Environmental influences on E-cigarette use among young people: A systematic review.

E-cigarettes are a popular mode of delivery for nicotine, tobacco and cannabis. The prevalence of vaping among youth is increasing and this review aims to identify features of the neighbourhood environment, e.g., retailers, advertisements, and policies, that are associated with youth vaping. We included 48 studies. Of these, approximately 40% and 60% reported that presence of e-cigarette retailers, and advertisements, was associated with statistically higher odds of e-cigarette use in youth, respectively. Approximately 30% of studies reported that policies affecting e-cigarette availability were associated with statistically lower odds of vaping. Identifying these influential features of the neighbourhood environment will help formulate appropriate policies to reduce e-cigarette use among youth.

Empowering patients with sickle cell anemia and their families through innovative educational methods.

Sickle cell disease (SCD) is a group of inherited blood disorders caused by a mutation in the beta subunit of hemoglobin (HbS). SCD will hereafter be referred to as sickle cell anemia (SCA) as this is the term our patients and their families prefer. There are approximately 5000 Canadians living with SCA including children. Pediatric SCA patient education can: improve knowledge, decrease hospitalization, improve medication possession ratio, lead to better SCA-related functioning, and lower pain impact. Innovative educational materials were developed to improve knowledge and self-efficacy regarding the illness management of patients and parents/guardians. Patients (n = 5; aged 8-18) with SCA and parents (n = 5) of patients (aged 0-18) were recruited via flyers sent directly to patients and distributed through partner patient organization Sickle Cell Awareness Network of Saskatchewan. Patient and parent focus groups were held separately over Zoom to receive feedback for the video. An additional interview was held for a participant that required a translation of the video. Audio recordings were transcribed using Zoom and Otter.ai. The coding of transcripts was facilitated by NVivo (QSR International Pty Ltd, 2022, release 1.6.2). The thematic analysis centered around SCA management concepts relevant to the research aims. Important themes that emerged included 'Age Appropriateness', 'Empowerment', 'Knowledge Gaps', 'Linguistic Accessibility', 'Medication Adherence', 'Strength in Community', and 'Transition to Adult Care'. The video was well received, and "brought peace of mind". Patient feedback was incorporated into the final version of the educational materials.

Examining how changes in provincial policy on vape marketing impacted the distribution of vaping advertisements near secondary schools in London, Ontario.

OBJECTIVES: On January 1, 2020, the Government of Ontario passed a regulation banning vaping advertisements by retailers, apart from specialty shops. A motivation for this ban was to limit youth exposure to vaping advertisements. The primary goal of this research was to evaluate the impact of this ban on the number and density of vaping advertisements surrounding secondary schools. Additionally, we examined whether the number of vaping advertisements varied by school socio-demographic characteristics. METHODS: This study used a pre-post design. Audits were conducted December 2019 (pre-ban) and again January to February 2020 (post-ban), to identify vaping advertisements within 800 m surrounding secondary schools (n = 18) in London, Ontario. RESULTS: Prior to the ban, there were 266 vaping advertisements within 800 m of secondary schools. After the ban, this was reduced to 58, a 78.2% reduction. The mean number of vaping advertisements surrounding schools significantly decreased from 18.1 before the ban to 3.6 after the ban (p < 0.001). A significant positive correlation was found, prior to the ban, between the number of vaping advertisements surrounding schools and school-level residential instability (r = 0.42, p = 0.02). After the ban, no significant correlations were found between the number of vaping advertisements and school socio-demographic characteristics. CONCLUSION: The provincial ban of vaping advertisements in select retail settings significantly reduced the number of vaping advertisements in the areas surrounding secondary schools in London, Ontario. The ban also reduced socio-demographic inequities in youths' potential exposure to marketing of vaping products. Continued monitoring of the geographic accessibility and promotion of vaping products is warranted.

