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tangledhearts1 · 12 days ago

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Post Elevate Your Space: Creative Home Renovation Ideas for Every Budget plan

Home renovation projects can transform your home, making it extra functional, aesthetically pleasing, and delightful. Whether you're aiming to carry out a major improvement or merely wish to make little modifications, there are many means to improve your home. From upgrading your cooking area with modern devices and elegant cabinetry to creating a serene outside oasis with landscaping and patio area updates, the opportunities are unlimited. The key is to recognize what areas of your home require the most focus and how you can achieve your wanted look without damaging the financial institution.

In today's world, DIY home improvement has actually gained tremendous popularity, encouraging home owners to take matters into their own hands. With a myriad of on-line sources, tutorials, and community online forums, also beginner DIYers can take on tasks ranging from paint and tiling to constructing custom furnishings. However, it's necessary to stabilize do it yourself initiatives with expert aid when needed, guaranteeing that more difficult jobs are taken care of by experts. By incorporating your creativity with tactical planning, you can elevate your home and produce a room that mirrors your individual style while additionally boosting its worth.

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tangledhearts1 · 1 year ago

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Unlocking the Advantages of Homeschooling: A Guide to Education And Learning Beyond the Class

Over the last few years, homeschooling has gotten popularity as an alternative form of education that provides versatility and customized discovering experiences. Households are progressively transforming to homeschooling to provide their kids with a customized education that meets their individual requirements and passions. By homeschooling, parents have the possibility to develop an understanding atmosphere that promotes imagination, critical reasoning, and a love for learning. This method enables a much more hands-on and experiential learning experience, where kids can check out topics in deepness and at their very own pace.Homeschooling additionally supplies the versatility for households to travel, pursue after-school activities, and integrate real-world experiences right into their curriculum. By personalizing the instructional program to fit the youngster's understanding design and interests, homeschooling can help pupils succeed academically and develop a solid feeling of freedom and self-motivation. As the education and learning landscape remains to evolve, homeschooling provides a special opportunity for families to take control of their children's education and offer a holistic discovering experience that goes beyond conventional class setups.

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tangledhearts1 · 1 year ago

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Mastering the Art of Website Design: A Comprehensive Overview to Creating Stunning Websites

In the busy digital world we stay in today, having an aesthetically appealing and user-friendly internet site is vital for organizations and people alike. Website design plays an important duty in capturing the interest of site visitors and keeping them involved. From choosing the ideal color plan and typography to producing a responsive format that functions seamlessly throughout various tools, there are numerous aspects to consider when designing an internet site. In this article, we will certainly look into the globe of website design and provide you with beneficial insights and tips to assist you create a magnificent web site that attracts attention from the crowd.Whether you are

an experienced web developer seeking to enhance your abilities or a beginner excited to find out the essentials, this guide is customized to meet your requirements. We will check out the most recent trends in web style, consisting of the significance of customer experience and access, along with sensible methods for enhancing your site for internet search engine. By understanding the art of internet layout, you can elevate your online presence, draw in even more site visitors, and eventually accomplish your objectives online. Stay tuned for our upcoming articles where we will dive deeper right into particular elements of website design and provide you with step-by-step tutorials to aid you bring your imaginative vision to life.

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tangledhearts1 · 1 year ago

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How to build your own SEO ‘second brain’ (and why you need it)

Whether you’re an internal SEO whiz or a digital agency pro, chances are you’ve experienced one or more of these all-too-familiar problems:

Feeling drowned in an ocean of ever-evolving industry trends.

Spending forever in the set-up phase, building deliverable trackers, audit sheets, keyword map templates, content briefs, and backlog grooming can feel like you’re on a never-ending treadmill.

Yes, I’ve been there too. I felt the relentless churn and knew that something had to shift dramatically if I wanted to continue growing as an SEO.

This realization led me to discover the game-changing concept of building a “second brain,” an idea popularized by Tiago Forte.

I’ve since applied this concept to my own SEO practices. Below, I’ll cover how you can build your own SEO second brain.

Why you should consider building an SEO second brain

Before building a second brain, let’s examine what an organic brain excels at and where it falls short. Here’s a quick snapshot:

Our brains are great at:

Generating original ideas.

Interconnecting ideas and spinning compelling narratives.

Fostering empathy with others.

But terrible at:

Retaining information over a prolonged period.

Segmenting and categorizing stored data.

Retrieving and applying stored information.

By delegating the latter tasks to an external database or a “second brain,” you can better store and retrieve crucial documentation, templates, and key learnings between websites.

