This is a 1000 gram iron bar. It’s raw value is around $20. If you decide to make horseshoes, its value would increase to $250.
If, instead, you decided to make sewing needles, the value would increase to about $70,00.
If you decided to produce watch springs and gears, the value would increase to about $600 thousand.
However still, if you decided to manufacture precision laser components out of it like ones used in lithography, it’ll be worth $1.5 million.
Your value is not just what you are made of - but above all -in what ways you can make the best of who you are.
Colby Amerine
“Aslında kadim caddelilerden bu sırrı bilen bir kaç kişi kalmış olmalı” diyor Fecriye Hanım, “Biz eskiden Fener Bahçesi’ne Trenlerle giderdik” diye ekliyor, çayını karıştırırken. Hatta o dönemler tramvay da vardı Bağdat Yolunda… Tramvay raylarını ise, bir demiryolu diklemesine keserdi. Eski köşklerin arasında tıngır mıngır giderdi trenimiz, herkesin üzerinde yazlık tuvaletler…
Odanın camlı kapısından balkona vuran ışık
sıcak bir kumaş gibiydi üstünde dizlerimin.
Ben rehavetli bir mahzunluk içinde
acayip şeyler düşünüyordum :
Feneryolu‘ndaki çınar
150 yaşındaymış.
Ömrü bir gün süren böcekler.
Gün gelecek
insanlar çok uzun
çok bahtiyar yaşayacaklar.
İnsanın yüreği ve kafası var…
İnsanın elleri…
İnsan?
Ne zaman ki,
nerdeki,
hangi sınıftan?
Onların insanları,
bizim insanlarımız.
Ve her şeye rağmen
yeni bir dünya için yapılan kavga.
Sonra sen
ben
bir kırık küvet
ve benim
kendime karşı duyduğum merhamet…”
16 Ağustos 1940
“Kırık bir küvet” şiirinden
Mehmet Nazım Hikmet Ran
22 Eylül 1872’de Haydarpaşa Garı’nın açılmasıyla hizmete giren Haydarpaşa-Pendik Banliyö tren hattı üzerinde yine aynı tarihte başlayan ve Haydarpaşa’dan yalnızca 19. yüzyılın ortalarından itibaren özellikle yaz aylarında mesire yeri olarak kullanılan Fenerbahçesi’ne çalışan özel bir tren daha hizmete girmişti. İşte bu nedenle, Fener’e giden yol anlamında bu yol ayrımının olduğu noktaya (bifurcation) o günden sonra Feneryolu adı verilmişti. Ve o yol ayrımının 150-200 metre kadar ilerisine de Feneryolu İstasyonu inşaa edilmişti.
Most people have no idea of who is pictured above, but you should. The sight of this man should cause a similar revulsion to that of seeing Mussolini, Mao, Stalin or Hitler, as he committed an African genocide that resulted in the killing of over 10 million people in the Congo.His name is King Leopold II of Belgium.
Most of people never learned about him in school, and have also most likely never heard about him in the media either. This is because he’s not included in the popular narrative of oppression (which includes things like U.S. slavery and the Holocaust).
King Leopold II is part of an ongoing history of colonialism, imperialism, slavery, and genocide in Africa that would clash with the popular social narratives taught in our school system today. It doesn’t fit neatly into school curriculums where, paradoxically, it is looked down upon to make overtly racist statements. However, it’s quite fine not to talk about a genocide perpetrated by European capitalist monarchs that killed over 10 million Congolese.
Belgium’s King Leopold II ran a personal empire so vast and cruel, it rivaled – and even exceeded – the crimes of even some of the worst dictators of the 20th century.
When Leopold II ascended to the throne in 1865, he ruled with the kind of gentle hand that Belgians wanted from their king after the democratization of the country in the wake of the multiple revolutions and reforms. He had great ambitions of building an overseas empire, and was convinced, like most statesmen of his time, that a nation’s greatness was directly proportional to the resources it could extract from those colonies.
He disguised his business transactions as “philanthropic” and “scientific” efforts under the banner of the International African Society and used slave labor to extract Congolese resources and services. His reign was enforced through work camps, body mutilations, torture, executions, and his own private army
The empire was known as the Congo Free State, and Leopold II stood as its undisputed slave master. For almost 30 years, rather than being a regular colony of a European government, Congo was administered as the property of Leopold II for his personal enrichment.
The world’s largest plantation, registering at 76 times the size of Belgium, possessed rich mineral and agricultural resources and lost nearly half of its population by the time the first census counted only 10 million people living there in 1924.
Interestingly, when we learn about Africa in the U.S., we learn about a caricatured Egypt, the HIV epidemic, the surface level effects of the slave trade, and if you went to a good school perhaps something about South African Apartheid. We also see lots of pictures of starving children on commercials, safaris on animal shows and we see pictures of vast savannahs and deserts in films and movies.
What we don’t learn about is the Great African War or Leopold’s Reign of Terror during the Congolese Genocide. Leopold II essentially turned Congo into his own personal part-plantation, part-concentration camp, part-Christian ministry, and yet history fails to retell the lessons of his tyrannical endeavor.
It seems that when you kill ten million Africans — you aren’t called ‘Hitler’, your name never comes to symbolize the living incarnation of evil, and your picture doesn’t produce fear, hatred, and sorrow — rather your crimes are simply swept under the historical rug and the victims of colonialism/imperialism remain forever voiceless.
IT research and advisory firm, Gartner, defines governance as, “The organizational style and process for making decisions about business technology and resources.”
If you have successfully expanded your program globally, or are still in the process of going global, one critical and often overlooked activity is to develop a global governance model for your program. Based on my experiences with different programs and models, I understand the complexity associated with the governance of a global program. That’s why I’ve outlined some key insights that I’ve learned when establishing a successful governance team.
A well-run global governance model provides a foundation for the program to meet corporate goals, offers a clear direction to all of the parties involved, and creates structure for sponsors who are taking the required steps to generate a constantly improving program.
The Three Layers of a Global Governance Program
Global governance is a framework for the entire program to help all parties better understand and execute the company’s goals. Many people still think of governance as an executive layer over a program, but decisions and practices should be pervasive throughout the entire program. This isn’t just a high-level exercise; a good governance program has interaction throughout the layers of the program.
The three layers of a global governance program include:
- The Global Governance Team: This group consists of leadership from the client business owner, the VMS technology, and the MSP/VMO. This is the level responsible for overall program strategy.
- The Operational Team: This should include the in-country leaders from the business, the VMS technology, and the MSP/VMO teams. These people are responsible for the day-to-day workings of the program.
- The User Community: This includes sponsors, hiring managers, project managers, non-employee workers, and suppliers.
Goals and Roles of the Global Governance Team
The first task of the Global Governance Team should be to outline the program goals and apply an order of importance to them. Examples of these goals include going global, reducing risk, spend savings, process efficiency, and budget/invoicing accuracy.
In order to execute the determined goals, the Global Governance Team performs several roles, including:
- Keeping the program on track. This team plays a key role when keeping the overall goals of the program on track. This does not mean getting into the weeds of the day-to-day issues, but rather, a general overview of the program’s performance.
- Ensuring alignment to the strategies developed. This team designs key policies to help the operational teams translate strategy into action.
- Prioritizing the projects that the program will tackle. This team is responsible for ensuring that projects and their corresponding priorities align with the determined goals, as well as ensuring that all program resources are aware of the roles they play when executing those goals.
- Enforcing the policies and guidelines developed. This includes formalizing the program communication channels.
- Pursuing strategic growth.This team should be proactively developing their global roadmap for perceived future goals.
Recommendations for Continued Program Success
Meet regularly. In order to ensure that the Global Governance Team is continuously pushing program improvements, this committee should meet once every other month for the first six months and quarterly thereafter. The objective during these meetings is to review the program goals and assess the progress made towards them. Those goals can be refined and changed during these meetings, as the dynamics of business changes constantly. As a result, objectives should adjust accordingly.
Discuss progress and address needed areas of improvement. A program dashboard aligning to the goals is a great way to discuss progress in this meeting, making it meaningful and specific. This meeting should also address any escalations or recommended program and process improvements. Each program should strive for continuous improvement and the Global Governance Team meetings are the place to turn those recommendations into strategy.
