Relationships

I've really enjoyed Seven Principles for Making Marriage Work.

It is a book on communication, but totally different from the usual approach. The research shows that there is a 90% correlation between some communication patterns and a marriage that succeeds or fails.

Do you have harsh openings when you talk to someone, or do you have gentle ones? When you have a disagreement, do you use sarcasm, do you ever change your mind, do you value your spouse's opinions (and care to hear them) or do you downgrade anyone you disagree with?

Do either of you make repair or soothing attempts, and if one occurs, do you respond to it?

Those are all patterns you can learn to recognize, control and improve.

The book has a lot more than those points, but it teaches them well and they are the core to successful relationships (with friends, at work, or in a marriage). It contains a lot of accessible checklists, advice and patterns you can use. Best, it is data driven rather than modeled on current trends, psych fads or common knowledge and old tales.

Based on it, I've got some rules for talking to a spouse.

1. Never say "you always" or "you never" or "you are." That leads to divorce because it devalues your spouse and puts them in the category of "bad" rather than someone you love. If you want not to love them, fine, but otherwise take a different approach.
2. Never use sarcasm in any emotional discussion with your spouse. If there is emotion, then you should never belittle, degrade or use sarcasm (you shouldn't anyway).
3. Be gentle with each other.
4. Never pile on. When a repair attempt occurs (e.g. "you forgot to pick up the milk." [not, "you always forget to pick up the milk"] "I did, that was stupid" -- that is a repair attempt) If you pile on a that stage (e.g. "you sure are stupid!") you are sending the message that you don't want change, you just want to hurt the other person.
5. Spend some time each day supporting your spouse's venting. Agree with them, don't try to fix it or offer solutions, don't try to talk them out of venting. Take at least 15 minutes and make sure they do at least 95% of the talking.

Obviously there is a lot more than my conclusions in this book (ok, it may not be obvious, and with some books, there would not be, but there are in this case). Different people will have different take away points (and I have more, but I just wanted five for this post), with different amounts of tangibility (application vs. general principles).

Worth getting through interlibrary loan or used at amazon.com. Bears revisiting and the checklists and quizes are useful for application.

I may do some more posts based on the book.

Eating Lunch

Back before my life adjusted, I used to eat lunch just down the street from work once in a while. I'd clean the plate and probably use a cup of sauce to do it with (a sugary red sauce the Chinese restaurant used).

Then, as I began to lose weight and I ate lunch at home every day. That went on for more than three years.

We moved, the house isn't close enough, and I've been eating lunch at work for the past six or so months.

I finally went back to the Chinese place, had asparagus chicken again. This time I skipped the rice, skipped the sauce, didn't finish the asparagus and enjoyed the chicken. It was like an entirely different experience.

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For a link to the article I read recently:

How American Health Care Killed My Father - The Atlantic ...

and a commentary on it:

How American Health Care Killed My Father, David Henderson ...

Not my experience. Not my story. But interesting and a comment on the health care reform debate.

Reflections on Karate and Wado Ryu

Completely off of my usual topics.

Modern karate began with Funakoshi Gichin (or Gichin Funakoshi in the west) whose greatest skill was his impeccable sense of manners and his complete lack of self promotion.

He taught a style of punching and kicking (and other strikes) with high stances that operated from the balls of the foot. Most of the students he taught were Judoka -- people with a great deal of training, experience and competition titles in Judo.

He had two heir apparents. Hironori Ōtsuka and Funakoshi's son. Ōtsuka was not part of the university and Judo groups and was eventually alienated and founded Wado-Ryu. Funakoshi's son Gigō (Yoshitaka) Funakoshi died early of tuberculosis .

As a result, Nakayama Masatoshi (M. Nakayama in the west) became the dominant force in Japanese karate, not just Shotokan by virtue of incredible political skills. A PhD who was the director of physical education at Takushoku University, he had sophisticated and developed teaching and planning skills, which he devoted to unifying the teaching of karate as a system. He also had his background in Kendo, not Judo. He also cooperated with Hidetaka Nishiyama.

Under Nakayama the transition to lower stances and driving from the heel (much like an Olympic powerlifter drives from the heel) matured and completed (though it started with Gigō Funakoshi who is credited with originating the concepts), with a transforming ripple that affected all of the techniques, kata and applications.

