Building Trust, by Flores and Solomon is a really good book. I rank it with The Wisdom of Insecurity, by Alan Watts as two of the most mind altering books I have read. Watts turned the conventional wisdom of insecurity on it's head, essentially showing that security or fixedness is closer to death and that insecurity or uncertainty is closer to life. When his wisdom sinks in, one comes to appreciate insecurity for what it is--the experience life-giving growth. On can then quit amplifying a certain amount of natural stress, by dropping the judgment that insecurity is bad.

Flores and Solomon turn broken trust and betrayal on their heads, as Watts did with insecurity. They allow one to see that trust and betrayal are sides of the same coin (one meaningless without the possibility of the other) and they also allow one to see that creating and rebuilding trust is the key act in creating a better and shared future. Without such acts of trusting and rebuilding of trust from moments of betrayal, no better future is possible. Trust is not a thing to be shattered. Trusting is a competency for all forward looking people to practice and learn--a verb, not a noun.

Below is a kind of relationship diagram that captures some of the ideas that filled my head as I read the book.

1:13:27 PM     comment []   Google It!  

A friend of mine, Gervase Bushe, wrote a very useful book: Clear Leadership. The insights and framework are based upon his career as a professor and business consultant

Clear Leadership is full of practical and immediately useful mental models and advice. Organizations are beginning to use it as a framework for leadership training at all levels.

After reading this book, I created a mnemonic and a drawing that help me keep a few of the book's key points in mind and handy for my use. I give them to you with Gervase's permission.

SOFTeNeD stories and maps.

Sensing--what is my body telling me? Am I poised for a fight, to flee, to hear, to learn, to have fun, etc.

Observing--what would others agree happened, what was objective, what data can we agree upon and share?

Feeling--awareness of feelings is very useful early on, as feeling color everything else.

experience, each person has a different one

Need (want)--what do I want to happen, what do I want in the way of agreements.

experience, our stories come from our experience, we can share these and ask others to share their's. Experience is subjective and has numerous aspects (SOFTND)

Do--what will I do and what will I agree to do?

This little graphic represents for me Gervase's four profound senses of self and matching sets of skills:

Appreciative self--the halos, understand what you and the other have done that you would like to see more of. It is a kind of "assets based" approach or "appreciative" approach and comes form the appreciative inquiry framework.

Aware self--the recursive loop, suggests that we spend time first going over the SOFTeNeD algorithm personally, before trying to tell others or ask others.

Descriptive self--the arrow from my mouth to the other's ear, suggests that I must describe my SOFTeNeD stories and maps to the other in an appreciative frame and expressing understanding that it is only my experience, not all facts.

Curious self--the arrow from the other's mouth to my ear, suggests that I must have skill in asking and hearing about their experiences and if possible their SOFTeNeD stories and maps. I try to hear in an appreciative frame.

It has been about a year since I read this book and I have not reviewed it for this post. I hope you will pick the book up and work with the concepts in it. We can all do our parts to reduce the "interpersonal mush" in our organizations and communities as well as at home.

11:47:45 AM     comment []   Google It!  

I have gradually come to realize that I unconsciously make a binary choice each time I think or act. I get out of my bed either on the defensive side or the learning side.

I either start my day holding on to... you name it. Or, I start my day open, willing and interested in learning, being vulnerable, wrong, embarrassed, over worked, surprised, delighted...open to a different future than I had yesterday. I think that it is this almost unconscious step that determines what is possible and what happens.

This is a short and somewhat personal post. I doubt that it requires more explaination.

I am just trying to be more aware of that first step each morning and each moment.

8:36:24 AM     comment []   Google It!  

A friend sent me a link to this poem. I pass it on to you. It is good and it rings true. It is by a doctor and more or less for doctors. But all may appreciate the sentiments.

A few lines:

"For the head will explain
      but the final common pathway is the heart
      whatever kingdom may come
For what matters finally is how the human spirit is spent"

Click here. 

Healthcare is science, reason and caring. May none be missing.

10:31:16 AM     comment []   Google It!  

My invaluable assistant, Jill Hickok, told me about an NPR presentation on the use of story telling in medicine. We are trying to do something similar in Whatcom County to heighten the awareness and understanding of the relational aspects of medicine, especially chronic conditions.