The benefits of establishing any sort of governance control over a program or project are generally the same: a conduit for communication, clarity towards the current defined goals, visibility into future program goals, and a more effective process for getting all parties to collaborate for success. Global governance is the opportunity to continuously improve your program and monitor results based on established goals
If you want to achieve different results, reach new heights, or even just change the direction of your life, you sometimes must be willing to make changes to your current actions and behaviors. We can't always expect to get different results by doing the same things we've always done.
Let’s explore the importance of breaking away from our current loop and embracing change in order to move towards a better future.
The Loop: Understanding Our Patterns and Habits
Our daily lives are often filled with routines, patterns, and habits. These repetitive behaviors form a loop that keeps us locked into our current trajectory. While some of these habits may be beneficial, others could be holding us back from achieving our goals or realizing our full potential.
To change where we're going, we must first identify the habits and actions that are keeping us stuck in our current loop. This requires self-awareness, reflection, and the courage to confront our own shortcomings.
Breaking the Loop: Embracing Change
Once we've identified the behaviors that need to change, it's time to take action. This can be challenging, as it often requires stepping out of our comfort zone and facing the unknown. However, embracing change is an essential part of personal growth and progress.
Here are some strategies to help you break the loop and pivot towards success:
- Set Clear Goals: Define what you want to achieve and create a roadmap to guide your journey. This will help you maintain focus and motivation as you make changes to your actions and behaviors.
- Create an Action Plan: Break down your goals into actionable steps, and establish a timeline for achieving each one. This will help you stay on track and measure your progress as you work towards your desired outcome.
- Seek Support: Reach out to friends, family, or mentors for guidance and encouragement. Having a support system can make it easier to navigate the challenges and setbacks that often accompany change.
- Embrace Failure: Understand that failure is a natural part of growth and learning. Instead of fearing it, use each setback as an opportunity to learn and refine your approach.
- Cultivate a Growth Mindset: Believe in your ability to improve and adapt. Embrace challenges as opportunities to grow and develop new skills.
Changing what you're doing to change where you're going can be a daunting process. It requires effort, persistence, and a willingness to step outside your comfort zone. Remember, the path to success is rarely a straight line. It's a journey filled with twists and turns, but with determination and the right mindset, you can make meaningful progress towards your goals and create the life you've always envisioned.
If you wish to make changes in your life, you need to find a place where you want to go and take action to achieve your goals. This may mean giving up certain habits, changing the way you behave, learning new skills or broadening your horizons.
For example, if you want to change your career path, you need to find the field you want to go to and take action to achieve that goal. You may need to learn new skills, expand your social circle, take relevant training or courses, etc. to adapt to the new field of work.
In short, changing where you want to go requires changing what you are doing, which requires us to be brave enough to try new things and put in the effort to achieve our goals.
Important point that change is necessary for growth and progress.
It's so easy to fall into a comfortable routine and stay there, but if we want to achieve new heights, we must be willing to step outside our comfort zone and embrace the unknown. Your strategies for breaking the loop and pivoting towards success are practical and actionable. Keep inspiring others to embrace change and pursue their goals! For better or worse, we are what we repeat. Habits are a double edged sword. Embracing change should become an essential part of our quest for growth.
"We can't always expect to get different results by doing the same things we've always done" Albert Einstein
We have to start embracing and accepting failure to "Grow" in life. Failure teaches more than Success. Success sometimes boosts the ego.
The revenue cycle management (RCM) market refers to the collection of software and services used by healthcare organizations to manage their financial processes, from patient registration and scheduling to billing and payment collection. RCM solutions help #healthcare providers optimize their revenue streams, reduce billing errors, and improve overall financial performance.
During the forecast period, the global revenue cycle management market is expected to experience significant growth, with a projected increase from USD 115.64 billion in 2022 to USD 246.40 billion by 2029, reflecting a compound annual growth rate (CAGR) of 11.4%. The market size was valued at USD 105.86 billion in 2021.
Key components of the revenue cycle management process include patient registration, insurance eligibility verification, charge capture, claims submission, payment posting, denial management, and patient billing. RCM software automates and streamlines these processes, enabling healthcare providers to efficiently manage their revenue cycle and ensure timely and accurate payments.
The RCM market has experienced significant growth in recent years due to several factors, including the increasing complexity of healthcare billing and coding, the transition to value-based care models, and the need to improve revenue capture and cash flow. Additionally, regulatory changes, such as the implementation of ICD10 coding standards and the shift towards electronic health records (EHRs), have further fueled the demand for RCM solutions.
𝗞𝗲𝘆 𝗣𝗹𝗮𝘆𝗲𝗿𝘀 𝗶𝗻 𝘁𝗵𝗲 𝗠𝗮𝗿𝗸𝗲𝘁:
·Allscripts Healthcare, LLC (U.S.)
·Cerner Corporation (U.S.)
·Conifer Health Solutions, LLC (U.S)
·EPIC Systems Corporation (U.S)
·GeBBS Healthcare Solutions (U.S)
·MEDHOST (U.S)
·McKesson Corporation (U.S)
·Medical Information Technology, Inc. (MEDITECH) (U.S)
·Optum Inc. (U.S.)
Sleep apnea diagnostics refer to the process of diagnosing sleep apnea, a sleep disorder characterized by pauses in breathing or shallow breathing during sleep. It is essential to accurately diagnose sleep apnea to initiate appropriate treatment and improve the quality of sleep and overall health.
Sleep Study: The gold standard for diagnosing sleep apnea is a sleep study, also known as polysomnography. During a sleep study, various parameters are monitored while the individual sleeps, including brain activity, eye movements, muscle activity, heart rate, respiratory effort, and oxygen levels. This comprehensive evaluation helps identify the presence and severity of sleep apnea.
Overnight Home Sleep Testing: In some cases, home sleep testing (HST) may be conducted as an alternative to in-lab polysomnography. HST involves wearing portable monitoring devices that track specific parameters such as breathing, oxygen levels, and heart rate while sleeping at home. It offers convenience and cost-effectiveness, primarily for individuals with a high suspicion of moderate to severe obstructive sleep apnea.
Screening Questionnaires: Healthcare professionals may utilize screening questionnaires, such as the Epworth Sleepiness Scale or the STOP-BANG questionnaire, to assess the likelihood of sleep apnea. These questionnaires evaluate symptoms, sleep quality, and daytime sleepiness, providing initial indications for further evaluation.
Physical Examination: A thorough physical examination by a healthcare provider can provide insights into potential risk factors and underlying conditions that contribute to sleep apnea. This may include assessing body weight, neck circumference, nasal passages, and other physical characteristics associated with sleep-disordered breathing.
Medical History Review: Gathering a detailed medical history is crucial in identifying factors that could contribute to sleep apnea. This includes assessing symptoms reported by the individual and reviewing any pre-existing medical conditions, such as obesity, hypertension, cardiovascular disease, or respiratory disorders.
Sleep Diary: Keeping a sleep diary for a week or two can help provide valuable information about sleep patterns, daytime symptoms, and potential triggers or factors that affect sleep quality. The diary may include information on bedtime routines, sleep duration, snoring, daytime fatigue, and use of medications or substances.
It is important to consult with a qualified healthcare professional, such as a sleep specialist or pulmonologist, for a comprehensive evaluation and diagnosis of sleep apnea.
I work in management consulting, I usually get three kinds of reaction – confusion (What do you do?), well pleased (You must get to travel a lot and make a lot of money), “Meh!” or not impressed (You people are good for nothing except making bewitching PPTs).
So, the question is what do consultants exactly do to invoke such a variety of reactions?
The primary goal of any business is to maximize profits. Financially stable companies desire steady or more growth and the struggling companies intend to turn around their fortunes. The companies can achieve their goals by expansion or improving operational KPIs or both. This calls for a constant need of data driven decision making. Many companies still lack the market intelligence to fairly assess their own position. In many cases, there’s no sufficient expertise available within the organization to analyze the data sensibly. Moreover, the lack of common goal-oriented approach and inter-departmental barriers can hinder the decision making. Lastly, there aren’t enough resources available within the organization to be dedicated to such focus projects.