Most importantly, never again will you forget crucial information when you most need it.

How to start building your own SEO second brain

Building your second brain may seem daunting initially, but take it one step at a time, and you’ll get there. Start with the following steps and tips:

Selecting the right tools to suit the way you work

Structuring your second brain with the PARA system

Operating your second brain: Start with idea capturing

A quick walkthrough of my own SEO second brain

You can use plenty of systems and platforms to build a second brain. It all comes down to your preference and which platform you’re most comfortable with.

I use Notion to build my SEO second brain (and operate most of my SEO projects), so I’ll use examples from Notion throughout this article.

A great way to identify which tool to use for building your SEO second brain is to get to know your style of information organization. Here are some examples Forte mentions:

The architect: Prefers systematizing information in a hierarchical manner, focusing on large-scale projects and using a systems mindset. They have to be careful not to force information into their system when it doesn’t fit. Apps like Notion and Craft are well-suited to this style.

The gardener: Thrives on cultivating many ideas at the same time, favoring relationships and connections. They must beware of getting easily distracted by new, unrelated information. Apps like Obsidian and Roam are well-suited to this style.

The librarian: Practical and project-oriented, they like to capture information from diverse sources and curate a collection of knowledge. Their pitfall might be amassing content without using it. Apps like Evernote and Microsoft OneNote are well-suited to this style.

The student: Usually new to knowledge management or focusing on a specific part of their life. They favor ease of use and avoid complexity. Apps like Apple Notes or Google Keep are well-suited to this style.

Structuring your second brain with the PARA system

The PARA system stands for:

Projects: Specific tasks linked to a goal or deadline.

Areas: Responsibilities that need to be maintained over time.

Resources: A topic or theme of ongoing interest.

Archives: Inactive items from the other three categories.

Here are some examples of which SEO tasks suit each category.

Projects: Your most important and time-sensitive tasks.

Example: Optimize the internal linking structure for a core landing page by the end of the week.

Areas: Your ongoing optimization efforts and routine tasks.

Example: Create monthly performance reports.

Resources: Shared credentials and background information.

Example: CMS logins and target personas.

Archives: Completed tasks and documentation

Example: Title tags updated over the past 24 months.

I’ve adopted some version of the PARA framework to manage SEO campaigns for 35+ websites.

It’s a game-changer to help me get the most impactful tasks done first and still deliver on smaller issues.

But how does this help me better manage SEO projects?

Traditionally, SEOs tend to structure our work into static categories like keyword research, technical audit, link building, and content production. However, this doesn’t mirror the dynamic nature of SEO projects.

This conventional and static way of organizing information is like categorizing your kitchen by individual ingredients rather than usage and priority (a fun analogy credited to Forte).

Wouldn’t it be odd to organize your kitchen by carrots, potatoes, and fruits rather than stovetop items, pantry goods, and fridge contents?

Like kitchens, static file structures can lead to “cross-contamination” between outdated and fresh documents, making it challenging to locate the most relevant information quickly.

Enter the PARA framework – a dynamic solution reflecting the shifting priorities of an SEO project:

Immediate concerns reside in the Project folder.

Ongoing work belongs to the Area folder.

Thematic and research material is kept in the Resources folder.

Completed tasks and old data go into the Archives folder.

This way, PARA keeps your SEO project fluid, organized, and current.

Operating your second brain: Start with idea capturing

Let’s say you’ve built an SEO second brain of your own. How do you go about using it in the best way possible?

For me, it’s all about idea capturing. This is the act of quickly and effortlessly storing information you’ve encountered throughout the day in a temporary repository.

It’s the single most important mechanism to master in operating a second brain.

That’s because it enables me to quickly and passively store new information in a temporary space of my second brain so that I can later revisit and move it to relevant sections of the brain.

These can include:

Important algorithm or industry updates.

Interesting articles on new tactics I can apply to my own websites.

Add meeting notes and recordings throughout the day.

Insightful conversations I’ve had with my colleagues.

I’ve built an empty page in my second brain called the Idea Capturing Station, meant to do just this, keeping it immediately accessible to me at all times on both desktop and mobile.

Here’s an example of how I quickly capture an interesting article on desktop:

And here’s how I quickly capture a new idea on mobile:

A quick walkthrough of my own SEO second brain

Here’s a quick snapshot of what my SEO second brain dashboard looks like.

Each of these individual areas, like Project Timeline, is then linked to separate databases where I store and organize information hierarchically. That’s right. I’m a classic architect when it comes to information organization.

