Tuesday, November 5, 2019

Engineering: Information Modeling ~: Pronouns - why do we care?

Pronouns - why do we care?

If you ever get a chance to work with a client to develop information models for the client's business, pronouns are watchwords that cannot be modeled as facts. However, pronouns do point to the facts and can be used to discover the facts. Pronouns do provide a view of the facts. "send them a bill" "when will it start"

Information modeling is an activity everybody does. From birth to death, our mind constructs information models of our personal world. Everybody's information model is unique. No other person has one's information model. The senses provide the gateway allowing world information to engage with the brain and mind.

Language is an expression of people's information models. Words are the seeds of thought.

The nine types of pronouns indicate the person's internal reference to something else.  It is a fact that pronouns identify something else. but not the actual fact to be modeled. From an information modeling perspective, pronouns are predicates that indicate some type of relationship.

The types of pronouns are types of relationships:

Subjective - Taking place within the mind.
Object - a material thing that can be seen and touched.
Possessive - demanding someone's total attention
Reflexive - directed or turned back on itself
Intensive - highly concentrated
Indefinite - designating an unidentified
Demonstrative - real or true
Relative -  connected with another
Archaic - something from an earlier period

https://www.thefreedictionary.com/List-of-pronouns.htm

List known pronouns
The Free Dictionary Blog > There are more than 100 pronouns.

A list of pronouns, plus definitions for each type of pronoun. Scroll to the end for a full pronouns list.


What is a pronoun?

Pronouns are some of the most useful words in the English language. They are used in the place of a noun to avoid it having to be named twice. For example, Suzy threw the boomerang and it came back to her. In this sentence, "it" is a pronoun that represents the boomerang, and "her" is a pronoun that refers to Suzy. Without pronouns, we'd have to say Suzy threw the boomerang and the boomerang came back to Suzy. Without pronouns, how would we even say "we"?
Here's the full definition.

Definition of Pronoun

In English, the part of speech used as a substitute for an antecedent noun that is clearly understood, and with which it agrees in person, number, and gender. Pronouns are classified as personal (I, we, you, he, she, it, they), demonstrative (this, these, that, those), relative (who, which, that, as), indefinite (each, all, everyone, either, one, both, any, such, somebody), interrogative (who, which, what), reflexive (myself, herself), possessive (mine, yours, his, hers, theirs). There are also pronominal adjectives, sometimes called possessive adjectives (my, your, his, her, our, their).

1. Personal Pronouns / Subject Pronouns

You already know subject pronouns, even if you didn't know that's what they were called. Subject pronouns are used to replace the subject in a sentence. You might also see them called "personal" pronouns, as they designate the person speaking (I, me, we, us), the person spoken to (you), or the person or thing spoken about (he, she, it, they, him, her, them). The following commonly used words are subject pronouns:
  • I
  • we
  • you (singular and plural)
  • he
  • she
  • it
  • they

Personal pronoun examples

I will be leaving soon.
You are welcome.
She is the new teacher.
He speaks three languages.
They are very friendly neighbors.

2. Object Pronouns

Object pronouns are used as the object of a verb or a preposition.
  • me
  • us
  • you (singular and plural)
  • her
  • him
  • it
  • them

Object pronoun examples

They offered me a ride. ("Me" is the object of the verb "offered.")
This letter is addressed to me. ("Me" is the object of the preposition "to.")
They gave us free tickets to the show. ("Us" is the object of the verb "gave.")

3. Possessive Pronouns

A possessive pronoun designates ownership and can substitute for noun phrases.
  • mine
  • ours
  • yours (singular and plural)
  • hers
  • his
  • theirs

Possessive pronoun examples

The green gloves are mine.
That cat is hers.
The red house is theirs.

Possessive Adjectives / Pronominal Adjectives

"Pronominal" describes something that resembles a pronoun, as by specifying a person, place, or thing, while functioning primarily as another part of speech. A pronominal adjective is an adjective that resembles a pronoun. "Her" in "her car" is a pronominal adjective.
  • my
  • our
  • your
  • her
  • his
  • their

4. Reflexive Pronouns

Reflexive pronouns might be the easiest group to remember because they all have one thing in common: the ending "self" or "selves." That's because reflexive pronouns show how the actions of an aforementioned person or group affects him or her (or them).
  • myself
  • yourself
  • herself
  • himself
  • itself
  • ourselves
  • yourselves
  • themselves

Reflexive pronoun examples

I bought myself a new car.
That man thinks a great deal of himself.
We may be deceiving ourselves.

5. Intensive Pronouns

Intensive and reflexive pronouns are actually the exact same words (ending with "self" or "selves"), but they function differently in a sentence. Intensive pronouns not only refer back to a previously mentioned person or people, but they also emphasize. As their name suggests, they intensify.
  • myself
  • yourself
  • herself
  • himself
  • itself
  • ourselves
  • yourselves
  • themselves

Intensive pronoun examples

myself was certain of the facts.
The trouble is in the machine itself.
The cooks themselves eat after all the guests have finished.