RéSUMé: OBJECTIFS: Le 1er janvier 2020, le gouvernement de l'Ontario adoptait un règlement interdisant les annonces publicitaires sur le vapotage dans les magasins de détail, sauf dans les boutiques spécialisées. L'une des raisons de cette interdiction était de limiter l'exposition des jeunes à la publicité sur le vapotage. Notre étude visait principalement à évaluer les incidences de l'interdiction sur le nombre et la densité des annonces publicitaires sur le vapotage autour des écoles secondaires. Nous avons aussi cherché à déterminer si le nombre d'annonces publicitaires sur le vapotage variait selon le profil sociodémographique des écoles. MéTHODE: Un protocole avant-après été utilisé pour cette étude. Des audits ont été menés en décembre 2019 (avant l'interdiction), puis de nouveau en janvier et février 2020 (après l'interdiction) pour dénombrer les annonces publicitaires sur le vapotage dans un rayon de 800 m des écoles secondaires (n = 18) de London, en Ontario. RéSULTATS: Avant l'interdiction, il y avait 266 annonces publicitaires sur le vapotage dans un rayon de 800 m des écoles secondaires. Après l'interdiction, ce nombre n'était plus que de 58, soit une baisse de 78,2 %. Le nombre moyen d'annonces publicitaires sur le vapotage autour des écoles a diminué de façon significative, passant de 18,1 avant l'interdiction à 3,6 après (p < 0,001). Une corrélation positive significative a été observée, avant l'interdiction, entre le nombre d'annonces publicitaires sur le vapotage autour des écoles et l'instabilité résidentielle au niveau des écoles (r = 0,42, p = 0,02). Après l'interdiction, aucune corrélation significative n'a été observée entre le nombre d'annonces publicitaires sur le vapotage et le profil sociodémographique des écoles. CONCLUSIONS: L'interdiction provinciale des annonces publicitaires sur le vapotage dans certains magasins de détail a considérablement réduit le nombre de ces annonces dans les environs des écoles secondaires de London, en Ontario. L'interdiction a aussi réduit les iniquités sociodémographiques de l'exposition potentielle des jeunes au marketing des produits de vapotage. Il est justifié d'assurer une surveillance continue de l'accessibilité géographique et de la promotion des produits de vapotage.

The Role of Nursing Professionals in the Management of Patients With High-Risk Neuroblastoma Receiving Dinutuximab Therapy.

Neuroblastoma, an embryonic cancer of the sympathetic nervous system, is the most common extracranial solid tumor in childhood. Dinutuximab (formerly called ch14.18), a monoclonal antibody targeting the disialoganglioside GD2, has been shown to significantly improve survival rates in patients with high-risk neuroblastoma. However, the safe and effective use of dinutuximab therapy in these high-risk patients requires medical expertise in patient selection, treatment administration, and the monitoring and management of adverse events. Findings of the randomized phase III study (ANBL0032) led to the approval of dinutuximab for the treatment of children with high-risk neuroblastoma. Multi-institutional nursing approaches to implementing standard protocols ensure the effective management of high-risk neuroblastoma patients receiving dinutuximab immunotherapy. Understanding and implementing recommendations for the management of the clinically important and most common adverse events are essential to ensuring patient continuation of therapy and improving patient outcomes.

Partying Last Weekend: Factors Related to Heavy Episodic Drinking Among People Who Use Recreational Drugs.

BACKGROUND: Heavy episodic drinking (HED) has negative consequences for both the individual and society. Research on HED has focused mainly on the general population while research into HED and other drug use among recreational drug using populations is less developed. OBJECTIVES: This study explores factors related to HED on a previous weekend among male and female recreational drug users. METHODS: Cross-sectional interviews were undertaken with those age 19+ who regularly use recreational drugs in a nightlife setting in two cities in Canada (n = 931) between 2008 and 2014. Participants were asked about their alcohol and other drug use the previous Friday or Saturday. Chi-square bivariate tests were used to determine factors significantly associated with HED with significant variables then entered into multivariate logistic regression models to determine related factors for men and women. RESULTS: Results showed that 53.4% of all participants met criteria for HED the previous weekend and the majority of those had used at least one other drug. Multivariate models showed being in postsecondary full-time, being between 19 and 25, using cocaine and using tobacco the previous weekend was associated with HED for men. For women, using cocaine the previous weekend was associated with HED, while being 26 and over, married or common law and using marijuana was associated with lower odds of HED. CONCLUSION: HED is common among recreational drug users but different factors were associated HED for men and women. Interventions for recreational drug users should include both alcohol and other drug messaging and be gender specific.