In reality, however, I rarely use this dashboard. I use the tool’s internal search function to find specific areas of my second brain I want to navigate to.

For instance, if I’d like to find one of my project timelines, I can search for it and hop straight to it like so.

Building reusable templates

One of the most useful “powers” of this second brain is its ability to create reusable templates, giving me an almost instant set-up each time we onboard a new client at my agency.

With just a few clicks, I am able to populate a full SEO roadmap timeline, each broken into tickets with specified templates to be delegated to team members and shared with clients. Here are a few examples:

Keyword mapping

Content production

Documentation at hand

What about that time you forgot a key piece of information or statistic while meeting with stakeholders?

I have a database called the Knowledge Bank that allows me to pull up key information to reference at all times.

Let’s say I’m trying to convince some stakeholders that it can be worthwhile pursuing keywords with “zero search volume.”

In the middle of the conversation, I vaguely recall having read an article by Steve Toff on discovering zero search volume keywords, showing strong evidence of their ROI potential.

In this case, I can quickly search for the article on my second brain and reference the article almost instantly.

How to make the most of your second brain? Exercise it!

My second brain is far from complete and probably always will be (very much like our organic brains!).

The key here is to exercise our SEO second brain regularly so that we get better at using it to store, retrieve and synthesize information.

Once you’re familiar, extend your second brain to other domains of life!

Our second brain goes far beyond SEO at Criclabs, the digital agency I’m running. We use it to track new hires, document company processes, run employee portals and more.

The good news is many of us already have an SEO second brain in the works, whether we know it or not. If you have a shared drive to store information or occasionally take notes on your phone, your SEO second brain is already on its way.

What you can do now is what we SEOs know best, optimize it!

Opinions expressed in this article are those of the guest author and not necessarily Search Engine Land. Staff authors are listed here.

Add Search Engine Land to your Google News feed.

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tangledhearts1 · 2 years ago

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Decisions by CVS and Optum Panicked Thousands of Their Sickest Patients

Arthur Allen

NEW YORK — The fear started when a few patients saw their nurses and dietitians posting job searches on LinkedIn.

Word spread to Facebook groups, and patients started calling Coram CVS, a major U.S. supplier of the compounded IV nutrients on which they rely for survival. To their dismay, CVS Health confirmed the rumors on June 1: It was closing 36 of the 71 branches of its Coram home infusion business and laying off about 2,000 nurses, dietitians, pharmacists, and other employees.

Many of the patients left in the lurch have life-threatening digestive disorders that render them unable to eat or drink. They depend on parenteral nutrition, or PN — in which amino acids, sugars, fats, vitamins, and electrolytes are pumped, in most cases, through a specialized catheter directly into a large vein near the heart.

The day after CVS’ move, another big supplier, Optum Rx, announced its own consolidation. Suddenly, thousands would be without their highly complex, shortage-plagued, essential drugs and nutrients.

“With this kind of disruption, patients can’t get through on the phones. They panic,” said Cynthia Reddick, a senior nutritionist who was let go in the CVS restructuring.

“It was very difficult. Many emails, many phone calls, acting as a liaison between my doctor and the company,” said Elizabeth Fisher Smith, a 32-year-old public health instructor in New York City, whose Coram branch closed. A rare medical disorder has forced her to rely on PN for survival since 2017. “In the end, I got my supplies, but it added to my mental burden. And I’m someone who has worked in health care nearly my entire adult life.”

CVS had abandoned most of its less lucrative market in home parenteral nutrition, or HPN, and “acute care” drugs like IV antibiotics. Instead, it would focus on high-dollar, specialty intravenous medications like Remicade, which is used for arthritis and other autoimmune conditions.

Home and outpatient infusions are a growing business in the United States, as new drugs for chronic illness enable patients, health care providers, and insurers to bypass in-person treatment. Even the wellness industry is cashing in, with spa storefronts and home hydration services.

But while reimbursement for expensive new drugs has drawn the interest of big corporations and private equity, the industry is strained by a lack of nurses and pharmacists. And the less profitable parts of the business — as well as the vulnerable patients they serve — are at serious risk.

This includes the 30,000-plus Americans who rely for survival on parenteral nutrition, which has 72 ingredients. Among those patients are premature infants and post-surgery patients with digestive problems, and people with short or damaged bowels, often the result of genetic defects.

While some specialty infusion drugs are billed through pharmacy benefit managers that typically pay suppliers in a few weeks, medical plans that cover HPN, IV antibiotics, and some other infusion drugs can take 90 days to pay, said Dan Manchise, president of Mann Medical Consultants, a home care consulting company.