6. Indefinite Pronouns

As the word "indefinite" suggests, these pronouns do not specify the identity of their referents. They are more vague than other pronouns.
  • all
  • another
  • any
  • anybody
  • anyone
  • anything
  • both
  • each
  • either
  • everybody
  • everyone
  • everything
  • few
  • many
  • most
  • neither
  • nobody
  • none
  • no one
  • nothing
  • one
  • other
  • others
  • several
  • some
  • somebody
  • someone
  • something
  • such

Indefinite pronouns examples

Both were candidates.
No one is home.
Several of the workers went home sick.

7. Demonstrative Pronouns

Demonstrative pronouns specify a particular person or thing.
  • such
  • that
  • these
  • this
  • those

Demonstrative pronouns examples

I don't much care for these.
Who's that?
Such are the fortunes of war.

8. Interrogative Pronouns

This group of pronouns question which individual referent or referents are intended by the rest of the sentence.
  • what
  • whatever
  • which
  • whichever
  • who
  • whoever
  • whom
  • whomever
  • whose

Interrogative pronoun examples

Who left?
Which of these is yours?
Do whatever you please.

9. Relative Pronouns

Relative pronouns introduce a dependent clause and refer to an antecedent (simply the word or phrase to which a pronoun refers). For instance, who in the child who is wearing a hat or that in the house that you live in.
  • as
  • that
  • what
  • whatever
  • which
  • whichever
  • who
  • whoever
  • whom
  • whomever
  • whose

Relative pronoun examples

The car that has a flat tire needs to be towed.
The visitor who came yesterday left his phone number.
Do whatever you like.

10. Archaic Pronouns

There are several pronouns that have fallen out of common usage but appear frequently in older texts, so there is still a good chance that you will encounter them. "Thee" is an old word for "you" used only when addressing one person, while "thy" is an old word for "your." "Thine" indicates the one or ones belonging to thee.
  • thou
  • thee
  • thy
  • thine
  • ye

Archaic pronoun examples

Thou shalt not kill.
With this ring, I thee wed.
Thy name is more hateful than thy face.
To thine own self be true.

List of all pronouns

A full list of every word that can be considered a pronoun or pronominal adjective:
  • all
  • another
  • any
  • anybody
  • anyone
  • anything
  • as
  • aught
  • both
  • each
  • each other
  • either
  • enough
  • everybody
  • everyone
  • everything
  • few
  • he
  • her
  • hers
  • herself
  • him
  • himself
  • his
  • I
  • idem
  • it
  • its
  • itself
  • many
  • me
  • mine
  • most
  • my
  • myself
  • naught
  • neither
  • no one
  • nobody
  • none
  • nothing
  • nought
  • one
  • one another
  • other
  • others
  • ought
  • our
  • ours
  • ourself
  • ourselves
  • several
  • she
  • some
  • somebody
  • someone
  • something
  • somewhat
  • such
  • suchlike
  • that
  • thee
  • their
  • theirs
  • theirself
  • theirselves
  • them
  • themself
  • themselves
  • there
  • these
  • they
  • thine
  • this
  • those
  • thou
  • thy
  • thyself
  • us
  • we
  • what
  • whatever
  • whatnot
  • whatsoever
  • whence
  • where
  • whereby
  • wherefrom
  • wherein
  • whereinto
  • whereof
  • whereon
  • wherever
  • wheresoever
  • whereto
  • whereunto
  • wherewith
  • wherewithal
  • whether
  • which
  • whichever
  • whichsoever
  • who
  • whoever
  • whom
  • whomever
  • whomso
  • whomsoever
  • whose
  • whosever
  • whosesoever
  • whoso
  • whosoever
  • ye
  • yon
  • yonder
  • you
  • your
  • yours
  • yourself
  • yourselves

Psychology: Grief Experience Source

Grief Experience Source


I used to think external events cause stress and anxiety as an artifact of a grief experience. Psychologist believe a person can self-produce stress and anxiety. If stress and anxiety are artifacts for grief, perhaps grief can be self-produced.

The grief experience table shows four sources of grief.