We are coming to believe that among all the change and stresses of medicine the experience is loosing it's meaning for some providers and patients. Focusing on people and their stories is one way to combat the cynicism fostered by a broken or non-existent system of care. Most of us came into the profession because of a love people and a deep interest in people and their stories.

Here is a link to the NPR piece: http://www.npr.org/features/feature.php?wfId=1480863   (I hope their RealPlayer download works better for you than it did for me. May be a firewall issue. I will try it at home tonight.)

Here is a link to a piece on the physician that is spearheading the effort, Rita Charon, M.D., Ph.D.

http://litsite.alaska.edu/uaa/healing/medicine.html

Here is a link to a biosketch on Dr. Charon. http://www.medinfo.ufl.edu/other/histmed/charon.html

I hope to learn more about this approach.

I have heard Dr. Rachel Remen talk about the power of story telling.  I find stories more transformative than powerpoint and analytical data. Perhaps it is because they contain what we find most interesting and important--other people.

Here are links to her work: http://www.rachelremen.com/; http://www.meaninginmedicine.org/about_fmm.html; http://www.almanacnews.com/morgue/2000/2000_04_12.hfa.html.

2:02:02 PM     comment []   Google It!  

The Bureau of Primary Health Care has successfully jump started the 100% Access 0 Disparity movement in America. Spokane, WA area is implementing a similar approch.

There is a summary of the BPHC experience that is very enlightening, if you wish to switch from projects and programs to "movements". I highly recommend reading it if you need to scale up some initiative to include more stakeholders.

A remarkable overview of the journy and the liberating concepts is chronicaled by John Scanlon in "Extrordinary Results on National Goals: Networks and Partnerships in the Bureau of Primary Healht Care's 100%/0 Campaign". The PDF file can be downloaded from THIS LINK on IBM Center for The Business of Government site. The site section is "New Ways to Manage". I agree that it is a real revolutionary way to think about how to manage large scale change.

1:02:03 PM     comment []   Google It!  

Some additional musings about leadership...

One of the hardest transitions I had to make as an officer in the Army was taking a command position (I had two company-level commands...I guess I screwed up the first one so they made me do it again!).  The saying "you're only qualified for the position you just left" applies here, where a commander knows well how to lead and manage platoon level activities.  But the path to success for a commander (and any other leader I have since realized) lies in the effectiveness of their subordinates.  You could be a great doer of things at the hands-on level but that will kill you as a commander.  Simply stated, you can't do everything and must trust your subordinates to pull things off.  Here's what you must pay attention to:

*Ensure your folks know and have interalized the mission, vision, and scope of the organization.  In this respect I spent much more time talking about what we were about (full-spectrum healthcare at the point of injury) than how we accomplished things.  This is critical, and the tendency is to slip back into focusing on 'how' because that's what you know personally.  Forget being the star player anymore, and even forsake coaching over pure cheerleading if you don't have time.  Coaching is harder than you think, but cheerleading we all can do.   

*Make sure your folks have the following two things: 1) a sure sense of ownership of the mission with the responsibility AND authority to pull it off, and 2) the resources to pull off that mission.  Too many times we expect people to somehow just absorb ownership of the mission because you gave them the task to accomplish this.  Think about the successful projects you have been on, and I bet you weren't doing them because you had to but because you knew it needed to be done.  THAT'S ownership + responsibility + authority in action.  And don't buy into the false buzzphrase of 'do more with less'.  Resource the mission/project so it will succeed.  And understand that much of the costs/time/resources will be expended well before much of the mission has started.

*Don't be afraid to push people to achieve tough goals...but make sure you are with them the entire way.  I have had a reputation of asking for the moon from my subordinates, but I can tell you I was pushing them less hard than I have myself.  But some amazing things come out of this push to excel.  1) People stretch their personal understand of what their limits are and gain tremendous confidence.  2) People WANT to be stretched.  No soldier goes to field training exercises and enjoys playing cards 12 hours a day but it happens in some units.  But good units train hard, back off, and ramp back up again to peak at the appropriate times in exercises.  3) The byproduct of this pressure is often some wonderful moments of teamwork, stories to brag about to their fellows, and an extreme sense of accomplishment.

*Leaders should be adept at finding good junior leaders under them, give those leaders increasing responsibility, and spend more time mentoring and nurturing those folks.  Remember, you ain't Da Man anymore.