In the 2010s, CVS bought Coram, and Optum bought up smaller home infusion companies, both with the hope that consolidation and scale would offer more negotiating power with insurers and manufacturers, leading to a more stable market. But the level of patient care required was too high for them to make money, industry officials said.

“With the margins seen in the industry,” Manchise said, “if you’ve taken on expensive patients and you don’t get paid, you’re dead.”

In September, CVS announced its purchase of Signify Health, a high-tech company that sends out home health workers to evaluate billing rates for “high-priority” Medicare Advantage patients, according to an analyst’s report. In other words, as CVS shed one group of patients whose care yields low margins, it was spending $8 billion to seek more profitable ones.

CVS “pivots when necessary,” spokesperson Mike DeAngelis told KHN. “We decided to focus more resources on patients who receive infusion services for specialty medications” that “continue to see sustained growth.” Optum declined to discuss its move, but a spokesperson said the company was “steadfastly committed to serving the needs” of more than 2,000 HPN patients.

DeAngelis said CVS worked with its HPN patients to “seamlessly transition their care” to new companies.

However, several Coram patients interviewed about the transition indicated it was hardly smooth. Other HPN businesses were strained by the new demand for services, and frightening disruptions occurred.

Smith had to convince her new supplier that she still needed two IV pumps — one for HPN, the other for hydration. Without two, she’d rely partly on “gravity” infusion, in which the IV bag hangs from a pole that must move with the patient, making it impossible for her to keep her job.

“They just blatantly told her they weren’t giving her a pump because it was more expensive, she didn’t need it, and that’s why Coram went out of business,” Smith said.

Many patients who were hospitalized at the time of the switch — several inpatient stays a year are not unusual for HPN patients — had to remain in the hospital until they could find new suppliers. Such hospitalizations typically cost at least $3,000 a day.

“The biggest problem was getting people out of the hospital until other companies had ramped up,” said Dr. David Seres, a professor of medicine at the Institute of Human Nutrition at Columbia University Medical Center. Even over a few days, he said, “there was a lot of emotional hardship and fear over losing long-term relationships.”

To address HPN patients’ nutritional needs, a team of physicians, nurses, and dietitians must work with their supplier, Seres said. The companies conduct weekly bloodwork and adjust the contents of the HPN bags, all under sterile conditions because these patients are at risk of blood infections, which can be grave.

As for Coram, “it’s pretty obvious they had to trim down business that was not making money,” Reddick said, adding that it was noteworthy both Coram and Optum Rx “pivoted the same way to focus on higher-dollar, higher-reimbursement, high-margin populations.”

“I get it, from the business perspective,” Smith said. “At the same time, they left a lot of patients in a not great situation.”

***

Smith shares a postage-stamp Queens apartment with her husband, Matt; his enormous flight simulator (he’s an amateur pilot); cabinets and fridges full of medical supplies; and two large, friendly dogs, Caspian and Gretl. On a recent morning, she went about her routine: detaching the bag of milky IV fluid that had pumped all night through a central line implanted in her chest, flushing the line with saline, injecting medications into another saline bag, and then hooking it through a paperback-sized pump into her central line.

Smith has a connective tissue disorder called Ehlers-Danlos syndrome, which can cause many health problems. As a child, Smith had frequent issues such as a torn Achilles tendon and shoulder dislocations. In her 20s, while working as an EMT, she developed severe gut blockages and became progressively less able to digest food. In 2017, she went on HPN and takes nothing by mouth except for an occasional sip of liquid or bite of soft food, in hopes of preventing the total atrophy of her intestines. HPN enabled her to commute to George Washington University in Washington, D.C., where in 2020 she completed a master��s in public health.

On days when she teaches at LaGuardia Community College — she had 35 students this semester — Smith is up at 6 a.m. to tend to her medical care, leaves the house at 9:15 for class, comes home in the afternoon for a bag of IV hydration, then returns for a late afternoon or evening class. In the evening she gets more hydration, then hooks up the HPN bag for the night. On rare occasions she skips the HPN, “but then I regret it,” she said. The next day she’ll have headaches and feel dizzy, sometimes losing her train of thought in class.

Smith describes a “love-hate relationship” with HPN. She hates being dependent on it, the sour smell of the stuff when it spills, and the mountains of unrecyclable garbage from the 120 pounds of supplies couriered to her apartment weekly. She worries about blood clots and infections. She finds the smell of food disconcerting; Matt tries not to cook when she’s home. Other HPN patients speak of sudden cravings for pasta or Frosted Mini-Wheats.