Grief Experience
Cause by Self
Cause by Others
Known to self
Internal Loss
Unknown to Self
Illness  External

In the table, illness, external trauma and loss are within the scope of normal grief experience triggers. The notion that oneself can knowingly create an internal grief experience suggests grief behaviors like anxiety and stress can be self-induced. As a mental experiment, replacing the word grief in the top-left cell with either anxiety or stress, the words in the cells seem to be just as valid as for grief.
Reference:



Johari window dimensions:

Johari Relationships  Known to self Unknown to Self
Known to others OpenBlind Spot
Unknown to othersHiddenUnknown to  All

Tuesday, October 29, 2019

Multiple Scleroses: Inside-Out Introduction

Inside-Out Introduction

The theme for my study on multiple sclerosis is "MS From the Inside Out."   The work started out as a way to look at MS from a different perspective. The basic theme is the trauma of MS. A few years ago, I visited a hospital and noted a sign that read "Trauma Center." Intuitively I knew the reference, but for some reason, the name nagged at me.The word trauma provokes visions of a TV ER with gurneys, blood, and madness. I decided to find a better explanation. At last, I found that the classical use of trauma means not only the injury but it also includes social and emotional impacts. For a person with a long-term injury, I added disability as an impact area. These 4 impact areas, injury, social, emotional and disability frame my MS study.

Over time , my career in engineering and computers developed my skill over for information modeling. In my early 30’s I was a manager for a group of engineers and programmers. I was having a devil of a time communicating with staff about job assignments and work activity. A friend suggested I see a psychologist. Skeptical, I made an appointment. I explained the situation to the therapist. After about 20 minutes, the psychologist said you are fine, you just need some more tools. She handed me a book called “Frogs into Princes” saying “Read the first 100 pages. Come back if you have more questions.” I never went back. The book was about neural linguistic programming (NLP).  For me, those 100 pages opened the door to information modeling and enabled many career advancements.

As humans, our brains store unique abstract information models of reality. These models are complex integrations of learned experiences biased by physical constraints, social norms, environmental limits and subjective discrimination.   From the "inside-out" is a statement specific to my information models.  When doing information modeling, sometimes new and unexpected perspectives emerge. The Blog has a few topics I find interesting.  My study includes impact models for injury, social and emotional areas.  A common theme in many of the models relates to the injury model.

Because MS affects the central nervous system resulting from loss of myelin around the nerve fiber's axons, the effect is loss of quality-of-life. Over time the intervals of immune system attacks remove axon myelin. When the attack occurs, the biological wound results in inflammation then eventually scarring and disability. The clinical name for the process is a relapse, an attack, and remitting, interval between relapses.  However, as a person living with MS, the clinical explanation omits an important consideration of living with neurological damage. When an MSer experiences an attack, we go to the neurologist to confirm the relapse. If the experience is an attack, the treatment is an infusion of then steroids to promote remission. My model changes the clinical model from the relapse/remittance to an event model relapse/remission/remodel where remodel is the period between relapses. This definition of remodeling became a common thread in my MS study.

Remodeling occurs constantly in life's events. I consider reframing and reshaping as two general categories of remodeling. Reframing usually refers to modifying the psychological impact and reshaping usually refers to adapting to the physical impact.  Generally reframing and reshaping are codependent changes acting as twisted wires bonding the new model.  

Consider a common life event of getting up from a chair, walk across the room and out the door.  A microscopic analysis could demonstrate millions of coordinated model events occurring in the event's processes. Fortunately, remodeling can be effectively recruited by common practice.






Tuesday, October 15, 2019

Multple Sclerosis: The MS Bike


Joseph’s MS Bike

Joseph’s MS Bike tells a story explaining Multiple Sclerosis.

While at a yard sale, laying on the lawn was a dirty old steel bike for $10.  Something about it attracted my attention. The rusted chain hung off the crank gears. The shredded cabling rubber dangled out of the shifter.  The bent wheels would never roll.  The seat rotted away, leaving only the metal frame. The logos and markings were long gone. For an offer of $5, I took it home and stashed it in the corner of the garage and forgot about it. As an ambassador for the National Multiple Sclerosis Society, I give talks about MS and my life with MS. One morning, a dream memory remained. In the memory vision was that yard sale bike but rebuilt, bright with new colors that explained MS.  For ambassador talks, I am always looking for a better way to communicate MS topics and issues.

In a dream vision, I could see a new design perfectly. On the top, down and seat tubes are the words Live, Ride, Believe. The neuron painted on the head tube and forks represent the dark mystery of MS hiding its cause and cure. The lighter spots on the tubes show where MS attacks the myelin on the axons leaving its scars (sclerosis). The orange is for all MS heroes who help MSers and support efforts to find a cure. The white is the belief that MS will be cured. On the chainstay tubes are the words “Stop MS”

As we all know, seeing something in a dream and making it come true are two very different stories. The yard sale bike was a steel frame fitted with 27-inch wheels, 10-speed gears, and the lever gear shifters clamped on the downtube. The brake levers attached to the drop-down racing style handlebars. The bike ventage is in the late 1970s. In the dream, fresh and the new components replaced the original, only the frame and the fork remained.

