CNN recently interviewed a young woman doctor who had just returned from working in Africa. The reporter asked her the principal difference between practicing medicine in Mozambique and in the United States. "In Mozambique the people bring me little gifts," she told the interviewer. "A fistful of walnuts, some eggs, a chicken, whatever they can to express their gratitude.

"In the States," she said, "I get sued."

What kind of gratitude is that?

"Gratitude is not only the greatest of virtues, but the parent of all the others," said the Roman philosopher Cicero.

In America, we put gratitude on the calendar -- the fourth Thursday of November each year. You may recall your early American history -- two-thirds of the Pilgrims did not make it to the first Thanksgiving they celebrated. Harsh conditions and little food were daily challenges. According to H.U. Westermayer: "The Pilgrims made seven times more graves than huts. No Americans have been more impoverished than these who, nevertheless, set aside a day of thanksgiving."

But is one day really enough?

Two psychologists, Michael McCollough of Southern Methodist University in Dallas and Robert Emmons of the University of California at Davis, conducted an experiment on gratitude and its impact on well-being. Participants were divided into three different groups and asked to keep diaries. The first group wrote what happened during the day without being told specifically to write about either the good or bad things. The second group was told to record their unpleasant experiences. And the last group was instructed to make a daily list of things for which they were grateful.

The results of the study indicated that daily gratitude exercises resulted in higher reported levels of alertness, enthusiasm, determination, optimism and energy. In addition, the gratitude group also experienced less depression and stress, while helping others more and making greater progress toward achieving personal goals.

This is just one of the studies that gratitude expert Lisa Ryan writes about in her new book, "The Upside of Down Times: Discovering the Power of Gratitude." Ryan says: "Gratitude is not a now-and-then thing. We need a consistent practice of acknowledgement to keep our appreciation muscles strong."

She recommends keeping a gratitude journal, sending thank-you notes and cards, and consistently acknowledging and appreciating the people who make a difference in our lives.

Ryan writes: "Because the mind cannot experience two opposite emotions at the same time, it's important to keep yourself in a state of gratitude as often as you can. For instance, the next time you are having a bad day, take a moment to think about something that you're grateful for and you will start to move into a happier place."

She divides her book into four sections using the acronym SHOW. "S" is for Self because gratitude improves your attitude and outlook. "H" is for Health -- improved physical health results from appreciation. "O" is for Others -- acknowledgement influences and improves our relationships. "W" is for Wealth -- gratefulness has a positive impact on your bottom line.

One of the points that really struck me in her book is how people respond to receiving a "thank you" today. People now say, "It's no problem" ... "It's nothing" ... "Don't worry about it." Ryan says that's the same as taking a gift and throwing it back. We should accept the gift with a simple, "You're welcome."

Even when you can't acknowledge the gift-giver, you should still adopt an attitude of gratitude. Here's a story you might remember by Daniel Defoe.

When Robinson Crusoe was shipwrecked on his lonely isle, he drew up in two columns what he called the evil and the good. He was cast on a desolate island, but still alive -- not drowned, as all his ship's company were. He was divided from mankind and banished from human society, but he was not starving. He had no clothes, but he was in a hot climate where he didn't need them. He was without means of defense, but he saw no wild beasts, such as he had seen on the coast of Africa. He had no soul to speak to, but God had sent the ship so near to the shore that he could get out of it all things necessary for his wants. So he concluded that there was not any condition in the world so miserable that it didn't contain something positive for which to be thankful.

Mackay's Moral: Gratitude should be a continuous attitude.

Many times, in order to survive, we have to start a change process. Change, for most people, is an unnerving experience. But as the old saying goes, change is inevitable. It's one of the only constants in life.

I have said before that it is easy to change things. It is not so easy to change people. And therein lies the rub. As author Bruce Barton observed, "When you are through changing, you are through."

Most organizations won't survive if they don't learn how to change as they grow and adapt to market conditions. But employees sometimes resist anything new -- not because they're stubborn or old-fashioned, but for these basic reasons:

-- They don't see the need. Management must explain why the change is necessary -- how it will help the company, customers and employees themselves. Set the stage for people. If employees don't know what's happening in the company and in its industry, they won't see any reason to do things differently. Share as much as possible about finances, problems the organization is facing, and what's likely to happen if nothing is done.

-- They're afraid of the unknown. Employees may not understand exactly what they'll have to do differently, or how the change will affect their daily lives. Or they may worry that they don't have the skills they'll need to adapt. Tell them what's changing, and give them the training and support required.

-- Management didn't seek their input. Employees need a sense of control over their work and their careers. Include them in planning from the beginning. Employees who know how the organization functions at the ground level will be able to help target the right areas for change, and they'll be more comfortable with the result. Consider everyone who'll be affected, from front-line employees to high management, as well as customers and other stakeholders. Provide them with updates on progress. Ask them how it's going and what could speed things along.

-- They're exhausted. Downsizings, reorganizations, new products and revamped org charts can take their toll. Employees may feel they don't have it in them to go through another major overhaul. Take their feelings into account when announcing any new direction so they know management understands what they're going through.

