Emerging cultural place-keeping initiatives in historic communities threatened by gentrification and displacement

Amid unprecedented economic pressures, the distinct cultural landscape of urban neighborhoods is increasingly threatened. Low income communities of color are feeling the impacts of urban redevelopment, rising rents, and incompatible adjacent uses most acutely. Affordable housing, light manufacturing, bodegas, barbershops, and community organizations are rapidly being replaced with luxury condos, co-work offices, urban spas, art galleries, and high-end restaurants. My research situates decades of these types of neighborhood change dynamics within historical trends of urban planning, calls attention to the expressions of neighborhood cultural identity at risk of erasure, and highlights emerging practices of cultural placekeeping within the community development field. It is designed to connect urban planners with innovative place-based planning strategies, policies, and programs which are being used to promote neighborhood revitalization and cultural resilience in historic neighborhoods threatened by gentrification and displacement. I draw on literature review, demographic analysis, case study research and stakeholder interviews to create neighborhood change narratives in four historic neighborhoods around the United States. The case studies stretch across diverse regions of the country as well as cities and neighborhoods of various scales from Wynwood, Miami to Mission District, San Francisco and from Pilsen, Chicago to La Alma Lincoln, Denver. Neighborhood change narratives examine the roles of various stakeholders in shaping urban redevelopment, reveal the dynamic balance of power between these stakeholders, and point to emerging pathways towards community leadership in neighborhood revitalization

Studi kasus tentang asuhan keperawatan pada Ny. B.L.U dengan Hipertensi di Puskesmas Alak Kota Kupang

Latar Belakang Hipertensi adalah keadaan di mana tekanan darah mengalami peningkatan yang memberikan gejala berlanjut pada suatu organ target di tubuh. Dalam keluarga jika ada anggota keluarga yang menderita hipertensi dan tidak menjalankan kelima fungsi keluarga tersebut dengan baik hal ini dapat menimbulkan kerusakan yang lebih berat, misalnya stroke (terjadi pada otak dan menyebabkan kematian yang cukup tinggi), penyakit jantung koroner (terjadi kerusakan pembuluh darah jantung), dan hipertrofi ventrikel kiri (terjadi pada otot jantung). Tujuan Mempelajari Asuhan keperawatan dengan pendekatan proses keperawatan pada Ny. B.L.U yang mengalami hipertensi. Metode : Jenis penulisan ini adalah penulisan secara kualitatif, dengan pendekatan studi kasus, sedangkan rancangannya adalah rancangan deskriptif Studi Kasus Keperawatan pada Ny.B.L.U Dengan Hipertensi di Puskesmas Alak Kota Kupang. Hasil : Masalah keperawatan yang didapatkan pada Ny. B.L.U adalah nyeri akut berhubungan dengan proses penyakit, kurang pengetahuan berhubungan dengan kurang terpapar informasi, yang dirawat selama 1 hari dengan melakukan teknik relaksasi, nafas dalam untuk mengatasi rasa nyeri dan memberikan pendidikan kesehatan tentang penyakit hipertensi untuk masalah kurang pengetahuan berhubungan dengan kurang terpapar informasi dan masalah belum teratasi. Kesimpulan : Masalah yang ditemukan, nyeri akut harus ditindak lanjut di oleh perawat yang ada di Puskesmas Alak Kota Kupang agar masalah tersebut dapat teratasi

Efficacy of Telmisartan Plus Amlodipine in Nonresponders to CCB Monotherapy

Hypertensive patients unable to reach blood pressure (BP) targets with antihypertensive monotherapy may be switched to a combination of two medications with complementary modes of action for improved treatment response. This post hoc analysis pools data from 2812 patients, 1891 of whom were not at goal (diastolic BP [DBP] <90 mm Hg) with amlodipine 5 mg (A5) monotherapy who subsequently switched to telmisartan 40 or 80 mg (T80)/A5 single-pill combination (SPC) or amlodipine 10 mg (A10) monotherapy, and considers an additional 921 patients, 616 of whom were not at goal with A10 monotherapy who switched to telmisartan/amlodipine SPC. Patients switched to telmisartan/amlodipine SPC achieved significantly greater BP reductions compared with continued monotherapy (P<0.0001) with reductions of −15.2/−10.9 mm Hg seen with T80/A5 after 8 weeks in patients switched from A5. BP goal (<140/90 mm Hg), systolic BP goal (<140 mm Hg), and DBP goal (<90 mm Hg) were reached by significantly more patients with telmisartan/amlodipine than with monotherapy (P<0.0001 for all comparisons; 56.1%, 69.7%, and 66.9%, resp., in patients who switched from A5 to T80/A5). Early use of such combination therapy should be considered to quickly reach BP targets, particularly in patients with added risk