The MS Bike took weeks to build. All the components had to be acquired.  After sandblasting the paint and rust off the frame,  new powder-coated paint made thee frame look new just off an assembly line. Wheels and gears, cables, brakes and shifters,  handlebars and a seat,  and MS Bike was ready to ride.

The dream became true. The Multiple Sclerosis bike story begins at the head tube where the neuron and axon image showed the dark mystery of MS, with no cause and no cure. The spots of yellow are the scars from the MS lesion. The orange is for all the people who have MS, the support partners and all the people helping to solve the mystery.  The white is the belief MS will be cured.

The MS Bike is Ready


The Parade Ready 



Tuesday, October 8, 2019

Multiple Sclerosis: MS From the Inside-Out ~ Evolution

MS From the Inside-Out ~ Evolution

In 1989, at 40 years old, I was diagnosed with multiple sclerosis. Then in 1993 was the lottery for the first MS disease-modifying treatment drug, Betaseron. By 1996, disability forced the end of my professional career. For the next few years, I continued to follow the traditional MS clinical explanations and recommendations. In 2008, MS started gaining too much power over me. I needed a new approach; I wanted to change myself and change my MS.

After years of physical therapy, treatment at different offices was the same, I found therapists did not know about neurological therapy and treatment for multiple sclerosis clients.  Unsatisfied with physical therapy, l decided to hire personal trainers so the trainer would work for me and not for a medical office.  I had years of physical therapy, I knew my MS, and I decided I needed help with training, not with physical therapy. At first, the idea seemed attainable, but I soon found for treatment I needed both physical therapy and personal training. However, in a little over a year of personal training, I went from occasionally walking with two canes, weighting 300 lbs to riding my fist Colorado Bike MS 150.

When I started training,  I could not find a personal training program that focused on MS.  Before my first personal training session, I knew I would need some techniques to use as the models for the program. Within a few sessions, the idea for the model revealed itself, "rebuild the connections that MS took from me." That idea of rebuilding connections grew into a program I named " Connection Toning." During the early training years, I training by intuition, following the mantra "tell the brain what going to be trained, train the brain, tell the brain what was trained."  Meanwhile, I still had the neurologist visits, the pills, and the disease-modifying treatment injections. And eventually, physical therapy, psychological therapy, occupational therapy, neuropsychology evaluations, nutrition counseling, support groups, and home exercise programs all again became part of my MS life. The mantra evolved, and then, resolved to be "remodel the connections."

MS is only part of an MSer's life. My wife of 20 years is not an MSer, but she lives with my MS too. Our daughter, now living on her own, used to go to MS meetings and sit with coloring books. For every MSer, MS affects at least four or more other people. The clinical replase-remitting disease explanation of MS  does not explain the MSer living with MS, and the impact on others. Species evolution describes the phenomenon of species changes over time. The phenomenon of an MS attack is similar but the change occurs in lifespan. Every MS relapse-remitting cycle causes a persistent lifestyle evolution change. The change affects the MSer and support partners. 

Initial drawings of "Multiple Sclerosis Trauma Evolution" began in 2008 while trying to understand how remodel training fits with the clinical models of MS symptoms.  As the person who experiences MS symptoms, my perspective was from the inside-out view. And the clinical perspective is from the outside-in view. Since both views are for the same symptoms, the same perspective should allow for both views.  The clinical model used the terms relapse-remitting to describe the cycles of symptoms where remitting is the time between attacks. 

The neurologist's outside-in MS explanations describe the three types of MS progression.  As an MS person, MS affects me from the inside-out. The clinical MS progressing types are variations of release-remitting cycles. My MS life with MS knew that between the relapses, something else happens. I experience MS as a series of events. A relapse event triggers treatment for a remission event. After remission is a pause until the next relapse. During the pause, I trained to adapt to the damage caused by the relapse. I realized the pause is another event, and the pauses' training's purpose was to remodel the damage, not just to adapt. The inside-out view is three events, relapse, remission and remodel.

As part of my sessions with the trainers, the term adapting did not reflect the essential purpose of what I needed from training, which is to identify and rewire the MS damage. The name remodel, as a term, describes the three challenges,  identity the trauma, impact assessment, and remedy.  Remodel is a process that begins with identifying the lesion damage, determine the lifestyle impact, and work to remedy a lifestyle.  (Over time I developed my technique for remodeling; provoked fatigue to identify the damage, therapy experts for impact assessments, and training methods for remedy, I hope others can develop better techniques.) 

In other posts, I describe my methods for remodeling. This post explains how both the outside-in and the inside-out description of MS trauma is relapse-remission-remodel. I retired as an Ambassador for the National Multiple Sclerosis Society. When I attended meetings with other MSers, many people told me their MS story. We know the statement, "No two people with MS have the same MS symptoms." Truthfully, those words is the same for most things, "No two people live the same life." "Everybody is different. "Everything in nature is different." In life, the human mind creates models of similarity that makes things appear the same. For training, I needed a better way to explain that remodeling is life long and not just an event between relapses. Another statement we hear about MS is, "No two relapses are the same." The Multiple Sclerosis Trauma Evolution drawing illustrates the relapse-remission-remodel definition; it does not illustrate the lesion's trauma. The drawing recognizes MS's trauma life consequences where disability increases and the ability to thrive decreases.

