Why it’s good for your health to be outdoors

Referencing a study where students who spent time in the forest had lower levels of inflammation than those who spent time in the city.

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Sure, there are treadmills at climate-controlled gyms and Nintendo’s Wii is still going strong with indoor workouts like Zumba Fitness 2.

And yet, old-fashioned advice to “go outside and play” is still the best for your health, according to researchers the world over. In one study published by the NCBI, researchers found a decrease in both heart rate and cortisol levels when participants spent time in the forest instead of the city.

“Stressful states can be relieved by forest therapy,” the researchers concluded.

The encouragement to “get outdoors” for health holds even in the face of the Asthma and Allergy Foundation of America’s assertion that pollen seasons have gotten stronger and longer over the years. The workaround: the AAFA recommended limiting outdoor activities, but only on days when pollen is high for the trees or grasses you are allergic to.

Being outside delivers other health rewards, too, from sharp mental health benefits to improved memory and decreased inflammation.

Here are four of the most significant health benefits from spending time outdoors, according to Business Insider:

Walking in the woods can improve your short-term memory.

“Nature walks have memory-promoting effects that other walks don’t,” BI noted, citing a study where participants who walked among trees did 20 percent better on a memory test than those who had taken in city sights.

Outdoor experiences can fight depression and anxiety.

Time in nature may combat depression, anxiety and other mental health issues, especially when combined with exercise.

One study associated walks in the forest with decreased levels of anxiety and bad moods while another found outdoor walks could be “useful clinically as a supplement to existing treatments” for major depressive disorder, BI reported.

Being outdoors has a demonstrated de-stressing effect.

One study published by NCBI found that students sent into the forest for two nights had lower levels of the stress marker cortisol than those who spent that time in a city.

Spending time outside reduces inflammation.

Inflammation in overdrive is associated with ills that include autoimmune disorders, inflammatory bowel disease, depression and cancer. “Spending time in nature may be one way to help keep that in check,” BI noted, referencing a study where students who spent time in the forest had lower levels of inflammation than those who spent time in the city.

More at https://on-ajc.com/2uDKqPT

Health grant to help AU study on how blood pressure impacts cognition

Which specific interneuron subtype drives neuronal response in the face of cardiovascular disease, suspecting it instead drives neuronal activity upward.

High blood pressure puts a squeeze on blood vessels in the brain that can disrupt a protective process that works to balance blood flow to the brain with the activity of resting neurons. When blood flow decreases due to hypertension, astrocytes – neuron-nurturing brain cells – may instead tell neurons to increase their activity, Filosa said.

The miscommunication between the brain blood vessels, astrocytes and neurons could be an early factor in how high blood pressure can impair cognitive function, according to Filosa.

“Untreated hypertension can lead to cognitive impairment but exactly how it happens, we don’t really know,” she said. “We need to understand the window of change or shift in function in all these different cells. By the time patients are symptomatic, a lot of the physiology of the vasculature has deteriorated so the question is: How can we diagnose impairments in vascular function way before that, years before cognitive impairments are established and become symptomatic.”

Filosa is hoping the grant will help her to find answers.

Regulation of blood flow is a normal body function, especially in the brain which doesn’t like extreme changes in blood flow. For example, large increases in flow can result in swelling, especially if blood pressure also rises. Lower pressure and decreased blood flow mean less energy for neurons which require a continuous stream of oxygen and nutrients found in blood to function.

“Neurons don’t have energy reserves so their activity is dependent on continuous blood flow,” said Filosa.

This is why brain cells can die quickly in the event of a stroke or head trauma, and why they likely do not function well with chronic hypertension.

High blood pressure also causes the parenchymal arterioles that carry blood for neurons constrict, so less blood is carried. Astrocytes then sense the increased pressure, and it appears to trigger an increase in calcium inside the astrocytes cells. Researchers believe this calcium increase causes increased constriction of blood vessels and promotes inflammation. One of the research goals is to find out what then happens to the neurons.

“A lot of these things get activated as a protective mechanism, but chronically they can shift into being more deleterious,” Filosa said.

The researchers will look at how a healthy balance occurs and what hypertension does to it. They will look at what happens to calcium levels in astrocytes in response to various blood pressure levels in the brains of booth normal mice and those that have impaired blood flow, and what mediates any change. They will also look at “which specific interneuron subtype drives neuronal response in the face of cardiovascular disease, suspecting it instead drives neuronal activity upward,” according to the release.

Point-of-care ultrasound: a reliable bedrock of the general hospital

Medical scope of practice can vary by state, country and/or local jurisdiction.

Point-of-care ultrasound is at the heart of Frimley Park Hospital’s anaesthesia department, guiding procedures such as vascular access and nerve blocks. Dr Tim Pepall, a consultant anaesthetist at Frimley Park, explained: “It’s essential to use ultrasound for central vascular access because of NICE guidelines, but we also use it occasionally for difficult peripheral vascular access and arterial lines.

Ultrasound has transformed regional anaesthetic practice and we were relatively early adopters of it – it made sense to see the nerves, rather than going in blind. There is so much variation in nerve and vascular anatomy that you realise your previous techniques were really feeling in the dark. Nowadays, I would be very reluctant to do a plexus block without an ultrasound machine.”