And that’s where the consultants come in:
1. Consultants bring in market intelligence with the industry benchmarks to show the stakeholders where their organization stands and where they intend to be (This is the major cause of awe-inspiring moments).
2. Consultants, being the external party, can operate without bias. After doing the interviews with the various functions of the company, consultants can chart out a plan to achieve the common goal – with all views considered.
3. Consultants are qualified to create hypotheses and test them. This is what gets the engine running and as Aristotle said – “Well begun is half done”. Do consultants use client’s data to do that? YES. Do they make bewitching PPTs to present their findings? ABSOLUTELY. It means the consultants are qualified enough to analyze the data, spot the patterns / anomalies, and make recommendations. EXCEL and PPT are consultant’s bread and butter and they take pride in their skills.
4. Yes, the consultants are paid to travel (from the most buzzing locations to the remotest of the villages where a plant is set-up). Although the trips are seldom enjoyable, the timely deliverables are always expected. Consulting professionals will wake up at 3 AM to catch a 6 AM flight for a 10 AM meeting, work the entire day, catch a flight back to hometown in the evening 7 PM, reach home by 10 PM (if there are no delays) and go to work the next day. They are efficiency monsters. They get done more in less time and save their client's time and money.
5. A consultant's main role is to act as a governance buffer and sell political capital to their clients. They help reinforce or provide reasonable justification to decision-makers within the company. This is the real product, management consultants are selling underneath
To summarize, consultants solve an organization’s strategic and/or operational problems in a structured manner using a data driven approach within a stipulated time to help it grow or stabilize.
So, whenever a business faces a problem that needs solving, we’ll be there to deliver!
The largest and lowest-pitched member of the viol family, the double bass dates back to the 15th century, and is generally considered to be the grandfather of the string family. A staple in classical music, as well as dance and jazz bands, the double bass can be played with a bow, or by plucking the strings with your fingers. By the 1950's, the double bass found its way into many popular groups at the dawn of rock'n'roll's inception, including notable favorites like Bill Haley and the Comets. Today, the double bass is still widely used, and within this section of options, you'll find a wide variety of exceptional models to choose from.
Whether you're a budding orchestral student or a touring rockabilly artist, this selection contains an extensive range of double basses from well-known and renowned brands. From Bellafina and Engelhardt to Etude, Florea and many more, these companies consist of experienced craftsmen who take pride in assuring that every double bass is made with meticulous attention to beauty, durability and playability.
For a double bass with impeccable construction and a rich sound, the Bellafina Model 50 double bass outfit is considered to be one of the finest models available for advancing student players. With its thumbwheel height adjusters on the bridge to accommodate various playing styles, as well as its slender neck for quick movement on faster orchestral passages, this double bass is the full package at a more than affordable price. Another option to think about is the Palatino Upright 3/4 – Size Billy Bass. Containing a cutaway design for easy access to the upper mid-section of the fingerboard, this model is actually one of few cutaway upright basses currently available. Plus, the instrument's maple bridge makes changing the tone easy, allowing you to go from hopping rockabilly sounds to cool and warm jazz.
One of the many great things about taking up a musical instrument is coming to realize that you don't have to stick to your instruments commonly associated genre once you master it. The double bass is a perfect example of an instrument that has spanned many genres over countless centuries, which is why anyone with a passion for music can benefit from learning one.
Devletin yerini kaba kuvvet alır,susulur.
Yasanın yerini din alır, korkulur.
Yolsuzluklar,cinayetler birbirini izler.
Eller kollar bağlanıp götürülür.
Vuran vurur.öldüren öldürür ve bütün bunlardan sonra bir çete gelir ve devleti teslim alır.
Uğur Mumcu
Looking for a JOB - How to Be the Next Hire
Making You the Most Viable Next Hire
Being flexible, creative and adaptable in today’s economy is the cornerstone to survival. The job search is no different and, with unemployment rising, requires just as much vigilance. One way you can keep your options open and make yourself even more marketable is by considering Consulting in addition to your quest for full-time employment. Often perceived as an “either-or” scenario, Consulting offers you just as many benefits as it does your “would be” employer:
Track record of Fixing Problems?
Career wise, people typically fall into one of two categories: those who thrive on problem solving and the prospect of a new challenge –or- someone who is exceptionally good at steering the ship once it is on course. If the thought of fixing something that is broken appeals to you (versus has you thinking about reaching for the Tylenol), then Consulting might be an avenue to explore.
A More Flexible Interview
Quite often, what a company needs is someone to tackle a specific problem, not a new full-time employee. Identifying this in the interview and being able to present yourself as the solution to their problem (at a lower cost), can ultimately create a job tailor made for you and your skill set. No one can compete against that.
Dating Before Marriage
A consulting engagement can give you the opportunity to see if this company is a nice place to visit or a great place to live. The only thing worse than a prolonged job search, is ending up in a position that results in you being unemployed again in 6-12 months. Consulting lets you do more due diligence than you could ever accomplish in an interview.
“Consulting” on Your Resume
To many recruiters, seeing “consulting” as your current role without any clients/engagements is just a way to dress up being out of work. But, with a list of key accomplishments at those engagements, you show that you are in demand, have more control over your search and are broadening your experience. The latter is extremely important if you are looking to transition industries.
Change Agent
For companies looking to make some sort of change internally (and you should like this if you have a track record of fixing problems), consulting is a more preferred approach versus hiring a permanent employee. It is much easier to come in as a consultant, effect the course correction and then hand it off to the internal leadership.
Money
Besides the obvious benefit of having income during your search, it also gives you breathing room to be more objective in selecting your next job.
It’s Easier to Find a Job When You Already Have One
So much of what makes this true is that fact that when you are employed, you tend to be a bit more objective because you have a “bird in hand.” Consulting (in addition to easing that financial strain, which helps here) can provide the self-assurance that comes along with being employed, which can get whittled away while unemployed.
Presenting yourself as a viable consultant or full time employee isn’t mutually exclusive. Rather, they are simply two sides to the same coin. For the companies where you interview, this will only make you more viable and versatile in your eyes. For you, there is nothing to lose. The worst thing that happens here is you generate some income to inevitable financial strain of your job search. On the other hand, you might just find through this process that you discover your next career move.
Bağdat Caddesi
Gel de parmaklara hakim ol, yapma bir Caddebostan, Bağdat Caddesi nostaljisi şimdi!...diğer bir deyişle 'Karşı taraf' . Cok uzun seneler yazları gittiğim, son yıllarda ise her Türkiye'ye gittiğimde kaldığım Istanbul'un bir başka eşşiz köşesi.
1960'lı 70'li yıllarda köşkleriyle, bahçelerinden salkım salkım sarkan ortancalarıyla, billur gibi denizliyle, 'sayfiye' yeri olmasıyla meşhur Erenköy, Suadiye, Caddebostan.
Dükkanların az, ağaçların çok olduğu, bunca yıl geçmesine rağmen hala güzelliğini koruyan Bağdat Caddesi. On, onbir yaşımdan itibaren yazlarım geçti oralarda. Sokaklarda oynanırdı o zamanlar, öyle pek araba filan geçmezdi. Doyasıya bisiklete binilir, el birakarak gitmek büyük marifet sayılır Erenköy, Saskınbakkal, Göztepe bisikletle rahat rahat gidilir dönülürdü. Deniz için bazı sokakların denize vardıkları noktalarda bulunan kayıkhanelerden saatlik ücretle kayık kiralanır, kadın erkek kürek çekmeyi bilir, kayıktan denize girilirdi. Bazı gençler dalıp iskele ayaklarından midye toplar bazıları ise sığ kumda zıpkınla vatos avlarlardı. Sokaklardan dondurmacılar geçerdi o zamanlar. Simdiki gibi binbir çeşit ne gezer 'Dondurma, Kaymaaak' diye bağıran dondurmacının küçücük arabasında sadece kaymaklı ve limonlu dondurma olur, bazen ise çeşit olsun diye vişneli bulunurdu.
