my first car that my father, my parents got me when I was in college was a 1975 Chevy Nova. Four door Chevy Nova. And the reason four doors is important is a... If it was a two door, the door would be longer. But it was a four door. By the time I gave that car to a friend, the engine was running beautifully but the body was falling apart. And, so, by the time I sold it to get the pickup truck, in order to get out of it, I'd have to throw my shoulder into the driver's door. Why? Because the door droop was so great that when you close the door, I mean the door drooped and this is not a four door, this is a two door. So, imagine if it was a two door the door would be even heavier. So, on a four door, the door drooped. And, so, when you closed it, you'd had to lift it and then close it in order to get out you had to... Oh, it's just my wife couldn't drive. It was just a nuisance.   0:04:17.6 AS: And, that in '75 was just about when the Japanese were really starting to go after the US car makers. And but I want to tell you just a quick one. I can't remember if I've told you, but I used to have a 1963 Lincoln Continental here in beautiful Bangkok. And I owned it for 10 years. And then eventually I sold it. But what a beautiful car. And people always ask me the same thing and they said, isn't it hard to take care of? And I said, you gotta remember back in those days, cars were simple.   0:04:49.1 BB: Yeah, yeah. So, the... So, with... So, the experience of 14 years or so, with the '75 Chevy Nova. And the door was like the straw that broke the camel's back. It just done with this, all right. So, we're gonna buy Japanese, bought a Toyota. That was the first one. And I think I've mentioned in the first podcast I mentioned that we had a 1998 Toyota Sienna, which is their first, it was their Toyota third attempt at a minivan. The first one I think was underpowered, the second one... And we knew we wanted a minivan. It was time, the kids were getting a little bit bigger. It was time for minivan. And just as we were ready to go buy it, they had a... I think a competitor came out with dual sliding doors. Dual sliding doors. And, so, instead of Toyota coming out with a one sliding door, they stepped back. I think Chrysler came out with two sliding doors. And they figured we can't come to market with one sliding door. They've got two sliding doors. So, then we waited another year and they finally came out and given all of our delight with the Toyota pickup truck, boom, that's what we wanted. And then the transmission failed, six months later with 10,000 miles in the car.   0:06:18.5 BB: And I have a photo of that. Not only did the transmission fail at 10,000 miles, but it failed on Christmas morning on our way to see friends about an hour away. And this guy, people were going to see, he knew I loved Toyota. And when he drove to pick us up, we transferred everything from that to his Ford F-150. He says to me... So, then we had to have the car towed on a flatbed to his house and the next day to the dealership, what a nuisance headache. But when he showed up, he looks at me knowing that I like Toyota. And he says, how's this data point change your theory about Toyota?   0:07:06.5 AS: I thought he was gonna say, if it was me, I would've said pop in the back.   0:07:12.6 BB: And I was like, yeah, that really hurts. Well when I shared that story with students at Northwestern's Business School, the Kellogg Business School, their advice and these are students that had worked in all different industries from Coke to banking, and a number of 'em have worked in the auto industry. And their advice was, I said, Professor Bellows never buy anyone's first model year, even Toyota. Now I have a friend who he and his wife bought the same model year Toyota Sienna. They did not have a problem.  Oe did. When I met at a Deming conference, a guy who worked in Georgetown, Kentucky which is where the Sienna was made. And, so, I met him at a conference and when he said he worked for Toyota, I said, oh, my wife and I buy nothing but Toyotas. He says, oh. And I said, we have a first model...   0:08:08.6 BB: Year Sienna. And everything was good. And then I'm thinking, I'm gonna ask the guy a question. And I looked straight in his eyes. We were pretty close together. And I'm about to ask him a question. I'm looking straight in his eyes and I said, we got a Toyota Sienna. He says, how do you like it? And I looked right at him and I said, the transmission failed at 10,000 miles. And he rolled his eyes. And I said, so, you know about this. It wasn't a look of shock. It was, yeah, all right. So, I said, all right, all right. Your expression just told me that you know something about this. I said, what's up? He says, we tried. This is so cool. He says, we tried to save a few pennies on a bearing.   0:09:00.8 BB: I said, you did but what you did cost me more than you saved. So, yeah you guys saved a few pennies on a bearing and cost my wife weeks of aggravation to have it towed from where it happened to the place we were going because it Christmas Day, it broke. Everything's shut down on Christmas days. You can't have it right? And, so, we had it towed, had to get a rental car. Then they're complaining about, we had... Who authorized this rental car? We only pay... It was just headache after headache. But we still buy Toyota Andrew. We still buy Toyota. Why? Because I'm afraid to buy from anybody else. Well, part of the reason I wanted to share that with our audience is I buy Toyota products based on value. And I believe that the best value we get in transportation, personal transportation is the money we spend buying a Toyota most often brand new. We've also bought some used, got great use out of them, never had a problem, anything like what I just shared with you. And that's having owned five or six different Toyotas. I mean, right now in our family we have three of them.   0:10:16.7 AS: I think I need to correct you.   0:10:19.1 BB: Go ahead.   0:10:19.9 AS: You buy Toyotas on value and values.   0:10:25.7 BB: Yes!   0:10:28.2 AS: You're aligned with their values and therefore you're willing to look beyond the mistakes and problems that it comes with every product, every service, every company, because you're aligned with their values.   0:10:42.2 BB: Well, what's funny is when we bought the Sienna and we're talking with 'em, doing the driving and signed agree to buy it, that's the color we want. We want these seats, blah, blah, blah. And then you go talk to the closer and the closer's a guy, the gal at the dealership that wants to add on the undercoating and the this and the this and the this and the this. And he wanted to sell us at a premium price, this extended warranty and I dunno what it costs, but I said, I've done a whole lot of research. And he says to me it's so funny. He says, when these things break down, a circuit board breaks and that'll cost you this and this and this, and, so, I'm gonna sign you up for the insurance policy, the extra coverage. And I said, no, and he is going on and on. And I said, look it, I've done a lot of research into how they're made and I said, and the values of that organization. So, I said, the reason we buy Toyota is that I have an understanding, a pretty damn good understanding of how they manage the product, the pieces and how it all comes together. And he's pushing back at me. Finally, I said, I teach university courses on how Toyota operates and their quality system.   0:12:14.8 BB: So, we didn't get the extra coverage. Now it was still covered under warranty, so, it was kind of laughable that. But anyways, the reason I bring that up is that...   0:12:27.3 AS: Before you do that, I want to just say for the listeners and viewers out there, what is the messaging from a corporate strategy perspective? And that is have values that you stand for. Communicate those to the market, stay loyal to them and the customers who align with those values will stick with you through the hard times that you're gonna definitely have. There's a quote by Alexander Hamilton says, "those who stand for nothing, fall for everything." If you do not stand for a clear set of values that the market can perceive, then people are gonna fall away from you as soon as times get tough.   0:13:07.2 BB: Oh yeah. And I...I, I. It's about that and that's why I've read lots about Toyota. How they operate written by people outside of Toyota trying to explain it, people inside of Toyota and their explanations. But part of the reason I bring this up is my fascination, my interest in Dr. Deming's philosophy, is a great deal to do with his system is based on an incredible appreciation of the difference between acceptability and desirability. All other quality management systems, whether it's the quality management within Lean is acceptability based, good parts and bad parts, Operational Excellence, Six Sigma Quality. In fact, there's a quote at the end of chapter 10 in "The New Economics". And chapter 10 was the original last chapter until the third edition came out. In which case there's chapter 11 written in large part by Kelly Allen, a good friend.   0:14:15.1 BB: And when chapter 10 was the end I thought it was pretty cool that at the very end of chapter 10. The last few pages of chapter 10 of “The New Economics” are about Dr. Taguchi's loss function. And this is what turned me on to Dr. Taguchi, was finding “The New Economics" in a brick and mortar bookstore. I knew from ASQ Quality Progress that this was coming out. So, I remember when it came out, this was before Amazon, going to the bookstore. Going through it and saying what does this guy think about Taguchi? Because Taguchi was my, the one I really idolized. And I opened it up and I turned to chapter 10 and it's all about the loss function, the problem and I thought this is way cool. So, the closing quote... The closing... The last sentence in chapter 10 which again was the original last chapter until third edition came out, is the following "Conformance to specifications," that's acceptability, "zero defects," that's acceptability. "Six Sigma quality," which is acceptability "and all other specification-based nostrums all miss the point, ,stated by Donald J. Wheeler."   0:15:42.6 BB: So, then I looked up, but what is a nostrum? And Dr. Deming not Dr. Deming a nostrum is defined as “quack medicine.”  So, "Conformance to specifications, zero defect, Six Sigma quality, and all other specification-based nostrums all miss the point." And, so, I wrote an article about this, gosh, 20 years ago. I said, what's the point? And my explanation, the point is, all of them are about managing parts in isolation. Looking at things in isolation. Again that's acceptability. And as I said earlier, I'm not saying acceptability is bad, I'm just saying acceptability is not desirability. And the other thing I wanna add is, why do I... My wife and I love Toyota products. I've got reason to believe through a lot of research and talking, sharing the ideas that we talk about in these podcasts with people within Toyota. And they have a desirability focus that nobody else... That I'm not aware of anybody else has.   0:16:54.9 BB: And, that's having presented around the world doing classes, at Kellogg Business School, at university. Yeah, the Kellogg Business School Northwestern University. I teach online classes at Cal State Northridge, Southern Utah University. I've lectured at many universities. And I never had anyone come to me working in industry saying, Bill, what you're talking about, we practice where I work. No. And, so, for those that are pursuing the Toyota Production System stuff. My response is, I don't buy Toyota products because they use the Toyota Production System. Now, that may help with getting the car to market faster. But I don't believe the Toyota Production System is why people buy Toyota products. I believe Toyota's quality management system... At least I buy Toyotas because I believe their quality management system, inspired by Dr. Taguchi, inspired by Dr. Deming, is providing something that nobody else has in many industries. All right. So, I wanted to get that out.   0:18:06.7 AS: So, are you saying Toyota Production System is more of a tool that is in their toolbox of quality management system?   0:18:18.4 BB: Um, the Toyota Production System is classic Industrial Engineering.   0:18:26.8 AS: Right.   0:18:27.0 BB: It's how to...   0:18:28.3 AS: It's a natural.   0:18:30.5 BB: How to improve flow, how to improve throughput by minimizing number of steps, by minimizing inventory. It's highly credited to Taiichi Ohno, who was mentored by the founder of the Toyota Motor Company. And it's all about, they don't have a lot of money. So, we need minimal inventory, minimum steps. So, it's like... So, the Toyota Production System is an efficiency based system based on, we don't have a lot of money, we're not gonna buy a lot of inventory. But the quality aspect of the Toyota Production System everywhere, everything I've written, everything I've read by people describing the Toyota Production System it's all explained by acceptability. So, that they may be moving things closer together so people don't walk so far.   0:19:27.8 BB: But what I'm looking at with Dr. Deming's work inspired by Dr. Taguchi is what is it about the quality system that causes those parts to come together so well and the products to perform so well? So, it's not just having the parts when I reach out, the part is there, but those parts integrate better. I've mentioned in the first podcast series that Toyota had 100% snap-fit pickup truck in 1969 at a time when Ford was banging things together using rubber mallets to get the parts together. They took apart and assembled a Toyota pickup truck twice 'cause they didn't believe the results the first time the parts went together without mallets. That's what I'm talking about, that within that system, the ability for the parts to come together to work together cannot be explained by an acceptability based system. And, so, having spoken with people and having the opportunity to share with people within Toyota the ideas we talk about inspired by Dr. Deming, I've learned that they do desirability in a way that nobody... I'm not aware of anyone else having done.   0:20:48.5 BB: All right, so, what I want to get into, add to the discussion tonight, relative to category thinking, is this idea of category thinking, continuum thinking. Category thinking quite simply is putting things in categories. So, in acceptability we have two categories, good or bad, or maybe three categories. It's good or it's scrap or it's rework. So, category thinking is generically putting things into categories. And so, we could look at category... Categories could be... There could be two categories, three categories.   0:21:27.1 BB: It's been a while since I've gone to see a movie, but I believe they still have a rating system of PG, PG-13, R, R-17, maybe X. Those are categories. Fruits and vegetables. Those are two high level categories. Within each of those categories, we have types of, we have apples and oranges, and within them we have types of apples. That's all category thinking. You go into a supermarket and every aisle... There's the cereal aisle. That's a category. There's the canned goods, those are categories. Religions - talk about categories. So, every religion you look at is its own category. And, then within those categories they have subcategories. How about music? How many categories in music are there Andrew?   0:22:18.9 AS: Well, it gets all messed up on my iTunes where I'm like, that's not heavy metal. That's rock.   0:22:28.6 BB: Yeah. And then there's types of rock. In the beginning it was rock and roll, and then there's types of rock and roll.   0:22:34.0 AS: Progressive rock.   0:22:34.0 BB: Progressive rock. And then we have people... So, what category would we put... I think somebody asked Lucinda Williams, we're going to see her in a few weeks. So, what category? Well, she doesn't fit a category. So, that's category thinking. Category thinking is putting things in categories. We could say, where did you go to college? That's a category. These are USC grads, those are Cal State grads. And, part of the point I want to make is that we use category thinking all the time. Putting people in categories is what we do. Such as you and our daughter are Cal State graduates.   0:23:17.6 BB: And, so, what degrees do they have? Those are categories. So, I don't know what we would do if we couldn't put things in the categories. So, I don't think category, putting people in category is not a bad thing. Now, when you start to associate values with the categories, now we're getting into racism or sexism and then, okay. But this idea that putting people in categories is a bad thing, I'd say category thinking is our simple way of organizing everything around us and these little file cabinets. Now added to that is when you put four or five things into a category, then what you're implying is that they're all the same. And that gets into acceptability.   0:24:12.8 BB: So, if this is a good part, that's a good part. That's a bad part. That's a good part. So, all the good parts go into the good part category. Then we say, oh, these are all good. Then we get into the sense of, and they're interchangeable. Well, maybe not. And that has to do with what I call continuum thinking. All right, so before we get to continuum thinking, Andrew, remember the question. What do you call the person who graduates last in their class of medical school?   0:24:43.3 AS: I don't remember that.   0:24:45.2 BB: Okay, so take a wild guess, Andrew, putting the pressure on, what do you call the person that graduates last in his or her class in medical school?   0:24:55.7 AS: Surgeon general.   0:24:56.9 BB: What's cool is that's a question I've been able to ask all around the world. Now, depending on where I go, I can't talk about baseball because they don't understand baseball. Or depending on where I go, I can't say soccer or I have to say football. Then if I say football, I have to say, well, I mean your football, not American football. But what's neat about this question, what do you call the person that graduates last in their class in medical school, that's "doctor." That's also acceptability thinking. From the first in class to the last in class, they all met requirements. Andrew, you know what that is? Acceptability. So, category thinking is a form... Acceptability is a form of category thinking. All right. Now I'm gonna give you three numbers and I'm going to ask you which two of the three are closest to being the same. You ready?   0:25:58.0 AS: Yep.   0:26:01.7 BB: 5.001, 5.999 and 6.001.   0:26:11.1 AS: 5.999 and 6.001.   0:26:17.6 BB: Are close to being the same?   0:26:18.8 AS: Yeah.   0:26:20.2 S3: That's what most people think. Okay. But...   0:26:25.7 AS: One's a six and one's a five. That's a problem.   0:26:29.5 BB: All right. And, so, again, the numbers were 5.001, 5.999 and 6.001. And the question is, which two of the three are close to being the same? And, what most people will say is 5.999 and 6.001, which infers that what does same mean?   0:26:48.5 AS: The integers?   0:26:49.1 BB: If you answered.   0:26:49.9 AS: I looked at the integers at the end rather than the whole number at the beginning.   0:26:56.7 BB: But is it safe to say you chose those numbers by saying they were closest together?   0:27:01.6 AS: Correct. Yes.   0:27:03.2 BB: So, in your case you're saying, if I plot those numbers from zero to infinity. Then those two are really close together. That's one definition of same is proximity. But, same could also be, they begin with five, in which case the first two are close to being the same. 'cause they both begin with five or they're both less than six. Or, I could say 5.001 and 6.001, because they both end in .001. So, it turns out there's three answers to the question. But the answer of the last two and proximity is what category is what continuum thinking is about. On a continuum these two are closest together. All right.   0:27:51.2 AS: And I have to tell you, we're gonna be running out of time, so we gotta wrap this up.   0:27:55.4 BB: All right. So, when I asked you the question, what do you call the person who graduates last in their class of medical school? And you said doctor, that's category thinking. If you used... Well actually the thing is, if I ask, what do you call the person who graduates last in their class at the United States, US Army's Military Academy, known as West Point, one answer is Second Lieutenant. 'cause they're all Second Lieutenants. But West Point uses continuum thinking to define the very last person in their class. So, it's the last person in class is not called second lieutenant. The last person in the class is called goat, as in the animal.   0:28:43.2 BB: And a very famous goat at West Point, who from my reading, was very proud to have graduated last because there's... I think Mike Pompeo, who was Secretary of State under president Trump, was first in his class at West Point, first in his class. A very famous, I wanna be the last person in my graduating class at West Point was George Custer. You've heard of him?   0:29:14.3 AS: Yep.   0:29:15.5 BB: And, he was deliberately lazy, so he wanted to be the very last person in his class. But that's, but the idea is that category thinking says they're all Second Lieutenants, they're all doctors. Continuum thinking is when you say this is the first, this is the second, this is the third. And when you come up, when you start to order them and say, the last one is goat, that's looking at things on a continuum, which is continuum thinking. Well, given that most quality systems, including Boeing's Advanced Quality System, are based on category thinking and category thinking, you have good parts and bad parts. When I ask a question as I brought up in the podcast five. I said I go to audiences and ask, how much time do you spend discussing parts which are good, that arrive on time? And the answer is none. And I say, well why is that? 'Cause in that system they're focusing on taking things from bad to good. And then what? Stopping at good.   0:30:20.0 BB: Well, part of the thing I wanna get across in this episode is the reason we're stuck in that model of stopping at good is because the quality system is based on category thinking of bad and good. And in a world of good and bad, there is no better. In a world of short and tall, there is no taller. And, so, continuum thinking allows us to go beyond that. And, so, going back to Dr. Deming's quote, conformance requirements, which is category thinking, zero defect, Six Sigma quality, those are all category based systems, which means it's good parts and bad parts. But then I come back to how does a system which is based on good parts and bad parts deliver such incredible reliability in the products? And, I believe it's because they're using continuum thinking. Not... And again not continuum thinking everywhere, but I think they have very judiciously figured out where to use continuum thinking and that is their differentiator. In my admiration for Dr. Deming's System of Profound Knowledge is, I've not come across any other type of management theory, which has that level of fidelity to explain that. And, in order to practice continuum thinking, implement it, you have to work together.   0:31:43.9 AS: And I'm gonna wrap this up by... One of the revelations that I come upon when I listen to what you're saying is. That's also what makes Deming's teachings sometimes hard to grasp, because there is no clear category and there is no clear beginning and end. There is no certification and therefore it's just hard for us who are used to being in categories to grasp. And that's my conclusion what I draw from everything you've just said.   0:32:16.6 BB: Well and let me add to that, really appreciate you saying that. Let me add to that,much of what I was doing at Rocketdyne... When I began to appreciate that the reason I was focusing on solving problems, solving problems and the problems we didn't solve were the problems where the customer, NASA said, we're gonna take this work and take it to the company down the street because you guys can't make it happen.  And, that scared the hell out of me that we're gonna lose this work to competitors because... And when I looked at it, was why are we stuck?  And I looked at Dr. Deming's work, the reason we're stuck is we're... 'cause our quality system is based on good parts and bad parts. We're waiting for trouble to happen. And, so, but still what I found is, and when I started to focus on... I went from being 100% Taguchi to more about Dr. Deming's work and trying to come up with everyday examples to make Dr. Deming's work more accessible.   0:33:16.9 BB: So, in Dr. Deming's work, you're not gonna find category thinking, continuum thinking. So many of the concepts we talk about in this series, in the prior series are... I refer to them as InThinking Concepts, just trying to make it easier for people to begin to absorb the brilliance of Dr. Deming's work. Because, I think absent that, when he says quality, what kind of quality is he talking about? Acceptability quality, desirability quality. So, I'm with you, I think the work is brilliant. I'm just hoping through our conversations and these podcasts that we can make his work far more accessible.   0:33:56.4 AS: Yep. Well, I think we're doing that. And Bill, on behalf of everyone at The Deming Institute and the audience, I wanna thank you again for this discussion. For listeners, remember to go to deming.org to continue your journey. Of course, if you wanna keep in touch with Bill, just find him on LinkedIn. This is your host Andrew Stotz. And I'm gonna leave you with one of my favorite quotes from Dr. Deming. "People are entitled to joy in work."