Tim continued: “We’ve been using FUJIFILM SonoSite point-of-care systems for the last 10 years. There are five SonoSite instruments in the anaesthetic department and we’ve stayed with the one manufacturer because we’ve been very happy with it – we like the back-up service, as well as the simplicity of the systems and the quality of images it provides.

The SonoSite S-Nerve interface is very intuitive, and it is great for portability, we can transfer it onto the wards and take it wherever we need to use ultrasound. With the new SonoSite X­Porte, we’re also doing more echocardiography than before – which saves us having to discuss preoperative cases with the cardiologists as often – and we can see dynamic changes as they occur, and responses to our interventions.”

SonoSite, the SonoSite logo, S-Nerve and X-Porte are trademarks and registered trademarks of FUJIFILM SonoSite, Inc. in various jurisdictions. FUJIFILM is a trademark and registered trademark of FUJIFILM Corporation in various jurisdictions. All other trademarks are the property of their respective owners. Copyright (c) 2018 FUJIFILM SonoSite, Inc. All rights reserved. Subject to change.

Medical scope of practice can vary by state, country and/or local jurisdiction.

FUJIFILM SonoSite, Inc., is the innovator and world leader in bedside and point-of-care ultrasound, and an industry leader in ultra high-frequency micro-ultrasound technology. Headquartered near Seattle, the company is represented by a global distribution network in over 100 countries. SonoSite’s portable, compact systems are expanding the use of ultrasound across the clinical spectrum by cost-effectively bringing high-performance ultrasound to the point of patient care.

Ecosystem Play to Generate $100T by 2028, Accenture Says

The survey found that about 50% of business leaders say they have already built or are currently building an ecosystem to respond to disruption, and another 10% more are seeking to build one.

Digital disruption can be a scary thing. You either innovate by building a digital platform that leverages big data and emerging tech like AI, blockchain, and the Internet of Things, or you get disrupted by somebody who can. But the good news is you don’t have to go it alone. In fact, according to a new report from Accenture Strategy, companies that leverage their surrounding ecosystems to build disruptive products and services will generate a mind-boggling $100 trillion in value over the next 10 years.

That eyebrow-raising assessment was delivered recently in a new research paper from Accenture Strategy titled “Cornerstones of Future Growth: Ecosystems.” The report is based in part on a survey of 1,252 business leaders that Accenture Strategy conducted to ascertain how they’re evolving business models to handle the potential negative and positive aspects of digital disruption. The survey found that about 50% of business leaders say they have already built or are currently building an ecosystem to respond to disruption, and another 10% more are seeking to build one.

Which begs the questions: Just what exactly is an “ecosystem,” how can a company build one, and in what way can it help?

An ecosystem, according to Accenture Strategy is:

“…The network of cross-industry players who work together to define, build and execute market-creating customer and consumer solutions…The power of the ecosystem is that no single player need own or operate all components of the solution, and that the value the ecosystem generates is larger than the combined value each of the players could contribute individually.”

Brick and mortar retailers, for example, are leveraging an ecosystem when they expand their reach to customers by selling products through online portals, such as Amazon or EBay. Hospitals can also tap into the ecosystem train by using rideshare services, such as Uber or Lyft, to help move patients to and from appointments.

ai-and-the-future-of-growth-1-638

We’ve definitely seen our share of digital disruption over the past 10 to 15 years. Physical stores selling books, toys, and music are few and far between, and thanks to Amazon’s $1-billion acquisition of PillPack, the neighborhood drug store could be next. Uber, which doesn’t own any cars but does have a popular ride-sharing app, is worth an estimated $50 billion, the same amount as General Motors, which made 3 million cars last year.

But according to Accenture Strategy’s survey, the potential disruption is just getting started. The survey found that 76% of business leaders say current business models will be unrecognizable in five years, and that the rise of the ecosystem play will be the main culprit.

Big data and technological innovation will play central roles in the ecosystem play. Accenture Strategy cites the partnership between Microsoft and GE and the companies’ integration of the Azure and Predix platforms as a good example of an ecosystem at work. A budding ecosystem that includes Google and Wal-Mart, similarly, is designed to make it easier for customer to order products via AI-powered Google Assistant, Accenture Strategy points out.

In some ways, the ecosystem concept bares some similarity to the “innovation chains” that Forrester analyst Brian Hopkins has explored in his research lately. Hopkins says that companies that can successfully link together disparate but related technologies (such as big data analytics, AI, distributed ledgers, IoT, cloud, and quantum computing) have a better chance at creating “breakthrough innovation” than those who lack the experience and expertise in those technologies.

While business executives seem to agree that leveraging ecosystems will be a key to future survival, many of them don’t know how to pull it off. According to the Accenture Strategy survey, only 40% of respondents said they have the capacity and experience to build, monitor, and manage an ecosystem at the moment.

Part of the problem with the ecosystem play is that companies are loathe to give up control, which must happen for an ecosystem to be successful. Accenture Strategy says sharing data is “essential” to sustaining an ecosystem, but adds that 44% of executives are hesitant to share company assets or secrets. Investment in data governance capabilities was identified as a critical need for enabling safe data sharing.