Caddebostan Plajı'nın yanı sıra bir de üyelikle girilebilen klüpler vardı. Marmara Yelken Klubü başta olmak üzere, Balıkadamlar, Caddebostan Yat Klübü ve İstanbul Yelken. Eğer bunlardan birine üyeyseniz veya üye bir arkadaşınız varsa bazı sporları yapma veya izleme olanağınız olur, voleybol, ping pong oynar, kıyıdan yelkenlilerin yarışlarını izlerdiniz. Denizin ortasında ise köfteciler vardı. Bunlardan aklımda kalanı ise mayomuzun kenarına sıkıştırdığımız parayla yüzdüğümüz, veya kayıkla yanaştığımız 'Fıştak'tı. Dönerken yüzülüyorsa demirlemiş kayıklara tutuna tutuna, dinlene dinlene yüzülürdü.
Akşamüstüne doğru herkesi bir 'piyasa' heyecanı alırdı. Saçlar yıkanır, bildiğımız ütüyle ütülenerek düzeltilir, ve (Bağdat) Cadde'ye binbir tur atmaya çıkılırdı. Bir aşağı, bir yukarı. Parkur ise genellikle Santral Durağı'ndan Saşkınbakkala kadardı. O zaman 'cafe' adeti bir elin parmaklarını geçmez, 'Borsa'da yer bulabilmek için hızlı davranmak gerekir, 'Divan' ise gençlere çok pahalı geldiğinden ancak hafif 'yaşı geçmiş'lerin duraklama mekanı olurdu. Hali varaba sahiakti oldukça yerinde olan birkaç genç ise bir aşağı bir yukarı arabayla giderek Mustang veya Corvette'leriyle gelene geçene hava atarlardı.
Geceleri ise açık hava sinemalarının keyfine doyulmazdı. Caddebostan'daki Ozan Sineması'nda genellikle Türk filmleri oynar, çıkınca biraz aşağıda, Caddebostan Maksim Gazino'sunun (MIGROS)yakınındaki büfe'de 'zümküfül' yenirdi (Bir çeşit sosisli sandoviç ) Yabancı filmlerin mekanı ise Budak Sineması'ydı (Şimdiki CKM). Yastıgını kapıp tahta iskemlelere yerleştirdikten sonra, çekirdeğini çıtlatarak izlenirdi filmler. Bazen bu sinemalarda Cem Karaca gibi o zamanın ünlü sesleri konserler verir, bazıları ağaç tepelerinden konser izlerdi.
Sonra sonra o köşkler birer birer yıkılmaya, yerlerin uzun uzun binalar dikilmeye, Cadde'deki evlerin yerlerini dükkanlar almaya, arabalar çoğalmaya, faytonlar yok olmaya, tekerlekli dondurmacıların yerini Algida'cılar almaya başladı. Ama ne mutlu ki tüm büyümeler, kalabalıklaşmalar rağmen 'Cadde'yi bozmayı başaramadı! O hala 'Cadde', İstanbul'un ,Türkiye'nin en güzide caddesi hala boydan boya yürümekten zevk aldığım, bir yerde oturup geleni geçeni izlemenin keyfini her yıl bir iki hafta yaşayabildiğim bir yer.
The best way to improve health care requires physicians and other stakeholders
My honest approach for how to improve the care is to support a methodology such as being self-serving. I would like to start a program to introduce a software-based point-of-care tool for obtaining patient feedback. This real time information can be used with clients to positively impact the patient experience, nurse engagement, physician (soft skills) competence and overall quality. In my perspective the criteria for fulfilling the demand for finding the best way to improve healthcare is that it need be simple to implement, impactful and cost effective. The most impact to healthcare improvement will come from process improvement and healthcare provider recruitment AND retention. The by-products will be reduced cost of care and improved patient satisfaction. This applies to hospitals and private practices. Based on current studies and the economy, supplying adequate healthcare to the community is already tough and is going to get more challenging. Recruiting sufficient healthcare coverage will boost revenue and provide some improvement to patient satisfaction (wait time and access). However, failure to retain the medical staff will significantly hurt the outcome. With high demand and low supply, it will be well worth the time and money to present "we have the greenest pastures here". The method mentioned above may be called such as point-of-care through successful implementations that may turn in to popular key parts of process improvement. You need to have some feedback from the patients and the physicians in order to measure the processes that should be or are currently being improved. In order to achieve this you have to create the acronym HOSPITAL to help those in Healthcare recall the numbers of different types of inefficiencies in any medical facility. Those who have been exposed to Six Sigma and Lean have an appreciation for improvement opportunities and generally view things through differently trained eyes that can see within all those facilities. Publishing the results of the similar programs online may offer a transparent access to the consumers to monitor these inefficiencies. Welcoming any feedback relative to this and encourage your staff to consider this method or similar training methods for their teams will be highly critical for the outcome. We have to understand that it is impossible to solve a problem that we are unaware of. By providing even the most basic tools at the lowest level possible, these problems have a way of surfacing. While everyone recognizes that healthcare systems and organizations need to improve, I think not enough time is spent on firstly identifying the key stakeholders, and secondly properly ENGAGING them. I strongly believe that not enough time is spent trying to engage physicians in this process. In my experience too many of these "improvement strategies" are top-down decisions by non-clinical managers who failed to conduct any research into what physicians might want or what stumbling blocks there are/were to get them to adopt the new technologies. EMR/EHR/CPOE are prime examples - all of these require a breakdown in the normal activity flow of providers, as it requires them to either find and log on to a terminal or carry a bulky instrument. Almost all clients and colleagues I have worked with resent and resist those methods. And look how few MDs are part of Healthcare consulting firm teams. IMHO, I believe more energy should be spent engaging rather than alienating MDs as a first step, then doing the same for patients in order to get buy in from the two key stakeholders as I see it. I've always found that engaging these stakeholders on projects from the beginning results in more buy-in and most importantly, better recommendations/outcomes (a better product).
Aşık Veysel’in Cumhuriyet destanı şiirinden:
Şeriatı düşündü şerciler
Bir takım millete fesat verdiler
Her biri bir yerde hep geberdiler
Onlar kurtulmadı toplarımızdan
Aklı başında olan düşünür bunu
Şeriatçı oldu tüketen onu
Dağda belde fukaraya soygunu
Verenler onlar idi vatanımızdan...
PEZEVENK
Dünya ahvalinden haberi yoktur
Sohbeti din ile açar pezevenk
Komşusu aç iken kendisi toktur
Sanki melek olmuş uçar pezevenk
Karanlık işlerde zıplama ister
Evine granit kaplama ister
Dünya mektebinden diploma ister
İnsanlık dersinden kaçar pezevenk
Herkesin kabına çeşmesi akmaz
Erkek sinekleri hareme sokmaz
Fakir komşusunun yüzüne bakmaz
Selâmsız sabahsız geçer pezevenk
Sanırsın Allah'la akde oturmuş
Cennete giderken macun götürmüş
Hûriler'i dizip işi bitirmiş
Şimdi gılmanları seçer pezevenk
Aydınlığa düşman yobazın dölü
Hû çekerken şişmiş ağzında dili
Erbâbi, ülkede bunlardan dolu
Durmadan zehrini saçar pezevenk
Âşık Erbabi
by
Erdem Asma on Thursday, August 5, 2010 at 11:05pm
Mission of working together to achieve a common goal
Under extreme conditions, immense amounts of stress, and insurmountable odds, still set your mission to always find a way.
🎯 Than a successful transformation needs more than only a vision so THINK BIG, support the cultural shift, and imagine the future as if it were the present.
🤝 Customer Centricity goes beyond listening and understanding – it´s about challenging each other, co-creating value adding IT solutions, and delivering best-in-class services where quality, speed and cost are in balance.
💭 Agile is more than a set of tools, frameworks, and methodologies, it´s a mindset – with our new way of working we bring IT closer to the business and business closer to IT.
💡 One of my key takeaways: By leveraging the team power, always have eachothers back, we can achieve great things while sailing through one of the most liberating route to success.
As Darwin said: “It´s not the strongest of the species that survives, nor the most intelligent, but the one that is the most responsive to change.”
To get to know the person better you are going to marry
To get to know the person better you are going to marry, you need to see how he behaves in these four situations.
1- How he feels and how he behaves when he's hungry? If he is not emotionally mature, the hungry person begins to behave impatiently and selfishly.