The human voice produces sound waves where no two utterances are the same. Yet, we can hear and recognize the words. The ocean waves rise and fall where each wake-wave are not the same. Yet, we can see and hear the pattern. The term 'eccentric' means instances in a unique pattern, it also means groups of instances in an observable framework. Each sound wave is an eccentric pattern, yet the accumulation of patterns permits recognitions. MS's trauma leaves disability markers as MS evolves with the repeated eccentric occurrences of relapse-remission-remodel. This is MS from the inside-out. 

The drawing shows relapse-remission-remodel as definable events. MS has two dimensions of disease activity.  On-the-surface is the measurable recognition of lesion damage. Below-the-surface is a disease activity that is not clinically diagnosed.  Remodel is effective for both dimensions of disease activity. Brain health is a major tenet of remodeling. My favorite expression in Connection Toning is "Healthy Lungs, Healthy Brain."  The brain requires 20 percent of the air supply. If the MS activity is above or below the surface,  brain health defuses trauma impact and enables remodeling. 


Inside-Out and Outside-In Views
Everybody responds to disability as their own to manage. The clinical model of MS uses the term loss of the quality-of-life to describe the effects caused by increases in disability.  When I asked myself, what does MS steal from me, the list was long. Unsatisfied with the list, I recalled the doctor's diagnosis of my father's death. On the certificate, the doctor wrote the words "Failure to thrive." Looking at my list again, I realized failure to thrive also meant able to thrive. While quality-of-life is a true statement, it is incomplete. My inside-out perspective accuses MS of stealing my ability-to-thrive.

MS not only stole some of my quality-of-life; MS stole some of my quantity of life. Ability-to-thrive means quality-of-life and quantity-of-life. The ability-to-thrive reveals an intrinsic survival power model for will-to-thrive. Remodeling and will-to-thrive have a direct relationship. Each provides a self-supporting resource for the other, and grit is the result. Grit is the will-to-thrive remedy that dampens the long-term eccentric effects of MS trauma. Grit is the seed that feeds remodel.




From storm to calm,
From relapse to remission,
From remission to remodel,
From wave to wake,
From day to night,
From earth to the moon,
From birth to death,
From neither the same,
From alive to thrive,
From change we know,
From remodel to thrive,
From storm to calm.

Thursday, October 3, 2019

Contonx: Everyday Connections

Everyday Connections

Connection toning training begins with learning to be aware of the body's connections to produce activity for movement.

Suppose you are in a room sitting in a chair, and you look out a door and see a bright day inviting you outdoors. You stand up, walk across the room to the door, and all of sudden the wind slams the door shut. 
The normal body movement requires three movement elements for action.  

  • Begin with physical prowess to stand. 
  • Neurological coordination to walk 
  • Cognitive planning orchestrates navigation to the door. 
  • Startle reflex combines the movements into a simultaneous action. The door slamming causes a startle reflex that slams the thee elements into a near-simultaneous event.

Connections in MS

In MS, the immune system attacks the insulating tissue myelin around the axons causing 3 possible electrical conditions.


  •  A circuit open happens when the axon is cut causing axon loss
  •  Resistance increases due to insulation loss 
  •  Shorts, crosstalk, happen due to the demyelinated axons touching. 


All three exhibit fatigue conditions sometimes called nerve fiber fatigue.

In a way, the MS fatigue experience is like fainting, but unlike a faint where the person fainting has no conscious awareness, the MS fatigue attack is more like watching from being stuck in a bowl of clear gelatin unable to move.

In my youth, I had mononucleosis. While mono has several symptoms, the main symptom I remember is the extreme fatigue. I was so weak my mother had to spoon-feed me.  In my adult life, I can recall 4 times when the MS fatigue reminded me of being in bed with mono.  The other symptom I remember learning to walk again because my legs had no strength. Some say mono and MS may be related biologically. But, I do know fatigue symptoms are comparable.

Remodel Connections

All body positions require tone.  Muscles, nerves, bones, blood, and mind work together to maintain tone. The most restful posture requires tone. Movement requires millions of changes in tone. Each change requires connections to transfer from tone to tone. The connection itself is a tone.

Trauma disrupts connection tones. Connection tone training is a process for remodeling the damage in body systems to rebuild or remake or construct new connection tones. 


                

Wednesday, October 2, 2019

Psyc: What not is apathy is grit

What not is apathy is grit.