Pursuing an ecosystem play can often mean working with one’s business adversary. Turning these competitors into “frenemies” is a good way to head off the risk of business disruption, said Accenture Strategy Managing Director Oliver Wright.

“Due to increasing market pressure, we’re likely to see more companies – particularly those that have traditionally been competitors – join forces as they look to create new growth and achieve competitive agility,” Wright stated in a press release. “‘Coopetition’ will continue to grow and exciting partnerships will form as a result, some of which have already remade markets and industries around the world.”

Michael Lyman, the senior managing director for Accenture Strategy, says companies can no longer create sustainable growth by going it alone. “They need the help of partners to form ecosystems to innovate and create new customer propositions, expand their customer base and enter new markets,” he said in a press release.

Ecosystem capabilities are not evenly distributed across industries. Telecommunication firms, banks, and utilities have the strongest ecosystem capabilities today, while companies in the insurance, healthcare, and travel industries are the weakest.

Read more at http://bit.ly/2LeZhYj

UK-US post-Brexit trade deal risks increased drug prices

US-UK bilateral trade deal is a key post-Brexit priority, with conversations already taking place to achieve this.

A trade deal between the UK and USA could risk increasing drug prices in the UK, which could diminish the affordability and accessibility of the NHS, according to a Viewpoint published in The Lancet.

The opinion piece outlines how the USA’s targeting of so-called ‘foreign free-riding’ in trade deals could lead to a poor deal on pharmaceuticals for the UK post-Brexit. The authors raise concerns that the USA could pressure the UK to change the way it regulates pharmaceuticals in trade deals.

Currently, all of the UK’s international trade deals are negotiated through the European Union, but, the UK Government will need to negotiate new deals to replace existing agreements post-Brexit. The USA is one of the UK’s most important trading partners after the rest of the European Union, and a US-UK bilateral trade deal is a key post-Brexit priority, with conversations already taking place to achieve this.

US policies to reduce ‘foreign free-riding’

American drug prices are some of the highest in the world, leading to economic hardship and poorer health outcomes for uninsured Americans and those who cannot afford to pay out-of-pocket. The US Government does not negotiate drug prices, and Medicare is prohibited by law from doing so. In addition, the Affordable Care Act prevents the US Food and Drug Administration and the Secretary of Health and Human Services from basing drug approval decisions on cost-effectiveness.

By contrast, similar drugs are often significantly cheaper in the UK, where the Government negotiates prices with pharmaceutical companies via the Pharmaceutical Price Regulation Scheme, and the NHS makes purchases based on clinical and cost-effectiveness assessments from the UK’s National Institute for Health and Care Excellence (NICE).

In May 2018, the US Department of Health and Human Services introduced the American Patients First blueprint, outlining measures to reduce US drug prices which include putting pressure on other countries to allow drug prices to rise in their jurisdictions. Unveiling the new policy, President Trump stated that “as we demand fairness for American patients at home, we will also demand fairness overseas. When foreign governments extort unreasonably low prices from US pharmaceutical companies, Americans have to pay more to subsidise the enormous cost of research and development”.

The Trump administration blueprint criticises single-payer healthcare systems which impose drug price controls, and accuses foreign governments of not paying their fair share of research and development costs to bring innovative drugs to market – proposing that other nations ‘free-ride’ off of American investment in drug development.

However, the Viewpoint authors argue that this interpretation overlooks the high cost of drugs for patients, and that drugs should be priced in line with how much benefit they give. They raise concerns that, rather than tackling the inherent issues of funding drug development, American Patients First instead represents the interests of pharmaceutical companies and their stakeholders, aiming to maintain or increase revenues.

“American Patients First is an attempt by the Trump Administration to make the USA’s drug pricing problem everybody else’s problem,” says lead author Dr Holly Jarman, University of Michigan, USA. “By shifting the economic, political, and social costs of policies made in the USA onto America’s trading partners, the Trump Administration is attempting to show voters that they are doing something about high drug prices while providing benefits to pharmaceutical companies and sympathetic campaign donors.” [1]

Potential effects for the UK post-Brexit

With the American Patients First policy and a turn towards protectionist, pro-American trade deals, the authors believe that the USA will push to alter drug regulation in future trade negotiations with the UK. This raises concerns because the ability to enter into trade deals is an executive power in the UK.

One of the authors, Professor Tamara Hervey, University of Sheffield, UK, points out: “While deals have to be ratified by Parliament, Parliament cannot amend the agreement that the Government negotiates, or be directly involved as the negotiation takes place. In addition, health groups are rarely consulted on trade deals, and Parliament and other health-focused stakeholders have limited opportunities to hold the Government to account in its trade negotiations.”

This is also exacerbated by the Brexit process. The Trade Bill introduced this year – if passed into law – could further limit parliamentary and public scrutiny of US-UK trade deals.

In addition, until recently the UK did not have a fully functioning trade ministry capable of complex negotiations with a highly experienced country like the USA. The authors say that the UK is unlikely to get a better deal with the USA than it has as part of the European Union, as the UK market is much smaller than the whole of the EU, meaning the UK has less bargaining power in negotiations.