2- When he’s angry at something or someone I would observe carefully how he reacts, how he behaves. The anger of the selfish person and the anger of the mature person are different. I would say that the best indicator of a person's maturity is how he manages his anger.
3- What does he do when he feels lonely? Does he shot himself down to the world and run away from everyone everything and be offended by every single thing, blame everyone, or can he be friends with his loneliness and accept these states of life with a calm maturity?
4- How does he behave when he is tired? It shows whether a person is selfish or not, how he feels and behaves best when he is tired. The mature person who understands the importance of his relationship (affair) with always considering others well-being in mind, no matter how tired they are.
Rejected on a Job Application due to being Overqualified
Overqualified means that someone is performing the role at a higher level. That the person possesses a skillset more/over and above than what is expected in the role. Age has nothing to do with being overqualified. Someone who’s 28 could be overqualified too. When hiring, it is about finding person who is the right fit, for the right role with the right motivation who also fits with the team/corporate culture.
Questions to the person applying for a role at a lower level could be: ‘why are you looking to take a step back in your career?’ and ‘since the role doesn’t sit at your current level, do you realize that the compensation is not on par with your current package/expectations?
Have you ever thought about this?
In 100 years like in 2123 we will all be buried with our relatives and friends.
Strangers will live in our homes we fought so hard to build, and they will own everything we have today. All our possessions will be unknown and unborn, including the car we spent a fortune on, and will probably be scrap, preferably in the hands of an unknown collector.
Our descendants will hardly or hardly know who we were, nor will they remember us. How many of us know our grandfather's father?
After we die, we will be remembered for a few more years, then we are just a portrait on someone's bookshelf, and a few years later our history, photos and deeds disappear in history's oblivion. We won't even be memories.
If we paused one day to analyze these questions, perhaps we would understand how ignorant and weak the dream to achieve it all was.
If we could only think about this, surely our approaches, our thoughts would change, we would be different people.
Always having more, no time for what's really valuable in this life. I'd change all this to live and enjoy the walks I've never taken, these hugs I didn't give, these kisses for our children and our loved ones, these jokes we didn't have time for. Those would certainly be the most beautiful moments to remember, after all they would fill our lives with joy.
And we waste it day after day with greed, greed and intolerance.
Yasarken Neler Yapmali ;-)
SAĞLIK:
1. Çok su için.
2. Kahvaltıyı kral, öğle yemeğini prens ve akşam yemeğini de dilenci gibi yiyin.
3. Ağaçlarda ve bitkilerde yetişen yiyecekleri çok ve fabrikalar da üretilen yiyecekleri az yiyin.
4. 3 E ile yaşayın -- Energy, Enthusiasm, and Empathy (enerji, heyecan ve duygu paylaşımı).
5. Kendinize zaman ayırın
6. Daha çok oyun oynayın.
7. 2008'de okuduğunuzdan daha fazla kitap okuyun.
8. Her gün en az 10 dakika sessiz olarak oturun.
9. 7 saat uyuyun.
10. Her gün 10–30 dakika yürüyüş yapın ve yürürken gülümseyin.
KİŞİLİK:
11. Hayatınızı başkalarınınkiyle karşılaştırmayın. Onların seyahatinin ne hakkında olduğu belirsiz....
12. Kontrol edemeyeceğiniz olumsuz düşüncelere veya şeylere sahip olmayın. Bunun yerine enerjinizi olumlu şekilde şu an için harcayın.
13. Kendinizi fazla abartmayın; sınırlarınızı bilin.
14. Kendinizi çok da ciddiye almayın; kimse yapmıyor.
15. Kıymetli enerjinizi gevezelikle, dedikoduyla boşa harcamayın.
16. Uyanık iken daha fazla hayal kurun.
17. Kıskançlık, çekememezlik zamanın boşa harcanmasıdır. İhtiyacınız olan her şeye sahipsiniz.
18. Geçmiş meseleleri unutun. Partnerinizin geçmiş hatalarını hatırlatmayın. Bu durum mevcut mutluluğunuzu bozar.
19. Hayat, birisine kin duyarak zamanı boşa harcamak için çok kısadır.
20. Geçmişinizle barış yapın ki, şimdiki zamanı bozmasın.
21. Senden başka hiç kimse senin mutluluğundan sorumlu değildir.
22. Hayatın bir okul olduğunu ve öğrenmek için burada o lduğumuzu unutmayın. Problemler, cebir dersi gibi gelip giden, ancak aldığımız derslerin bir ömür boyu devam ettiği eğitim programının bir parçasıdır.
23. Daha fazla gülümseyin ve gülümsetin
24. Her tartışmayı kazanmak durumunda değilsiniz. Aynı fikirde olmamak için anlaşın.
SOSYAL YAŞANTI:
25. Ailenizi sık arayın.
26. Her gün diğerlerine iyi bir şey verin.
27. Herkesi her şey için affedin.
28. 70 yaşından büyük ve 6 yaşından küçük kimselerle vakit geçirin.
29. Her gün en az 3 kişiye gülümseyin, tanımadığınız en az 1 kişiye "GÜNAYDIN" deyin.
30. Başkalarının sizin hakkınızda ne düşündüğü sizi hiç ilgilendirmesin.
31. Hasta olduğunuz zaman, işiniz size bakamaz ama aileniz ya da arkadaşınız bakabilir.
HAYAT:
32. Doğru şeyi yapın!
33. Faydalı, güzel veya neşe dolu olmayan her şeyden uzak durun.
34. İyilikler her şeyi güzelleştirir.
35. Bir durum iyi veya kötü olsun, nasılsa değişecektir.
36. Nasıl hissettiğinizin önemi yok, haydi kalkın, giyinin ve ortaya çıkın.
37. En iyisine henüz sıra gelmedi.
38. Sabah canlı olarak uyandığınız zaman, buna sevinin.
39. Maneviyatınız daima mutludur. Öyleyse mutlu olun.
“The Mother’s Prayer for Its Daughter” from Tina Fey's new book, Bossypants ...
“The Mother’s Prayer for Its Daughter” from Tina Fey's new book, Bossypants ...
First, Lord: No tattoos. May neither Chinese symbol for truth nor Winnie-the-Pooh holding the FSU logo stain her tender haunches.
May she be Beautiful but not Damaged, for it’s the Damage that draws the creepy soccer coach’s eye, not the Beauty.
When the Crystal Meth is offered, May she remember the parents who cut her grapes in half And stick with Beer.
Guide her, protect her
When crossing the street, stepping onto boats, swimming in the ocean, swimming in pools, walking near pools, standing on the subway platform, crossing 86th Street, stepping off of boats, using mall restrooms, getting on and off escalators, driving on country roads while arguing, leaning on large windows, walking in parking lots, riding Ferris wheels, roller-coasters, log flumes, or anything called “Hell Drop,” “Tower of Torture,” or “The Death Spiral Rock ‘N Zero G Roll featuring Aerosmith,” and standing on any kind of balcony ever, anywhere, at any age.
Lead her away from Acting but not all the way to Finance. Something where she can make her own hours but still feel intellectually fulfilled and get outside sometimes And not have to wear high heels.
What would that be, Lord? Architecture? Midwifery? Golf course design? I’m asking You, because if I knew, I’d be doing it, Youdammit.
May she play the Drums to the fiery rhythm of her Own Heart with the sinewy strength of her Own Arms, so she need Not Lie With Drummers.
Grant her a Rough Patch from twelve to seventeen. Let her draw horses and be interested in Barbies for much too long, For childhood is short – a Tiger Flower blooming Magenta for one day – And adulthood is long and dry-humping in cars will wait.
O Lord, break the Internet forever, That she may be spared the misspelled invective of her peers And the online marketing campaign for Rape Hostel V: Girls Just Wanna Get Stabbed.
And when she one day turns on me and calls me a Bitch in front of Hollister, Give me the strength, Lord, to yank her directly into a cab in front of her friends, For I will not have that Shit. I will not have it.
And should she choose to be a Mother one day, be my eyes, Lord, that I may see her, lying on a blanket on the floor at 4:50 A.M., all-at-once exhausted, bored, and in love with the little creature whose poop is leaking up its back.