To understand something ask two questions:
   What not is ....   -- find the opposite
   What is not ...    -- describe something

The brain and the mind always exist together as a mood. Neither the brain nor the mind can coexist without being in a mood. The term mood has multiple meanings. The brain/mind can change moods hundreds of times a second. A mood state is a repeated occurrence of a mood that can be observed as a behavioral trait.

Keep Your Grit


The drawing Keep Your Grit began with the question "What not is apathy?" and discovered grit as the opposite. The change from an apathy state to a grit state means overcoming multiple blocking challenges. Once at a grit state, the same blocking challenges reduce the risk of returning to an apathy state. 

In drawing are eight belief mood states and each mood has an opposite mood. Each mood has two adjacent moods. 

The two risk-reward circles show the two mood change paths for will-to-thrive in one direction and the other direction loss of will-to-thrive. Each path is a continuous experience. Confidence can become doubt and doubt can become confident. Determination can become avoidance and avoidance can become determination. Doubt is the opposite of determination. Confidence is the opposite of avoidance. Doubt and avoidance are risk pathways leading to apathy. Confidence and determination are reward pathways leading to grit. 

At the center is belief. The name could be willpower, love, conviction, view, idea. belief or any tenet of self one holds true to be the source for the will-to-thrive.


Grit Wellness Moods

The Grit Wellness Moods drawing unfolds the eight belief moods to model transition moods between two beliefs moods.  Each belief mood has four transition moods. The drawing illustrates the relationships between the eight belief moods, the sixteen transition moods and the four pathway moods. 

A possible application of the model is an explanation of a person trapped by anxiety is to remodel the risk triggers into constructive rewards passions or to replace anxiety triggers with order tactics to gain certainty.

The drawing shows the moods as synchronous. In practice, mood experience is asynchronous and can be in any mood state. However, with experience, the moods will focus leading to a goal.


The reward statement "What is not apathy is grit." also has the risk statement "What is not grit is apathy." 

The two drawings are models for identifying moods and explaining mood change. The name I used for the moods are labels that I understood to best define transition states. 

Something to think about.

If every mood has a transition mood, what is the transition mood of the transition mood? The drawing shows 4 levels of transition moods. Each level is a transition mood. The three additional levels remain undefined for the Keep Your Grit model. The interesting question is what is W, X, Y, Z. 




Monday, September 30, 2019

Veteran: Comment on the Wolfe vs VA case


Comment on the Wolfe versus VA case


Wolfe & Boerschinger v. Wilkie, No.18-6091(DATED: September 9, 2019 PER CURIAM); 38 C.F.R. § 17.1005(a)(5) is invalid because it is contrary to 38 U.S.C. §1725; reimbursement of emergency medical care at non-VA facilities

References below.

The Court's opinion and the process leave me with big questions and that the VA can be ordered in a direction that will fix the problem.

The Court and NVLSP have the entire basis for the case wrong. The estimated cost does appear more sensational than factual. Unless the basis changes the DVA will not change its business rules. 

The Law says:

Statute 38 USC 1725 (c) (4) (D) states “The Secretary may not reimburse a veteran under this section for any copayment or similar payment that the veteran owes the third party or for which the veteran is responsible under a health-plan contract."

The statute means:  When the veteran’s insurance company pays a provider the insurance’s share of copayment, the VA will not pay back a veteran for the money insurance paid to a provider. That is all it means, that is all it can mean. The wording is exact. 

Without the statue, the veteran can claim the money from insurance belongs to veteran and invoice for reimbursement.   The statute prohibits double-dipping where insurance and the VA pay for the same medical expense. The VA does not have a regulation to prevent double-dipping.

The VA created CFR 17.1005 (5) "VA will not reimburse a veteran under this section for any copayment, deductible, coinsurance, or similar payment that the veteran owes the third party or is obligated to pay under a health-plan contract.”

The statute is correct, the regulation is fictitious.  The VA abuses the term reimbursement to include payment to the provider. 

Furthermore, the VA inappropriately uses the regulation to demand an explanation of benefits confidential business information from the patient and the provider. The Law defines third party to be the insurance company (patient, provider, insurer).  The VA switched the third party to mean (VA, veteran, provider).

The correct wording for CFR 17.1005 (5) is “The VA will not reimburse the veteran for a copay or coinsurance money paid under a health plan contractor.” ( A health plan contract can payout to either the medical services provider or to the insured.)  Or better: CFR 17.1005 (5) should be “The VA will not reimburse the veteran for an episode of care payments made to the provider or the veteran for episode’s medical expenses. “

Unless the regulation is like the above, the veteran can double-dip on payments made to the provider by asking to be reimbursed for payments made directly to the provider. In the case of medical insurance copayments, the title for the money belongs to the veteran patient. Medical insurance payment is exactly the same as if the veteran patient wrote at check to the provider.