Lastly, the authors raise concerns that pharmaceuticals will be one part of a wider trade agreement between the UK and USA, and could be an area that the UK compromises on to ensure better deals elsewhere.

“Perhaps the ultimate issue is the extent to which UK politicians are willing to defend the existing regulatory regime in the context of risks to their political careers,” says Professor Martin McKee, one of the authors from the London School of Hygiene & Tropical Medicine, and member of the advisory board of Healthier In (an NGO which campaigned to remain in the EU).

He continues: “In view of President Trump’s recent trade policy actions, policy makers should take the administration’s argument over drug prices very seriously. The UK health policy community should press the UK Government to make clear to the public and to the USA that they are not willing to bring the UK’s drug pricing and evaluation regime to the negotiating table in any future UK-US trade talks.”

http://bit.ly/2L5l2Nn Read more here

Education Technology’s Machine Learning Problem

Educators should also be able to try artificial intelligence technology before making a purchase.

From Formula 1 to Yelp, industries across the board are seeking ways to apply machine learning to their work. Even academics and Goldman Sachs analysts tried using it to predict World Cup winners. (Those predictions proved very, very wrong.)

But how is machine learning playing out in education—and how does it impact not just students, educators and parents, but also the businesses building technology tools to support teaching and learning?

At the SF Edtech Meetup, hosted by EdSurge on July 10, four panelists gathered to discuss the challenges around deploying machine learning in the classroom and the boardroom. The speakers were Carlos Escapa (Senior Principal, AI/ML Business Development, Amazon Web Services), Vivienne Ming (Founder and CEO, Socos Labs), Matthew Ramirez (Director of Product Management, AI Writing Tools, Chegg) and Andrew Sutherland (CTO and co-founder, Quizlet).

The Data Problem

What makes machine learning work is data—but that data can be biased in problematic ways that can lead to misleading and disturbing outcomes. (Ming referenced the time when Google’s image recognition algorithms classified black people as gorillas.)

“When you’re doing this in advertising, who cares if you get some of it wrong,” Ming said. “When you’re doing it in diagnostics or in education or in hiring, you potentially just ruined someone’s life. You have a real moral obligation to understand why your system is making the recommendations it’s making.”

Education and human development is complex, Ming noted, and there’s still not a mass of training data that connects what activities four-year-olds do with their parents in the evenings to what their life outcomes will be. In complex data sets, particularly ones with lots of human data, she warned, the number of spurious correlations that don’t actually mean anything are often more common than evidence of reliable causal relationships.

If there’s something wrong with the data you’re using to support a decision, added Escapa, then there will be something wrong with the decision. Data must be representative of the population it’s trying to serve, and there must be sufficient data from that population. “It’s very easy to make a mistake creating a model where you’re trying to generalize a solution to a problem, and you actually have insufficient data from some of the demographics that you’re trying to address,” he said.

Great Data, Great Responsibility (and Costs)

So what can education companies do to reduce biases in their tools?

Ramirez advised that a company wanting to build out its machine learning system should figure out a “ground source of truth” that guides how a company is building its tools.

There’s human effort involved as well. Ming recommended that companies hire domain experts who can build the machine learning system. And what Ramirez has found helpful for his writing tool are human annotators who can look at the data and identify whether or not a student should receive a certain suggestion or piece of feedback.

Machine-learning technology can help humans perform these types of tasks. “I think AI assistive platforms are super fascinating and really interesting, because there are a lot of human experts that can do this kind of work, that are eager to do this kind of work, and are extremely well qualified to do this kind of work,” Ramirez said.

But getting this support isn’t cheap. For those that have raised venture capital, Ramirez says it’s reasonable to expect at least half of that money to go towards AI research and development—and hiring machine-learning engineers. Companies need to allocate a bigger budget to hire these experts than for general web developers, he noted.

These costs are “something that I think a lot of people going into this industry don’t foresee, and which venture capitalists are now just learning how to forecast.” For that reason, he welcomes the hype around AI among venture capital circles.

What Should Teachers Ask?

Investors are not the only ones barraged with pitches from edtech companies promising that their AI and machine learning tools with transform education. Increasingly, so too are educators and administrators who make decisions around what technologies to use and purchase.

So what how can they do to make smart choices—and not fall for gimmicks?

Escapa thinks educators should ask AI companies what data they use to generate their models, how they curate that data, how often they update those models and how they know their data doesn’t have bias. Also, educators should tell companies to convince them that their data is representative of the population they serve.

Sutherland said that educators should also be able to try artificial intelligence technology before making a purchase.

“It’s one thing to have Powerpoint demos or a fixed demo where you say, ‘Oh, it produced this decision or this outcome.’ But then there’s another way—you actually have a teacher try the tool for five minutes,” Sutherland said. “They know all the mistakes a student might make. They can try them on the tool, and if it doesn’t work, then it doesn’t work.”

Read more at http://bit.ly/2L6M5I7

7 Ways to Earn Trust and Get Your Search Work Implemented

Learn how to navigate corporate bureaucracy and cut through red tape to help your clients and colleagues understand your search work.

Tell me if this rings a bell. Are your search recommendations overlooked and misunderstood? Do you feel like you hit roadblocks at every turn? Are you worried that people don’t understand the value of your work?