Yet HPN “has given me my life back,” Smith said.

She is a zealous self-caretaker, but some dangers are beyond her control. IV feeding over time is associated with liver damage. The assemblage of HPN bags by compounding pharmacists is risky. If the ingredients aren’t mixed in the right order, they can crystallize and kill a patient, said Seres, Smith’s doctor.

He and other doctors would like to transition patients to food, but this isn’t always possible. Some eventually seek drastic treatments such as bowel lengthening or even transplants of the entire digestive tract.

“When they run out of options, they could die,” said Dr. Ryan Hurt, a Mayo Clinic physician and president of the American Society for Parenteral and Enteral Nutrition.

***

And then there are the shortages.

In 2017, Hurricane Maria crippled dozens of labs and factories making IV components in Puerto Rico; next came the covid-19 emergency, which shifted vital supplies to gravely ill hospital patients.

Prices for vital HPN ingredients can fluctuate unpredictably as companies making them come and go. For example, in recent years the cost of the sodium acetate used as an electrolyte in a bag of HPN ballooned from $2 to $25, then briefly to $300, said Michael Rigas, a co-founder of the home infusion pharmacy KabaFusion.

“There may be 50 different companies involved in producing everything in an HPN bag,” Rigas said. “They’re all doing their own thing — expanding, contracting, looking for ways to make money.” This leaves patients struggling to deal with various shortages from saline and IV bags to special tubing and vitamins.

“In the last five years I’ve seen more things out of stock or on shortage than the previous 35 years combined,” said Rigas.

The sudden retrenchment of CVS and Optum Rx made things worse. Another, infuriating source of worry: the steady rise of IV spas and concierge services, staffed by moonlighting or burned-out hospital nurses, offering IV vitamins and hydration to well-off people who enjoy the rush of infusions to relieve symptoms of a cold, morning sickness, a hangover, or just a case of the blahs.

In January, infusion professionals urged FDA Commissioner Robert Califf to examine spa and concierge services’ use of IV products as an “emerging contributing factor” to shortages.

The FDA, however, has little authority over IV spas. The Federal Trade Commission has cracked down on some spa operations — for unsubstantiated health claims rather than resource misuse.

Bracha Banayan’s concierge service, called IVDRIPS, started in 2017 in New York City and now employs 90 people, including 60 registered nurses, in four states, she said. They visit about 5,000 patrons each year, providing IV hydration and vitamins in sessions of an hour or two for up to $600 a visit. The goal is “to hydrate and be healthy” with a “boost that makes us feel better,” Banayan said.

Although experts don’t recommend IV hydration outside of medical settings, the market has exploded, Banayan said: “Every med spa is like, ‘We want to bring in IV services.’ Every single paramedic I know is opening an IV center.”

Matt Smith, Elizabeth’s husband, isn’t surprised. Educated as a lawyer, he is a paramedic who trains others at Columbia University Irving Medical Center. “You give someone a choice of go up to some rich person’s apartment and start an IV on them, or carry a 500-pound person living in squalor down from their apartment,” he said. “There’s one that’s going to be very hard on your body and one very easy on your body.”

The very existence of IV spa companies can feel like an insult.

“These people are using resources that are literally a matter of life or death to us,” Elizabeth Smith said.

Shortages in HPN supplies have caused serious health problems including organ failure, severe blisters, rashes, and brain damage.

For five months last year, Rylee Cornwell, 18 and living in Spokane, Washington, could rarely procure lipids for her HPN treatment. She grew dizzy or fainted when she tried to stand, so she mostly slept. Eventually she moved to Phoenix, where the Mayo Clinic has many Ehlers-Danlos patients and supplies are easier to access.

Mike Sherels was a University of Minnesota Gophers football coach when an allergic reaction caused him to lose most of his intestines. At times he’s had to rely on an ethanol solution that damages the ports on his central line, a potentially deadly problem “since you can only have so many central access sites put into your body during your life,” he said.

When Faith Johnson, a 22-year-old Las Vegas student, was unable to get IV multivitamins, she tried crushing vitamin pills and swallowing the powder, but couldn’t keep the substance down and became malnourished. She has been hospitalized five times this past year.

Dread stalks Matt Smith, who daily fears that Elizabeth will call to say she has a headache, which could mean a minor allergic or viral issue — or a bloodstream infection that will land her in the hospital.

Even more worrying, he said: “What happens if all these companies stop doing it? What is the alternative? I don’t know what the economics of HPN are. All I know is the stuff either comes or it doesn’t.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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