*Look for opportunities outside your normal mission boundaries.  Coupled with an organization that expects to do miraculous things they will pull off more missions outside their normal operational scope.  And it provides them an opportunity to show to others their multifaceted capabilities.  My medical units were often called on to help provide primary security for the assembly areas we were in.  Why? Because we often trained in environments other support units wouldn't attempt, and we employed the same tactics, techniques and procedures that a combat unit would in our operations.

*Make time to get together outside the work environment.  Work hard and play hard but do it together.  Have a beer (or three) with your folks.  I found out more about the pulse of the organization by being available to talk in an informal manner with folks.

*Don't take yourself too seriously.  You should account for what has brought any success your way, and if you followed the items above you know that somebody ELSE made the great things happen.  Not you.  I also think a great sense of humor can ease tensions, bring off-track conversations back to the forefront, and make for a more fun workplace.  Especially fun for your subordinates is when you go along with them teasing you about some attribute you exhibit.  If they feel comfortable enough to poke fun at you to your face then the organization is probably healthy.  If they do it behind your back then something is dysfunctional.  There's a great article in this month's Havard Business Review about humor in the workplace  http://harvardbusinessonline.hbsp.harvard.edu/b01/en/common/item_detail.jhtml;jsessionid=BMRTF4MBXCGEOCTEQENR5VQKMSARUIPS?id=F0309A 

*Reflect often on how you are doing as a leader.  Are you the type of person that you'd want to have as a boss??  Be a reflective-practitioner of leadership and know that you will never 'arrive'.  Some may mistake this process as some sort of second-guessing oneself, or a flaw in their confidence to lead.  We all have blind spots, but if we never try to find them because of hubris then we will never grow as leaders.

*People sense a phony and respect genuineness.  I can't tell you how many times I have validated this with both subordinates and superiors.  I have been fortunate to work for people who appreciate candor.  I have even had to tell subordinates things that were quite difficult but by speaking in a frank and honest way with them they have appreciated it much more.  Even when disciplining them I have had feedback that the soldier appreciated knowing how things stood rather than me shirking away from telling them.

In my next post I'd like to share my feelings about visiting Marc Pierson in the flesh...what a special treat to meet a dedicated and talented group that Marc has formed.

4:43:07 PM     comment []   Google It!  

Several doctors at the WA State Medical Society meeting ask for more information on what Advanced Access is. So I put a web page together with some good references. Just click on "web page".

I am skeptical that rapid improvement can occur until most physicians have taken this step. It is a happy circumstance that their profit should increase about 9% and their number of visits should simultaneously decrease about 16%.

2:29:31 PM     comment []   Google It!  

Imagine this. You are asked to create a human body. You choose a hospital in California to create a gastrointestinal system,  a health system in New York to create a heart and blood vessels, a city in Vermont to create a brain, a hospital Iowa to create a peripheral nervous system, a group of hospitals in Illinois to create the lungs, etc., etc.

Enough. Some things can't be done separately, some can. Organic things typically cannot. Some complex things can be "componentized" and assembled, some things must interact to even come into existence.

Some people at the Robert Wood Johnson Foundation read the Institute of Medicine Report, Crossing the Quality Chasm and ask organizations to make proposals to radically improve American health care.

Experienced people in organizations in Whatcom County took the request very seriously. We had the same hopes and desires and we had been working separately and collectively for the same goal for more than ten years.

With much thought and discussion and in collaboration with patients we developed a radical plan for a radical change--no individual piece of it was radical, it was the understanding that it all had to be done together that was radical. To extend the analogy started above, we understand the we needed a small GI system, a small cardiovascular system, a small nervous system, etc. for any of it to work. And that with all the essential systems working to support each other they could grow together to a mature effective health system of care--better than anything in existence.

We have been at this for just over one year. It no longer seems unattainable. It is clearly attainable. What is difficult is getting all of this done in less than two years so that it is self-sustaining.

We are hopeful that some of the agencies and foundations that fund parallel, sequential, or distributed "demonstration" "projects" can see the difference here and fund an organic, systematic approach. Nothing less will create the radical transformation called for by the IOM Chasm Report and needed by the American public.

Reductionist approaches can do much. They cannot build an organism, not yet, perhaps never. Supporting the growth of a small, complete, organism (community health system) may be the right approach to radical transformation of US healthcare. We believe it is. Do you?