Dreaming of the American Dream? If you're a Brazilian citizen looking to obtain a US green card, there are three KEY things you absolutely must know. Don't navigate the complex immigration process alone, I'll break down these crucial details to make your journey smoother. Timestamps:  0:00 - Introduction: Important Green Card Information for Brazilians 0:06 - Overview of Key Sections 0:08 - Preparing for the Green Card Process 0:09 - Meet Immigration Lawyer John Khosravi 0:13 - Starting with Number One 0:15 - Common Problems with Brazilian Cases 0:18 - Different Ways Brazilians Get Green Cards 0:21 - Importance of Documents 0:24 - Requirement of a Birth Certificate 0:28 - Issues with Birth Certificates in Brazil 0:31 - Variations in Birth Certificates 0:33 - Common Issues with Document Updates 0:34 - Abridged vs. Unabridged Birth Certificates 0:38 - Grandparents Listed as Parents 0:42 - Importance of Unabridged Long Version 0:47 - Handling Marriage and Divorce Records 1:00 - Document Updates and State-Specific Issues 1:11 - Importance of Accurate Divorce and Marriage Records 1:16 - Need for Original Documents and Certified Copies 1:23 - Police Certificates for Green Card Applications 1:26 - Federal and State Police Certificates Requirements 1:37 - Variations in State Documents 1:44 - Common Document Issues in Brazil 1:50 - Familiarity with Commonly Seen Documents 1:54 - Importance of Marriage Records 2:07 - Marriage Green Cards and International Marriages 2:11 - Registering Divorces in Brazil 2:21 - Alternatives to Getting Married in Brazil 2:26 - Benefits of Getting Married Online 2:33 - Simplifying the Marriage Process 2:37 - Common Law Marriage Recognition 3:01 - Summary of Document and Marriage Issues 3:04 - Common Law Marriage and Stable Relationships 3:18 - Acceptability of Common Law Marriages 3:21 - Final Tips and Advice 3:24 - Additional Information and Resources 3:30 - Handling Misspelled Names and Late Registrations 3:31 - Common Issues with Birth Certificates 3:38 - Impact of Delayed Birth Registrations 3:43 - Tourist Visa Issues and 90-Day Rule 4:03 - Tourist Visa to Green Card Concerns 4:08 - Misuse of Tourist Visas 4:11 - Potential for Fraud or Misrepresentation 4:17 - Importance of Proper Intent 4:33 - Medical Requirements for Brazilian Green Card Applicants 4:36 - Panel Physician and Tuberculosis Testing 5:03 - Additional Medical Tests and Issues 5:07 - X-Rays for Tuberculosis 5:12 - Handling Medical Tests for Pregnant Clients 5:21 - Avoiding Unnecessary Medical Tests 5:26 - U.S. Agreements with Other Countries 5:32 - E-2 Treaty Investor Program 6:09 - Dual Citizenship and Business Investment Options 6:18 - Other Visa Options and Business Investment 6:24 - Final Thoughts and Encouragement 7:02 - Contact Information and Resources 7:19 - Summary and Closing Remarks 7:27 - Encouragement for Brazilians Considering the U.S. 7:32 - Additional Resources and Contact Details 8:02 - How to Get in Touch with John Kasra 8:07 - Closing and Best Wishes

We're continuing Supervision September with a look into the future of supervision: Remotely supervising others from the comfort of your own home. Or, at least, it seemed like a futuristic skill five or six years ago. But even though we're all comfortable with Zoom-ing into an appointment, does that make us capable of effectively supervising staff and trainees using the same modalities? We look at some of the common barriers encountered in remote supervision work, some solutions to overcome them, and some tips for how to bring everything together to create meaningful and effective supervision activities. This episode is available for 1.0 SUPERVISION CEU. Articles discussed this episode: Simmons, C.A., Ford, K.R., Salvatore, G.L, & Moretti, A.E. (2021). Acceptability and feasibility of virtual behavior analysis supervision. Behavior Analysis in Practice, 14, 927-943. doi: 10.1007/s40617-021-00622-3 Sipila-Thomas, E.S. & Brodhead, M.T. (2024). A survey of barriers experienced while providing supervision via telehealth: Implications for future research and practice. Behavior Analysis in Practice, 17, 70-86. doi: 10.1007/s40617-023-00860-7 Ninci, J., Colic, M., Hogan, A., Taylor, G., Bristol, R., & Burris, J. (2021). Maintaining effective supervision systems for trainees pursuing a behavior analyst certification board certification during the COVID-19 pandemic. Behavior Analysis in Practice, 14, 1047-1057. doi: 10.1007/s40617-021-00565-9 Fronapfel, B.H. & Demchak, M. (2020). School's out for COVID-19: 50 ways BCBA trainees in special education settings can accrue independent fieldwork experience hours during the pandemic. Behavior Analysis in Practice, 13, 312-320. doi: 10.1007/s40617-020-00434-x If you're interested in ordering CEs for listening to this episode, click here to go to the store page. You'll need to enter your name, BCBA #, and the two episode secret code words to complete the purchase. Email us at abainsidetrack@gmail.com for further assistance.

Major David Phillips discusses his article on the feasibility, acceptability, and suitability of redeploying non-strategic nuclear weapons to South Korea. He highlights the need for the US to re-examine its policy goal of achieving denuclearization of the Korean Peninsula and suggests that the redeployment of nuclear weapons would strengthen deterrence and assurance in the region. He emphasizes the importance of fully informed conversations among US policymakers and the need for bold action to ensure strategic stability in East Asia.Major David Phillips (Jobs) is a Nuclear and Missile Operations Officer in the United States Air Force, current student at the School of Advanced Nuclear Deterrence Studies (SANDS), member of the Center for Strategic and International Studies (CSIS) Mid-Career Cadre, and former Nuclear Scholar with the CSIS. His latest nuclear policy research, “Nuclear Redeployment: A Roadmap for Returning Nonstrategic Nuclear Weapons to the Korean Peninsula,” examines the feasibility, acceptability, and suitability of the United States returning nuclear weapons to the Republic of Korea; this research was nominated and selected for the 2024 General Larry D. Welch Deterrence Writing Award. David has over 9,000 nuclear command and control alert hours in support of our national defense and strategic deterrent across three nuclear weapon platforms. He holds a Master of Business Administration degree and Bachelor of Science degree in Biology from the University of Denver as well as a graduate certificate in Great Power Competition from the Naval Postgraduate School. His areas of focus include nuclear weapons policy, Great Power Competition, Nuclear Command and Control, and the Korean Peninsula.Chapters00:00 Introduction and Congratulations on Winning the Larry D. Welch Writing Award02:06 Motivation Behind the Article: The Dangerous Situation on the Korean Peninsula04:18 Main Findings: Feasibility, Acceptability, and Suitability of Redeployment06:48 Costs and Affordability of the Redeployment Proposal08:49 US Policy and the Acceptability of Redeploying Nuclear Weapons11:20 Suitability of Redeployment as a Solution to Deterrence Challenges23:35 Re-examining US Policy on Denuclearization of the Korean Peninsula29:59 Taking Bold Action for Strategic Stability in East AsiaSocials:Follow on Twitter at @NucleCastFollow on LinkedIn: https://linkedin.com/company/nuclecastpodcastSubscribe RSS Feed: https://rss.com/podcasts/nuclecast-podcast/Rate: https://podcasts.apple.com/us/podcast/nuclecast/id1644921278Email comments and topic/guest suggestions to NucleCast@anwadeter.org

Oh, snap! It's Supervision September! An entire month of episodes dedicated to improving our ability to supervise using the best behavior analysis and management trainings have to offer. Seriously, if you listen to every episode this month, you'll meet your minimum bi-annual supervision CE needs! And this cycle, every supervision topic has NEVER BEFORE BEEN DISCUSSED (by us). We're talking remote supervision. We're talking compassionate care supervision. We're talking discipline in supervision. PLUS the Girl's Squad takes over with Rob still sick in bed. Articles for September 2024 Training Supervisees in Compassionate Care Practices Canon, L.F. & Gould, E.R. (2022). A preliminary analysis of the effects of clicker training and verbal instructions on the acquisition of relationship-building skills in two applied behavior analysis practitioners. Behavior Analysis in Practice, 15, 383-396. doi: 10.1007/s40617-021-00555-x Rohrer, J.L. & Weiss, M.J. (2023). Teaching compassion skills to students of behavior analysis: A preliminary investigation. Behavior Analysis in Practice, 16, 763-782. doi: 10.1007/s40617-022-00748-y Denegri, S., Cymbal, D., & Catrone, R. (2023). A multilevel framework for compassionate care in ABA: Approaches to cultivate a nurturing system. Behavior Analysis in Practice. doi: 10.1007/s40617-023-00828-7 Remote Supervision Simmons, C.A., Ford, K.R., Salvatore, G.L, & Moretti, A.E. (2021). Acceptability and feasibility of virtual behavior analysis supervision. Behavior Analysis in Practice, 14, 927-943. doi: 10.1007/s40617-021-00622-3 Sipila-Thomas, E.S. & Brodhead, M.T. (2024). A survey of barriers experienced while providing supervision via telehealth: Implications for future research and practice. Behavior Analysis in Practice, 17, 70-86. doi: 10.1007/s40617-023-00860-7 Ninci, J., Colic, M., Hogan, A., Taylor, G., Bristol, R., & Burris, J. (2021). Maintaining effective supervision systems for trainees pursuing a behavior analyst certification board certification during the COVID-19 pandemic. Behavior Analysis in Practice, 14, 1047-1057. doi: 10.1007/s40617-021-00565-9 Fronapfel, B.H. & Demchak, M. (2020). School's out for COVID-19: 50 ways BCBA trainees in special education settings can accrue independent fieldwork experience hours during the pandemic. Behavior Analysis in Practice, 13, 312-320. doi: 10.1007/s40617-020-00434-x Discipline Without Punishment Book Club Grote, D. (2006). Discipline without punishment: The proven strategy that turns problem employees into superior performers (2nd edition). Amacom.