-- They aren't focused on the long term. Change is a process, not a single event. Emphasize that it will take time, and to be successful, people will have to look to the future, not to short-term gains and losses. Remember that performance won't be transformed overnight. Once a company has restructured, implemented new systems or launched new strategies, allow adequate time for a learning curve. Don't be so impatient for results so as to sabotage people's efforts.

-- They don't see commitment from the top. Change needs to start at the highest levels of the organization. If management is not setting a spectacular example, demonstrating an absolutely united front, then the rank and file has no reason to jump on board. Will every manager immediately embrace new practices and procedures? They will if they value their jobs!

Be prepared for some resistance, and be willing to periodically assess changes to see if they are really producing the expected results. Then, and only then, if the outcome isn't satisfactory, reassess and figure out how to change things for the better.

In his best-selling book "Who Moved My Cheese?" Spencer Johnson used a parable to dramatize human resistance to change. The story contains four imaginary characters named Sniff, Scurry, Hem and Haw.

Sniff and Scurry are two mice. Hem and Haw are "little people," small as mice but containing all the qualities of human beings. All four characters are intended to represent the simple and the complex parts of ourselves, regardless of our age, gender, race or nationality.

According to the book's introduction, sometimes we may act like:

-- Sniff, who sniffs out change early, or

-- Scurry, who scurries into action at the slightest provocation, or

-- Hem, who denies and resists change as he fears it will lead to something worse, or

-- Haw, who learns to adapt in time when he sees changing leads to something better.

"Whatever parts of us we choose to use," Johnson writes, "we all share something in common: a need to find our way in the maze and succeed in changing times."

Mackay's Moral: The only people who like change are wet babies.

A young boy asked his mother what he should do in order to be a success when he grew up. The mother thought for a moment, and then told her son to bring her a pencil. Puzzled, the boy found a pencil and gave it to her.

"If you want to do good," she said, "you have to be just like this pencil."

"What does that mean?" her son asked.

"First," she said, "you'll be able to do a lot of things, but not on your own. You have to allow yourself to be held in someone's hand.

"Second, you'll have to go through a painful sharpening from time to time, but you'll need it to become a better pencil.

"Third, you'll be able to correct any mistakes you might make.

"Fourth, no matter what you look like on the outside, the most important part will always be what's inside.

"And fifth," the mother finished, "you have to press hard in order to make a mark."

Great advice. His mother touched on five important topics -- teamwork, being able to accept criticism, correcting mistakes, self-confidence and working hard. Let's take them one at a time.

Teamwork. As I like to say, even the Lone Ranger had Tonto. You can't do it all alone. My definition of teamwork is a collection of diverse individuals who respect each other and are committed to each other's successes. Teamwork sometimes requires people to play roles that aren't as glamorous as they'd like.

For example, I once asked a symphony conductor which instrument is the most difficult to play? Without missing a beat, the conductor replied: "Second fiddle. I can get plenty of first violinists. But finding someone who can play second fiddle with enthusiasm is a real problem. When we have no second violin, we have no harmony." And you just can't be successful without harmony or teamwork.

Criticism. Giving and taking criticism is no easy task, but it is necessary if you want to become better. If you ignore the problem and hope it goes away, you are not going to improve. Every office I've ever worked in or done business with has been made better because of suggestions or criticisms of the people who spend their working hours there. No one ever choked to death swallowing his or her own pride! Admit you aren't perfect. Remember that the goal of honest criticism is to make you better than you were before.

Mistakes. Everyone makes mistakes. What's important is that you learn from them. President Ronald Reagan said: "What should happen when you make a mistake is this: You take your knocks, you learn your lessons, and then you move on."

The greatest mistake a person can make is to be afraid to make one. In fact, you often need to increase your failures to become more successful. Mistakes don't make you a failure. How you respond to a mistake determines just how smart you actually are. There are really no mistakes in life, there are only lessons.

It's important to remember that the person who made a mistake isn't the only one who can learn from that experience. Talk about mistakes, so they are not repeated by others.

Self-confidence. When I'm interviewing potential employees, one of the traits I look for is confidence. Confidence doesn't come naturally to most people. Even the most successful people have struggled with it in their careers. The good news is that you can develop confidence, just like any muscle or character trait, if you're willing to work at it. My advice: Track your success, practice being assertive, accept that failure is not the end of the world, step out of your comfort zone, set goals, keep improving your skills and above all else, don't compare yourself to others.

Work hard. Success comes before work only in the dictionary. Many people look for a magic formula to turn things around, but there is no magic formula. Sure, natural talent can make a big difference. But show me a natural .300 hitter in the major leagues, and I'll show you someone who bangs the ball until their hands bleed, trying to keep that hitting stroke honed. Ask any surgeon about how much sleep he or she got for the eight to 10 years it took to get through medical school, internship and residency. It takes iron determination and lots of hard, hard work.

Mackay's Moral: If you want to make your mark, sharpen your skills.