Copay and coinsurance are terms specific to pay for a medical expense where the insurer pays some and the insured pays some. The definition of a medical expense is a fee for a medical service. 

The VA has no legal right to demand an episode of care explanation of benefits from the provider, the insurance company, or the patient. The patient, insurance, and provider have a private contract. By demanding the EOB and refusing to pay benefit is bureaucratic extortion. The Law requires the provider to reconcile all payout before invoicing the VA. That is all the information the VA needs.

The VA’s limit on medical expense payout is the maximum allowable amount (MAA) which is the same as the Medicare fee. Once the MAA is paid by any party, the Law exhausts further charges for the medical expense. I suspect the large cost estimate is calculated for the unpaid insurance payout rather than the MAA. 

If the VA suspects the provider being dishonest about reconciling payouts, the provider commits fraud in which case the problem belongs to legal and not a reason to deny veteran’s benefits.

The Court and the DVA treat reimbursement as a gratuitous act and not a formal business process. 38 USC 1725 instructs the VA to either pay the provider or reimburse the veteran. This statute defines the existence of 3 contracts and to make a payment the contracts require an invoice and a payment. Contracts: 
  • Veteran & VA, 
  • VA and Provider, 
  • Veteran & Provider. 
Elsewhere in 1725, 2 other contracts exist. 
  • Provider and The Veteran Patient, 
  • Veteran Patient (insured) & The Patient Medical Insurance company (insurer)
  • Note: no contract exists between the VA and the insurance company. A reimbursement requires an invoice before payment.  Unless the veteran files a Form 10-7078 (or equal)   invoice, the VA cannot make rules that bypass the Form.
Statute 38 USC 1725 (c) (4) (D) states “The Secretary may not reimburse …” Without a reimbursement invoice, the rest of the statue is void.  The VA regulation completely ignores the Law's reimbursement requirement.

Contract law and privacy law supersede Title 38.

To help understand Title 38, these are some of the first principles:
  • Title 38 is Congress’s life grant of benefits to all veterans for the veteran’s national service.
  • The Department of Veteran Affairs is Congress’s agent to pay veteran’s benefit expenses from the Federal Budget.
  • Title 38 defines the veteran’s benefits and the business rules the DVA uses for operation and payout.
  • A veteran’s benefit is a fee for a Title 38 service.
  • By Congress’s grant, the veteran owns the benefit, the DHA has the responsibility to provide services and payout from the Budget.
  • The DVA is not a veteran. The DVA is an agent of Congress, and cannot own benefits.
  • The veteran owns all benefits.
  • To receive Federal Budget benefits, the veteran must register with the DVA.
  • The DVA likes to market itself as a benefits organization. While pleasant-sounding, the words misspeak its authority and responsibility.
  •  Section 38 USC 1725 The Law instructs the Secretary to either pay-the-provider or reimburse-the-veteran.
  • Pay-the-provider and reimburse-the-veteran is a formal business process of invoice and payment.
  • Contract law and privacy law are the frameworks of business rules.
If NVLSP represented me with the Court of Veteran's Appeals, this is a list of conduct I would not expect the attorney to allow. 
  • NVLSP allowed the VA to use the terms copayment, coinsurance, and deductibles in defense arguments.  These terms copay and coinsurance mean two payers, the insurer copay and the insured copay.  The VA created a regulation for the insured copay; however, the Law applies only to insurer copay.   The term deductible is not in 38 USC 1725.   If the DVA does follow the Court, the veteran can double-dip on other payments made directly to the provider. It is simple, the medical insurance payout is the property of the insured. When insurance pays a provider, the insurer acts as a broker for the insured to pay the bill for the insured.
  • NVLSP allowed the VA to use the explanation of benefits (EOB) information to deny the veteran benefits. In a community provider episode of care, the EOB is private information, and the VA has no legal right or authority to demand.
  • NVLSP allowed the VA to claim itself as the first party in separate contracts. The Law defines the veteran as the first party.
  • NVLSP allowed the VA to substitute medical expense (fees for a medical service)  for insurance expense (cost of insurance)
  • NVLP allowed the VA to limit the meaning of copay and coinsurance to mean the patient's share rather than the insurer's share.
  • The CAVA, NVLSP,  and the VA tend to use the term reimbursement as a gratuitous act and not as a formal business process.
References:

United States Court of Appeals for Veterans Claims Docket Case Number:18-6091

Case NO. 18-6091 AMANDA JANE WOLFE AND PETER E. BOERSCHINGER, PETITIONERS, 




Thursday, September 19, 2019

Contonx: Contonix Exertion Scales

The Contonix Exertion Scales is a self-assessment grading method on the effectiveness of Mind-It Training (MIT) exercises. Tone is an active event that occurs when forces act together to maintain balance. If a person extends an arm and holds is stead, all biological systems act together to hold tone. As soon as the moves, the biological systems continue to act together to sustain continue change in tone. The means to change from one tone state to another is connection toning.