As an aside, many of the conflicts between karate instructors can be better understood in terms of the University caste system vs. the old fashioned birth caste system (e.g. many early karate-ka had university credentials and gained status as graduates of the Japanese equivalents of the American Ivy League schools in a Japan where that status was very important -- these are the same people who refereed matches in suits and ties). The older birth caste system (which ranked people's status by the nobility of their parents -- Samurai caste and various degrees in that caste, for example) was fading and being supplanted at the time. Many in that caste had martial arts traditions in their families, but due to the social shifts were unable to finish university educations.

As to Wado and Shotokan, which is better and which is the better way to begin martial arts instruction? I'm not qualified to decide. Shotokan can have tai sabaki (when our club in Wichita Falls trained under Nic http://nikchapapas.typepad.com/ every work out included a fair amount of tai sabaki drills as a part of the warm-up), Wado can have a great deal of power. I had Judo training before Karate. I admire people in both styles, I just could not continue in Shotokan after Robin died. Wado is something I can do right now, and I was able to keep my dad's death from derailing me.

But, I had not seen the thoughts I'm expressing here expressed anywhere else, so I wrote this post and edited the Wiki a little. I train because it has been part of my life since I was a teenager, and I'm glad to find a place I can train that is not overwritten by emotional issues or too far to drive from my house.

What should we call Triage?

Every health care plan has triage of some sort. If nothing else, there are limits of time and risk so that accepting one treatment plan will take time that can not be spent on something else.

But most have limits that cut in before there are risks that people are unwilling to take or limits on just what sort of treatment people choose. Insurance won't cover experimental treatment. Some policies have lifetime treatment caps. Most electives are outside of coverage. That is triage.

The first time I encountered triage was when a guy ran a red light and hit me. We ended up in the same ER and they took care of him first. Triage is applying limited resources in order of need and effectiveness. It is often not pretty and often not fair.

Health plans have triage There are limits to the time and money available. People tend to want three things. First, they want more than they are paying for, second, they often want treatment past what other people would judge to be the point of diminishing returns and third, they often want treatment so they can avoid being compliant in observing their own health.

At times, triage comes together harshly. In WWII, antibiotics went first to treat venereal diseases, and then what was left over went to treat those injured in combat. Generally, combat infections resulted in death. V.D. got you treatment. But the treated went back to war, those rotting from combat wounds would have gone home (and, you could treat 20 cases of V.D. for the same antibiotics that one infected wound would take).

Often, triage also seems arbitrary. Decisions made seem to be random, often decided by cultural matters. Sometimes the decisions are mechanical, made in advance by formulas (Oregon's hierarchy list for example).

So, what do you call triage? In some ways it decides who gets an extra chance at life and who dies now. It also decides who gets treatment for non-compliance and who gets optional benefits (e.g. dialysis for for kidney problems brought on by not controlling sugar intake, AZT for AIDS, abortions, Viagra, or cosmetic surgery -- you name it, it might be on someone's list).

In addition, at some point, medical care is no longer done for someone, it is done to someone. Who decides that point? Some people would pay a million dollars to live an extra hour in pain rather than die an hour earlier in peace, especially if it is someone else's money.

It is disingenuous to claim that triage and plans for triage do not exist. It is a lie to deny that. However, it is questionable to characterize such plans as "death panels." Perhaps, perhaps not. But denying that triage exists is not only a lie, it is a harmful lie, because it stops communication about the real issue.

Given that perhaps half of Medicare money goes to mostly futile expenditures in the last ninety days of life, given the growing expense of non-compliance, given all of these other issues, we need a rational discussion on triage. Avoiding it by claiming that it is not happening or can be avoided serves no one. Until we can have an open and honest discussion on triage, we will be in denial, with all the increasing failures that causes.

What will be the answer we get? I don't know. What is the right answer? I don't know. But we can't find either the right answer or any answer if we don't have an honest discussion.

Triage in a Finite World

There is always triage. If nothing else, there is never enough time, and everything done excludes something there was not enough time to do as well. In every area of choice, choices have to be made. In addition, for most of us, there are financial and political limits, as well as limits to risk. Nikita Khrushchev may have ruled Russia with an iron fist, but he could not obtain a day at Disneyland for all his power.