Continuing their discussion from part 3 of this series, Bill Bellows and Andrew Stotz talk more about acceptability versus desirability. In this episode, the discussion focuses on how you might choose between the two. TRANSCRIPT 0:00:00.0 Andrew Stotz: My name is Andrew Stotz and I'll be your host as we continue our journey into the teachings of Dr. W. Edwards Deming. Today, I'm continuing my discussion with Bill Bellows, who has spent 31 years helping people apply Dr. Deming's ideas to become aware of how their thinking is holding them back from their biggest opportunities. Today is Episode 4 of the Misunderstanding Quality Series, and the title is Quality, Mind the Choices. Bill, take it away.   0:00:31.3 Bill Bellows: All right, Andrew, welcome. So podcast three, I think the title was Acceptability and Desirability. And one correction there, when I went back and looked at the transcript the concept of... At least the first person I heard tie together acceptability, desirability, at least in the Deming community, was a professor, Yoshida, Y-O-S-H-I-D-A. He was a PhD student of Dr. Deming, I believe at NYU but I mispronounced or misspelled his first name. I thought I've heard people refer to him as Kauro, perhaps spelled K-A-U-R-O, maybe that's his nickname, and maybe I just didn't remember properly but his proper first name is Kosaku, K-O-S-A-K-U and he at one point in time was in Greater Los Angeles at Cal State Dominguez Hills. And then I think sometime in the mid '90s, early '90s, last I heard he moved to Japan.   0:01:51.1 BB: I've never met him. I've watched videos of him, there's a classic presentation. I don't know if it's got, it might be online someplace of he did a guest lecture. There was a... Dr. Deming was speaking in Southern California and needed an emergency surgery, had a pacemaker put in, so this would've been '92 timeframe. And Professor Yoshida was called in to give a guest lecture. And that ended up being something that I think was sold eventually. The video, the lecture was sold by Claire Crawford Mason and so he is... I don't know how much of that is online, but anyways.   0:02:38.4 AS: Is Kauro, Kauro wasn't that the name of Kauro Ishikawa?   0:02:43.7 BB: That may be where I... Yes that was a Kauro. There's two Ishikawas. There's a father and the son and I... So I'm not sure if Kauro was the father or the son, but anyway correction there. In the first series we did, going back to '23, 2023, I mentioned the name Edgar Schein, but I don't believe I've mentioned his name in this series. So I wanted to throw that, introduce that in this series today and give some background on him for those who have not heard his name or not aware, did not listen to the first series and Edgar Schein, who passed away January of this year. He was an organizational theorist, organizational psychologist, spent the greater part of his career at MIT. And one of the concepts I really like about what he talked about is looking at an organization in terms of its artifacts. So if you walk around an organization, what do you see? What are the artifacts? That could be the colors, it could be the artwork on the wall, but the physical aspect of the organization Schein referred to as the artifacts. And what he also talked about is if you dig beneath the artifacts, they come from a set of beliefs, and then the beliefs come from a set of values.   0:04:23.9 BB: And again, the first series we did, I talked about Red Pen and Blue Pen Companies, and Me and We Organizations, and Last Straw and All Straw organizations. And those titles should make it easy for our listeners who are not aware to go back and find those. And what I talked about is, this imaginary trip report, if you visited a Deming organization, if we could think in terms of two simple organizations, a Deming organization, and a non-Deming organization in this very simple black and white model. And I had people think about the physical aspects of both, if they were to go visit both. What I then followed up on in our conversation is what you see physically comes from a set of beliefs. Now, they may not be articulated beliefs, what Schein would call espoused beliefs. And then you have what they really believe and I forget the term, I use this for that, but it comes from a set... But anyway, the physical comes from the beliefs, the beliefs come from the values.   0:05:39.0 BB: And part of the reason I bring that up for our listeners, and I'm thinking in terms of the people that have a responsibility in their respective organizations. They could be consultants, internal consultants, working in quality likely, given the focus of this series. First of all, you have to start where you are. But even added on, included in start where you are, is you have to start where your management is. So, if your management is tasking you with an improving scrap and rework, then that's what you better be talking about. Now, you don't have to be guiding your actions based on acceptability because the other aspect is scrap and rework are typically associated... Well, not typically, they are associated with acceptability. The lack of acceptability, acceptability is the idea that this is good, it is acceptable, it meets the requirements, defines...the quality requirements that are defined.   0:06:52.0 BB: If it's good, it is acceptable, if it's bad. There's two categories of bad, bad could be I have to throw it away, that's scrap, which means I can't recover it or rework, which means I can do something with it and perhaps salvage it. And so if your management is tasking you with improving scrap and rework, then first of all, where they're coming from, quite naturally, is acceptability. And why do I say that? Because everywhere I've gone, that is the deepest foundation of quality in every organization I've ever met, worked with, I have met people that work from whether it could be... Whether it's clients that I've worked with, whether it's students, my university classes. Acceptability, scrap, and rework, all go together. And, so if that's where your management is, then they're asking you to focus on improving acceptability.   0:08:05.6 BB: But, you may find it invaluable to shift your focus to desirability to improve acceptability. And that will be a focus, well I get into some of that tonight and others or today, and then on a future podcast later. But, I remember once upon a time at Rocketdyne, the executives were, the VP of Quality was task master asking for improvements to scrap and rework and also things called process capability indices, Cp's and Cpk's. And if you've heard of a Cp or a Cpk, great, if you haven't all I could say is I find them dangerous. I find them, well I say they're all about acceptability. And what makes it, reason I would encourage people to stay away from them because they appear to be desirability, but they're really acceptability.   0:09:15.7 BB: We'll save that for later. But anyway you have to start where they are. So if people are asking for improvements in scrap and rework, then, instead of fighting them, you go with it. And then what we'll be talking about tonight is, is it worthwhile to shift? Well, what does it mean to improve acceptability and the difference between acceptability and desirability? And relative to the title tonight, Mind the Choices is being aware that there's a place for acceptability and there's a place for desirability. And going back to Yoshida in episode three, what I was referring to is, in presentations he was doing from the early '90s, maybe even going back to the '80s, he talked about Japanese companies are about desirability. So, he presented this model of acceptability and desirability. And then, his explanation of what makes Japanese companies, again, back in the '80s, Japanese companies were viewed as those setting the quality standards.   0:10:20.5 BB: And, he was trying to say that the way they're doing that is that they don't rely on acceptability as other companies in other countries do. They have a higher standard. And that's what I wanted to introduce in our last episode, Episode 3. And, what I wanted to do tonight in this Episode 4, is to put some, add some more to that. But, also reinforce I'm not saying that there's anything wrong with acceptability, it's a question of what does the organization need at that point of time? And, really it has to do with... Really, it has to do with how big a system you wanna look at. So if you're looking at something in isolation, which is, I mean, when you look at something and saying it's good or bad, that is the epitome of looking at something in isolation.   0:11:17.5 BB: You're looking at a pen and saying it's good. You're looking at the diameter of a hole and saying it's good. That is not looking at what goes in the hole, that is not looking at how the pen is being used. So by definition, that's what Ackoff would call analysis, which is looking inward. It's not what Ackoff would call synthesis, which is looking outward. And how far outward you look is all according... I mean you could look, it comes down to how big is the system. And I wanna introduce the name Shel Rovin, Sheldon was his full name. Shel was his nickname. I met Shel through Russ Ackoff in 2006. Shel was, he was in charge of the Chief Nursing Officer program, which was a two-week immersion program at the University of Pennsylvania.   0:12:14.5 BB: And he was doing that in the, 2003, 4, 5, timeframe when I met him. And Shel was a dentist by background. He was Dean of the School of Dentistry at University of Kentucky and University of Washington. And I met him through Russ and invited him to Rocketdyne on numerous occasions. And Shel spoke about relative to looking at a system, 'cause people talk about, well "Andrew, we've gotta look at the whole system," but how big is the system? And, so people say, well, systems thinkers look at the whole system. Well, how big is that? Is that 1,000 foot view? And people say, oh no, Bill, it's bigger than that. Is it a 10,000 foot view? Is it... How big is the system? Well, Shel's perspective, and the word I wanna introduce from Shel is relative to systems is boundarylessness.   0:13:12.7 BB: Say that a few times fast. 'Cause systems have no boundaries. So I'm sure our listeners... I'm sure you have heard, I don't if our listeners have all heard, Dr. Deming would say to executives, does your system include the future? He used to ask questions such as what business are you in? What business will you be in five years from now, 10 years from now? Well, why not 15 years from now? Why not 25 years from now? Native American Indians, associated with Native American Indians is the idea of looking at the seventh generation after you when you're making choices. And so what I would ask people is, well, why seven? Why not eight? Why not nine? Why not 10? I mean, within an organization, we could be working with our supplier to try to get across these quality ideas to our suppliers.   0:14:05.5 BB: Well, that's looking at the system. Well, wait a minute. Do our suppliers have suppliers? Yes. Do their suppliers have suppliers? And so relative to boundarylessness is this idea is when people start talking about the whole system, I don't know what "whole" means. What I'd rather look at is what size system are we looking at? That's a choice. That's a choice. So we could decide to look at our suppliers. We're gonna go one step, we're gonna look at procurement. Who do we buy from? Now, we may educate them and give them the responsibility of looking at their suppliers on... But that would be a way of managing quality. Likewise, we can look at the impact of our work on our customer and give them heads up as to how to look at the impact of their work on their customers. But that's looking at the system in an X, Y, Z, physical coordinate, add onto that, the time dimension. And so, again, all I wanna throw out there is that when it comes to making choices on acceptability, desirability, a lot of it has to do with how big is the system that we're looking at. Some everyday examples of acceptability.   0:15:23.5 BB: Again and what I wanna get across is, in part the difference to help people make choices. And so when we were on a vacation in Europe recently, I took a number of photos of people making choices. And,` when I travel, anywhere I travel, especially out of the country, I love walking into supermarkets just to see what they sell that perhaps is not sold in the States or in California. I know there are things you can't find in California that you can find on the East Coast. That's one thing. But I like going into supermarkets just to see what products are there. I mean, you can go to England and find in the refrigerator section, hard cider, apple cider, you know, alcoholic cider that I got exposed to going to a Deming conference in 2000. I've become a fan of it ever since. Well, in the States it's pretty hard to find hard cider, period. You go to England and you'll find, a dozen different brands and each brand may have a number of different types.   0:16:44.9 BB: And so that's, but anyway, relative to that when you walk into a supermarket, if you're looking at canned goods, or just look, well, looking at cider, we can look at this cider versus that cider. We treat a can as a can, whether it's buying tomato soup or cider, we treat all those cans as interchangeable, interchangeable parts. But when we go to into the bakery section, that's where I was taking photos in Amsterdam and I was watching people sort through the pastries. And yet what was laid out were a bunch of pastries of the same style. And yet people were, I want this one, I want that one.   0:17:26.0 BB: Well, part of acceptability is treating all those pastries as the same as we would treat all those cans of tomato soup as the same. Now relative to tomato soup I know you live with your mother, and I'm willing to bet your mom, early, early on when she took you to the supermarket, taught you how to buy canned goods, right? And she says "Andrew when you buy a can of something you pick it up, you're looking for dents," right?   0:17:55.1 AS: Mm.   0:17:56.0 BB: Because if it's dented, that's bad. And if it's not dented, that's good. I know my mother taught me that. So I know when it comes to buying canned good we look for dents. If dented, that's bad. If it's not dented, it's acceptable. But I don't see people sorting between cans of tomato soup made by the same manufacturer. They're just, we treat it as they're acceptable. Acceptable implies either one, the differences don't matter or I don't see differences.   0:18:33.0 BB: Desirability is, you wanna see a great example of desirability, go to the produce section and again, either watch people sort through pastries that are all acceptable, and yet they're looking for the biggest one, or... And when it comes to fruit, we're looking for the ripest banana, or maybe we're looking for bananas that are green because we're not gonna use them for a while. So acceptability, again, I'm trying to give everyday examples of acceptability is going in and saying, looking at all the fruit there, and just taking five peppers, whatever it is, and throwing them in the bag and saying, I need five 'cause my spouse said, go get five. And I throw them in the bag. And it could be time-wise, I don't have time to sort through them, or I quite frankly don't care that they're different. That's acceptability. So acceptability is either acknowledging they're different and saying, I don't care. Or...   0:19:29.6 AS: Seeing them as the same.   0:19:32.4 BB: Or pretending they're all the same. And I had a guy in class years ago, and I was asking about buying fruit and I was trying to use the example of we go into the supermarket. We sort through the oranges looking for the ripest one, and this guy says, well, I don't sort through the oranges. I said, well, how do you buy the oranges? I buy them by the bag. I said, do you sort between the bags? He says, no, I don't sort and his arms were crossed. I don't sort, I don't sort. So then I noticed that he had a ring on his left hand, a wedding ring on his left hand. So I said, I see you're wearing a wedding ring. And he said, yep. I said, did you sort?   0:20:15.2 AS: I don't sort.   0:20:15.3 BB: Meaning... I don't sort. And so when you're looking at things that meet all the requirements and saying there is no variation or the variation doesn't matter, that's acceptability, Andrew. When you look at all the things that meet requirements and you see them as being different and saying, I want this one, that's desirability. And so that could be, when it comes to selecting a spouse, when it comes to selecting an orange, when it comes to selecting a parking spot, in a university, you're looking for the, an ideal, the best professor for Thermodynamics II, and there's 10 professors the university says are acceptable. And you talk to classmates and you find out, oh, no, no, no, stay away from that one. What are you doing? You're sorting amongst things that meet requirements, that are acceptable and saying, that's not good enough for me in that situation.   0:21:17.2 BB: Well, what I wanna say then added to that is, this is not to say desirability is better than acceptability. It really comes down to is desirability worth the effort? Because when it comes to desirability, I am looking beyond, I'm looking at a bigger system. So I'm looking at the fruit in terms of how I'm using it. If I'm aware of that, I'm looking at the parking spots in terms of: I'm gonna be in the store for an hour and I want the most shade, or these parking spots have a little bit different distances between cars, and I want a spot with a little bit more width so somebody doesn't ding my car. So what I'm hoping is with these examples, people can appreciate that every day we make choices between acceptability and desirability.   0:22:11.3 BB: Every day we're making a decision based on saying, this is okay, code word for acceptable, or I'll take that one, that's desirability.   0:22:27.6 AS: That's quite a breakdown.   0:22:28.1 BB: Well, and the idea being... The other aspect of it is when you're choosing to say, I want... When you decide that acceptability is not worthwhile, my proposal it's because you're looking at a bigger system. You've got a bigger system in mind. You're not looking at that fruit in isolation. You are somehow saying, there's something about how I plan to use that, which is the reason for this decision. And then it gets into how big is the system that you're looking at? Are you looking at the person downstream of you at work, which that could be an internal customer. People used to use those terms. Are you looking at the person after them, two down from them, three down from them? And that gets into a choice. So what I would tell the folks I was mentoring at Rocketdyne is that they were designing things or going to see how they were used. And I'd say, first of all, nothing requires you to go see how that's used. Your job as a designer, whatever it is in engineering you design it, you give it to manufacturing. But you don't have to go downstairs and see how they're using it.   0:23:47.5 BB: I said, but if you do, you might learn a lot. And then they might say, "well, so I should go talk to the person who's first using it." Well that might be helpful. And then what about the person after that? Well, that might be helpful. And then what about the person after that? Well, that might be helpful. And I was trying to get across to them, we hire really bright people and if we just turn you down to don't look beyond, just deliver the thing, complete those drawings, do whatever it is, pass it to the next person. I said, the system may not require you to go look to see how it's used.   0:24:31.9 BB: But what Dr. Deming is proposing is, the better you understand how it's used, the better you can serve the system. But then you get into the question of how big is the system that you want to be thinking about? And there I would tell them that there's no right answer. I mean, you wanna be and this is what I would tell them is we hire really bright people and then we condition you to believe that it doesn't matter. What I'm proposing guided by Dr. Deming is that there's a possibility that it matters anywhere from a little to a lot, but you won't know unless you go look.   0:25:12.2 AS: Yeah. It's funny.   0:25:12.3 BB: And so what I wanna get... Go ahead Andrew.   0:25:14.4 AS: When I was a supervisor at Pepsi in Los Angeles at our Torrance factory, they asked me to help... Could I figure out how to quicken the pace with which we got 80 trucks or 100 trucks out the gate every morning because it mattered. If you got trucks out an hour late on the LA freeways, now you have overtime and all kinds of trouble. So, what I did is I climbed up... At 4:00 AM I climbed up on top of a building, one of our buildings.   0:25:54.1 BB: Wow.   0:25:54.9 AS: And I had a clipboard, which I always have. I have extra clipboards always with me, here's one right here. And I had paper and then I just observed, and I took a lot of notes. And what I was seeing was all these drivers were, they were checking their trucks and they were spending a lot of time with their trucks. So, after I observed it that morning, the next morning I went down and went around and I asked them, what are you doing? And they said, well I'm checking that the quantity that's on the paper is the quantity that's on the truck. And I said, how could that not be? And they said, the loaders at night don't fill it up right. So, the next night I went and talked to the loaders and I said, drivers are saying that you guys are making errors.   0:26:40.4 AS: No, we're not making any errors. Okay. So, now I gotta dig deeper into the loaders. And then I start to see, okay, the loaders are making errors. So, I went and talked to one loader and said, why are you making this error? He said, well, the production are supposed to put this particular Pepsi item in this spot. But they didn't, they put it in another and I got confused, but it's just 'cause it's normally always there. So, I go to talk to the manufacturer, hey guys come on, why did you put that stuff in the wrong spot? He said, well, sales told us to produce so much that we were overloaded. We didn't have any place to put all of this products. So, we had to basically put it anywhere we could as it's racing off the line and on and on.   0:27:27.9 AS: And then you start to realize like, okay, the system is bigger. Now I went and focused on the loaders and said, how do we make sure that when the loaders load that we can lock the truck and then tell the drivers, you must not open this truck. How do we build the trust between the loaders and the drivers that they're loaded correctly and that they can go, because the drivers don't want to get to San Bernardino or wherever they're going and find out, oh, I don't have what this particular customer wanted and it's supposed to be on here. So that's just a little bit of a picture of kind of a very narrow start that starts to bring in more of the system.   0:28:06.8 BB: Oh, yeah. Oh, that's a brilliant example. And also what you're talking about is a term we used the first series, which is the value of synchronicity. That those handoffs are smooth. And they disrupt...   0:28:26.7 AS: I love that word handoffs, by the way. I was just talking with a client of mine. We were talking about the core processes of the business. And I just now realize that what I was missing and what we were missing in our discussion was how do we make sure that the handoffs work.   0:28:43.6 BB: Well, then the other thing, again a concept you may recall from the first series is, I liken it... I think in terms of two types of handoffs. And, actually, I think in one of the first, maybe in the second episode we talked about this, is associated with acceptability. When I hand off to you something, my report, whatever it is I'm assigned to delivered to Andrew by 5 o'clock tomorrow, you look at it, you inspect it, and you're making sure before you accept it that it is acceptable, that it has all the content. And, if anything's missing a figure, a graph, a label, you send it back to me and then I go through and massage it and then send it off to you. And, part of acceptability is when you say, that's good, then the handoff we're talking about is physical.   0:29:51.6 BB: Right. I mean, there's nothing wrong with a physical handoff. I give it to you physically. And what you may recall me mentioning, I think, again likely episode 2, podcast 2 of this series is I would demonstrate this with people in the class. And I would say, if, if what I give you is not acceptable, what do you do? You give it back to me and you say it's incomplete. And then I go through, massage it. If I now give it to you and all the requirements have been met, it's acceptable. Now what happens? What do you say? And I would kid them and so now you say, thank you. But what I'd also point out is that part of acceptability in a non-Deming organization is the handoff is physical and mental. I mean, physical is: It is yours, not mine.   0:30:38.5 BB: Mental is that if you have trouble with how that fits into what you are doing with it, because that report does not exist in isolation, you're doing something with it. Right. So you're doing your things with it. Now we're looking at the system. And if in the system of you're using it, you have an issue and you come back to me, in non-Deming environment, acceptability is my way of saying "Andrew I'm not sure why we're having this conversation because what I gave you is acceptable." But in a Deming organization, the handoff is physical, but not mental. What does that mean? It means, I'm willing to learn from what you just said and the issues you're having. And now I'm beginning to wonder, there's two possibilities. Either one, what I gave you is not acceptable. There's something wrong with the inspection.   0:31:34.3 BB: Or two, what's missing is desirability, that there's some... What I give you is acceptable, but there's something about how it's, it's um, there's a degree of acceptability, and so instead of viewing it as it's good or it's bad, black and white. Now we're saying there's degrees of good. Desirability is degrees of good. And, so in a Deming environment, when I hand off to you and you have an issue with it, you come back the next day and say, "Bill, somehow this didn't get caught in the control chart." And I said, "well, let me take a look at it," and I may find there was something wrong with the inspection, or I may find that there's a degree of good I'm not giving you that I need to be giving you. So, that can either be an acceptability issue or a desirability issue. I'm willing to have that conversation with you in a Deming environment. So, in a Deming environment, the handoff is physical but not mental. And the learning, as you're demonstrating, the learning that comes from the ability to have those conversations, improves the system. That's a lot more work.   0:32:53.8 AS: So, if you were to sum it up, was that the sum up or would you add anything else to your summation of what you want people to take away from this discussion?   0:33:05.6 BB: Yeah, that's it. I'd like to say one is that there's, acceptability is fine. Choose acceptability, if that's all the situation demands then you've chosen that. But pay attention to how it's used, pay attention to the ramifications of that decision, which may show up an hour from now, may not show up until a year from now. And, the possibility that hiccup a year from now could be either it wasn't acceptable, in which case there's an inspection issue or it was acceptable, which means there's a degree of good, which means it's a desirability issue. And, that gets us into future conversations, talking about degrees of good and the whole idea of variation in things that are good. That's desirability, variation in things that are good.   0:33:57.6 AS: All right. Bill, on behalf of everyone at T      he Deming Institute, I want to thank you again for this discussion. And for listeners, remember to go to deming.org to continue your journey. And if you wanna keep in touch with Bill, just find him on LinkedIn. He responds. This is your host, Andrew Stotz, and I'll leave you with one of my favorite quotes from Dr. Deming. "People are entitled to joy in work."