HYPOCARNITINAEMIA IN DISORDERS OF ORGANIC ACID METABOLISM

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23891/1/0000130.pd

Reduction of late stillbirth with the introduction of fetal movement information and guidelines – a clinical quality improvement

We have performed a full cross-validation of this clinical Femina data collection against the routinely collected data of the Medical Birth Registry of Norway to validate the estimates of reduced mortality in the total population. The original estimate of fewer deaths during the intervention with OR 0.7 remains virtually unchanged for the original data collection

24-Hour ambulatory blood pressure control with triple-therapy amlodipine, valsartan and hydrochlorothiazide in patients with moderate to severe hypertension

To determine the effectiveness and safety of once-daily combination therapy with amlodipine, valsartan and hydrochlorothiazide for reducing ambulatory blood pressure (ABP) in patients with moderate to severe hypertension, a multicenter, double-blind study was performed (N=2271) that included ABP monitoring in a 283-patient subset. After a single-blind, placebo run-in period, patients were randomized to receive amlodipine/valsartan/hydrochlorothiazide (10/320/25 mg), valsartan/hydrochlorothiazide (320/25 mg), amlodipine/valsartan (10/320 mg) or amlodipine/hydrochlorothiazide (10/25 mg) each morning for 8 weeks. Efficacy assessments included change from baseline in 24-h, daytime and night time mean ambulatory systolic BP (SBP) and diastolic BP (DBP). Statistically significant and clinically relevant reductions from baseline in all these parameters occurred in all treatment groups (P<0.0001, all comparisons versus baseline). At week 8, least squares mean reductions from baseline in 24-h, daytime and night time mean ambulatory SBP/DBP were 30.3/19.7, 31.2/20.5 and 28.0/17.8 mm Hg, respectively, with amlodipine/valsartan/hydrochlorothiazide; corresponding reductions with dual therapies ranged from 18.8–24.1/11.7–15.5, 19.0–25.1/12.0–16.0 and 18.3–22.6/11.1–14.3 mm Hg (P⩽0.01, all comparisons of triple versus dual therapy). Treatment with amlodipine/valsartan/hydrochlorothiazide maintained full 24-h effectiveness, including during the morning hours; all hourly mean ambulatory SBP and mean ambulatory DBP measurements were ⩽130/85 mm Hg at end point. Amlodipine/valsartan/hydrochlorothiazide combination therapy was well tolerated. Once-daily treatment with amlodipine/valsartan/hydrochlorothiazide (10/320/25 mg) reduces ABP to a significantly greater extent than component-based dual therapy and maintains its effectiveness over the entire 24-h dosing period

Choosing an angiotensin-receptor blocker: blood pressure lowering, cardiovascular protection or both?

Angiotensin-receptor blockers (ARBs) offer superior tolerability to angiotensin-converting enzyme inhibitors, and are increasingly used in patient management. ARBs vary in their pharmacological profiles, which results in efficacy differences. Therefore, deciding between ARBs should be evidence-based and related to the specific requirements of the individual patient. For patients with hypertension but at low additional risk, an ARB that provides sustained, powerful 24-h reductions in blood pressure is suitable. For patients at very high additional risk (with heart failure), an ARB with demonstrated efficacy in this patient population is the preferred option. For patients at increased risk, telmisartan should be the ARB of choice based on the results from the Ongoing Telmisartan Alone and in Combination with Ramipril Global End Point Trial (ONTARGET), which demonstrated for the first time that an ARB has equivalent protection to the reference angiotensin-converting enzyme inhibitor in a broad cross-section of at-risk patients but a better side-effect profile. </jats:p