The minimum  essential small "parts" or "organ systems" that we have in Whatcom County, WA are:

1) direct patient involvement in all teams and in governance,
2) using evidence as the basis for care design,
3) starting with two chronic medical conditions[heart failure and congestive heart failure] and then moving to all others over a few years,
4) information systems designed and deployed so that everyone including the patient has the information that the patient wants them to have when and where they need it,
5) clinical office and hospital  work flow reconfituration so that the new work is integrated into the old and the old is made less frustrating and more efficient for everyone, and finally
6) modeling of the health care benefits and the economic impact on all of the stakeholders so that potential winners and losers can cooperate for the good of the patients and the whole community.

2:29:07 PM     comment []   Google It!  

Balanced human interactions will make sense of some of the craziness that is US healthcare.

I would like you to read the very thoughtful and humane comments that Daniel Shurman makes. After a very difficult year he and his wife Bonnie have insights we should all reflect upon. There is nothing I can say that will add to his message.

Dan is responding to my post on Sunday, June 22, '03.

8:24:35 AM     comment []   Google It!  

After reading the though provoking article Chronic Illness, Comorbidities, and the Need for Medical Generalism, by Kevin Grumbach, MD, in the first edition of Annals of Family Medicine. I had these thoughts:

The idea of non-reductionist thinking and wholistic planning is so important and so non-western. A reductionist nightmare.

Placing the patient at the center begins to make sense of things. I am not yet sure that we aren't trying to put the PCP at the center; even though that may move in the right direction in some cases.

With the help of Robert Wood Johnson Foundation, we in Whatcom County, WA are building a system to deliver "patient-centered, community-wide, chronic disease management" based upon Wagner's chronic care model. Even that model may be too physician centric. See my post.

Conidering the chaotic non-system and it's misaligned reimbursement, I am not sure that the overburdened PCP can help all the patients navigate. We are using nurse care coordinators Connie Golas and Nancy Stothard to assist, and we also use a patient centered/patient designed Shared Care Plan

I will follow your new journal with interest. As you poit out in the article, we should not be too self congratulatory. For even the best approaches in the US are very inadequate from the patient's perspective. See the Commonwealth Fund report (pdf)

A chasm exists. Any narrow focus on the parts, even the PCP role, risks a further Balkanization of US healthcare. We must focus on the patient and their family, we must include the patient in all the discussions. So long as the journals exclude patients from the dialogue they will miss an opportunity for truly integrative solutions. Even the PCPs may be a "specialists" compared to patients and their families.

10:58:56 AM     comment []   Google It!  

Pursuing Perfection in Whatcom County is not an undertaking of convenience. It is a matter of commitments. Commitments have been made.

The prior five or six years of work by CHIC memebers were agreements and collaborations of convenience, we publicly promised nothing, we did things in our own time. Pursuing Perfection is different, we have made difficult promises to patients and we must keep them. As Karl Weick points out, to have true commitment one must state voluntarily, personally, publicly, and in an irrevocable manner what you will do. We have done this.

8:03:04 AM     comment []   Google It!  

A few local ideas about leading community coalitions: It is about shared values--creating, unearthing and polishing them.

Jim Reinertsen, on behalf of the Institute for Healthcare Improvement, ask me to prepare some thoughts on leading coalitions from our learnings in Whatcom County's Pursuing Perfection work.

First I disclaim: I don't know. We are improvising. In fact, the key is probably improvisation.

Next, a recommendation: find at least one person that is or will become consumed by the opportunities.

Here are ten ideas we seem to be using in Whatcom County Washington as we pursue perfection in health care delivery across a community.

1. Bring the outside in.

Don't assimilate it. Protect it. Pay the money. Don't expect double duty.

Trust is the key. Find those known to be "pure of heart" and help them stay that way. If you have this role (outside brought in) understand that the relationship with the outside is the key value on the inside. Invite the Trojan Horse in. Don't lose the affiliation and affection.

You are looking for someone who represents the positive values that you share with the community and who understands the conflicting values.

2. Hire and empower successful revolutionaries as leaders.

Transformation is a kind of revolution.

They must want and see the new way more and clearer than you do.

You must support and protect them. Trust them. Trust your job to them--to the cause.

Be willing to be overthrown if necessary (but try to keep up with the revolution--the loss of your job probably helps no one except your successor.)