Is reaching A+ quality always the right answer? What happens when you consider factors that are part of the system, and not just the product in isolation? In this episode, Bill Bellows and Andrew Stotz discuss acceptability versus desirability in the quality realm. TRANSCRIPT 0:00:02.5 Andrew Stotz: My name is Andrew Stotz and I'll be your host as we continue our journey into the teachings of Dr. W. Edwards Deming. Today, I'm continuing my discussion with Bill Bellows, who has spent 31 years helping people apply Dr. Deming's ideas to become aware of how their thinking is holding them back from their biggest opportunities. Today's episode, episode three, is Acceptability and Desirability. Bill, take it away.   0:00:28.1 Bill Bellows: Thank you, Andrew, and welcome back to our listeners.   0:00:30.7 AS: Oh, yeah.   0:00:31.4 BB: Hey, do you know how long we've been doing these podcasts?   0:00:36.6 AS: No.   0:00:40.8 BB: We started... Our very first podcast was Valentine's Day 2023. I was gonna say 2013. 2023, so roughly 17 months of podcast, Andrew.   0:00:53.4 AS: That was our first date, huh?   0:00:55.0 BB: Our first date was Valentine's Day 2023.   0:00:58.9 AS: All right. Don't tell your wife.   [laughter]   0:01:03.1 BB: All right. And so along the way, I've shared reflections from my first exposures to Dr. Deming, as well as my first exposures to Genichi Taguchi. Talked about Edward de Bono, Tom Johnson, others, mentors, Bill Cooper, Phil Monroe, Gipsie Ranney was a great mentor. Last week, Andrew, while on vacation in New England with my wife, I visited for a day my 85-year-old graduate school advisor who I worked with for ten years, Bob Mayle, who lives in, I would say, the farthest reaches of Maine, a place called Roque Bluffs. Roque Bluffs. How's that for... That could be North Dakota. Roque Bluffs. He's in what they call Down East Maine. He's recently got a flip phone. He's very proud. He's got like a Motorola 1985 vintage flip phone. Anyway, he's cool, he's cool. He's...   0:02:15.9 AS: I'm just looking at that place on the map, and looks incredible.   0:02:19.0 BB: Oh, yeah. He's uh, until he got the phone, he was off the grid. We correspond by letters. He's no internet, no email. And he has electricity, lives in about an 800 square-foot, one-floor bungalow with his wife. This is the third time we've visited him. Every time we go up, we spend one day getting there, one day driving home from where my in-laws live in New York. And then one day with him, and the day ends with going to the nearby fisherman's place. He buys us fresh lobster and we take care of them. [chuckle]   0:03:01.3 AS: Yeah, my sister lives in Kennebunk, so when I go back to the US, I'm...   0:03:08.8 BB: Yeah, Kennebunk is maybe 4 hours away on that same coast.   0:03:15.3 AS: I'm just looking at the guide and map book for Roque Bluffs' State Park, and it says, "a beautiful setting with oceanfront beach, freshwater pond, and hiking trails."   0:03:25.9 BB: Yeah, he's got 10 acres... No, he's got, I think, 20, 25 acres of property. Sadly, he's slowly going blind. He has macular degeneration. But, boy, for a guy who's slowly going blind, he and I went for a walk around his property for a couple hours, and it's around and around... He's holding branches from hitting me, I'm holding branches from hitting him and there's... Let alone the terrain going up and down, you gotta step up and over around the rocks and the pine needles and all. And it was great. It was great. The week before, we were close to Lake George, which is a 32-mile lake in Upstate New York. And what was neat was we went on a three-hour tour, boat ride. And on that lake, there are 30 some islands of various sizes, many of them owned by the state, a number of them owned privately. Within the first hour, we're going by and he points to the island on the left and he says it was purchased in the late '30s by Irving Langmuir. Yeah, so he says, "Irving Langmuir," and I thought, I know that name from Dr. Deming. That name is referenced in The New Economics.   0:04:49.1 BB: In fact, at the opening of Chapter Five of The New Economics, the title is 'Leadership.' Every chapter begins with a quote, right? Chapter Five quote is, "You cannot plan to make a discovery," so says Irving Langmuir. So what is... The guy's describing this island purchased back in the late '30s by Langmuir for like $5,000. I think it's... I don't know if he still owns it, if it's owned by a nonprofit. It's not developed. It's privately held. I'm trying, I wrote to Langmuir's grandson who did a documentary about him. He was a Nobel Prize-winning physicist from GE's R&D center in Schenectady, New York, which is a couple hours south of there. But I'm certain, and I was looking for it earlier, I know I heard of him, of Irving Langmuir through Dr. Deming. And I believe in his lectures, Deming talked about Langmuir's emphasis on having fun at work, having fun. And so I gotta go back and check on that, but I did some research after the day, and sure enough came across some old videos, black and white videos that Langmuir produced for a local television station, talking about his... There's like show and tell with him in the laboratory. And in there, he talks about joy and work and all that.   0:06:33.5 BB: So I'm thinking, that's pretty cool. So I'm waiting to hear from his grandson. And ideally, I can have a conversation with his grandson, introduce him to Kevin and talk about Deming's work and the connection. Who knows what comes out of that? Who knows? Maybe an interview opportunity with you and Irving Langmuir's grandson. So, anyway.   0:06:52.7 AS: Fantastic.   0:06:54.7 BB: But going back to what I mentioned earlier in my background in association with Deming and whatnot, and Taguchi, and I offer these comments to reinforce that while my interests in quality were initially all things Taguchi, and then largely Deming, and it wasn't long before I stopped, stepped back and an old friend from Rocketdyne 20 some years ago started focusing on thinking about thinking, which he later called InThinking. And it's what others would call awareness of our... Well, we called it... Rudy called it, better awareness of our thinking patterns, otherwise known as paradigms, mental models.  We just like the way of explaining it in terms of becoming more aware of our thinking patterns. And I say that because... And what I'm presenting relative to quality in this series, a whole lot of what I'm focusing on is thinking about thinking relative to quality.   0:07:58.8 BB: And so last time, we talked about the eight dimensions of quality from David Garvin, and one of them was acceptability. And that is this notion in quality, alive and well today, Phil Crosby has created this focus on achieving zero defects. Everything meets the requirements, that gets us into the realm, everything is good. Dr. Deming and his red bead experiments talked about red beads and white beads. The white beads is what we're striving for. All the beads are good. The red beads represent defects, things we don't want. And that's this... Thinking wise, that's a thinking pattern of "things are good or bad." Well, then we can have high quality, low quality and quality. But at Rocketdyne, when I started referring to that as category thinking, putting things into categories, but in the world of quality, there's only two categories, Andrew: good and bad. This either meets requirements or it doesn't. And if it's good, then we're allowed to pass it on to the next person. If we pass it on and it's not good, then they're going to send it back to us and say, "Uh-uh, you didn't meet all the requirements." And what I used to do in class, I would take something, a pen or something, and I would go to someone in the seminar and I'd say, "If I hand this to you and it doesn't meet requirements, what are you going to say?" You're gonna say, "I'm not going to take it. It hasn't met the requirements."   0:09:36.4 BB: And I would say you're right. All the I's are not dotted, all the T's are not crossed, I'm not taking it. Then I would take it back and I'd say, "Okay, now what if I go off and dot all those I's and cross all those T's?" Then I would hand them the pen or whatever the thing was, and I'd say, "If all those things have been met," now we're talking acceptability. "Now, what do you say?" I said, "Can you reject it?" "No." I say, "So what do you say now that all those things... If you're aware that all those requirements have been met, in the world of quality, it is as good, now what do you say?" And they look at me and they're like, "What do I say?" I say, "Now you say, thank you." But what I also do is one more time... And I would play this out to people, I'd say, "Okay, Andrew, one more time. I hand you the pen, Andrew, all the requirements are met. And what do you say?" And you say, "Thank you." And I say, "What else just happened when you took it?"   0:10:45.4 AS: You accepted it.   0:10:47.3 BB: Yes. And I say, "And what does that mean?" "I don't know. What does that mean?" I said, "It means if you call me the next day and say, I've got a problem with this, you know what I'm going to say, Andrew?"   0:10:58.5 AS: "You accepted it."   0:11:01.5 BB: Right. And so, what acceptability means is don't call me later and complain. [laughter] So, I get a photo of you accepting it, you're smiling. So if you call me back the next day and say, "I've got a problem with this," I'd say, "No, no, no." So acceptability as a mental model is this idea that once you accept it, there's no coming back. If you reveal to me issues with it later, I deny all that. I'd say, I don't know what your problem with Andrew... It must be a problem on your end, because what I delivered to you is good. And if it is good, then there can't be any problems associated with it. So, if there are problems, have to be on your end, because defect-free, everything good, implies, ain't no problems, ain't no issues with it. I'm thinking of that Disney song, trouble-free mentality, Hakuna Matata.   [chuckle]   0:12:04.5 BB: But now I go back to the title, Acceptability and Desirability. One of Dr. Deming's Ph.D. students, Kauro [actually, Kosaku] Yoshida, he used to teach at Cal State Dominguez Hills back in the '80s, and I think sometime in the '90s, he went to Japan. I don't know if he was born and raised in Japan, but he was one of Dr. Deming's Ph.D. students, I believe, at NYU. Anyway, I know he's a Ph.D. student of Dr. Deming, he would do guest lectures in Dr. Deming's four-day seminars in and around Los Angeles. And, Yoshida is known for this saying that Americans are all about acceptability meets requirements, and the Japanese are about desirability. And what is that? Well, it's more than meeting requirements. And, I wanna get into more detail on that in future episodes. But for now, we could say acceptability is meeting requirements. In a binary world, it can be really hard to think of, if everything's met requirements, how do I do better than that? How do I continue to improve if everything meets requirements?  Well, one clue, and I'll give a clue, is what I shared with the senior most ranking NASA executive responsible for quality.   0:13:46.4 BB: And this goes back to 2002 timeframe. And we had done some amazing things with desirability at Rocketdyne, which. is more than meeting requirements. And the Vice President of Quality at Rocketdyne knew this guy at NASA headquarters, and he says, "You should go show him what we're doing." So I called him up a week in advance of going out there. I had made the date, but I figured if I'm going to go all the way out there, a week in advance, I called him up just to make sure he knew I was coming. And he said something like, "What are we going to talk about?" He said something like, "We're going to talk about that Lean or Six Sigma stuff?" And I said, "No, more than that." And I think I described it as, we're going to challenge the model of interchangeable parts. And he's like, "Okay, so what does that mean?" So the explanation I gave him is I said, "What letter grade is required for everything that NASA purchases from any contractor? What letter grade is ostensibly in the contract? What letter grade? A, B, C, D. What letter grade is in the contract?" And he says, "Well, A+."   [laughter]   0:15:01.2 BB: And I said, "A+ is not the requirement." And he's like, "Well, what do you mean?" I said, "It's a pass-fail system." That's what acceptability is, Andrew. Acceptability is something is either good or bad, and if it's bad, you won't accept it. But if it's good, if I dot all the I's and cross all the T's, you will take it. It has met all the requirements. And that gets into what I talked about in the first podcast series of what I used to call the first question of quality management. Does this quality characteristic, does the thrust of this engine, does the roughness of this surface, does the diameter of this hole, does the pH of this bath meet requirements? And there's only two answers to that question, yes or no. And if yes is acceptable, and if no, that's unacceptable. And so I pointed out to him, much to his chagrin, is that the letter grade requirement is not A+, it's D- or better. [chuckle] And so as a preview of we'll get into in a future podcast, acceptability could be, acceptability is passing. And this guy was really shocked. I said, "Procurement at NASA is a pass-fail system."   0:16:21.9 BB: Every element of anything which is in that system purchased by NASA, everything in there today meets a set of requirements, is subject to a set of requirements which are met on a pass-fail basis. They're either, yes, it either meets requirements, acceptable, or not. That's NASA's, the quality system used by every NASA contractor I'm aware of. Boeing's advanced quality system is good parts and bad parts. Balls and strikes. And so again, for our viewers, acceptability is a pass-fail system. And what Yoshida... You can be thinking about what Yoshida's talked about, is Japanese companies. And again, I think it's foolish to think of all Japanese companies, but back in the '80s, that's really the way it came across, is all Japanese companies really have this figured out, and all American companies don't. I think that's naive. But nonetheless, what he's talking about is shifting from a pass-fail system, that's acceptability, to, let's say, letter grades of A's or B's. That would be more like desirability, is that it's not just passing, but an A grade or a B grade or a C grade. So that's, in round terms, a preview of Yoshida... A sense of, for this episode, of what I mean by acceptability and desirability.   0:17:54.7 BB: In the first podcast which was posted the other day, I made reference to, instead of achieving acceptability, now I can use that term, instead of achieving zero defects as the goal, in the world of acceptability, once we continuously improve and achieve acceptability, now everything is passing, not failing. This is in a world of what I refer to as category thinking, putting things in categories. In the world of black and white, black is one category, white is a category. You got two categories, good and bad. If everything meets requirements, how do you continuously improve if everything is good? Well, part of the challenge is realize that everything is good has variation in terms... Now we could talk about the not all letter grade A, and so we could focus on the things that are not A's and ask the question, is an A worthwhile or not? But what I was saying in the first podcast is my admiration for Dr. Deming's work uniquely... And Dr. Deming was inspired towards this end by Dr. Taguchi, and he gave great credit to that in Chapter Ten of The New Economics. And what I don't see in Lean nor Six Sigma, nor Lean/Six Sigma, nor Operational Excellence, what I don't see anywhere outside of Dr. Deming's work or Dr. Taguchi's work is anything in quality which is more than acceptability.   0:19:32.0 BB: It's all black and white. Again, Boeing's Advanced Quality System is good parts and bad parts. Now, again, I'm not suggesting that there's anything wrong with that. And I would also suggest in a Deming-based organization there may be characteristics for which all we need is that they're good. We don't need to know how good they are, we don't need to know the letter grade. And why is that? Because maybe it's not worth the trouble to discern more than that. And this is where I use the analogy of balls and strikes or kicking the ball into the net.  If you've got an open net... That's Euro Cup soccer. There's no reason to be precisely placing the ball. All you want to do is get it into the net. And that's an area of zero defects, maybe all that is worthwhile, but there could be other situations where I want the ball in a very particular location in the strike zone. That's more of this desirability sense. So I want to clarify for those who listened to the first podcast, is what I'm inferring is I'm not aware of any quality management system, any management system in which, inspired by Dr. Deming and Taguchi, we have the ability to ask the question, is acceptability all that is required?   0:20:55.7 BB: And it could be for a lot of what we do, acceptability is not a bad place to be. But I'm proposing that as a choice, that we've thought about it and said, "You know what? In this situation, it's not worth, economically, the extra effort. And so let's put the extra effort into the things where it really matters." And if it doesn't... So use desirability where it makes sense, use acceptability elsewhere. Right now, what I see going on in organizations unaware of Dr. Deming's work, again, Dr. Taguchi's work, is that they're really blindly focusing on acceptability. And I think what we're going to get into is, I think there's confusion in desirability. But again, I want to keep that for a later episode. Now, people will say, "Well, Bill, the Six Sigma people are about desirability." No, the Six Sigma people have found a new way to define acceptability. And I'll give you one other fun story. When I taught at Northwestern's Kellogg Business School back in the late '90s, and I would start these seminars off by saying, "We're going to look at quality management practices, past, present, future." And so one year, I said, "So what quality management practices are you aware of?" And again, these are students that have worked in industry for five or six years.   0:22:17.6 BB: They've worked at GM, they worked at General Electric, they worked for Coca Cola, banking. These are sharp, sharp people. But you got into the program having worked somewhere in the world, in industry, so they came in with experience. And so they would say, zero defect quality is a quality management practice. And I'd say, "Okay, so where'd that come from?" And again, this is the late '90s. They were aware of the term, zero defects. They didn't know it was Philip Crosby, who I learned yesterday was... His undergraduate degree is from a school of podiatry. I don't know if he was a podiatrist, but he had an undergraduate... A degree in podiatry, somebody pointed out to me. Okay, fine. But Philip Crosby, his big thing was pushing for zero defects. And you can go to the American Society for Quality website to learn more about him. Philip Crosby is the acceptability paradigm. So, students would bring him up and I'd say, "Okay, so what about present? What about present?" And somebody said, "Six Sigma Quality." So I said, "So what do you know about Six Sigma Quality?" And somebody said," Cpk's of 2.00." And I said, "So what's... " again, in a future episode, we could talk about Cpk's."   0:23:48.5 AS: But I said to the guy, "Well, what's the defect rate for Six Sigma... For Cpk's or Six Sigma Quality or Cpk's of 2?" And very matter of factly, he says, "3.4 defects per million." So I said, "How does that compare to Phil Crosby's quality goal from 1962? Here we are, 1997, and he's talking about Motorola and Six Sigma Quality, a defect goal of 3.4 defects per million. And I said, "How does that compare to Phil Crosby's quality goal of zero defects in 1962?" And the guy says... [chuckle] So cool, he says, "Well, maybe zero is not worth achieving." 'Cause again, zero was the goal in 1962. Six Sigma sets the goal for 3.4 per million. Not zero, 3.4, to which this guy says... And I thought it was so cool, he says, "Well, maybe zero is not worth achieving." So, there. Well, my response was, "Well, what makes 3.4 the magic number for every process in every company around the world? So, what about that?" To which the response was crickets. But what I want to point out is we're still talking about zero... I mean 3.4 is like striving towards zero and admitting some. It is another way of looking at acceptability. It is... And again, and people claim it's really about desirability. I think, well, there's some confusion in desirability and my hope in this episode is to clear up some of that misunderstanding in acceptability as well as in desirability. And they... Let me just throw that out.   0:25:58.1 AS: Yeah, there's two things that I want to say, and the first one is what he should have replied is, for those older people listening or viewing that can remember the movie, Mr. Mom with Michael Keaton, I think it was. And he should have replied, "220, 221, whatever it takes." And he should have said, "Well, yeah, 3.4, 3.5, 3.6. It's could be around there."   0:26:27.5 BB: Well, the other thing is, why we're on that is... And I think this is... I'm really glad you brought that up, is, what I would push back on the Lean and the Six Sigma, those striving for zero defects or Cpk's of 2 or whatever they are is, how much money are we going to spend to achieve a Cpk of 2, a zero defects? And again, what I said and... Well, actually, when I posted on LinkedIn yesterday, "I'm okay with a quality goal of 3.4 defects per million." What I'm proposing is, instead of blindly saying zero defects is the goal and stop, or I want Cpk's of 1.33 or whatever they are everywhere in the organization, in terms of the economics of variation or the new economics, is how much money are we going to spend to achieve zero or 3.4 or whatever it is? And, is it worth the return on the investment? And this is where Dr. Taguchi's loss function comes in.   0:27:49.2 BB: And so what I'm proposing, inspired by Genichi Taguchi and W. Edwards Deming is, let's be thinking more about what is... Let's not blindly stop at zero, but if we choose to stop at zero, it's an economic choice that it's not worth the money at this time in comparison to other things we could be working on to improve this quality characteristic and that we've chosen to be here... Because what I don't want people to think is what Dr. Deming and Taguchi are talking about is we can spend any amount of money to achieve any quality goal without thinking of the consequences, nor thinking about, how does this goal on this thing in isolation, not make things bad elsewhere. So we have to be thinking about a quality goal, whether it's worth achieving and will that achievement be in concert with other goals and what we're doing there? That's what I'd like people thinking about as a result of this podcast tonight.   0:28:56.0 AS: And I think I have a good way of wrapping this up, and that is going back to Dr. Deming's first of his 14 Points, which is, create constancy of purpose towards improvement of product and service with the aim to become competitive, to stay in business, and to provide jobs. And I think that what that... I link that to what you're saying with the idea that we're trying to improve our products and services constantly. We're not trying to improve one process. And also, to become competitive in the market means we're improving the right things because we will become more competitive if we are hitting what the client wants and appreciates. And so... Yeah.   0:29:46.3 BB: But with regard to... Absolutely with regard to our customers, absolutely with regard to how it affects different aspects of our company, that we don't get head over heels in one aspect of our company and lose elsewhere, that we don't deliver A+ products to the customer in a losing way, meaning that the A+ is great for you, but financially, we can't afford currently... Now, again, there may be a moment where it's worthwhile to achieve the A... We know we can achieve the A+, but we may not know how to do it financially. We may have the technology to achieve that number. Now, we have to figure out, is, how can we do it in an economically advantaged way, not just for you, the customer, but for us. Otherwise, we're losing money by delivering desirability. So it's gotta work for us, for you, but it's also understanding how that improvement... That improvement of that product within your overall system might not be worthwhile to your customer, in which case we're providing a... The classic...   0:31:18.8 AS: You're not becoming competitive then.   0:31:21.8 BB: The better buggy whip. But that gets into looking at things as a system. And this is... What's invaluable is, all of this is covered with a grasp of the System of Profound Knowledge. The challenge is not to look at goals in isolation. And even I've seen people at Lean conferences quote Dr. Deming and his constancy of purpose and I thought, well, you can have a... A non-Deming company has a constancy of purpose. [chuckle]  The only question is, what is the purpose? [laughter] And that's when I thought, a constancy of purpose on a focus on acceptability is good provided all of your competitors are likewise focusing on acceptability. So I just be... I just am fascinated to find people taking Deming's 14 Points one at a time, out of context, and just saying, "Well, Dr. Deming said this." Well, there we go again. [laughter]   0:32:29.9 AS: Bill, on behalf of everyone at The Deming Institute, I want to thank you again for this discussion. For listeners, remember to go to deming.org to continue your journey. If you want to keep in touch with Bill, just find him on LinkedIn. This is your host, Andrew Stotz. And I'll leave you with one of my favorite quotes from Dr. Deming, "People are entitled to joy in work."