I had an eye-opening moment when my colleague David Mitchell, Chief Technology Officer at VML, said to me, “You know the best creatives here aren’t the ones who are the best artists — they’re the ones who are best at talking about the work.”

I have found that the same holds true in search. As an industry, we are great at talking about the work — we’re fabulous about sharing technical knowledge and new developments in search. But we’re not so great at talking about how we talk about the work. And that can make all the difference between our work getting implementing and achieving great results, or languishing in a backlog.

It’s so important to learn how to navigate corporate bureaucracy and cut through red tape to help your clients and colleagues understand your search work — and actually get it implemented. From diagnosing client maturity to communicating where search fits into the big picture, the tools I share in this article can help equip you to overcome obstacles to doing your best work.

Buying Your Services ≠ Buying In

Just because a client signed a contract with you does not mean they are bought-in to implement every change you recommend. It seemingly defies all logic that someone would agree that they need organic search help enough to sign a contract and pay you to make recommendations, only for the recommendations to never go live.

When I was an independent contractor serving small businesses, they were often overwhelmed by their marketing and willing to hand over the keys to the website so my developers could implement SEO recommendations.

Then, as I got into agency life and worked on larger and larger businesses, I quickly realized it was a lot harder to get SEO work implemented. I started hitting roadblocks with a number of clients, and it was a slow, arduous process to get even small projects pushed through. It was easy to get impatient and fed up.

Worse, it was hard for some of my team members to see their colleagues getting great search work implemented and earning awesome results for their clients, while their own clients couldn’t seem to get anything implemented. It left them frustrated, jaded, feeling inadequate, and burned out — all the while the client was asking where the results were for the projects they didn’t implement.

What Stands in the Way of Getting Your Work Implemented

I surveyed colleagues in our industry about the common challenges they experience when trying to get their recommendations implemented. (Thank you to the 141 people who submitted!) The results were roughly one-third in-house marketers and two-thirds external marketers providing services to clients.

The most common obstacles we asked about fell into a few main categories:

  • Low Understanding of Search
    • Client Understanding
    • Peer/Colleague Understanding
    • Boss Understanding
  • Prioritization & Buy-In
    • Low Prioritization of Search Work
    • External Buy-In from Clients
    • Internal Buy-In from Peers
    • Internal Buy-In from Bosses
    • Past Unsuccessful Projects or Mistakes
  • Corporate Bureaucracy
    • Red Tape and Slow Approvals
    • No Advocate or Champion for Search
    • Turnover or Personnel Changes (Client-Side)
    • Difficult or Hostile Client
  • Resource Limitations
    • Technical Resources for Developers / Full Backlog
    • Budget / Scope Too Low to Make Impact
    • Technical Limitations of Digital Platform

The chart below shows how the obstacles in the survey stacked up. Higher scores mean people reported it as a more frequent or common problem they experience:

Some participants also wrote in additional blocks they’ve encountered – everything from bottlenecks in the workflow to over-complicated processes, lack of ownership to internal politics, shifting budgets to shifting priorities.

Too real? Are you completely bummed out yet? There is clearly no shortage of things that can stand in the way of SEO progress, and likely our work as marketers will never be without challenges.

Playing the Blame Game

When things don’t go our way and our work gets intercepted or lost before it ever goes live, we tend to be quick to blame clients. It’s the client’s fault things are hung up, or if the client had only listened to us, and the client’s business is the problem.

But I don’t buy it.

Don’t get me wrong — this could possibly be true in part in some cases, but rarely is it the whole story and rarely are we completely hopeless to affect change. Sometimes the problem is the system, sometimes the problem is the people, and my friends, sometimes the problem is you.

But fortunately, we are all optimizers — we all inherently believe that things could be just a little bit better.

These are the tools you need in your belt to face many of the common obstacles to implementing your best search work.

7 Techniques to Get Your Search Work Approved & Implemented

When we enter the world of search, we are instantly trained on how to execute the work – not the soft skills needed to sustain and grow the work, break down barriers, get buy-in and get stuff implemented. These soft skills are critical to maximize your search success for clients, and can lead to more fruitful, long-lasting relationships.

Below are seven of the most highly recommended skills and techniques, from the SEO professionals surveyed and my own experience, to learn in order to increase the likelihood your work will get implemented by your clients.

1. How Mature Is Your Client?

Challenges to implementation tend to be organizational, people, integration, and process problems. Conducting a search maturity assessment with your client can be eye-opening to what needs to be solved internally before great search work can be implemented. Pairing a search capabilities model with an organizational maturity model gives you a wealth of knowledge and tools to help your client.

I recently wrote an in-depth article for the Moz blog about how to diagnose your client’s search maturity in both technical SEO capabilities and their organizational maturity as it pertains to a search program.

For search, we can think about a maturity model two ways. One may be the actual technical implementation of search best practices — is the client implementing exceptional, advanced SEO, just the basics, nothing at all, or even operating counterproductively? This helps identify what kinds of project make sense to start with for your client. Here is a sample maturity model across several aspects of search that you can use or modify for your purposes:

This SEO capabilities maturity model only starts to solve for what you should implement, but doesn’t get to the heart of why it’s so hard to get your work implemented. The real problems are a lot more nuanced, and aren’t as easy as checking the boxes of “best practices SEO.”