Ask your team and others in the coalition about their credentials as revolutionaries. Encourage a radically transformative stance. Model it. Be irreverent.

We have wonderful revolutionaries. We have people with years of successful experience with coalition building.

3. Become a story junky.

Find them, tell them, get others tell them. Make them up if necessary.

Stories around campfires have created and sustained the tribes and communities for thousands of years. Long before Excel and PowerPoint. We are programmed to create meaning from stories. Stories go to the heart and heart is what is needed for transformation.

Become the story you need.

Make sense, create new meaning with stories. From the chaos of  "facts" pull out the relevance you need and storify it.

This is the job of a leader.

4. Revert to common values. Technique will not work here (yet?).

Explore values all the time.

Talk about values.

Tell stories about values.

Hire strong value-based leaders and staff for this work.

Values trump power (status quo). You must ensure this.

5. Make it up as you go.

Karl Weick talks about bricolage. A French word that does not translate well. A bricoleur is a  person that can routinely make what they need from what is at hand. They can make a uniquely useful machine from spare parts in a barn and it may do the job better than anything on the market. Gather all the bricoleurs you can find for this kind of work.

Bricolage--A form of improvisation practiced by some, using whatever resources and repertoire come to hand, in order to perform the immediate task. A person who practices bricolage is called a bricoleur.

In a paper called Organizational Redesign as Improvisation, Karl Weick identifies the following requirements for successful bricolage.

• intimate knowledge of resources
• careful observation and listening 
• trusting one's ideas
• self-correcting structures, with feedback

Improvisation is a related idea. Quite different than "experimentation".

Think of the "improvisational organization" as a variant on the "learning organization." More real time, more masterful. That is what is needed.

For an in depth understanding of this concept and also a related exploration of  "wisdom as improvisation " see these articles by Karl Weick .

The Attitude of Wisdom: Ambivalence as the Optimal Compromise, Karl E. Weick. At this web link (on Tuesday March the 4th, '03) is a useful simple diagram and explanation.

6. Appreciative Engagement.

I have coined this term to combine two profound yet simple ideas. "Appreciative" points to a stance and techniques that are well explained by David Cooperrider of Case Western Reserve and Gervase Bushe of Simon Frasier University as well as others. The idea most simply stated is look for what you appreciate and want to see more of instead of focusing first on what you don't like and want to see less of. "Engagement" points to Axelrod's thesis that many of the problems of change can be avoided by investing in the engagement up front, at the beginning of the exploration, in all the folks who have to implement or change. Pay, listen, and engage now to avoid failure in the implementation phase.

7. Systems thinking must trump liner, simplistic planning.

Complex adaptive systems (CAS) are a useful way to think about health care and especially across organizations--coalitions. Plsek's Appendix B in the Chasm Report is the most important part of the book. The challenge of the book is to create a coherent system that will dramatically reduce the burden of illness in the citizens of this nation. Success is impossible without understanding the way complex, adaptive systems work.

Rules for optimizing a CAS:

1. Agreement upon clear aims (patient-centered, safe, equitable, etc.)
2. Follow a few simple rules (cooperation, relationship, transparency, etc.)
3. Ensure effective communication among the agents/parts
4. Provide opportunities and resources for experiments (fertilizing and watering)
5. Pruning (removing resources from experiments that fail to move the system closer to the aims)

Explicitly model the sytem for policy making if you can afford it.

Robert Wood Johnson Foundation paid for the modeling of Congestive Heart Failure and Diabetes care in Whatcom County. The understanding of the local health care system's dynamics  is already helping our key stakeholders to come together and prevent misaligned incentives preventing cooperation. I have never seen anything like this before.

8. Get committed.

Karl Weick gives a useful operational definition of commitment. I am probably paraphrasing but my memory of it is: 1) personal, 2) voluntary, 3) public, and 4) irrevocable statement of intentions and agreements.

In a coalition, don't assume you have commitment without having all parts of this formula for each key stakeholder and leader. Get boards, CEOs, opinion leaders, and front line staff to tell their stories in a way that fulfill these criteria. Model it yourself and invite others.

9. It's about LOVE, FAITH, and FORGIVENESS.

The fuel for transformation is passion and freedom.

Only love of others and self will get you through the maze and confusion. It is the beacon and fundamental value.