Currently, the limits of time and money are coming to the fore in health care. Oregon faced it head on. They ranked treatments by cost effectiveness and then matched them up with State resources. If there is money, and your treatment does not mean someone else is denied a more effective treatment (for spending the money on your treatment instead), you get the treatment at state expense. If the answer is different, they will pay for counseling and for euthanasia treatments (which are legal in that state).

The easiest way to finance health care for all is to take the current dollars spent and pour them over into a new system that covers everyone. But if that is done, you will get different triage choices than the current system offers.

Now triage happens. Insurance will often not pay for things (which reminds me of battles in past years to force insurers to pay for treatments now known to be failures). But there are often improvements. Hypoplastic left ventrical used to be a death sentence. Now 60% of those treated with surgery survive, though year after year after year of failures occurred first.

We need an open, honest and extensive national discussion on triage in a finite world. Not only about what we cannot accomplish, but about the things we can.

Becoming a Category of One

Part of being unique in a field is to have two virtues:

Trust, those you deal with must be able to trust you to do what you say and to keep your promises. They must trust your ability to deliver.

Reliability, people need to be able to rely on you, that things will be what they expect

Yes, these two virtues are very similar, they are part of a package, that needs both elements.

In addition to the two virtues, you need to have a core concept. Much of that is being able to answer the question "What is your story?" You need to be able to answer what it is that you do in a way that has meaning.

Finally, you need to realize that the goal you are seeking is not painless or effort free. Reaching the so-called position of a category of one is not trite. If things don't change, you have not made the necessary commitment. If bonuses go to the top of an organization in a change initiative, before anything happens or before positive long-term results have been measured, you have already failed.

Assuming you want to be extraordinary and that you are willing to do the work, there is a book that tells you much of how to do it. It also addresses the two questions:

1. Why you might need to make the effort.
2. Why you instead of someone else.

It would be nice to see an ADR related book of this type for Mediation and other ADR providers.

Becoming a Category of One: How Extraordinary Companies Transcend Commodity and Defy Comparison by Joe Calloway (Paperback - Aug 24, 2009)

(28)

Other Editions: Kindle Edition, Hardcover, Paperback

Excerpt - Front Cover: "... Becoming a Category of One How Extraordinary Companies Transcend Commodity and Defy Comparison 2nEr Editiol ..."Surprise me! See a random page in this book.

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I should note that I enjoy reviewing books. Occasionally I get sent review copies of books that I really don't like or that don't speak to me. For example, The No Complaining Rule: Positive Ways to Deal with Negativity at Work by Jon Gordon really seemed too short to me.

But, it was just the right length for my boss to borrow and read it (she is sometimes pressed for time, already workign 70 hours a week and a daughter who is an elite skater). Amazingly, I actually kept it on my desk for a couple of months, in the vertical position, so that anyone walking in my office would be confronted by it. I'd say it reduced some complaining by 90% or better just by people reading the title every time they came in my office to complain.

The book really worked, just from people having to confront the title.

Why Our Ancestors Put Liars and Cowards to Death

I am realizing why a person was put to death for lying.

An interesting essay.

My dad died

Much sooner than anyone expected, about 7:30 p.m. last night.

I loved him and love him still.

Dying from Parkinson's

Dying from Parkinson's is not linear or mechanical. It has multiple pathways.

• The mind can go to the point where the body becomes deregulated.
• The body can go to the point where one is no longer strong enough to breathe and suffocates.
• Other body systems can weaken and fail, together or in sequence.
• Some people just sleep longer and longer and finally do not wake up.
• Some lose the desire to eat and eventually just fade away from not eating.

All of these pathways are active at the same time and act at different rates for different people, sometimes getting worse and sometimes getting better. I've known a number of people with the disease, each has had different pathways take them to the end. A friend's father, who died recently had a particularly difficult death.

As for my dad, he expected to die a couple of years ago, wanted everyone near him and a blessing to make the transition easier (he was in constant pain, serious delusions and completely bed bound). He recovered and started walking again instead of dying.

But, it was temporary, it looks like he is now in the final decline. He has lost his appetite and begun to waste. That is probably the gentle way. He still recognizes everyone, he is at peace with death now. Hospice comes daily, but there is no concrete time line.