“My mother did this for me once,” she will realize as she cleans feces off her baby’s neck. “My mother did this for me.” And the delayed gratitude will wash over her as it does each generation and she will make a Mental Note to call me. And she will forget. But I’ll know, because I peeped it with Your God eyes.
~Tina Fey
by Erdem Asma on Tuesday, April 19, 2011 at 9:23pm
Beethoven's Love Letter "my eternally beloved"
July 6 1806, in the morning by Ludwing Van Beethoven~
"My angel, my all, my very self - Only a few words today and at that with pencil (with yours) - Not till tomorrow will my lodgings be definitely determined upon - what a useless waste of time - Why this deep sorrow when necessity speaks - can our love endure except through sacrifices, through not demanding everything from one another; can you change the fact that you are not wholly mine, I not wholly thine - Oh God, look out into the beauties of nature and comfort your heart with that which must be - Love demands everything and that very justly - thus it is to me with you, and to your with me. But you forget so easily that I must live for me and for you; if we were wholly united you would feel the pain of it as little as I - My journey was a fearful one; I did not reach here until 4 o'clock yesterday morning. Lacking horses the post-coach chose another route, but what an awful one; at the stage before the last I was warned not to travel at night; I was made fearful of a forest, but that only made me the more eager - and I was wrong. The coach must needs break down on the wretched road, a bottomless mud road. Without such postilions as I had with me I should have remained stuck in the road. Esterhazy, traveling the usual road here, had the same fate with eight horses that I had with four - Yet I got some pleasure out of it, as I always do when I successfully overcome difficulties - Now a quick change to things internal from things external. We shall surely see each other soon; moreover, today I cannot share with you the thoughts I have had during these last few days touching my own life - If our hearts were always close together, I would have none of these. My heart is full of so many things to say to you - ah - there are moments when I feel that speech amounts to nothing at all - Cheer up - remain my true, my only treasure, my all as I am yours. The gods must send us the rest, what for us must and shall be - Your faithful Ludwing"
by Erdem Asma on Tuesday, April 5, 2011 at 1:42am
The surprising benefits of lemon!~Limonun Faydalari
This is the latest in medicine, effective for cancer!
Read carefully & you be the judge.
Lemon (Citrus) is a miraculous product to kill cancer cells. It is 10,000 times stronger than chemotherapy.
Why do we not know about that? Because there are laboratories interested in making a synthetic version that will bring them huge profits. You can now help a friend in need by letting him/her know that lemon juice is beneficial in preventing the disease. Its taste is pleasant and it does not produce the horrific effects of chemotherapy. How many people will die while this closely guarded secret is kept, so as not to jeopardize the beneficial multimillionaires large corporations? As you know, the lemon tree is known for its varieties of lemons and limes. You can eat the fruit in different ways: you can eat the pulp, juice press, prepare drinks, sorbets, pastries, etc... It is credited with many virtues, but the most interesting is the effect it produces on cysts and tumors. This plant is a proven remedy against cancers of all types. Some say it is very useful in all variants of cancer. It is considered also as an anti microbial spectrum against bacterial infections and fungi, effective against internal parasites and worms, it regulates blood pressure which is too high and an antidepressant, combats stress and nervous disorders.
The source of this information is fascinating: it comes from one of the largest drug manufacturers in the world, says that after more than 20 laboratory tests since 1970, the extracts revealed that: It destroys the malignant cells in 12 cancers, including colon, breast, prostate, lung and pancreas ... The compounds of this tree showed 10,000 times better than the product Adriamycin, a drug normally used chemotherapeutic in the world, slowing the growth of cancer cells. And what is even more astonishing: this type of therapy with lemon extract only destroys malignant cancer cells and it does not affect healthy cells.
Institute of Health Sciences, 819 N. L.L.C. Cause Street, Baltimore, MD1201
Tıpta son yenilik, kansere karşı etkili! Limon, kanser hücrelerini öldüren mucizevi bir mahsul. Kemoterapiden 10,000 kat daha güçlü!!! Neden biz bunları bilmiyoruz? Çünkü bazı laboratuarlarda üretilen sentetik ilaçlarla birileri çok büyük karlar elde ediyor. Şimdi bir arkadaşına bu maili yollayarak limon suyunun kanseri önleyici faydalarını bilmesini sağlayabilirsin. Limonun tadı güzel ve kemoterapinin korkunç yan etkilerine sebep olmuyor. Multimilyonerlerin sahip olduğu büyük şirketlerin karlarına zeval gelmesin diye bu sır saklanırken daha kaç kişi ölecek? Bildiğiniz gibi limon ağacı, limon ve lim (yeşil limon) gibi çeşitleriyle bilinir. Bu meyveyi farklı şekillerde yiyebilirsiniz: posasını yiyebilir, suyunu sıkabilir, içecekler hazırlayabilir, şerbetler ve tatlılar yapabilirsiniz. Bir çok erdemleriyle tanınır, ama en ilginç olanı tümör ve kistler üzerine olanıdır. Bu bitki her tür kanser tipine karşı kanıtlanmış bir çaredir. Bazıları kanserin her türlü varyasyonuna karşı yararlı olduğunu söylüyor. Bakteri enfeksiyonları ve mantarlara karşı anti mikrobal spektrum olduğu, kurt ve parazitlere karşı etkili olduğu kabul ediliyor. Yüksek tansiyonu dengeliyor. Bunlar dışında stresle savaşan, sinir bozukluklarına iyi gelen antidepresan etkisi var. Bu bilginin alındığı kaynak gerçekten büyüleyici: Dünyanın en büyük ilaç üreticilerinden birinden öğrenildiğine göre; 1970'ten beri 20'den fazla farklı laboratuar test etti ve sonuç olarak limon ekstresinin 12 kanser tipinde kötü huylu hücreleri yok ettiği ortaya çıktı! Bu kanserler içinde kolon, göğüs, prostat, akciğer ve pankreas kanserleri de var. Kanser hücrelerinin büyümesini yavaşlatmada limon ağacı bileşenlerinin Adriamycin adlı bütün dünyada genellikle kemoterapide kullanılan ilaçtan 10,000 kat daha iyi olduğu gösterildi. Daha da hayret verici olan; limon ekstreleri ile yapılan bu terapi sadece kötü huylu kanser hücrelerini yok ediyor ve sağlıklı hücrelere hiçbir etkisi bulunmuyor.
by Erdem Asma on Wednesday, February 23, 2011 at 8:25am
To all who likes to know, today is the fist day of Ramadan!
It is required to fast for the duration of the month every year in Islam for all healthy Muslims.
Islam order the Muslims to stop eating , drinking , smoking and some other marriage activities from morning Fajr prayer till evening Maghrib prayer. Ramadan is 29 or 30 days depends on the moon followed by 3 days Eid holiday. In the evening after Maghrib prayer, until sunrise the life get back to normal, they can eat, drink and etc. Wish you peace, happiness and divine blessing. Ramadan Mubarak.
by Erdem Asma on Wednesday, August 11, 2010 at 9:14am
Pakize Suda'dan
KASABA esnafından biri olmalıydı kocam.
Akşam, güneş batmadan
Dükkanını kapatıp eve gelmeliydi.
Evimiz mümkünse bahçeli olmalıydı.
Yaz akşamları sulayıp serin serin oturmalıydık.
Ben, orta boylu tıknazca, ev hanımı olmalıydım.
Cinsiyeti önemli değil, eli ayağı düzgün iki çocuğumuz olmalıydı.
Derslerine yardım etmeye yetecek eğitimim olmamalıydı.
Ama ara sıra ''Dersinizi bitirdiniz mi?'' diye sormalıydım.
Daha çok üstleri başlarıyla...
Yedikleri içtikleriyle. ..
Öksürükleri, aksırıklarıyla ilgilenmeliydim.
Yavaştan yavaştan çeyizlerini düzmeliydim.
Her ayın 15'i kabul günüm olmalıydı.
Ellerime sağlık, kekler,poğaçalar yapmalıydım.
İnce belli bardaklarda çaylar ikram etmeliydim.
Sabahları hırkamı omzuma alıp komşuya kahve içmeye geçmeliydim.