We also need to diagnose the organizational maturity of the client as it pertains to building, using and evolving an organic search practice. We have to understand the assets and obstacles of our client’s organization that either aid or block the implementation of our recommendations in order to move the ball forward.

If, after conducting these maturity model exercises, we find that a client has extremely limited personnel, budget and capacity to complete the work, that’s the first problem we should focus on solving for — helping them allocate proper resources and prioritization to the work.

If we find that they have plenty of personnel, budget, and capacity, but have no discernible, repeatable process for integrating search into their marketing mix, we focus our efforts there. How can we help them define, implement, and continually evolve processes that work for them and with the agency?

Perhaps the maturity assessment finds that they are adequate in most categories, but struggle with being reactive and implementing retrofitted SEO only as an afterthought, we may help them investigate their actionable workflows and connect dots across departments. How can we insert organic search expertise in the right ways at the right moments to have the greatest impact?

2. Speak to CEOs and CMOs, Not SEOs

Because we are subject matter experts in search, we are responsible for educating clients and colleagues on the power of SEO and the impact it can have on brands. If the executives are skeptical or don’t care about search, it won’t happen. If you want to educate and inspire people, you can’t waste time losing them in the details.

Speak Their Language

Tailor your educational content to busy CEOs and CMOs, not SEOs. Make the effort to listen to, read, write, and speak their corporate language. Their jargon is return on investment, earnings per share, operational costs. Yours is canonicalization, HTTPS and SSL encryption, 302 redirects, and 301 redirect chains.

Be mindful that you are coming from different places and meet them in the middle. Use layperson’s terms that anyone can understand, not technical jargon, when explaining search.

Don’t be afraid to use analogies (i.e. instead of “implement permanent 301 redirect rewrite rules in the .htaccess file to correct 404 not found errors,” perhaps “it’s like forwarding your mail when you change addresses.”)

Get Out of the Weeds

Perhaps because we are so passionate about the inner workings of search, we often get deep into the weeds of explaining how every SEO signal works. Even things that seem not-so-technical to us (title tags and meta description tags, for example) can lose your audience’s attention in a heartbeat. Unless you know that the client is a technical mind who loves to get in the weeds or that they have search experience, stay at 30,000 feet.

Another powerful tool here is to show, not tell. Often you can tell a much more effective and hard-hitting story using images or smart data visualization. Your audience being able to see instead of trying to listen and decipher what you’re proposing can allow you to communicate complex information much more succinctly.

Focus on Outcomes

The goal of educating is not teaching peers and clients how to do search. They pay you to know that. Focus on the things that actually matter to your audience. (Come on, we’re inbound marketers — we should know this!) For many brands, that may include benefits like how it will build their brand visibility, how they can conquest competitors, and how they can make more money. Focus on the outcomes and benefits, not the granular, technical steps of how to get there.

What’s In It for Them?

Similarly, if you are doing a roadshow to educate your peers in other disciplines and get their buy-in, don’t focus on teaching them everything you know. Focus on how your work can benefit them (make their work smarter, more visible, make them more money) rather than demanding what other departments need to do for you. Aim to align on when, where, and how your two teams intersect to get greater results together.

3. SEO is Not the Center of the Universe

It was a tough pill for me to swallow when I realized that my clients simply didn’t care as much about organic search as my team and I did. (I mean, honestly, who isn’t passionate about dedicating their careers to understanding human thinking and behavior when we search, then optimizing technical stuff and website content for those humans to find it?!)

Bigger Fish to Fry

While clients may honestly love the sound of things we can do for them with search, rarely is SEO the only thing — or even a sizable thing — on a client’s mind. Rarely is our primary client contact someone who is exclusively dedicated to search, and typically, not even exclusively to digital marketing. We frequently report to digital directors and CMOs who have many more and much bigger fish to fry.

They have to look at the big picture and understand how the entire marketing mix works, and in reality, SEO is only one small part of that. While organic search is typically a client’s biggest source of traffic to their website, we often forget that the website isn’t even at the top of the priorities list for many clients. Our clients are thinking about the whole brand and the entirety of its marketing performance, or the organizational challenges they need to overcome to grow their business. SEO is just one small piece of that.

Acknowledge the Opportunity Cost

The benefits of search are no-brainers for us and it seems so obvious, but we fail to acknowledge that every decision a CMO makes has a risk, time commitment, risks and costs associated with it. Every time they invest in something for search, it is an opportunity cost for another marketing initiative. We fail to take the time to understand all the competing priorities and things that a client has to choose between with a limited budget.

To persuade them to choose an organic search project over something else — like a paid search, creative, paid media, email, or other play — we had better make a damn good case to justify not just the hard cost in dollars, but the opportunity cost to other marketing initiatives. (More on that later.)

Integrated Marketing Efforts

More and more, brands are moving to integrated agency models in hopes of getting more bang for their buck by maximizing the impact of every single campaign across channels working together, side-by-side. Until we start to think more about how SEO ladders up to the big picture and works alongside or supports larger marketing initiatives and brand goals, we will continue to hamstring ourselves when we propose ideas to clients.