I visit from time to time, Win sits with him on Wednesdays so my mom can spend the morning at the temple, I come by on Saturdays to get him out of the bath (my mom isn't strong enough to get him out) and when he slips and falls to the floor (she isn't strong enough to lift him). He hasn't walked for some time, but he does transition to and from a wheel chair with the tools they gave my mom to make that possible. I suspect that is likely to end soon as he is just not strong enough to help at all in the transitions.

It isn't faster than expected, but it comes and goes irregularly. My mom has lived her life by structure, so this really does not fit, but then life never does.

I've got posts written, will get them up, just wanted to respond to some e-mails here. That's the news from Lake Woebegone, so to speak.

More Philosophy

http://www.principiacomica.com/archive/1.html

Ok, I've only read some of them, but they were funny.

e.g. http://www.principiacomica.com/archive/7.html

And, a choice of philosophy boxes:

http://www.principiacomica.com/archive/augustbox2008.html

Dominion

I'm quoting from http://www.feministmormonhousewives.org/?p=2629 but this is great relationship material. Visit over there and read the whole thing.

So here’s my deal, we humans, we are a bunch of messed up sinners. All of us. We’re weak and lazy and selfish and power hungry. I think most all of us would like a dominion in which we are fanned by palm fronds and fed pealed grapes while receiving a foot massage and being read to by Morgan Freeman. Whilst sending our minions off to buy more jello and clean the toilets. Sigh.

But a righteous dominion must exist, no? Or there would be no need to warn of the unrighteous variety. I don’t know if in any substantial way dominion is different from the leadership, the words certainly feel different to me, to be led or to be dominated, even righteously.

THE HANDOUT

Each husband, each father, should ask some questions of himself to see if he may be on the borderline of unrighteous dominion:

1. Do I criticize family members more than I compliment them?

2. Do I insist that family members obey me because I am the father or husband and hold the priesthood?

3. Do I seek happiness more at work or somewhere other than in my home?

4. Do my children seem reluctant to talk to me about some of their feelings and concerns?

5. Do I attempt to guarantee my place of authority by physical discipline or punishment?

6. Do I find myself setting and enforcing numerous rules to control family members?

7. Do family members appear to be fearful of me?

8. Do I feel threatened by the notion of sharing with other family members the power and responsibility for decision making in the family?

9. Is my wife highly dependent on me and unable to make decisions for herself?

10. Does my wife complain that she has insufficient funds to manage the household because I control all the money?

11. Do I insist on being the main source of inspiration for each individual family member rather than teaching each child to listen to the Spirit?

12. Do I often feel angry and critical toward family members?

To which, let me add my own bit of poetry:

WATER

a medley by Steve Marsh

a man is supple and weak when living
hard and stiff when dead

No power or influence can be maintained, except

the hard and the strong are the signs of death
the supple and changing the signs of life

by persuasion, by long suffering, by meekness and by gentleness

that which is forceful will not vanquish
that which is strong will fall to the axe

by kindness and pure knowledge

the strong fails
the supple succeeds

without hypocrisy and without guile

nothing is more submissive and weak than water
yet for breaking mountains, nothing can surpass it

Charity and virtue

that the weak overcome the strong, the
submissive the hard, all know
Yet none can put it into practice

Then the priesthood shall distill upon thy soul

as the dew from heaven and without

compulsory means dominion

shall flow unto thee

Forever and ever

Lao Tze
Tao Te Ching

Joseph Smith
Doctrine and Covenants 121

Missing, still.

I find myself missing Robin today. It is a day early, though it was a Sunday, it was the 31st. I should be over everything, but somehow I am not.

Sat with my mom and talked about dad some. She has always had such exact schedules, and this time nothing goes in easily planned or predicted increments. It can be hard for her.

Anyway, it was a couple tough days, remembering my daughter who died, when the third time was not a charm, but a third death, more than I thought I could ever take. Perhaps it was.

Bought another Elgin Print

It Knows Where It's Going Print 11 $25.00 Now that I've bought mine, I'll link to it for anyone else who is interested. The print I received was much better than the catalog appears. George Elgin has done a fine job with Suzette Haden Elgin's artwork and the prints. This one reminds me a lot of the boat used in some of the stories at http://adrr.com/story/

Honesty and Recovery

I was reading on PTSD when it hit me that there is a concept where grief recovery, twelve-step programs and a number of other things converge. That concept is honesty.

