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skyingdepths · 28 days

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The Expanding Trend of Homeschooling: Benefits, Challenges, and Tips for Success

In recent times, homeschooling has ended up being an increasingly popular selection for several family members looking for an extra customized and versatile approach to education and learning. With the ability to customize curriculum to specific understanding styles and choices, homeschooling offers an one-of-a-kind opportunity for children to thrive academically and personally. Moms and dads commonly point out the capability to produce a risk-free and nurturing learning setting, supply individually interest, and impart their values and beliefs as crucial factors for selecting homeschooling.While homeschooling can be

unbelievably gratifying, it additionally offers its own set of obstacles. Parents might battle to balance training duties with work and house obligations, browse legal requirements and regulations, and discover socialization chances for their children. Nonetheless, with careful planning, support from homeschooling areas, and a commitment to ongoing learning and growth, households can efficiently navigate the homeschooling journey. In this article, we will certainly check out the advantages of homeschooling, address typical difficulties, and supply useful pointers for producing an effective homeschooling experience for both parents and youngsters.

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skyingdepths · 5 months

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The Ultimate Guide to Vehicle Repair Work: Every Little Thing You Need to Know

Recognizing the Basics of Vehicle Repair Service

Car repair work is a crucial element of auto ownership that can not be neglected. Whether it's a regular upkeep task or a significant fixing, having a standard understanding of car repair is important to make certain the long life and integrity of your automobile. In this extensive guide, we will look into the basics of automobile repair service, providing you with the knowledge you require to make enlightened choices about your vehicle's maintenance and repairs.First and foremost,

it is essential to familiarize yourself with common automobile parts and their functions. From the engine and transmission to the brakes and suspension, each part plays an essential function in the general efficiency of your lorry. Understanding just how these parts collaborate can assist you determine potential issues and connect successfully with your mechanic. In addition, understanding the numerous indication your auto might show, such as weird noises or control panel indications, can help you identify problems at an early stage and avoid more damage.Finding the Right Auto Repair Service Shop for Your Demands When it involves car repair work, finding a trusted and reliable auto mechanic is important. With countless alternatives readily available, it can be overwhelming to pick the best automobile service center for your needs. Nonetheless, there are a few vital variables to consider that can aid you make a notified decision.Firstly, constantly choose for a licensed or accredited auto mechanic that focuses on the certain make and model of your car. This ensures that they have the essential knowledge and understanding to handle your automobile's distinct demands. Additionally, take into consideration the track record and experience of the auto repair work store. Reading on the internet evaluations and looking for referrals from family and friends can give useful understandings right into the high quality of service provided.Furthermore, don't forget to ask regarding guarantees and warranties offered by the car service center. A reputable mechanic should wait their work and supply service warranties on components and labor.

Lastly, contrast costs and obtain price quotes from numerous auto repair service shops to guarantee you are getting a reasonable bargain without jeopardizing on quality.In final thought, having a solid understanding of car repair essentials and understanding exactly how to discover the ideal vehicle repair work store can save you time, money, and unnecessary anxiety. By putting in the time to inform yourself and make informed choices

, you can guarantee that your automobile gets the ideal possible care, keeping it running efficiently and securely for many years to come.

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skyingdepths · 7 months

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Opening the Potential of a Home Based Business: Methods for Success

Intro: Over the last few years, the idea of a home based business has gotten substantial momentum and popularity. With the rise of modern technology, the opportunities for starting and running an effective company from the convenience of your very own home are unlimited. Whether you're a stay-at-home moms and dad, an aspiring entrepreneur, or simply seeking added earnings, a home company gives a versatile and practical alternative. In this post, we will certainly check out the potential of a home based business and supply you with valuable strategies for attaining success in this dynamic and ever-evolving field.The Advantages