It’s our responsibility to seek big-picture perspective and figure out where we fit. We have to understand the realities of a client’s internal and external processes, their larger marketing mix and SEO’s role in that. SEO experts tend to obsess over rankings and website traffic. But we should be making organic search recommendations within the context of their goals and priorities — not what we think their goals and priorities should be.

For example, we have worked on a large CPG food brand for several years. In year one, my colleagues did great discovery works and put together an awesome SEO playbook, and we spent most of the year trying to get integrated and trying to check all these SEO best practices boxes for the client. But no one cared and nothing was getting implemented. It turned out that our “SEO best practices” didn’t seem relevant to the bigger picture initiatives and brand campaigns they had planned for the year, so they were being deprioritized or ignored entirely. In year two, our contract was restructured to focus search efforts primarily on the planned campaigns for the year. Were we doing the search work we thought we would be doing for the client? No. Are we being included more and getting great search work implemented finally? Yes. Because we stopped trying to veer off in our own direction and started pulling the weight alongside everyone else toward a common vision.

4. Don’t Stay in Your Lane, Get Buy-In Across Lanes

Few brands hire only SEO experts and no other marketing services to drive their business. They have to coordinate a lot of moving pieces to drive all of them forward in the same direction as best they can. In order to do that, everyone has to be aligned on where we’re headed and the problems we’re solving for.

Ultimately, for most SEOs, this is about having the wisdom and humility to realize that you’re not in this alone – you can’t be. And even if you don’t get your way 100% of the time, you’re a lot more likely to get your way more of the time when you collaborate with others and ladder your efforts up to the big picture.

One of my survey respondents phrased it beautifully: “Treat all search projects as products that require a complete product team including engineering, project manager, and business-side folks.”

Horizontal Buy-In

You need buy-in across practices in your own agency (or combination of agencies serving the client and internal client team members helping execute the work). We have to stop swimming in entirely separate lanes where SEO is setting goals by themselves and not aligning to the larger business initiatives and marketing channels. We are all in this together to help the client solve for something. We have to learn to better communicate the value of search as it aligns to larger business initiatives, not in a separate swim lane.

Organic Search is uniquely dependent in that we often rely on others to get our work implemented. You can’t operate entirely separately from the analytics experts, developers, user experience designers, social media, paid search, and so on — especially when they’re all working together toward a common goal on behalf of the client.

Vertical Buy-In

To get buy-in for implementing your work, you need buy-in beyond your immediate client contact. You need buy-in top-to-bottom in the client’s organization — it has to support what the C-level executive cares about as much as your day-to-day contacts or their direct reports.

This can be especially helpful when you started within the agency — selling the value of the idea and getting the buy-in of your colleagues first. It forces you to vet and strengthen your idea, helps find blind spots, and craft the pitch for the client. Then, bring those important people to the table with the client — it gives you strength in numbers and expertise to have the developer, user experience designer, client engagement lead, and data analyst on the project in your corner validating the recommendation.

When you get to the client, it is so important to help them understand the benefits and outcomes of doing the project, the cost (and opportunity cost) of doing it, and how this can get them results toward their big picture goals. Understand their role in it and give them a voice, and make them the hero for approving it. If you have to pitch the idea at multiple levels, custom tailor your approach to speak to the client-side team members who will be helping you implement the work differently from how you would speak to the CMO who decides whether your project lives or dies.

5. Build a Bulletproof Plan

Here’s how a typical SEO project is proposed to a client: “You should do this SEO project because SEO.”

This explanation is not good enough, and they don’t care. You need to know what they do care about and are trying to accomplish, and formulate a bullet-proof business plan to sell the idea.

Case Studies as Proof-of-Concept

Case studies serve a few important purposes: they help explain the outcomes and benefits of SEO projects, they prove that you have the chops to get results, and they prove the concept using someone else’s money first, which reduces the perceived risk for your client.

In my experience and in the survey results, case studies come up time and again as the leading way to get client buy-in. Ideally you would use case studies that are your own, very clearly relevant to the project at hand, and created for a client that is similar in nature (like B2B vs. B2C, in a similar vertical, or facing a similar problem).

Even if you don’t have your own case studies to show, do your due diligence and find real examples other companies and practitioners have published. As an added bonus, the results of these case studies can help you forecast the potential high/medium/low impact of your work.

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Simplify the Process for Everyone

It is important to bake the process into your business plan to clearly outline the requirements for the project, identify next steps and assign ownership, and take ownership of moving the ball forward. Do your due diligence up front to understand the role that everyone plays and boil it down into a clear step-by-step plan makes it feel easy for others to buy-in and help. Reducing the unknown reduces friction. When you assume that nothing you are capable of doing falls in the “not my job” description, and make it a breeze for everyone to know what they’re responsible for and where they fit in, you lower barriers and resistance.

Forecast the Potential ROI

SEOs are often incredibly hesitant to forecast potential outcomes, ROI, traffic or revenue impact because of the sheer volumes of unknowns. (“But what if the client actually expects us to achieve the forecast?!”) We naturally want to be accurate and right, so it’s understandable we wouldn’t want to commit to something we can’t say for certain we can accomplish.