DOI: 10.13056/acamh.28954 In this Papers Podcast, Dr. Matti Cervin discusses his JCPP paper ‘Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis' (https://doi.org/10.1111/jcpp.13934). Matti is the lead author of the paper. There is an overview of the paper, methodology, key findings, and implications for practice. Discussion points include: The importance of examining efficacy and acceptability of cognitive-behavioural therapy and serotonin reuptake inhibitors in the context of the pediatric population. The two domains of treatments that have an evidence base for paediatric obsessive-compulsive disorder (OCD) – cognitive-behavioural therapy and medication. The difference between different forms of cognitive-behavioural therapy (CBT) delivery – traditional in-person, remote CBT, and internet-delivered CBT. Difference between in-person CBT and internet-delivered CBT. Implications for policymakers and child and adolescent mental health professionals. In this series, we speak to authors of papers published in one of ACAMH's three journals. These are The Journal of Child Psychology and Psychiatry (JCPP); The Child and Adolescent Mental Health (CAMH) journal; and JCPP Advances. #ListenLearnLike

Kindy Moves: the feasibility of an intensive interdisciplinary programme on goal and motor outcomes for preschool-aged children with neurodisabilities requiring daily equipment and physical assistanceMatthew Haddon, Loren West, Catherine Elliott, Corrin Walmsley, Jane Valentine, Natasha Bear, Dayna Pool, Healthy Strides Research Advisory CouncilAbstractObjectives: To determine the feasibility of an intensive interdisciplinary programme in improving goal and motor outcomes for preschool-aged children with non-progressive neurodisabilities. The primary hypothesis was that the intervention would be feasible.Design: A single group feasibility study.Setting: An Australian paediatric community therapy provider.Participants: Forty children were recruited. Inclusion criteria were age 2-5 years with a non-progressive neurodisability, Gross Motor Function Classification System (GMFCS) levels III-V or equivalent, and goals relating to mobility, communication and upper limb function. Exclusion criteria included orthopaedic surgery in the past 6 months, unstable hip subluxation, uncontrolled seizure disorder or treadmill training in the past month.Intervention: A goal-directed programme of three 2-hour sessions per week for 4 weeks (24 hours total). This consisted of treadmill and overground walking, communication practice, and upper limb tasks tailored by an interdisciplinary team.Primary and secondary outcome measures: Limited-efficacy measures from preintervention (T1) to postintervention (T2) and 4-week follow-up (T3) included the Goal Attainment Scaling (GAS), Canadian Occupational Performance Measure (COPM), Gross Motor Function Measure (GMFM-66) and 10-Metre Walk Test (10MWT). Acceptability, demand, implementation and practicality were also explored.Results: There were improvements at T2 compared with T1 for all limited-efficacy measures. The GAS improved at T2 (mean difference (MD) 27.7, 95% CI 25.8 to 29.5) as well as COPM performance (MD 3.2, 95% CI 2.8 to 3.6) and satisfaction (MD 3.3, 95% CI 2.8 to 3.8). The GMFM-66 (MD 2.3, 95% CI 1.0 to 3.5) and 10MWT (median difference -2.3, 95% CI -28.8 to 0.0) improved at T2. Almost all improvements were maintained at T3. Other feasibility components were also demonstrated. There were no adverse events.Conclusions: An intensive interdisciplinary programme is feasible in improving goal and motor outcomes for preschool children with neurodisabilities (GMFCS III-V or equivalent). A randomised controlled trial is warranted to establish efficacy.Trial registration number: ACTRN12619000064101.Keywords: Clinical trials; Developmental neurology & neurodisability; Neurological injury.

This week we welcome Dr. Mallory Quinn back to the show to provide us her expertise in the health, sports, and fitness field. And when we realize we won't get cast in “West Side Story” with only an hour of work, we decide to spend our time talking with her about supervision instead. We review what behavior analysts interested in HSF should know whether they're starting their journey into this speciality or getting ready to teach others to practice. And while we run out of time to become prima ballerinas, Dr. Quinn shares a manual on the subject that might help us out. This episode is available for 1.0 SUPERVISION CEU. Articles discussed this episode: Quinn, M., Blair, K.C., Novotny, M., & Deshmukh, S. (2022). Pilot study of manualized behavioral coaching program to improve dance performance. Journal of Applied Behavior Analysis, 55, 180-194. doi: 10.1002/jaba.874 Holland, M.A., & Slowiak, J.M. (2021). Practice and ethical considerations for behavior analysts in health, sport, and fitness. Behavior Analysis: Research and Practice, 21, 314-325. doi: 10.1037/bar0000188 Simmons, C.A., Ford, K.R., Salvatore, G.L, & Moretti, A.E. (2021). Acceptability and feasibility of virtual behavior analysis supervision. Behavior Analysis in Practice, 14, 927-943. doi: 10.1007/s40617-021-00622-3 If you're interested in ordering CEs for listening to this episode, click here to go to the store page. You'll need to enter your name, BCBA #, and the two episode secret code words to complete the purchase. Email us at abainsidetrack@gmail.com for further assistance.