of a Home BusinessOne of the primary benefits of a home based business is the adaptability it uses. By getting rid of the restraints of a traditional workplace setting, you have the liberty to set your very own functioning hours and produce a routine that fits your way of life. This flexibility not just allows you to balance your personal and specialist commitments however also allows you to seek your passions and interests. Additionally, a home service gets rid of the need for a daily commute, saving you both time and cash. Furthermore, with advancements in innovation, you can conveniently link with customers and consumers from around the world, broadening your reach and prospective consumer base.Strategies for Success in a Home BusinessSetting up a home based business requires mindful planning and implementation. To start with, it is necessary to select an organization idea that aligns with your abilities, rate of interests, and market demand. Conduct detailed market research to determine your target audience and competitors, and create a distinct value proposal to distinguish on your own in the market. As soon as your service is up and running, develop a committed office within your home to advertise efficiency and emphasis. Establish a routine and established clear goals to remain arranged and motivated. Networking with various other home based business proprietors and taking part in online areas can likewise give useful assistance and chances for partnership. Finally, continuously purchase your personal and professional development to remain in advance of sector patterns and improve your skills.In verdict, a home based business provides enormous potential for people seeking flexibility, financial independence, and the possibility to seek their enthusiasms. By understanding the advantages and executing reliable approaches, you can open the complete potential of your home service and begin on a meeting and successful business journey.

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skyingdepths · 8 months

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Plumbing 101: A Comprehensive Guide to Comprehending and also Keeping Your Home's Pipes System

Pipes is a necessary facet of any type of residence, in charge of delivering clean water and getting rid of waste efficiently. However, it is often forgotten until a trouble arises, creating hassle and also potential damage. In this blog post, we will look into the world of pipes, offering a thorough overview to aid you comprehend as well as keep your home's pipes system.Paragraph 2: From recognizing typical pipes issues to carrying out preventative actions, we will cover all aspects of pipes upkeep. You will discover just how to discover and also fix leaks, unblock drains pipes, and also address low tide stress. Furthermore, we will talk about the importance of regular assessments as well as the role they play in preventing major plumbing catastrophes. Whether you are a novice homeowner or merely wanting to broaden your knowledge, this article will certainly equip you with the required details to tackle pipes problems with confidence as well as make sure the long life of your home's pipes system.

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skyingdepths · 9 months

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Incredible video on How To Become A Certified Life Coach

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skyingdepths · 10 months

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Cool video on How Do I Start A Life Coaching Business

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skyingdepths · 11 months

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YouTube Ads ecommerce guide: When, how and why

Several DTC ecommerce advertisers are doing admirably well with Facebook Ads.

But I don’t think any brand should depend on a single marketing platform.

I’ve written before about how to bring winning Facebook assets over to Google using a Performance Max campaign that replicates the social experience as best as possible.

Today, I want to make a case for when, how, and why to consider YouTube Ads.

What to know before you begin

YouTube is a unique platform – not truly search, not fully social. It’s part of Google, yet it stands on its own. As a result, it’s not easy to master.

I tackled this in 7 important YouTube Ads lessons every media buyer should know. If you don’t want to click through, here’s the gist.

Facebook and Instagram combined great targeting with a captive audience to shorten the conversion cycle, spoiling other platforms for many advertisers. On YouTube, users either watch content they enjoy or learn how to do something.

YouTube lets you target people based on something they searched for, but they’re not actually searching for it at that moment. This intent lag, combined with the diversity of intent, means the “next step” after YouTube has to be particularly compelling.

A brand with a robust organic YouTube program will outdo one that’s using the platform solely for advertising. They have high-quality content waiting for people who end up on their channel from an ad.

A7: It's funny how many companies don't leave their video ad variations unlisted on YouTube. A lot of times you can just go to their channel and see exactly what they're advertising. #ppcchat

— Joe Martinez (@MilwaukeePPC) August 6, 2019

For brand safety, you can opt out of sensitive categories at the campaign level. Paired with audience and interest targeting, you can effectively lock out people who shouldn’t see your ads.

Google leans heavily on automation, so you have to monitor your campaigns. Even with your targeting absolutely right, you still need to feed data back to Google to improve its decision-making.

The reporting for video action campaigns is more in-depth and robust than many other Google campaigns, including Performance Max. You can take advantage of this to optimize quickly and intelligently.

YouTube fits nicely into a wider marketing or media buying mix, whether you need a new platform to expand your audience or want to scale an existing campaign. But you can only succeed if you know and accept its limitations.

With that in mind, here’s why direct-to-consumer (DTC) ecommerce brands should consider YouTube Ads.