But to say that forecasting is impossible is patently false. There is a wealth of information out there to help you come up with even conservative estimates of impact with lots of caveats. You need to know why you’re recommending this over other projects. Your clients need some sort of information to weigh one project against the next. A combination of forecasting and your marketer’s experience and intuition can help you define that.

For every project your client invests in, there is an opportunity cost for something else they could be working on. If you can’t articulate the potential benefit to doing the project, how can you expect your client to choose it above dozens of potential other things they could spend their time on?

Show the Impact of Inaction

Sometimes opportunity for growth isn’t enough to light the fire — also demonstrate the negative impact from inaction or incorrect action. The greatest risk I see with most clients is not making a wrong move, but rather making no move at all.

We developed a visual tool that helps us quickly explain to clients that active optimization and expansion can lead to growth (we forecast an estimate of impact based on their budget, their industry, their business goals, the initiatives we plan to prioritize, etc.), small maintenance could at least uphold what we’ve done but the site will likely stagnate, and to do nothing at all could lead to atrophy and decline as their competitors keep optimizing and surpass them.

Remind clients that search success is not only about what they do, it’s about what everyone else in their space is doing, too. If they are not actively monitoring, maintaining and expanding, they are essentially conceding territory to competitors who will fill the space in their absence.

You saw this in my deck at MozCon 2017. We have used it to help clients understand what’s next when we do annual planning with them.

Success Story: Selling AMP

One of my teammates believed that AMP was a key initiative that could have a big impact on one of his B2B automotive clients by making access to their location pages easier, faster, and more streamlined, especially in rural areas where mobile connections are slower and the client’s clients are often found.

He did a brilliant job of due diligence research, finding and dissecting case studies, and using the results of those case studies to forecast conservative, average and ambitious outcomes and calculated the estimated revenue impact for the client. He calculated that even at the most conservative estimate of ROI, it would far outweigh the cost of the project within weeks, and generate significant returns thereafter.

He got the buy-in of our internal developers and experience designers on how they would implement the work, simplified the AMP idea for the client to understand in a non-technical way, and framedin a way that made it clear how low the level of effort was. He was able to confidently propose the idea and get buy-in fast, and the work is now on track for implementation.

6. Headlines, Taglines, and Sound Bytes

You can increase the likelihood that your recommendations will get implemented if you can help the client focus on what’s really important. There are two key ways to accomplish this.

Ask for the Moon, Not the Galaxy

If you’re anything like me, you get a little excited when the to-do of SEO action items for a client is long and actionable. But we do ourselves a disservice when we try to push every recommendation at once – they get overwhelmed and tune out. They have nothing to grab onto, so nothing gets done. It seems counterintuitive that you will get more done by proposing less, but it works.

Prioritize what’s important for your client to care about right now. Don’t push every recommendation — push specific, high-impact recommendations that executives can latch on to, understand and rationalize.

They’re busy and making hard choices. Be their trusted advisor. Give them permission to focus on one thing at a time by communicating what they should care about while other projects stay on the backburner or happen in the background, because this high-impact project is what they should really care about right now.

Give Them Soundbites They Can Sell

It’s easy to forget that our immediate client contact is not always able to make the call to pull the trigger on a project by themselves. They often have to sell it internally to get it prioritized. To help them do this, give them catchy headlines, taglines and sound bites they can sell to their bosses and colleagues. Make them so memorable and repeatable, the clients will shop the ideas around their office clearly and confidently, and may even start to think they came up with the idea themselves.

Success Story: Prioritizing Content

As an example of both of these principles in practice, we have a global client we have worked with for a few years whose greatest chance of gaining ground in search is to improve and increase their website content. Before presenting the annual strategy to the client, we asked ourselves what we really wanted to accomplish with the client if they cut the meeting short or cut their budget for the year, and the answer was unequivocally content.

In our proposal deck, we built up to the big opportunity by reminding the client of the mission we all agreed on, highlighted some of the wins we got in 2017 (including a very sexy voice search win that made our client look like a hero at their office), set the stage with headlines like, “How We’re Going to Break Records in 2018,” then navigated to the section called, “The Big Opportunities.”

Then, we used the headline, “Web Content is the Single Most Important Priority” to kick off the first initiative. There was no mistaking in that room what our point was. We proposed two other initiatives for the year, but we put this one at the very top of the deck and all others fell after. Because this was our number one priority to get approved and implemented, we spent the lion’s share of the meeting focusing on this single point. We backed this slide up verbally and added emphasis by saying things like, “If we did nothing else recommended in this deck, this is the one thing to prioritize, hands down.”

This is the real slide from the real client deck we presented.

The client left that meeting crystal clear, fully understanding our recommendation, and bought in. The best part, though? When we heard different clients who were in the meeting starting to repeat things like, “Content is our number one priority this year.” unprompted on strategy and status calls.

7. Patience, Persistence, & Parallel Paths

Keep Several Irons in the Fire

Where possible, build parallel paths. What time-consuming but high-impact projects can you initiate with the client now that may take time to get approved, while you can concurrently work on lower obstacle tasks alongside? Having multiple irons in the fire increases the likelihood that you will be able to implement SEO recommendations and get measurable results that get people bought in to more work in the future.

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