Now that lousy March weather is over, it's time for cool April and another bunch of podcast episodes on topics that smell as sweet as Spring flowers. First we welcome back Dr. Mallory Quinn to share strategies for meaningful supervision in the realm of health, sports, and fitness. Then we run the gamut on old and “hot-off-the-press” topics with a review of schedule thinning and how to get involved in public policy. Because if you don't, who will? Plus, for patrons, our Spring 2024 Book Club will take you right from the page to your practice in using picture activity schedules. Articles for April 2024 Supervision in Health, Sports, and Fitness w/ Dr. Mallory Quinn (SUPERVISION) Quinn, M., Blair, K.C., Novotny, M., & Deshmukh, S. (2022). Pilot study of manualized behavioral coaching program to improve dance performance. Journal of Applied Behavior Analysis, 55, 180-194. doi: 10.1002/jaba.874 Holland, M.A., & Slowiak, J.M. (2021). Practice and ethical considerations for behavior analysts in health, sport, and fitness. Behavior Analysis: Research and Practice, 21, 314-325. doi: 10.1037/bar0000188 Simmons, C.A., Ford, K.R., Salvatore, G.L, & Moretti, A.E. (2021). Acceptability and feasibility of virtual behavior analysis supervision. Behavior Analysis in Practice, 14, 927-943. doi: 10.1007/s40617-021-00622-3 Schedule Thinning and FCR Hanley, G.P., Iwata, B.A., & Thompson, R.H. (2001). Reinforcement schedule thinning following treatment with functional communication training. Journal of Applied Behavior Analysis, 34, 17-38. doi: 10.1901/jaba.2001.34-17 Betz, A.M., Fisher, W.W., Roane, H.S., Mintz, J.C., & Owen, T.M. (2013). A component analysis of schedule thinning during functional communication training. Journal of Applied Behavior Analysis, 46, 219-241. doi: 10.1002/jaba.23 Greer, B.D., Fisher, W.W., Saini, V., Owen, T.M., & Jones, J.K. (2016). Functional communication training during reinforcement schedule thinning: An analysis of 25 applications. Journal of Applied Behavior Analysis, 49, 105-121. doi: 10.1002/jaba.265 Kranak, M.P. & Brown, K.R. (2023). Updated recommendations for reinforcement schedule thinning following functional communication training. Behavior Analysis in Practice, 17, 87-106. doi: 10.1007/s40617-023-00863-4 ABA and Public Policy Coop, B., Ice, E.D., Tomei, A., & Powell, R.U. (2023). Why public policy matters: A call to action for the everyday behavior analyst. Behavior Analysis in Practice. doi: 10.1007/s40617-023-00878-x Evanko, C.D., Moss-Lourenco, T., Kramer, R., & Napolitano, D.A. (2024). Why we all need to shape the profession of behavior analysis through advocacy and how to get started. Behavior Analysis in Practice. doi: 10.1007/s40617-023-00895-w Scibak, J.W. (2023). An analysis of voting and legislative behavior. Behavior Analysis in Practice. doi: 10.1007/s40617-023-00875-0 Thompson, R.L., Belokas, J., Johnson, K., & Williams, A.L. (2023). The public policy advocacy actions checklist: Success stories from three states. Behavior Analysis in Practice. doi: 10.1007/s40617-023-00874-1 Activity Schedules for Children with Autism Book Club (PATRONS ONLY) McClannahan, L.E. & Krantz, P.J. (1999). Activity schedules for children with autism: Teaching independent behavior. Woodbine House. McClannahan, L.E. & Krantz, P.J. (2010). Activity schedules for children with autism: Teaching independent behavior. (2nd ed.). Woodbine House.

Patient-reported outcomes (PROs) have become increasingly integral in healthcare for assessing the effectiveness of treatments from the patient's perspective. It sounds like a reasonable step in improving clinical research and care provision, but gathering data can be more difficult then you may think. It isn't easy to get to marginalized communities. There are language barriers in collecting data. There are cultural aspects that impact responses. So, how can you design useful electronic solutions for patient-reported outcomes? Hear from Mustafa Ali Syed, Researcher at the Manchester Academic Health Science Centre, The University of Manchester, and Ben James, Co-founder/Chief Design Officer at uMotif - ePRO, an engagement platform designed to power clinical and real-world research. Both are co-authors of a recently published paper titled Exploring the Cross-cultural Acceptability of Digital Tools for Pain Self-reporting. www.facesofdigitalhealth.com Newsletter: https://fodh.substack.com/ Show notes: 00:00:00 Why Do PROs Matter? 00:04:00 Evolution of Data Collection 00:06:00 Importance of Diversity in Clinical Trials 00:08:00 Ethnicity, Culture, and Pain Perception 00:12:00 The Role of Technology in PROs 00:14:00 Designing Inclusive Digital Solutions 00:20:00 Challenges in Engaging Targeted Populations 00:22:00 Language and Communication Barriers 00:26:00 The Future of PRO Research

On this episode I was joined by Naveen Aggarwal founder of Creative Analytic Solutions and host of "Let's talk risk". In this episode, Naveen walks through the big changes to risk management with the QMSR, and risk beyond safety. The episode covers the confusion surrounding the mandatory nature of risk management in particular and we spend the second half of the episode talk about risk acceptability charts, risk & quality policy, explaining vs. justifying risk based decision making with regards to the traffic light charts that most companies use for risk acceptance. Episode Chapters: 02:00 Interpreting the QMSR and Its Implications 05:56 Impact of QMSR on Risk Management 08:34 Risk Management in Practice 12:09 Insights from FDA Inspections and Warning Letters 23:30 The Importance of Process-Based Approach 24:57 Deep Dive into Risk Policy and Risk Acceptability 26:05 Understanding the Framework of 14971 26:42 The Role of Quality Policy in Risk Management 27:32 Risk Control 29:47 Risk Acceptability in Risk Policy 30:59 Understanding Risk Matrix 32:16 Risk Control and Quality Policy 41:00 Understanding Risk Acceptability Charts Naveen Agarwal PhD is an Engineer by training with nearly 20 years of professional experience in Product Development, Quality Systems and Data Analytics. As a result, he's developed a very broad and deep expertise in all of the core functions involved in the entire lifecycle of medical products. Naveen joins us from Creative Analytics Solutions where his mission is Helping Medical Companies Build Safe Products. Naveen is a PhD Polymer scientist turned QM consultant and expert.

This episode features Sue-Ling Chang, (CHU de Québec-Université Laval Research Center, Oncology Division, Québec City, QC, Canada)   What is already known about the topic? There is a growing interest in psilocybin-assisted therapy worldwide, particularly to treat existential distress at the end of life.   What this paper adds? In this study, we show that the social acceptability of psilocybin-assisted therapy to treat existential distress at the end of life is high in Canada and identify factors associated with favourable attitudes of the population towards it.   Implications for practice, theory, or policy Our findings may help mobilise resources to address barriers and challenges for implementing psilocybin-assisted therapy within palliative medicine and society. This could also have implications for policies regarding medical assistance in dying.  Full paper available from:     https://journals.sagepub.com/doi/full/10.1177/02692163231222430  If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu:  a.nwosu@lancaster.ac.uk

Summary Welcome to the first episode of our ongoing series on Psychedelic Assisted Therapy (PAT). Today we welcome Christi Myers, CEO of Flow Integrative--a team of healthcare professionals spearheading the effort to make PAT more available to veterans and first responders.  Kristy brings over 25 years of experience working as a First Responder and understands the demands inherent to these professions. She is on a mission to “help the help” and is doing that by pioneering the use of psychedelics.  In this episode we'll be covering all things mental health. From the benefits of PAT and the development of protocols for psychedelics, to coping mechanisms and teaching our kids how to be good stewards of their mental health.  Enjoyshow and make sure to give us a follow if you haven't already! Show Links  Get 1-month of FREE access to the ⁠Vet Collective Community⁠ by using discount code: NLT1UQTI Sign up for our Weekly Newsletter Download Free Business Launch Guide Watch on Youtube Listen on Apple Listen on Spotify Follow on LinkedIn⁠ ⁠ Christi's Links https://flowintegrativeketamine.com/ https://www.linkedin.com/in/christi-myers-15351a213/ Chapters 00:00 Introduction to the guest and the topic 01:25 Understanding the concept of psychedelics for mental health treatment 04:26 Becoming the observer of trauma and reducing suffering 05:39 The mirror molecule and collapsing timelines 07:02 The impact of childhood trauma and generational curses 08:26 Differentiating trauma from truth 09:03 The evolution of consciousness and growth 10:30 Discovering ketamine as a treatment option 12:15 Different uses of ketamine in medical settings 15:45 The first ketamine experience and its impact 25:00 The importance of integration and the work required after ketamine treatment 30:37 Integration activities and tools for post-treatment 35:00 The importance of being present and avoiding rumination 35:51 The Impact of Lack and Routine 37:20 Preservation of Family and Force 38:43 Rest and Restoration for Longevity 40:22 Navigating Parenting and Command Presence 41:44 Transitioning from Authority to Insubordination 47:13 The Struggles of Car Seats 50:16 Making Ketamine Treatment Accessible 55:57 Empowering Doctors with Ketamine Infusion Therapy 59:51 Cultivating Love and Shifting Consciousness 01:01:06 The Developmental Effects of MDMA and DMT 01:05:21 The Future of Mental Health Treatment 01:06:41 Access to Underground Space 01:07:08 The Culture of Drinking in the Military 01:07:37 The Need to Teach Drug Use 01:08:18 Developing Protocols for Psychedelic Medicine 01:09:17 Expanding Access to Treatment 01:10:13 Working with the VA 01:11:23 Treating Mental Health in Veterans 01:12:20 The Importance of Standardization 01:13:12 The Overprescription of ADHD Medication 01:14:07 The Impact of Technology on Mental Health 01:15:08 The Value of Boredom 01:17:19 The Power of Belief Systems 01:18:27 Cultivating Balance and Healing 01:20:04 Challenges in Getting Approval from the VA 01:22:02 The Need for Change in Leadership 01:23:06 The Acceptability of Alcohol vs. Psychedelics 01:25:18 The Importance of Clinical Settings 01:26:00 Expanding Access to Treatment for Veterans 01:29:11 Teaching the World How to Do Drugs 01:30:09 Supporting Flow Integrative

Anthony Defulio & Rosemarie Davidson join us to talk about their paper, Feasibility, Acceptability, and Preliminary Efficacy of a Smartphone-Based Contingency Management Intervention for Buprenorphine Adherence   Show Notes Remember to join us on Facebook to suggest articles to review and questions for authors. https://www.facebook.com/BApractice Acknowledgments Host and Executive Producer: Cody Morris, Ph.D., BCBA-D, LBA https://salve.edu/users/dr-cody-morris Assistant Producers Megan Ellsworth Jesse Perrin Organizational Support ABAI https://www.abainternational.org/welcome.aspx Behavior Analysis in Practice Editor, Stephanie Peterson, Ph.D., BCBA-D, LBA https://www.abainternational.org/journals/bap.aspx Music Cruising Altitude by Jim Carr and his band New Latitude http://www.newlatitudemusic.com Link to Article Feasibility, Acceptability, and Preliminary Efficacy of a Smartphone-Based Contingency Management Intervention for Buprenorphine Adherence | Behavior Analysis in Practice (springer.com) References Dallery, J., Defulio, A., & Raiff, B. R. (2023). Digital contingency management in the treatment of substance use disorders. Policy Insights from the Behavioral and Brain Sciences, 10(1), 51–58. https://doi.org/10.1177/23727322221144648 DeFulio A. (2022). Dissemination of contingency management for the treatment of opioid use disorder. Perspectives on Behavior Science, 46(1), 35–49. https://doi.org/10.1007/s40614-022-00328-z Defulio, A., Brown, H. D., Davidson, R. M., Regnier, S. D., Kang, N., & Ehart M. (2023). Feasability, acceptability, and preliminary efficacy of a smartphone-based contingency management intervention for buprenorphine adherence. Behavior Analysis in Practice, 16(2), 450-458. https://doi.org/10.1007/s40617-022-00730-8 Dinsmoor K. (1987). "Money's the cheapest thing we've got"?. Journal of the Experimental Analysis of Behavior, 48(3), 472–475. https://doi.org/10.1901/jeab.1987.48-472 Higgins, S.T., Delaney, D.D., Budney, A.J., et al. (1991). A behavioral approach to achieving initial cocaine abstinence. American Journal of Psychiatry, 148, 1218-1224. https://doi.org/10.1176/ajp.148.9.1218 Higgins, S.T., Budney, A.J., Bickel, W.K., et al. (1993). Achieving cocaine abstinence with a behavioral approach. American Journal of Psychiatry, 150, 763-769. https://doi.org/10.1176/ajp.150.5.763 Higgins, S.T., Budney, A.J., Bickel, W.K., et al. (1994). Incentives improve outcome in outpatient behavioral treatment of cocaine dependence. Archives of General Psychiatry, 51, 568-576.https://doi:10.1001/archpsyc.1994.03950070060011

THE CROWD Don't Look Back 2.18.24 Luke 9:51 As his time drew near, Jesus resolutely set his face towards Jerusalem. The question for the crowd: Will they stay with Jesus and become His disciples or will they turn away and desert Him? 1. Curious 2. Outraged 3. Excited 4. Selfish The social psychology behind mob mentality: • Deindividuation – when people are a part of a group, they experience a loss of self-awareness • Identity – when people are part of a group, they can lose their sense of individual identity and adopt a group identity • Emotions – being a part of a group can lead to heightened emotional states: excitement, anger, hostility, etc. • Acceptability – behaviors that are often seen as unacceptable become acceptable when others in a group are seen carrying them out • Anonymity – people feel anonymous within a large group, which reduces their sense of responsibility and accountability Crowds have the power to make the timid brave, the good better or the bad devastating. - Greg Morse Luke 9:57-62 57 As they were walking along the road, a man said to him, “I will follow you wherever you go.” 58 Jesus replied, “Foxes have dens and birds have nests, but the Son of Man has no place to lay his head.” 59 He said to another man, “Follow me.” But he replied, “Lord, first let me go and bury my father.” 60 Jesus said to him, “Let the dead bury their own dead, but you go and proclaim the kingdom of God.” 61 Still another said, “I will follow you, Lord; but first let me go back and say goodbye to my family.” 62 Jesus replied, “No one who puts a hand to the plow and looks back is fit for service in the kingdom of God.” • Jesus addresses the gods of comfort and clarity • Jesus addresses the god of misdirected priorities • Jesus addresses the gods of convenience and partial surrender What we must consider if we choose to take up our cross and walk the road of discipleship with Jesus: • Jesus demands unqualified commitment • Jesus clarifies our relationship with the world • Jesus urges us to count the cost of discipleship

Things You'll Learn In This Episode of Our Prophet:- Hadith in Bukhari about the ban on Mut'ah at Khaybar- How does Mut'ah (temporary marriage) compare with permanent marriage?- Acceptability (validity) of a verbal contract in Islamic law- Three important purposes that Mut'ah serves- Rules in the temporary marriage contract that prevent prostitution- Answer to the claim that Mut'ah allows a woman multiple partners in a day- Objection by Sheikh Shaltut on temporary marriage & its response- Conversation between Abu Hanifa and Mu'min al-Taq on Mut'ah- How Mut'ah's permissibility does not imply universal encouragement- What is Misyar, and how is it similar to Mut'ah?- Proof of Mut'ah found in Quran accepted by all scholars- Dubious standards of morality of Sunni Scholars regarding Mut'ah- Hadiths that prove Mut'ah was widely practised during the Prophet's life- Proofs in Sunni Hadith that it was Umar who banned Mut'ah- Ethical guidelines and caution by Imams regarding Mut'ah- Comparison between the legality of drinking wine and Mut'ahJoin us in creating the most comprehensive life story (seerah) of Prophet Muhammad (s). Dedicate episodes in the memory of your loved ones by visiting https://thaqlain.org/ourprophet.Visit https://app.thaqlain.org and download the first "Knowledge App" from the School of Ahlulbayt.#ProphetMuhammad #PropheticBiography #OurProphetSupport this podcast at — https://redcircle.com/our-prophet/donations

In this episode, we explore whether the olanzapine–samidorphan combination helps with psychosis while halting weight gain. We also look into the cost vs benefit of the combination as well as the metabolic side effects. Faculty: James Phelps, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 51 Comparative Efficacy, Safety, and Acceptability of Pimavanserin and Other Atypical Antipsychotics for Parkinson's Disease Psychosis: Systematic Review and Network Meta-Analysis

This episode explores the controversial role of pimavanserin in treating psychosis in Parkinson's disease. How does it compare with quetiapine or clozapine? Sneak peek: All of these medications are effective, yet none distinctly surpasses the others. Faculty: Jim Phelps, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 51 Comparative Efficacy, Safety, and Acceptability of Pimavanserin and Other Atypical Antipsychotics for Parkinson's Disease Psychosis: Systematic Review and Network Meta-Analysis

My guest is Dr. Gina Berg and Trauma PA Deanna Parsons discuss their published study "Acceptability and Implementation of Debriefings After Trauma Resuscitation.". The episode lays the groundwork for any hospital/service/team to provide a standard approach to an after-action debriefing. If you want to improve your team's communication and possibly decrease burnout, this episode is for you. 