Patlıcan, biber kızartmalı,reçel kaynatmalıydım.
Akşamları özene bezene sofrayı kurmalıydım.
Kocam ajansı dinlerken ben lafa girmeliydim,
O, ''Sus hanım bi dakka'' demeliydi.
Böyle dese de beni çok sevmeliydi.
O uyuklamalı, ben bulaşık yıkamalı, çocuklar ders çalışmalıydı.
Bazen akşam oturmasına komşular gelmeliydi.
Öyle Haremlik selamlık gibi değil ama kadın erkek ayrı oturmalıydık.
Erkekler memleketi kurtarırken biz bütün kasabayı dilimizden
geçirmeliydik.
Herkes birbirinin kocasına, karısına ''Falanca Bey'', ''Filanca Hanım''
diye hitap etmeliydi.
Yanlışlkla bacağımız, göğsümüz biraz açılıverse
Yüzümüz kızarmalı,hemen toparlanmalıydık.
Kocam kırk yılda bir, bir tek atmalı,
Neşelenip bir hicaz şarkı mırıldanmalıydı.
Şehvetten uzak şefkate yakın bir cinsel hayatımız olmalıydı.
Gözümüzü birbirimizde açmış olmalıydık, öyle de sürüp gitmeliydi.
Harama uçkur çözmemeliydik.
Zaten etrafımızda evli barklı komşularımızdan başka kadın olmadığından....
Dükkanda çelimsiz çıraktan gayrı, öyle sekreter falan çalışmadığından...
Ortalıkta gidilecek bar mar bulunmadığından...
Mankenler bizim kasabaya uğramadığından...
Ve de kocam, efendi bir adam olduğundan beni aldatamazdı.
Tamam, abarttım biraz.
Belki de böyle bir aile yapısı örneği kalmamıştır artık.
Ama, acaba diyorum...
Buna benzer bir hayat tarzı beni daha mutlu eder miydi?
Kendim de dahil uçuk kaçık insanlardan gına geldi artık.
Normalliği özlüyorum.
Özgürlüğün tadını çıkaralım derken suyunu çıkardık galiba.
Herkes çok zeki, çok akıllı, çok bilgili, çok şu, çok bu...
Ve de çok mutsuz...
Depresyona giren girene.
Çok bilmişliğin kimseye bir faydası yok galiba.
Pakize Suda
by Erdem Asma on Thursday, August 5, 2010 at 3:24pm
TANSİYON
Kalbin vücuda kanı dağıtmak için kullandığı güce tansiyon denir. Tansiyonun
ölçüm birimi mm/hg dir.
Büyük tansiyon; Kalbin sol kalpten kanı vücuda doğru pompalarken kullandığı güce denir. Buna birinci veya büyük tansiyon da denir.
Küçük tansiyon; Kalbin kan pompalanmasını bitirdikten sonra damarlarda ortaya çıkan basınca da ikinci veya küçük tansiyon denir.
YÜKSEK TANSİYON
Yapılan bilimsel çalışmalara ve Dünya Sağlık Teşkilatının tarifine göre yüksek tansiyon sınırı yaşla değişiklik göstermesine rağmen, orta yaşlı insanlarda büyük tansiyon en fazla 160 mmhg, küçük tansiyon ise en fazla 85 mmhg olmalıdır. TANSİYON halinde ve tekrar tekrar ölçümün sonucu verilenden daha yukarı rakamlar çıkıyorsa, hastada yüksek tansiyon var demektir. Yüksek tansiyon hastada çoğunlukla belirti yapmadığı halde, teşhis konduktan sonra, sebebi mutlaka açıklanmalı ve tedavisi mutlaka yapılmalıdır. Tedavisi uzun vadelidir. Tansiyonun %20'sinin sebebi bilinir. Sebebi bilinmiyor ve ortadan kaldırılamıyorsa, hayat boyu sürer. Başta şişmanlık olmak üzere, böbrek hastalıkları, hormon bozuklukları ve bazı kalp hastalıkları tansiyona sebep olabilir. Örneğin; hastada doğuştan böbrek damarı daralması varsa, ameliyatla damar ve açılır ve tansiyon hastalığı ortadan kalkar. Tansiyonda
kalıtım önemli rol oynar. Fazla tuz ve kırmızı et yenmesi de tansiyona sebep olan etkenler arasındadır.
Belirtileri;
Baş ağrısı,
Baş dönmesi,
bulantı,
Kulak çınlaması,
Burun kanaması,
Kalp ağrıları olarak sıralanır.
Tedavisi
Günümüzde tansiyon tedavisi her zaman için kontrol altına alınabilir. Az tuz, az kırmızı tüketilmelidir. Şişman hastaların kilo vermesi gerekir. Uyku düzeni olan stressiz, içki ve sigaradan uzak bir hayat tavsiye edilir.
Yapılan diyet sonucu tansiyon düşmüyorsa ilaç tedavisi verilir. İlaç alınımından sonra tansiyon düzene girse bile kesinlikle doktora danışmadan ilaç bırakılmamalıdır. Yüksek tansiyonun tedavisinde kan basıncı düşürmek için özellikle diyet uygulanır ancak tansiyon çok yüksek ve organik hastalıklardan kaynaklanıyor ise, diyet ve ilaç tedavisi aynı zamanda
uygulanır. Bu hastalığın kesin bir nedeni ve tedavisi olmaması, ömür boyu diyet uygulamayı gerektirmektedir. Yüksek tansiyonu şişmanlıktan kaynaklanan kişiler için en uygun tedavi şekli kilo vermektir. Yüksek tansiyonu olan şişmanlar için ilaç gerekli olduğu durumlarda yine kilo verilmeli ki böylelikle ilacın etkisi artabilsin. Tansiyon, damar setliği ve beyin kanamasının en önemli sebebidir.
Yüksek Tansiyonda Beslenme İlkeleri
Şişman kişilerde yüksek tansiyon ortaya çıkma olasılığı normal kilolu insanlara göre 2 mislidir ve şişmanların %70'inde yüksek tansiyon görülür. Yedikleri fazla yemekle daha fazla tuz almaları da tansiyonlarının daha yükselmesine sebep olur. İşte bu sebeplerden ötürü kilo vermesi şarttır. Yüksek tansiyon hastalarının günlük tuz kullanımını en aza indirilmeli (5-7 gram) hatta mümkünse hiç kullanılmamalıdır. Doğal besinlerden; yeşil yapraklı sebzeler, süt, et, yumurta, işlemmiş besinlerden; kek, bisküvi, konserveler, hazır çorbalar, ekmek, yarım yağlı margarin, zeytin, peynir, turşu, hardal, ketçap, mayonez, salata sosları en çok tuz içeren besinler olmalarından dolayı az kullanılmaları tavsiye edilir. Tansiyon düşürücü ilaçlar az tuz kullanıldığında daha tekili olurlar. Alkol kan basıncı arttıracağından ve kilo almaya sebep olacağından kullanılmamalıdır. Sigaranın tansiyonu arttırıcı etkisi olduğundan kesinlikle bırakılmalıdır, böylelikle tansiyon düşürücü ilaçların etkisi de artacaktır. Fazla miktarda hayvansal yağ içeren besinler yerine bitkisel yağları (mısır özü, zeytinyağı) tercih etmek gerekir. Doymuş hayvansal katı ve sıvı yağlar yerine doymamış bitkisel katı ve sıvı yağlar tercih edilmelidir. Tansiyon çok yüksek değilse, fazla olmamak kaydıyla çay ve kahve içebilir.EĞER VÜCUDUNUZA GEREKLİ BESİN DESTEKLERİ VERİRSENİZ, TANSİYON SİZE ZARAR
VERMEZ.
Düşük Tansiyon Nedir?
Sol kalbin kanı vücuda pompalarken gerekli basıncın düşük olması demektir. Bu basınç ölçüldüğünden ilk basınç 120'den düşük, ikincisi ise, 80'den düşük olmalıdır. Düşük tansiyona sebep olan nedenler çok çeşitlidir. Çoğunlukla insanın yapısına bağlıdır. Tansiyon düşmesi, ani ayağa kalkmalarda, beyin merkezinde ur olması durumunda, kalp adalesi zayıflaması, aort kapakçığının hastalanması gibi kalp hastalıkları söz konusu olduğu zamanlarda, böbrek üstü bezinin çalışması bozulduğunda veya hormon bozukluklarında meydana gelir.