The best place to begin with honesty is when you are wrong, promptly admit it. When you have failed to get something done, do not hide, instead acknowledge it. I try to train staff who work for me to do this (it is extremely rare for any mistake they could make to do more than be an inconvenience -- if they tell me so I can fix it). When someone else fails, look for solutions, don't waste time on blaming or anger.

Part of this is letting others express their anger without cutting them off or making excuses. You can explain later, much later, and always in the context of "I mess up by ... and this is how I will avoid it in the future." If the excuse is really good, you won't need to make it (e.g. I missed a hearing because I was rear ended and my care caught on fire. When my office called the Court ten minutes before the hearing was to start and said "Mr. Marsh will be delayed, his car is on fire" no one neeced an explanation or excuse later.).

Avoid legalisms or strained constructions. "Sure I practiced piano today [in my mined, while I was asleep]" is not honest, truthful, persuasive or useful. Looking for someone to blame is even worse than not useful.

As a place to start recovery, honesty is essential. You will have real trouble finding truth if you are not honest. The truth is that recovery can come. The honest truth is that it takes honesty for recovery to happen in a real sense.

Dad is down twenty pounds in the last thirty days

My dad's Parkinson's disease has moved into the wasting stage. He can no longer walk, and doesn't have strength for much. Has begun to not eat much at all. The last candy I bought him is still there. The drop off in appetite was extremely precipitous. He remains happy and pleasant.

Seems so sudden, but considering the time they gave him as an estimate, guess it is not.

Not much else to say.

Gravity and Levity

http://gravityandlevity.wordpress.com/

An interesting blog.

For example:

... my eight lifetimes. In it, I postulated that we measure time relative to our age, and as a result each length of time wherein our age doubles carries an equal psychological weight. There’s nothing scientific about this discussion — it’s just an idea. But it has absolutely changed the way I think about my life and the process of getting older. At the risk of being a shameless self-promoter, I highly recommend reading it.

The argument about “my eight lifetimes” can be summarized this way: in your life you will undergo roughly eight major transformations. That is, you get eight “lifetimes” during which you become a new and different person. If you’re reading this blog, chances are that you’re already on your sixth or seventh. This is not to say you have one foot in the grave: having an entire lifetime ahead of you is still a big deal. For me, a 25-year-old, the two remaining lifetimes are the transformation from a 20-something-year-old to a middle aged man, and then from middle age to an old man. Both of those time periods are a big deal, and each of them contains plenty of living to be done. I just imagine that the time period between age 6 and age 12 was a similarly big deal.

All of this brings me back to the Gompertz Law of human mortality. The Gompertz Law is already an extraordinarily fair statement: no one escapes mortality, which becomes exponentially more probable in old age. But if you subscribe to my idea of time progressing relative to itself (of life being composed of “lifetimes”), then the consequence of the Gompertz Law is an almost extreme level of fairness. Look at it this way: about 96% of people survive to age 48 (the beginning of the “eighth lifetime”), but only 4% make it to age 96 (the end of the eighth lifetime). If you try to come up with an equation for probability of survival vs. number of lifetimes lived, you get an almost absurd exponential within an exponential within an exponential.

Veganism crosses the line into a moral error ...

An interesting argument by a law professor.

He concludes (I'm taking an excerpt, read the whole thing by clicking on the links):

my own view is that veganism is a kind of harmless and in many ways sweet eccentricity (who can get mad about people who love animals?), but it crosses the line into a moral error insofar as people think it is morally obligatory or morally superior to non-vegan lifestyles.

I expect stating this plainly will open me up to lots of abuse, but since vegans do not, as far as I can see, have any arguments that can appeal to shared background attitudes, they probably have no choice. As A.J. Ayer noticed long ago, "It is because argument fails us when we come to deal with pure questions of value, as distinct from questions of fact, that we finally resort to mere abuse."

But, he is a liberal, at Chicago via UT. He is used to some abuse.

The overall point, those who do not have arguments that can appeal to shared background attitudes, have only abuse to argue with. Combined with the triumph of value ethics, every disagreement becomes a proof of moral failing in those one disagrees with, rather than a disagreement.

Interesting to consider.

Why Loyalty Matters

Management fads are often driven by the conflict of interest that bonus structures create. Sunbeam had massive downsizing which resulted in extreme riches to managers who battened on the health and wealth of the company to its harm. Texas Instruments had its culture ravaged by the same sort of thing and has been striving to make things right. In every case the company involved betrays the loyalty of its workers to benefit often transitory and predatory managers.