Best Practices for Chemotherapy Administration in Pediatric Oncology: Quality and Safety Process Improvements (2015).

The administration of chemotherapy to children with cancer is a high-risk process that must be performed in a safe and consistent manner with high reliability. Clinical trials play a major role in the treatment of children with cancer; conformance to chemotherapy protocol requirements and accurate documentation in the medical record are critical. Inconsistencies in the administration and documentation of chemotherapy were identified as opportunities for errors to occur. A major process improvement was initiated to establish best practices for nurses who administer chemotherapy to children. An interdisciplinary team was formed to evaluate the current process and to develop best practices based on current evidence, protocol requirements, available resources, and safety requirements. The process improvement focused on the establishment of standardized and safe administration techniques, exact administration times, and consistent electronic documentation that could easily be retrieved in medical record audits. Quality improvement tools including SBAR (Situation, Background, Assessment, Recommendation), process mapping, PDSA (Plan, Do. Study, Act) cycles, and quality metrics were used with this process improvement. The team established best practices in chemotherapy administration to children that have proven to be safe and reliable. Follow-up data have demonstrated that the project was highly successful and improved accuracy, patient and nurse safety, and effectiveness of chemotherapy administration.

A comparison of motivations for use among users of crack cocaine and cocaine powder in a sample of simultaneous cocaine and alcohol users.

This study examined the motivations for using cocaine and alcohol comparing those who primarily smoked crack and those who primarily used cocaine powder when using simultaneously with alcohol. Motivations examined included: 1) to cope with a negative affect, 2) enhancement, 3) to be social and 4) to conform. The research design was a cross-sectional study in which clients in treatment for cocaine and alcohol problems completed a self-administered questionnaire about their substance use. Among those who primarily smoked crack or snorted cocaine when also using alcohol (n=153), there were 93 participants who reported primarily snorting cocaine and 60 participants who primarily reported smoking crack. Bivariate analyses found that those who primarily smoked crack reported lower social motivations to use alcohol and cocaine. When adjusting for other covariates in a multivariate analysis, social motivation was still significantly different between groups. Additionally, those who primarily smoked crack were more likely to be older, report higher cocaine dependence severity, be unemployed and were less likely to have completed some post-secondary education, than those who primarily snorted cocaine. No differences were found in enhancement, coping or conformity motivations between the two groups. These results suggest that simultaneous cocaine and alcohol use may have social importance to those who primarily snort cocaine, but that this importance is less evident to those who smoke crack. Consequently, future studies examining motivations for simultaneous cocaine and alcohol use should distinguish between different routes of cocaine administration.

Ayahuasca-assisted therapy for addiction: results from a preliminary observational study in Canada.

INTRODUCTION: This paper reports results from a preliminary observational study of ayahuasca-assisted treatment for problematic substance use and stress delivered in a rural First Nations community in British Columbia, Canada. METHODS: The "Working with Addiction and Stress" retreats combined four days of group counselling with two expert-led ayahuasca ceremonies. This study collected pre-treatment and six months follow-up data from 12 participants on several psychological and behavioral factors related to problematic substance use, and qualitative data assessing the personal experiences of the participants six months after the retreat. FINDINGS: Statistically significant (p < 0.05) improvements were demonstrated for scales assessing hopefulness, empowerment, mindfulness, and quality of life meaning and outlook subscales. Self-reported alcohol, tobacco and cocaine use declined, although cannabis and opiate use did not; reported reductions in problematic cocaine use were statistically significant. All study participants reported positive and lasting changes from participating in the retreats. CONCLUSIONS: This form of ayahuasca-assisted therapy appears to be associated with statistically significant improvements in several factors related to problematic substance use among a rural aboriginal population. These findings suggest participants may have experienced positive psychological and behavioral changes in response to this therapeutic approach, and that more rigorous research of ayahuasca-assisted therapy for problematic substance use is warranted.