Belirtileri Nelerdir?
Baş dönmesi,
Ani bayılmalar,
Terleme,
Bulantı,
Yorgunluk hissi gibi yüksek tansiyondaki belirtileri gözlenir.
Düşük Tansiyon Tedavisi Nasıl Yapılır?
Tansiyon düşüklüğü insanın yapısından kaynaklanıyorsa, bu hastalara spor yapmaları (yüzme, bisiklet sürme) aynı anda sıcak ve soğuk duş yapmaları, tuzlu ayran gibi tuzlu sıvılar almaları önerilir. Diğer nedenlerden kaynaklanan düşük tansiyon ise, nedenleri tedaviye yöneliktir. Örneğin; Böbrek üstü bezinin çalışması bozulmuş ise, bu durumu tedavi etmekle tansiyonda düzelmiş olacaktır.
by Erdem Asma on Thursday, July 29, 2010 at 6:06pm
Yine ayni rezalet!
Soru 1 : Dünyanın en tehlkeli teknolojik ürünü nedir?
What is the most dangerous tech product in the world?
Cevap 1 : Nükleer santral.
Nuclear reactors.
Soru 2 : Nükleer santrallerin en kötüsünü dünyaya yapan ülke hangisi?
Which country maintains the worst nuclear reactors?
Cevap 2 : Rusya.
Russia
Soru 3 : Rüşvetin en çok yendigi ülke hangisidir?
Country has a long history of bribery and corruption.
Cevap 3 : Rusya.
Russia
Soru 4 : Dünyada kilovat saati 6-7 cent olan nükleer santral elektiriğini Rusya'dan 12.35 cente 15 yıl boyunca alma anlaşması yapan ülke hangisidir?
While the average cost of the residential price of nuclear powered electricity in the world 6-7 cents per kWh, which country agreed to purchase it from 12.35 cents for the next 15 years?
Cevap 4 : TÜRKİYE!
by Erdem Asma on Sunday, July 11, 2010 at 3:53pm
Healthcare today and tomorrow from Captain's perspective
In the era of globalization, cut-throat competition is going on in healthcare industry, so healthcare organizations have to formulate right strategies at the right time and at economical cost for survival. The long-term success of a healthcare organization depends upon its ability to deliver best services with care at the right price and by maintaining financial health through operational efficiencies. As a healthcare professional with 12 years of experience in the sector I support the idea that the operational realization can be achieved only through successfully interfacing reliable computer based information systems that work in a harmony with the ideal current/future workflow throughout the organization. Today’s business may only get awarded for better clinical outcomes with reduced medical errors that will return to your organization as greater revenue. As a care provider highly dependent on accurate clinical information systems, which provide decision support and automate process tools capable of improving overall success and productivity. HIS vendor’s primary objective is to make the client prepared for not only remaining in business while facing the competition but to improve the financial outcome of the organization’s long term goals. The ultimate goal is to bridge the gaps between care giver and the encounters. This may only be achieved by the quality/accuracy of the data that you manage to gather during your everyday operations. In our day the biggest handicap is to learn how to eliminate the need to avoid unintended user contact and utilize the advance health information technology which provides better quality and faster interaction/ response times not only to continue growing financially strong but to extend with less force and results in fewer ratio of loss. Maintaining revenue integrity is the expertise to guide the business owners through but it is also supposed to be the care providers’ benefit while guaranteeing patients’ and healthcare professionals best benefit. Given that the effects of the financial trash hold in US economy annual healthcare expenditures are outgrowing, and the stakes are enormous regardless of the current economic crisis. But the critical point is to approach the dilemma from the perspective of the care provider since these high costs leave absolutely no room for inaccuracy. When undetected, most errors count against your annual revenue or long term limit on quality improvement. The way you invest misspent today can mean greater financial risk tomorrow. The complexities of clinically driven revenue management in healthcare, frequent regulatory change and continuous coding updates present intimidating challenges. In order to achieve the revenue integrity revenue consultants/specialists provide coaching in most critical fundamentals. To help the business office to send out to their payers the ultimate form and capability of efficiently transferred high volumes of claims in a timely manner once the staff verify for proper coding and accurate reimbursement. As a requirement, it is detrimental to maintain the ability to protect the patient data against any type of risk and abuse. By educating care providers in designing/building security in an experienced way can avoid patient information safety risks and claims submission mistakes while elevating their billing practices. Protection of the collected patient data should start with an analysis of possible threats, an identification of the costs of counter-measures and the decision on how security tools must be used on basis of a cost/benefit analysis. As there is no suitable product to be used by almost every solution, the healthcare IT management consultant’s experiences within the area offers a systematic approach how to implement adequate security in the healthcare enterprise. Since existing hospital access management systems always use point-to-point methods to implement integration, so they lack the support to complex hospital business processes and it is difficult to assure fluent execution of business processes, it is still difficult to adequately address revenue integrity due to the increasingly high number of changes in coding, coverage and payer guidelines, and be able to generate accurate claims without implementing and utilizing the most suitable software automation products. Otherwise it is only time and budget consuming for hospitals and medical system staffs. Fortunately the information technology is there to analytically guide the users through on the access management responsibilities, in addition to clinical others. In the year of 2009 still many organizations continue to struggle with manual processes. Auditing in paper based slow the process with limited reach in terms of the volume of claims reviewed as well as rules and edits applied. New electronic process solutions on the other hand focus on flagging unclean claims and identifying coding errors and more. They help the specialists to uncover duplicate files, gauge eligibility, or quickly review claims histories without referring on to the paper and give you the ability to track overpaid bills or duplicate bills which creates a significant financial difference. These solutions/software can monitor practices or providers over time however monitoring the efficiency of the data and manipulating the outcome may require further skills, which is especially critical in the age of electronically managed workflow implementations. As long as the vendors provide constructive feedback to their clients by upgrading the limits of intelligent technology since there is always plenty of room for growth and improvement to utilize the clean/accurate database. Once the demonstrative data stored it has to be filtered by the providers while understanding where the errors possibly stored. Software packages let payers equip their providers with remittance advice and reimbursement recommendations to assist in scrubbing future claims. With education on correct billing procedures, payers are helping to update their providers’ billing systems so future claims will not be returned unpaid. At the same time, the information that the provider gathers can improve payer provider relations by minimizing the friction and effort associated with deliberations regarding reimbursement rates. Revenue integrity technologies benefit those dedicated to improving their billing operation. As forward-thinking, organizations with the higher percentage of clean claims will ultimately lead to superior cash flow. However first to choose the right automation tools for the special needs of the organization, and installation followed by the integration with existing systems should be financially and timely well managed due to the risks of possible disruption or downtime. Furthermore, users in the scheduling, registration, medical records, billing departments should have to redesign their future workflows for electronic data input procedures and maybe apply customization to carry out an effective implementation. During the process of customizing/designing HIS products to successfully interface without distressing or necessitating major change to the rest rather than breaching the existing patient accounting system, the overall automation project requires successful implementation experience in managing account workflow. This support allows account representatives to focus on payer and guarantor follow-up while performing billing and collection practices. Best team with the most experience can guide the user to improve operational practice by creating business rules and workflow strategies to manage activities such as sending letters, attempting contacts and utilizing management reports. Once the business owner has the ability and knowledge to use the solutions in their best level of efficiency it will be easy to facilitate denial management by prioritizing and queuing accounts that need worked, tracking payer denials and automating your organization's denials response. Professionals such as myself better be proficient in clinical department workflows that are outside the business office therefore they can allow the provider to incorporate into their future workflow, improving exchanged information quality, timeliness and accuracy. As a final word, even though it is difficult, painful, and costly to participate in the process of developing and managing the health information system implementations due to the extensive numbers of subsystems/legacy systems along with the budgetary complications of the business process, overall the technology improves patient safety and service quality, saves time, provides higher accuracy rate, and helps the budget in the long run. Better control on the financial authority always means better chance to improve care quality.
Erdem Asma, MSM, PMP
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