Wednesday Night Bible Study

⌚️Did you know that your fitness tracker has NO idea how many calories you burn?In this episode of Talking Nutrition, Johan first breaks down what the research indicates when it comes to fitness trackers' abilities to measure steps, heart rate, calories burned, and more.Then, you'll learn how following your fitness tracker can work against your weight loss goal, and finally, how to accurately manage your calories (and so, your transformation).Enjoy the episode!Related blog:https://odysseycoachingsystems.co/fitness-tracker-accuracy/Timestamps:0:00 Introduction5:15 Recent research on the accuracy of fitness trackers10:05 How following your fitness tracker can work against your weight loss goal16:21 Managing energy balance without tracking calories burned20:50 Benefits of using a fitness tracker27:57 Using data is a tool, not the goal**This episode is brought to you by Odyssey Coaching Systems**Studies:- Accuracy of Heart Rate Watches: Implications for Weight Management (2016) - PMID: 27232714- Reliability and Validity of Commercially Available Wearable Devices for Measuring Steps, Energy Expenditure, and Heart Rate: Systematic Review (2020) - PMID: 32897239- Wrist-worn devices for the measurement of heart rate and energy expenditure: A validation study for the Apple Watch 6, Polar Vantage V and Fitbit Sense (2022) - PMID: 34957939- Accuracy and Acceptability of Wrist-Wearable Activity-Tracking Devices: Systematic Review of the Literature (2022) - PMID: 35060915 More from Talking Nutrition and Odyssey Coaching Systems

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the field of critical psychiatry with Dr. Elia Abi-Jaoude and Lucy Costa. Dr. Abi-Jaoude is a staff psychiatrist at The Hospital for Sick Children and Assistant Professor and Clinician Investigator in the Department of Psychiatry at the University of Toronto in Toronto, Canada. Lucy Costa is Deputy Executive Director of the Empowerment Council, a voice for clients of mental health and addiction services primarily at the Centre for Addiction and Mental Health in Toronto.   While this topic could be very philosophical and expansive, we are going to focus our discussion by considering the practical implications of this field on psychiatric practice. What do you need to know about critical psychiatry as a trainee, and how might it impact your clinical practice?   The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Define the term critical psychiatry and describe how the field has evolved over time Review core principles of critical psychiatry and apply them to a clinical situation Understand the potential benefits and harms of critical psychiatry and where the field is headed   Guests: Dr. Eila Abi-Jaoude and Lucy Costa   Hosts: Dr. Gaurav Sharma (PGY5), Dr. Nikhita Singhal (PGY5), Dr. Monisha Basu (PGY2), and Saja Jaberi (IMG)   Audio editing by: Gaurav Sharma   Show notes by: Gaurav Sharma and Nikhita Singhal   Conflicts of interest: Neither of our guests nor hosts have declared any conflicts of interest related to this topic. Interview content: Introduction - 00:13 Learning objectives - 02:35 Defining critical psychiatry - 03:33 How our experts got involved in critical psychiatry and incorporate it into their work - 04:50 What are some of the questions critical psychiatry tries to answer? - 15:07 Why care about critical psychiatry and “holding truths lightly”? - 23:55 Principles of critical psychiatry - 24:55 Applying critical psychiatry principles to a case - 32:40 Potential benefits and harms of a critical psychiatry approach - 41:49 Future directions for critical psychiatry - 58:29 Review of learning objectives and summary - 1:01:30 End credits - 1:03:17   Resources: Critical Psychiatry Textbook Restoring Study 329  Psych Debate 14 | Critical Psychiatry and Diagnosis   References: Barkil-Oteo A. Collaborative care for depression in primary care: how psychiatry could "troubleshoot" current treatments and practices. Yale J Biol Med. 2013 Jun 13;86(2):139-46. Craddock N, Mynors-Wallis L. Psychiatric diagnosis: impersonal, imperfect and important. The British Journal of Psychiatry. 2014;204(2):93-95. doi:10.1192/bjp.bp.113.133090 Kirsch I. The emperor's new drugs: medication and placebo in the treatment of depression. Handb Exp Pharmacol. 2014;225:291-303. doi:10.1007/978-3-662-44519-8_16 Middleton H, Moncrieff J. Critical psychiatry: a brief overview. BJPsych Advances. 2019;25(1):47-54. doi:10.1192/bja.2018.38 O'Donoghue T, Crossley J. A critical narrative analysis of psychiatrists' engagement with psychosis as a contentious area. Int J Soc Psychiatry. 2020 Nov;66(7):724-730. doi: 10.1177/0020764020934516 Samara MT, Dold M, Gianatsi M, et al. Efficacy, Acceptability, and Tolerability of Antipsychotics in Treatment-Resistant Schizophrenia: A Network Meta-analysis. JAMA Psychiatry. 2016;73(3):199–210. doi:10.1001/jamapsychiatry.2015.2955   Important figures in the history of anti-psychiatry and critical psychiatry (discussion edited from episode for length): Anti-Psychiatrists: R. D. Laing (UK) Thomas Szasz (USA) Michel Foucault (France)   Critical Psychiatrists: Joanna Moncrieff (UK) Suman Fernando (UK) Sami Tamini (UK) Pat Bracken (UK) Derek Summerfield (UK) Sandra Steinguard (USA) Critical Psychiatry Network  (International Email List)   For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

Commentary by Dr. Candice Silversides

The dramatic overrepresentation of autistic people among those seeking sex changes ought to give us pause. This vulnerable sector of the population has repeatedly been the victim of one leftist frenzy after another. Now, they’re the victim of mutilations. Read the article at Homefront Crusade.

Welcome back to the summer shorts series! Over the summer, the CAR podcast team are bringing you bite-sized episodes on a recently published paper from different members of the team at the Centre for Appearance Research. In this summer short, Abbi speaks with A/Prof Nicola Stock about her recently published paper titled 'Feasibility and Acceptability of the Promoting Resilience in Stress Management-Parent(PRISM-P) Intervention for Caregivers of Children with Craniofacial Conditions'. Read the paper here: https://journals.sagepub.com/doi/10.1177/10556656231157449?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Episode produced by Abbi Mathews Summer shorts series developed by Nadia Craddock

Do you want people to be more likely to follow whatever rules, policies, or procedures you create? It's time to make them more human. Understanding and empathizing with the perspectives of others plays a crucial role in effective rule adherence. Comprehending the dynamics of rules can lead to beneficial outcomes in various aspects of life, from lessening conflicts to fostering compliance within organizational settings. Those who understand and communicate the reasons behind their rules are more likely to gain cooperation from those affected. It also helps reduce misunderstanding and resistance, promoting a smoother and more efficient implementation of rules or policies. Guest Christian Hunt, during his conversation with Melina Palmer, explained his thoughts on this matter, drawing on his experience as the founder of Human Risk, host of the Human Risk podcast and author of Humanizing Rules. Hunt believes that, to instill rule adherence, it is important to understand the perspectives of individuals subjected to those rules. He also iterated the need for effective communication, emphasizing that rules are more likely to be accepted and adhered to when individuals understand the rationale behind them. Christian introduces his HUMANS framework during the conversation, and shares interesting, real-world examples from transportation, Netflix, and more. In this episode: Understand the relevance of emotional intelligence and empathy in compliance with rules. Acquire knowledge about the role of clear communication in improving rule compliance. Analyze the issues linked with changing speed limits and the crucial role of enlightenment. Appreciate the need to present regulatory efforts as advantageous and pertinent to the workforce. Learn Christian's HUMANS framework and how to start using it in your business. Show Notes: 00:00:00 - Introduction, Melina Palmer introduces Christian Hunt, the founder of Human Risk, a company that specializes in using behavioral science to manage the risks of human decision-making. Christian shares his background in financial services and regulation, which led him to focus on the human side of compliance and ethics. 00:02:20 - Unique Perspective from Regulation to Compliance, Christian discusses his unique experience of transitioning from a regulator to a compliance professional, allowing him to see both sides of the problem when he had to enforce his own rules (and realized they didn't align properly). He emphasizes the importance of understanding the reasons behind rules and regulations in order to effectively manage them. 00:05:57 - Applying Behavioral Science to Ethics and Compliance, Christian explains how his experience in risk and compliance led him to realize the relevance of behavioral science in influencing human decision-making. He shares his mission to help organizations use behavioral science to get the best out of their people while mitigating risks. 00:08:03 - Navigating "Weird" Rules, Christian provides advice for individuals who find themselves dealing with rules that seem strange or unnecessary. He suggests understanding the reasons behind the rules and considering whether they serve a genuine purpose. Having a dialogue and presenting alternative perspectives can be helpful in managing such rules. 00:11:41 - Balancing Compliance with Dialogue, Christian acknowledges that in tightly regulated industries, dialogue may not always be possible. However, for those who can engage in discussions, he emphasizes the importance of approaching the conversation with empathy and understanding of the other party's perspective. 00:12:37 - Understanding the Fundamental Attribution Error, Christian Hunt discusses the difficulty of putting oneself in someone else's shoes and the tendency to blame others instead of seeking to understand their rationale. He emphasizes the importance of pausing and considering where others may be coming from in order to find better solutions. 00:13:30 - The Importance of Questioning What is Normal, Christian highlights the concept of "normal" and how rules and expectations are often based on extreme, non-common examples. He shares a story about his train journey and the importance of understanding the rationale behind rules. He initially dismissed the need for bag labels, but a staff member explained that they were necessary in case of train evacuation. This experience taught him the importance of not making presumptions and considering the reasoning behind rules. 00:18:25 - Learning from Mistakes and the Dunning-Kruger Effect, Christian discusses the Dunning-Kruger effect and admits to falling victim to it himself. He shares a story about a rule regarding variable speed limits on roads, where drivers often question the need to slow down. He emphasizes the importance of recognizing that rules are often in place for valid reasons, even if they may not be immediately apparent. 00:24:53 - The Frustration with Rules, Christian discusses how rules can be frustrating when they are imposed due to the actions of others. He highlights the need for clear communication and understanding between authorities and the people being controlled. 00:25:49 - Societal Reasons for Rules, Christian acknowledges that some rules are put in place for the greater good, such as slowing down traffic for the safety of elderly drivers. He emphasizes the importance of considering the rationale behind rules and whether they apply to specific subsets of the population. 00:26:39 - The Challenge of Communicating Rules, Christian recognizes the challenge that authorities face in communicating the reasons behind certain rules. He believes that authorities should be more transparent and ethical in their communication, especially in democratic societies. 00:28:00 - The Employment Contract Fallacy, Christian discusses the fallacy of relying solely on the employment contract as a reason for imposing rules. He argues that just because authorities have the power to enforce rules doesn't mean they should, and they should consider the perspective of those being controlled. 00:31:02 - Differentiating Between Rules, Christian explains the importance of distinguishing between rules that are irrecoverable (serious violations) and rules that are recoverable (less serious violations). He uses Netflix's approach of focusing efforts on irrecoverable actions as an example of effective rule implementation. 00:37:23 - Understanding Requirements and Imposing Tasks, The importance of understanding requirements and tasks from both the perspective of the person giving the task and the person receiving it. It is crucial to ensure that the person giving the task understands what they are asking for and the potential challenges involved. Imposing tasks without understanding can lead to frustration and inefficiency. 00:38:09 - Recognizing Risk and Impact on Employees, It is essential to recognize the potential risks and impact of imposing tasks on employees. If a task is likely to be unhelpful and difficult for the employee to understand, it poses a higher risk. Employers should consider whether the benefits outweigh the potential negative impact on employee relationships and trust. 00:39:30 - Using Behavioral Science as a Design Tool, Behavioral science can be used as a design or diagnostic tool to improve task implementation. If reality cannot be changed, the perception of a task can be altered through framing or breaking it down into smaller, more manageable tasks. Understanding the impact and finding ways to make tasks more user-friendly is crucial. 00:40:43 - The Pitfalls of Compliance Training, Compliance training exercises often fall short in effectively teaching and assessing employee understanding. Testing employees on obscure information that is unlikely to be relevant to their job can lead to frustration and a sense of wasted time. Employers should reconsider the purpose and effectiveness of compliance training exercises. 00:49:38 - Introduction to Incentives, Companies often use incentives, such as prize drawings, to encourage customers to fill out surveys. The same principle applies to employees in the workplace. Incentives can increase compliance and the quality of work. 00:50:22 - Importance of Incentives, Incentives are crucial for tasks that require a high standard of work. If people don't see the value in doing something, they are less likely to do it. Consider what's in it for them as an individual and find ways to make tasks feel worth doing. 00:51:11 - Feasibility of Compliance, Consider whether it is feasible for individuals to comply with a rule or task. If something is too difficult or requires significant effort, compliance is less likely. Make tasks easier to increase compliance. 00:52:02 - Acceptability of Rules, Just because a rule can be imposed doesn't mean it will be accepted. Consider whether employees find a rule acceptable based on their specific circumstances and employment. Overreach can lead to resistance. 00:53:44 - Social Proof and Normalcy, The perception of what is normal and acceptable plays a role in compliance. Consider social proof and whether other people in similar circumstances are being asked to do the same thing. Make rules salient and relevant to increase compliance. 00:56:04 - Conclusion, Melina's top insights from the conversation. What stuck with you while listening to the episode? What are you going to try? Come share it with Melina on social media -- you'll find her as @thebrainybiz everywhere and as Melina Palmer on LinkedIn. Thanks for listening. Don't forget to subscribe on Apple Podcasts or Android. If you like what you heard, please leave a review on iTunes and share what you liked about the show.  I hope you love everything recommended via The Brainy Business! Everything was independently reviewed and selected by me, Melina Palmer. So you know, as an Amazon Associate I earn from qualifying purchases. That means if you decide to shop from the links on this page (via Amazon or others), The Brainy Business may collect a share of sales or other compensation. Let's connect: Melina@TheBrainyBusiness.com The Brainy Business® on Facebook The Brainy Business on Twitter The Brainy Business on Instagram The Brainy Business on LinkedIn Melina on LinkedIn The Brainy Business on Youtube Learn and Support The Brainy Business: Check out and get your copies of Melina's Books.  Get the Books Mentioned on (or related to) this Episode: Humanizing Rules, by Christian Hunt Both/And Thinking, by Wendy Smith and Marianne Lewis Friction, by Roger Dooley Mixed Signals, by Uri Gneezy What Your Employees Need and Can't Tell You, by Melina Palmer Connect with Christian:  Christian on Twitter Follow Christian on LinkedIn Human Risk Podcast Top Recommended Next Episode: What Problem Are You Solving? (ep 126) Already Heard That One? Try These:  Dunning-Kruger Effect (ep 266) Adam Hansen and the Curse of Knowledge (ep 176) Inequity Aversion (ep 224) Behavioral Science in the Wild, with Dilip Soman (ep 241) Framing (ep 296) Confirmation Bias (ep 260) Design for Decision, with Sam Evans (ep 291) Influence, with Robert Cialdini (ep 157) Mixed Signals, with Uri Gneezy (ep 273) Good Habits, Bad Habits with Wendy Wood (ep 127) Overwhelm and Decision Making (ep 32) Reciprocity (ep 238) Social Proof (ep 87) Friction, with Roger Dooley (ep 274) Other Important Links:  Brainy Bites - Melina's LinkedIn Newsletter Melina as a guest on the Human Risk podcast 

