An Initiative to Educate and Support Young Adults Diagnosed with Hypertension

An Initiative to Educate and Support Young Adults Diagnosed with Hypertension Page Tomlinson, BS, RN, DNPc Background: Hypertension is a common diagnosis in the US with significant long-term effects. While guidelines for optimal hypertension management exist, young adults lag behind older adults in treatment and control3. The young adult is arguably more capable of lifestyle changes, primarily due to fewer physical limitations than older adults. Promotion of disease self-management is the most effective way to engage young adults in seeking control over their blood pressure1,2. Lifestyle modification as a young adult decreases costs of care and risk for cardiovascular events, while lack of guidance and support at this stage of life may increase risk for cardiac events over their lifetime. This project examined disease self-management in young adults aged 18-39 years at a local primary care office. Methods. Patients aged 18-39 years with diagnosis of hypertension were identified. A questionnaire on self-efficacy in hypertension management was sent and preference for lifestyle modification counseling (LMC) was assessed. Follow up calls placed. Semi-structured interviews conducted. Provider survey conducted. Results: Three patients discussed their experience of being diagnosed with hypertension in semi-structured interviews. Fourteen patients were not interested in participating. Provider survey (n=7) response 100%. Patient information handout created. Conclusions. While the literature demonstrates the positive effect of LMC on outcomes in hypertensive young adults, efforts to engage this population proved challenging. Young adults desire consistent guidance and support with lifestyle modification yet are unwilling to engage in lifestyle modification when they are asymptomatic and do not have rapport with the offering provider. Key Words: hypertension, young adult, support, lifestyle modification Word count [246] References: Johnson, H., Olson, A., Lamantia, J., Kind, A., Pandhi, N., Mendonça, E., Craven, M., & Smith, M. (2015). Documented lifestyle education among young adults with incident hypertension. Journal of General Internal Medicine, 30(5), 556-64. Trento, M., & Porta, M. (2012). Structured and Persistently Reinforced Patient Education Can Work. BMJ: British Medical Journal 345, e5100. Zhang, Y. E., & Moran, A. (2017). Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension Among Young Adults in the United States, 1999 to 2014. Hypertension, 70(4), 736-742

The Resurrection of Joseph Bourne: Or a Word or Two on Those Port Annie Miracles by Jack Hodgins

Review of The Resurrection of Joseph Bourne: Or a Word or Two on Those Port Annie Miracles by Jack Hodgins

\u3ci\u3eKrupski\u3c/i\u3e and Relation Back for Claims Against John Doe Defendants

Federal Rule of Civil Procedure 15(c)(1)(C) governs amendments that change the party or naming of a party in a pleading after the statute of limitations has run. Many courts have found amendments identifying defendants previously named as John Doe to be outside the scope of the rule, holding that a lack of knowledge does not constitute a mistake under Rule 15. In 2010, however, the U.S. Supreme Court refocused the relation back inquiry on what the party to be brought in by amendment knew or should have known within the limitations period—away from what the plaintiff knew or should have known at the time of filing the complaint. In light of that decision, a number of federal district courts have reinterpreted Rule 15(c) and have begun to allow relation back for claims against John Doe defendants when the requirements of Rule 15(c) are met. This Note examines relation back for claims against John Doe defendants and concludes that this new approach is supported by the Supreme Court’s relation back doctrine as well as the text and purpose of Rule 15(c), and it avoids the tension with Rule 11 that the John Doe rule creates

The Empire of Enterprise: Scottish Business Networks in Asian Trade, 1793-1810

The rise of British rule in India in the late eighteenth century was accompanied by the emergence of extensive business networks based on London, Calcutta and Canton. These networks, which organised the private trade of British civilians and military personnel in India, linked the export and import economies of Bengal, Madras, Java, the Philippines, the Malay peninsula and southern China, and came to dominate much of the regional trade of the Indian Ocean, as well as its links to Europe. Many of those engaged in this activity were Scots, and the connections between them - based in part on kinship - provided the institutional setting for the remittance of private money from Asia to Europe. While the activities of the East India Company provided an important part of the setting for these activities, much of them also depended on private enterprise and non-official networks. As a result, the volume of capital remitted from Bengal to Britain during the 1790s and 1800s was much larger than has previously been estimated

Transition to peace leaves children of the Northern Irish Troubles more vulnerable to suicide

Northern Ireland’s suicide rate has doubled since the Good Friday Agreement. Michael Tomlinson explains that the toxic mix of greater political stability and increasing social isolation is putting those born into the Troubles at much greater risk of suicide than their British or Irish counterparts

De-industrialization not decline: a new meta-narrative for post-war British history

Much of the economic and other historiography of post-war Britain is shaped by the perceived failure of Britain to consistently match the growth rates of GDP experienced in other rich countries. These declinist narratives are commonly coupled to tendentious and ideologically driven analyses of economic, social and political developments. This article seeks to displace this declinist narrative by one focussing upon de-industrialization and its consequences. The argument is that de-industrialization, beginning in the 1950s, brought about such a range of profound changes, that it provides the best underpinning narrative for understanding late twentieth-century Britain. After suggesting why ‘growth’ and ‘decline’ are not the best terms for understanding this period, the article sets out the case for seeing the employment changes brought about by de-industrialization as crucial to many changes in economic welfare. De-industrialization not only increased wage inequalities and job insecurity, but also re-shaped the social security system and the pattern of public employment. In addition, de-industrialization has seriously compromised the aim of neo-liberalism to free the labour market from the influence of government

Orientalism at work?: Dundee’s response to competition from Calcutta, circa 1870-1914

From the late nineteenth century the Dundee jute industry faced intensifying competition from Calcutta. This article examines the responses in Dundee to this competition, focusing upon the ways Dundonians understood Calcutta and India, and how these understandings shaped the debate on possible lines of action. It argues that the diversity of approaches to the threat, inter-linked with the complexities of local politics, led to a concentration of effort on seeking to establish and then strengthen Indian factory legislation. The severity of competition from another empire country posed acute dilemmas for pro-imperial politics in the city: how could such a politics be sustained if the local economy was being so harmed by Calcutta's invasion of Dundee's markets, yet a protective response was ruled out by the realities of imperial policy