Why YouTube and DTC ecommerce pair well

Remember the frame of mind people are in when they’re browsing YouTube.

You’ve got folks in theater mode, looking for a solution or catching up on content. And you’ve got people scrolling through Shorts, similar to the endless scroll of social media.

But unlike Facebook, ads on YouTube are interruptive. Whether they appear at the start of a video or in the middle, you’re asking for attention when people would rather be doing something else.

But if there’s one thing DTC ecommerce advertisers are good at, it’s thumb-stopping hooks.

Ultimately, both platforms are about the retention graph. Like Facebook, YouTube shows you a chart of how many viewers stay on a video until the end. You’ll want to refer to that chart and tweak your creatives accordingly.

How do you get more people to stay to the end? Make your content more interesting.

With a strong hook and compelling storyline, your “ad” could be anything from a music video to a fix-it guide.

As long as it’s entertaining, people will watch videos several minutes in length because that’s what they came to YouTube for.

Another approach is to build around short-form, snackable content. Take your winning ads from Facebook, chop them up if they’re longer than 60 seconds, and populate your channel with several organic Shorts.

You can use these to start advertising (see below for how to set this up). Any content that does well organically should also do well in the ads platform and vice versa.

5 recommendations for new YouTube advertisers

It’s easy to get things wrong on YouTube, from unrealistic expectations to expecting crystal clear attribution. But with the right approach, an already strong brand will likely be elevated further.

Here are five things you should do to give your brand the best chance of achieving that.

1. Know what you’re getting into

YouTube has over 2.68 billion users, making it the second-largest search engine behind Google. So once you’ve tapped out other networks – Search, Shopping, Performance Max, Facebook, Instagram, TikTok and everything else – YouTube offers tremendous scale to diversify further.

Note: Google’s attribution is largely click-based, so you won’t see as many reported conversions. Both your ROAS and CPA will be lower than you’re accustomed to, while campaigns will need more time before you start seeing the results in post-purchase surveys.

2. Understand the platform

YouTube Shorts is particularly interesting, but Google doesn’t offer the ability to create a Shorts-only campaign. There are ways of getting past this – kind of.

Create a new video action campaign that targets only mobile devices. This somewhat forces the system to go only to mobile devices, and in that format, it tends to lean towards Shorts.

Be sure to only provide vertical video assets shorter than 60 seconds.

3. Adopt the right mindset

You won’t get the same ROAS you do on Facebook, at least not the same reported ROAS. But it can provide a similar level of incremental revenue and scale.

Your approach must differ since YouTube is about creating awareness so other platforms can win more conversions.

Whatever revenue is reported by Google, know that it’s just a drop in the bucket in terms of its incremental impact on your business.

4. Don’t try too much at once

If you go in heavy with YouTube, there’s a good chance you won’t get any results. Start with one campaign and see how things go. YouTube is budget-intensive.

Without sufficient investment, there’s a good chance that you’ll go months without seeing any scale. Or worse, pull the plug on what could have been a high-potential campaign.

5. Use your own attribution

There’s a strong chance you already use post-purchase surveys to ask customers where they first heard about your brand. This is a good way to find people who discovered you on YouTube but converted elsewhere.

But it’s self-identifying and not foolproof, so you may wish to consider tools like Northbeam or Triple Whale to measure impact. Just remember, no attribution is ever perfect.

YouTube is the next frontier for high-performing ecommerce brands

I like to think of YouTube Ads clicks as the beginning of a beautiful journey.

Some people go on to become website traffic and enter your remarketing campaigns. Some will join your email list. A few may not click or visit your site but think about you later and look for you by name, eventually entering your funnel via a branded ad.

Naturally, attribution and reporting aren’t robust enough to track all that. So you’ll need to be patient, trust in YouTube as well as your own creatives, and look for incremental correlation rather than causation. This means not testing out other platforms as you expand to YouTube.

Keep in mind what YouTube means to people. It’s a source of entertainment, an escape from reality. A place where people go to have their biases confirmed, problems are solved, and businesses and careers are made.

It’s only natural that users value their time there and have demanding attention spans.

But if you’re sitting on winning assets that offer and align with what they’re looking for, ignoring YouTube is as good as leaving money on the table.

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

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skyingdepths · 1 year

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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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