Generate your faith that others will find their love and their forgiveness and that you will continually rediscover yours. Generate your faith that something great will result even if it is not what you anticipated. Generate your faith that transformation will come from clear and agreed upon aims with a few simple rules all of which are guided by love and forgiveness.

Forgiveness of self and others is the moment-by-moment skill and key competency for transformation. Pursuing perfection is not about punishing self or others for lack of perfection. We are all so hard on ourselves and others that we create an unbearable burden. Drop it. Again and again.

10. Give away (through stories) all the success.

Take responsibility for all the screw ups. There will be plenty.

--------------------------------------------

MY REQUEST--please invite new IHI faculty, specifically:

1. Karl E. Weick (Sensemaking and High Reliability Organizations)
2. David Cooperrider and Gervase Bushe (Appreciative Inquiry and Clear Leadership)
3. David Snowden (Cynefin Model and Cynefin Centre)
4. Jack Homer and Gary Hirsch (Group System Dynamics Modeling and Simulation for cross organizations, cross industry policy making.)

5:41:08 PM     comment []   Google It!  

Total quality management (TQM) and continuous quality improvement (CQI) have not had the expected results in healhtcare. Much effort and resources and enthusiasm has been spent. Some have said the TQM and CQI don't work in healhtcare.

Let's look deeper.
Click here to see a larger image.

I have just begun to document what will become a rather lengthy "story" or article with lots of reference and links. Click here to read it.

10:58:41 PM     comment []   Google It!  

Lynne, I read your post of Jan. 27 with much interest. Teamwork is going to be key to improving the healthcare system and the work lives of healthcare providers. Nurses and doctors are not alone in the increasing isolation that has accompanied the accelerated pace and the heightened pressure to be accountable for costs globally. A book has been written by Robert D. Putnam, titled Bowing Alone. Follow this link for more information. http://www.bowlingalone.com/ 

I think this issue of teams and "community" are key to any useful improvement in our work and our lives.

6:28:13 PM     comment []   Google It!  

There is an interesting chapter, by Karl E. Weick, in either of two books 1) Organizational Wisdom and Executive Courage, by Suresh Srivastva (Editor), David L. Cooperrider (Editor) and 2) Making Sense of the Organization, Karl E. Weick. I found Dr. Weick's framing of wisdom useful and practical. Wisdom exists between the overconfidence of absolute knowing and the inaction of paralyzing doubt and uncertainty. His framing of wise action as improvisation is wonderful and it rings true. One starts toward original action with the faith that our past experiences and our ability to pull them together in new ways will lead to successful action. Often discovering and creating the future as we go along. Good writing, good thinking.

The thoughts are Karl Weick's, the drawing is mine. The drawing represents a sort of energy of activation diagram, from chemistry, there is a pull for the extremes. Energy must be applied to stay in the realm of wisdom. From the place of wisdom, armed with experience and some self confidence, one can choose to take off, improvise into the unknown and act wisely to create something new.

7:41:17 PM     comment []   Google It!  

In my view David Snowden brings knowledge management into alignment with Karl Weick's world of sensemaking and positive organizational scolarship.
Dave Snowden is the director of the new IBM Cynefin Center for Organizational Complexity.
His Cynefin model (download PDF file) is the best integration of knowledge management that I have seen. It is profound and it addresses intersections of LEADERSHIP, CULTURE, COMMUNITY, BUREAUCRACY, CHAOS, EXPERTISE and more.
I am working to understand Dave Snowden's thinking on the third age of knowledge management. He moves beyond knowledge as a thing to "knowledge as an active process of relating."
With a little more work on this reader's part his ideas will be personally usable. Here are my notes on Snowden's article "Complex acts of knowing--paradox and descriptive self-awareness" from a special issue of the Journal of Knowledge Management.

12:16:45 PM     comment []   Google It!  

In my first post into the category of Transformation, I must say that I am deeply skeptical that leadership as we currently understand it has much to do with transformation. What caterpillar has ever planned to enter a cocoon to come out as only God knows what? Who will lead their organizations into the radical process of transformation?
    Learning about organizational and community transformation is essential if we are to bridge the chasm between the quality of care patients could have and what they currently do have.
   Transformed mental models may need to precede any organizational planning for transformational change. This is a true opportunity for exploration and learning.

9:07:24 AM     comment []   Google It!