It goes back to business schools. I had a friend in the early 80s who expressed his unhappiness that to continue in his then area of choice he needed to find a plant and close it to demonstrate toughness. He needed to sacrifice the careers and lives of hundreds of employees to have a resume item. He noted that probably more than 75% of plant closings at that time in the 1980s were not justified – they were betrayals of worker loyalty for modest personal profit for the managers closing them at the expense of the corporate entity and the loyal employees.

It is no surprise that after about thirty years of this type of treatment, older workers tend to lack loyalty and younger workers (often their children) see loyalty as foolish. That is one of the gifts that elite MBA schools and management consultants have given modern America – an erosion of loyalty. That same experience has bled out into consumer relationships.

I can compare a small business I know with Volvo. When the UPS strike hit, in order to make his commitments to clients to make thirty day delivery turn-around, John paid for overnight express delivery and ate the loss. He was and is loyal to his customers and a man of integrity. Volvo, I bought a car from them (two actually). The paint was bad. They kept promising that they had fixed it when all they had done was buff and use colored wax that would hide the problem for 2-3 months. Finally, they offered to pay for half of the cost of repainting – if I used their provider. Of course they wanted me to pay about $2,500.00 for my half, up front, for a paint job that should have cost a total of less than $1,500.00 (same color, one color, no primer needed). I actually had the job done for $800.00 and it has lasted several years and is still excellent.

In other words, Volvo offered to make only a $1,600.00 profit at my expense for fixing their problem. Did that show or inculcate loyalty, honesty or trustworthiness? Obviously not at all. I’ll never buy a Volvo again and would advise anyone I know not to buy one.

Yet, there is a reason people are happier when they are loyal. Companies that are loyal have more satisfied and effective employees and better served customers. Now loyalty alone won’t do the job, but without loyalty in the mix, the job does not get done well.

As you might suspect, I’ve been enjoying

Why Loyalty Matters: The Groundbreaking Approach to Rediscovering Happiness, Meaning and Lasting Fulfillment in Your Life and Work by Timothy Keiningham, Lerzan Aksoy, and Luke Williams (Hardcover - Jul 7, 2009)

If you pick it up, it is easy to mistake it for a book length advertisement for a web 2.0 application. Of course access to the application is free with the book and only tangential to the book itself (in other words, it is an effort to provide “value added” material, not a cheesy attempt to get you to pay for a book length advertisement for a web app).

Once you get past the short aside for the web based service, what you get is an explanation of what loyalty is, why it is important, how to measure loyalty (rather than how to make superficial guesses like most “loyalty programs” do) and how to nurture and integrate loyalty with the other elements that lead to corporate and personal success, and that are essential for individual satisfaction and happiness.

The book is honest. For example, 80% of your loyal customers are ones you are losing money on and will never turn a profit on (which is one of the reasons they are loyal).

However, it is important to realize that your life will be more satisfying and you will be happier if you have areas where you can be loyal. Understanding loyalty is a significant point in finding happiness in your life.

I’ll write more on the book and on loyalty, but it is a worthwhile read.

A sidenote, link to some beautiful art

http://bysuzettehadenelgin.com/store/print8.html for example (the one I just bought).

On the left hand side of the page there are three buttons:

• Suzette's Art Prints:Homepage
• Print List
• Friends

The first takes you to the home page. The second is a list of the prints available (not a link to print the list). The third will change names, it is the next print on the list. You can scroll through the prints by just clicking on that link over and over again. Oh, and I cheated on the links -- instead of Friends (the text on the page I've linked to) taking you to that print, it jumps to another one I really liked ;)

If more people read my blog, I'd probably have had second thoughts, since I expect I'll go back and buy that one too and I would want it to sell out before I get the chance ...

But just scrolling through the prints can enrich your day and make you smile, even if you don't buy one.

Suzette is a living saint, btw, one of the Elachi.

Remembering that there is always another side.

There is another side. There is always another side. Sometimes it takes a long time to hear it. But hearing it is essential if we are to be “no more strangers and foreigners, but fellow citizens…of the household of God” (Ephesians 2:19).

That is a great truth.

Also of interest: http://en.wikipedia.org/wiki/Systems_of_Survival