Dennis provides career advice based on personal experience. In this podcast he introduces a method for evaluating the suitability, feasibility, and acceptability of a plan. Suitability means assessing if the plan will achieve the desired outcome. Feasibility evaluates whether the plan is possible to execute with resources available. Acceptability assesses if the cost (money, time, resources) of the plan is acceptable to stakeholders. Applying these evaluations increases the chance of successfully executing a plan.The speaker also promotes his book on finding a job that fits your life on Amazon. hank you for listening! Please subscribe, like, and share with your friends. I appreciate your support, input, and questions. Website: https://www.dennisguzik.com Pick up your copy of “Find A Job That Fits Your Life” by Dennis Guzik today! Stop wavering over whether it's time for a big move - get all the support and resources needed in one place so can make the best decision possible without any regrets! I release a new episode every Tuesday, and each one is about 7 minutes in length. My podcast is available on: Apple: https://apple.co/3NqN95Z Google: https://bit.ly/3LAsBXv Spotify: https://spoti.fi/3MClzmv Stitcher: https://bit.ly/3xrxIVX

In this episode, Latesha Elopre, MD, MSPH, and Jason Farley, PhD, MPH, ANP-BC, FAAN, FAANP, AACRN, answer questions about HIV PrEP including:How long someone can receive PrEP and the monitoring that is needed over timeRecommendations for monitoring bone health while receiving oral PrEPTreatment as prevention and PrEP efficacy data and options for people who inject drugsThe role of circumcision in HIV preventionThe use of PrEP in pregnancyConcern for ART resistance if someone seroconverts while receiving PrEP, especially when using nondaily PrEP optionsThe possibility of using FTC/TAF on demandInequities in adherence and persistenceCost considerations with different PrEP modalitiesRecommendations for hospitalized patients receiving PrEPPrEP considerations for patients with renal dysfunction and higher BMIsPrEP efficacy based on site of exposurePresenters:Latesha Elopre, MD, MSPHAssociate ProfessorDivision of Infectious DiseasesAssistant Dean of Diversity and InclusionGeneral Medical EducationUniversity of Alabama at BirminghamBirmingham, AlabamaJason Farley, PhD, MPH, ANP-BC, FAAN, FAANP, AACRNProfessorSchool of NursingJohns Hopkins UniversityNurse PractitionerDepartment of Infectious DiseasesJohn G. Bartlett Specialty PracticeBaltimore, MarylandLink to full program:https://bit.ly/3Fqdgs9

Neste episódio falamos de: Depressão e probióticos Quais Cepas são Psicobioticas Neuroinflamação Adoçantes e risco de doenças do coração Banho de flloresta Processamentos Top Down e Bottom Up Detox de R1talina e Neuroproteção Homens que são muito exigente Dose exata da cafeína Artigos citados: Suran M. Sugar Substitutes Don't Help Weight Control and May Increase Risk of Heart Disease and Diabetes, WHO Warns. JAMA. Published online June 14, 2023. doi:10.1001/jama.2023.10967 Braga J, Lepra M, Kish SJ, et al. Neuroinflammation After COVID-19 With Persistent Depressive and Cognitive Symptoms. JAMA Psychiatry. Published online May 31, 2023. doi:10.1001/jamapsychiatry.2023.1321 Debras C, Chazelas E, Sellem L, Porcher R, Druesne-Pecollo N, Esseddik Y et al. Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort BMJ 2022; 378 :e071204 doi:10.1136/bmj-2022-071204 Nikolova VL, Cleare AJ, Young AH, Stone JM. Acceptability, Tolerability, and Estimates of Putative Treatment Effects of Probiotics as Adjunctive Treatment in Patients With Depression: A Randomized Clinical Trial. JAMA Psychiatry. Published online June 14, 2023. doi:10.1001/jamapsychiatry.2023.1817

https://www.yourcyberpath.com/98/ In this episode, we are back discussing Security Design Principles, and this time we are focusing on Psychological Acceptability. The Security design principles are crucial for your work as a cybersecurity professional, they will not only help you do really well, they will also help your work stand out. Psychological Acceptability is defined as “the protection mechanism should be easy to use, at least as easy as not using it” and here comes the struggle of wanting to make controls easier to use while still providing high level security. Kip mentions the term “False sense of security” which is really common in the field where you as a cybersecurity professional are under the impression that you have everything under control while in fact you are missing a lot of risks due to your workforce not psychologically accepting the high level controls put in place and trying to find workarounds to make their jobs more convenient. In the end, Jason discusses Password Managers, which is a great example of Psychological Acceptability, and how it can be one of the few controls in cybersecurity where you can increase security and productivity at the same time. What You'll Learn ●   What is Psychological Acceptability? ●   What are the challenges that come with Psychological Acceptability? ●   What is a False sense of security? And how can it be dangerous? ●    What is a good example of Psychological Acceptability? Relevant Websites For This Episode ●   https://www.udemy.com/course/irresistible-cybersecurity/ Other Relevant Episodes ●   Episode 57 - Best time of the year to get hired ●   Episode 80 - Risk Management Framework with Drew Church ●   Episode 92 - Password Managers

On this episode of "The Bruce Exclusive", Bruce reacts to multiple pieces of Buffalo Bills news, including the extension for defensive tackle Ed Oliver, the signing of Leonard Floyd and Cameron Dantzler, and Josh Allen being the cover athlete for "Madden 24" while recognizing that opinions on certain items will be shaped by individual standard set, subconsciously or otherwise, by the opiner. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Join Drs Russo and Nguyen for a discussion of the current status and history of male contraception, including research published in the journal. Relevant articles: Post-abortion contraception, an opportunity for male partners Online community queries on hormonal male contraception Male contraception is coming: Who do men want to prescribe their birth control? Medical mistrust as a barrier to male contraception for Black American men in Los Angeles, CA Access to male sexual and reproductive health services in publicly funded California clinics in 2018 Acceptability of the oral hormonal male contraceptive prototype, 11β-methyl-19-nortestosterone dodecylcarbonate (11β-MNTDC), in a 28-day placebo-controlled trial Acceptability of oral dimethandrolone undecanoate in a 28-day placebo-controlled trial of a hormonal male contraceptive prototype

In this episode, Carolyn Chu, MD, MSc, FAAFP, AAHIVS, and Samantha Strong, PharmD, BCACP, AAHIVP, CDCES, answer questions including:Strategies to improve disparities in pre-exposure prophylaxis (PrEP) access in difficult-to-reach populations Key remaining questions related to PrEP options for cisgender women and people who inject drugsConcerns about resistance at seroconversion in patients with suboptimal PrEP complianceImplementation of molecular screening for patients receiving PrEPExpectations for weight gain and patient counseling pointsPresenters:Carolyn Chu, MD, MSc, FAAFP, AAHIVSChief Medical OfficerAmerican Academy of HIV MedicineChief Clinical OfficerNational Clinician Consultation CenterSamantha Strong, PharmD, BCACP, AAHIVP, CDCES Clinical Director of PharmacyNevada Health CentersLas Vegas, NevadaLink to full program: https://bit.ly/3Fqdgs9

Subscribe to Mamamia Jelena Dokic has been the target of online abuse amidst a controversial Australian Open. What does the horrific trolling of a former tennis champ/accomplished commentator tell us about the idea of a woman's 'acceptability window'? Plus, how has dating evolved in 2023? The lessons from a 'Please Date Me' PowerPoint that's going viral. And…our best and worst of the week, including a live TV stuff up, a smoothie and a new couch. The End Bits:  Listen to the Jelena Dokic conversation on Here If You Need: One Week After The World Cup Cayla George Was Gifted A Baby Listen to our last episode: Who Our TikTok Algorithms Think We Are RECOMMENDATIONS: Mia wants you to watch Bojack Horseman on Netflix.  Sign up to the Mamamia Out Loud Newsletter for all our recos from the week in one place.  GET IN TOUCH: Feedback? We're listening. Call the pod phone on 02 8999 9386 or email us at outloud@mamamia.com.au CREDITS: Hosts: Mia Freedman, Jessie Stephens & Claire Murphy Producer: Emma Gillespie Audio Producer: Leah Porges Assistant Producer: Susannah Makin Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures. Just by reading our articles or listening to our podcasts, you're helping to fund girls in schools in some of the most disadvantaged countries in the world - through our partnership with Room to Read. We're currently funding 300 girls in school every day and our aim is to get to 1,000. Find out more about Mamamia at mamamia.com.auBecome a Mamamia subscriber: https://www.mamamia.com.au/mplusSee omnystudio.com/listener for privacy information.

Dealing with death is a commonly an avoided topic to discuss. In this episode we crash the barrier and discuss our inevitable passing. What teachings does the church provide with how we should face the end of our journey? Episode TimeLine:00:00 Accepting Our Own Death03:28 Saint Maximilian Kolbe Courageous Choice 05:24 Being Brutally Forced into the “Starvation Bunker”08:04 The Tension of Valuing Suffering10:45 Benedictine Monk's Celebrating the End of a Fellow Monk's Journey12:27 Acceptability of Surrendering to Death 15:47 Human Brains Entering Trauma Mode When Seeing Death18:42 Personally Approaching Our Death 22:48 Finding Infinite Peace in What is Acceptable, Especially Together                                            The podcast Father and Joe brings us, as individuals, closer to the Holy Spirit and His Church.Seek Peace. Be Open to God and Love. Learn from Your Sufferings. Thank you for listening.FatherAndJoe@gmail.comAlso you can find is on twitter @FatherAndJoe    Catholic, Church, God, Life, Jesus, Benedictine Monk, Father Boniface Hicks, Joe Rockey, Relationships, Family, Love, Ready to Die, Maximilian Kolbe, Choice, Boldness, Offering Sufferings, Suffering, Life's Journey, Surrendering to Death,  #Catholic #Church #God #Life #Jesus #BenedictineMonk #FatherBonifaceHicks #JoeRockey #Relationships #Family #Love #ReadytoDie #MaximilianKolbe #Choice #Boldness #OfferingSufferings #Suffering #Life'sJourney #SurrenderingtoDeath             

In this episode, Jason E. Farley, PhD, MPH, ANP-BC, FAAN, FAANP, AACRN, discusses optimizing HIV pre-exposure prophylaxis (PrEP) selection and persistence for men who have sex with men (MSM), including:Disparities in PrEP uptake for MSMWhat healthcare professionals can do to address disparities in PrEP uptakeProviding PrEP within a program that includes sexual health and primary care services, in addition to prescribing PrEPPrEP medication options for MSMHelping patients access PrEP medicationsBarriers to PrEP persistenceStrategies for aiding in PrEP persistence, including:          - Increasing access to healthcare professionals through text messaging and telemedicine         - Ensuring a welcome and sex-positive environment         - Partnering with pharmacists and community health workers for follow-up Jason E. Farley, PhD, MPH, ANP-BC, FAAN, FAANP, AACRNProfessorSchool of NursingJohns Hopkins UniversityNurse PractitionerDepartment of Infectious DiseasesJohn G. Bartlett Specialty PracticeBaltimore, Maryland See the full program at: https://bit.ly/3WhbBvZ

Welcome to our December Dictionary Series! We recognise that we reference a whole bunch of terms and theories on this podcast and felt it was time to have a handy series of definitions that you can keep coming back to. This is a series of 24 x 5 minute episodes covering some key terms that we use a lot in our work at the centre. Episodes will be released daily and definitions have been co-created with or provided by various members of the Centre for Appearance Research team. In this episode, Abbi discusses some definitions of 'COGNITIVE BEHAVIOURAL THERAPY'. Episode links: NHS: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/ Assessing the usability and acceptability of FaceIT@home: An online CBT intervention for people with visible differences: https://www.researchgate.net/publication/362269959_Assessing_the_Usability_and_Acceptability_of_FaceIThome_an_online_CBT_Intervention_for_People_with_Visible_Differences YP Face it: https://www.ypfaceit.co.uk/ Please remember to rate, review, share and subscribe and happy listening! The CAR podcast team xxx To find out more about the Centre for Appearance Research, follow us: On Twitter:  twitter.com/CAR_UWE On Instagram:  www.instagram.com/car_uwe/ On Facebook:  www.facebook.com/AppearanceResearch Transcript available soon at: bit.ly/3FfqSH6 Cover image designed by Abbi Mathews Episode developed and produced by Abbi

“Effective communication with healthcare providers, making informed decisions about their care, and gaining strength through connections to others” are the key aspects of patient self-advocacy, ONS member Teresa Thomas, PhD, RN, assistant professor at the University of Pittsburgh School of Nursing in Pennsylvania, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, in a conversation about how patients can self-advocate and how nurses can support them. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by November 25, 2024. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Upon completion of this activity, participants will report an increase in knowledge related to patient self-advocacy. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast episodes: Episode 183: How Oncology Nurses Find and Use Credible Patient Education Resources Episode 197: Patient Learning Needs and Educational Assessments Thomas's research articles: “I Was Never One of Those People Who Just Jumped Right In for Me”: Patient Perspectives on Self-Advocacy Training for Women With Advanced Cancer “I Pretty Much Followed the Law, and There Weren't Any Decisions to Make”: A Qualitative Study of Self-Advocacy Experiences of Men With Cancer A Conceptual Framework of Self-Advocacy in Women With Cancer Symptom Burden and Self-Advocacy: Exploring the Relationship Among Female Cancer Survivors Teaching Patients With Advanced Cancer to Self-Advocate: Development and Acceptability of the Strong Together™ Serious Game Perspectives on Self-Advocacy: Comparing Perceived Uses, Benefits, and Drawbacks Among Survivors and Providers Patient Education vs. Patient Experiences of Self-Advocacy: Changing the Discourse to Support Cancer Survivors Thomas's clinical trial: Efficacy of a Self-Advocacy Serious Game Intervention Clinical Journal of Oncology Nursing article: Oncology Nurses' Role in Promoting Patient Self-Advocacy Sigma Theta Tau International Honor Society of Nursing University of Wisconsin–Madison Center for Patient Partnerships American Society of Clinical Oncology National Coalition for Cancer Survivorship To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Effective communication with healthcare providers, making informed decisions about their care, and gaining strength through connections to others. That's really how we define the key aspects of what patients do to advocate for themselves.” Timestamp (TS) 04:39 “At the end of the day, if a patient doesn't feel like the care really is attuned to what is going on in their life and they don't feel like they're understood or appreciated, or their self-worth isn't identified by their care team, then are we really patient-centered?” TS 06:32 “Really, patient self-advocacy is about making sure that your clinical care team knows what's most important to you, even if the clinician doesn't ask you, ‘What is it like at home?' or ‘Tell me about your family,' or ‘Tell me about what you're looking forward to getting back to after treatment.' Put that into the conversation where they understand exactly what your quality of life means to you and they understand what your main goals of treatment are.” TS 12:33 “When patients don't have that voice to speak up, ask questions, and push a little bit if they don't understand what's happening, their care, adherence, health, and quality of life suffer because they don't know enough to be engaged enough to ask for help.” TS 19:53 “We're interested in patients' quality of life, and we see that their emotional, social, physical, religious, and spiritual quality of life just goes down because they're not themselves and they don't quite know how to get back to themselves. And that's the saddest part to see—them going through the physical rigor of going through cancer treatment is one thing, but feeling like you're not yourself—we've had several people call it self-worth, the idea that I'm worth fighting for and I'm worth standing up to my providers and insisting that my pain finally gets a treatment that works.” TS 21:27 “Patient self-advocacy really centers around communication, and the informed decision making comes part and parcel with that because that's the getting the information and gathering the resources to help communicate those ideas to your providers or whomever. And the connected strength also is about communication, too, since frequently family dynamics also require really good communication skills. So, if there was one thing that we would really want to train our patients in in terms of self-advocacy, it's that effective communication aspect.” TS 31:42 “We know that cancer puts people at a disadvantage and makes them feel different from who they are. And what we're trying to do is get them to feel like who they are is the same person they were, maybe slightly different from, who they were before cancer and that their cancer team and their loved ones know and support them for who they are.” TS 57:47