Thursday, September 12, 2019

Multiple Sclerosis: The cause of my MS.

Could something from 1971 point to reason I have multiple sclerosis?

When I was a teenager, my father earned extra money by doing did odd jobs for realtors like constructions, painting, cleanup. From the time I was 8 and until I was 18 and enlisted in the Marine Corps, I would go to many jobs with him. I think he had is own right of passage rules, because starting high school, he assigned me the high jobs like roof repair. I had no fear of heights. My enlisted ended in 1971, I  was 21 and often I would help him.  From an incident 50 years ago, my mind is still clear about what happened on a 1971 summer day.

Dad asked me to carry a bundle of shingles up to the roof where others worked. Putting the shingles on my shoulder, up the ladder, and walking across the roof, I put the shingles down for the roofers. I turned around to start down the roof, my legs froze. I could not move. Dad was calling me to come down for another bundle. I could barely hear him. He must have sensed something was wrong. He called out to one of the roofers to check on me. I am still standing frozen. The roofer looked at me, waved for my Dad to come up. The other roofer came oven and the three of them helped me to sit on the roof.  Dad told the roofers to help him get me down. They sat me on the roof. By pushing and tugging they slid me down to the ladder and help me turn over. One on the ladder, Dad is talking me down and help put my feet on the rungs while the roofers held my hands,  At halfway down, I could hold onto the ladder legs. And a few more rungs I was down.  Sill a little wobbly, Dad help me to lean on the pick-up.

A few minutes passed I was fine and could do other work. The building only was just a one-story house. During those few minutes, I was frozen with fear. Before the incidence, I had no fear of heights nor standing on the edge. The crew and I  had a good laugh about being me being afraid of work.  I never worked on a roof again. Forty-five years later, the exact same thing happened. I was at the gym, exercising on a spin bike. I felt fine, not physically exhausted. But, when I stood up, my legs froze, they would not move, I could not tell them to move. Standing there for a few minutes, the stiffness passed.  The legs became wobbly, and I was able to move to the next machine.

For 45years, the incidence on the roof caused self embarrassment. I did not understand. I always felt I let my Dad down. I showed weakness on the job but also the image of a Marine being afraid of a little old roof. I knew I was not a coward, I just did not understand what actually happened. Twenty years after the roof incident, I was diagnosed with multiple sclerosis. When the incident happened in the gym, I knew exactly what happened. Both the roof and the gym incidences was an MS exacerbation. In my life with MS, I spend a lot of time studying MS from the inside-out. systems perspective, not from the biological science perspective. The incident in the gym was a breakthrough event in my studies about MS and fatigue. For movement, we need three resources. The physical prowess to move. The neurological coordination of body systems. And, the cognitive capability to plan movement with the ability to send coordination orders for the plan.

The incident on the roof and in the gym was MS neurological fatigue. Both incidents had exactly the same pattern, frozen legs.  fear of being a lost and defenseless, and rest relaxing the frozen legs. If my analysis is true, then in the twenty years, before the MS diagnosis, from the time I was 21 until 40,  I experience undiagnosed  MS symptoms.  In 1976, I was a field engineering for a medical instruments company and my service territory was the central western states and the land area was a third of the United States.  The work involved fixing equipment in hospital labs and at university reseach labs. Travel to the cities meant flying. In a week's time could be one to four flights a day. In and out of Denver, to Salt Lake, to Phoenix to Albuquerque and back to Denver was an easy week.  Once I was so fatigued, I had to spend several days in a Salt Lake hotel room just resting.  I remember tossing the keys to the valet, bearly being able to walk to the front desk. I had to sit in the lobby and rest before going to my room. I thought I had the flu, but now I know the symptoms were from an MS attack.  When I returned to Denver, the family doctor gave me some vitamin shots along with bed rest. I was 25. A few months later the fatigue happened on the last flight home to Denver.  Will power got me to the parking lot and my car. For two days only I walked between the bedroom and the bathroom.  One the third day, I went to the family doctor again. More vitamin shots and rest.  At 26 I was burned out and 4 days later I quit that job.

The story just sounds like being overworked. The fatigue was MS.   At the time,  the fatigue appeared as job stress. The one thing I recall was not walking well and the legs being wobbly. Years later, I learned that wobbly walking is a symptom of MS. 

Could something have happened to me between 18 and 21 that caused MS? I am the only MSer in generations of past and present family members. I have an idea about what happened to me that is exclusive of others. I am still working on the idea.

Once I identified the fatigue pattern, I could recall other fatigue events before and after diagnosis with the same pattern. I named the pattern the -n event for the no-neurological coordination. Each fatigue event is different,  only a few are  -n severe disabling events. 

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