Testing the results of municipal mixed-use zoning ordinances: a novel methodological approach.

Municipal mixed-use zoning (MUZ) is one public health strategy to create more walkable neighborhoods by reducing the separation of daily activities. This study uses a novel data-gathering methodology to evaluate municipal zoning ordinances in twenty-two California cities in conjunction with the walkability potential of resulting mixed-use zones, to explore the extent to which variations in uses mandated by MUZ ordinances are correlated with variations in walking opportunities. We find that, after controlling for population, socioeconomic status, and zone size, significant relationships exist between the range and precision of uses mandated by MUZ ordinances and the mixture and breadth of walking destinations in these zones. The study also demonstrates that analysis of municipal zoning codes and a novel data-gathering methodology yield valid data. The analysis of MUZ ordinances is a significant complement to other approaches to measuring walkability and can be used across cities.

Considerations for Cell and Gene Therapy Programs Entering the Clinical Space.

Cell and gene therapy (CGT) describes a broad category of medicinal products with potential applications to prevent and treat human disease in multiple therapeutic areas. These therapies leverage the use of modified nucleic acids, altered cells or tissue, or both. The modality, mechanism, route of administration, and therapeutic indication for a CGT product will influence the challenges and opportunities for early clinical development, some of which may be highly specific to the product under consideration. Both the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) encourage early interaction between sponsor and health authority to align on key elements of the CGT development program.

Telehealth, Mobile Applications, and Wearable Devices are Expanding Cancer Care Beyond Walls.

OBJECTIVES: To review telehealth solutions, mobile applications, and wearable devices that are currently impacting patients, caregivers, and providers who work in the oncology setting. DATA SOURCES: A literature search was conducted using the terms (Telehealth, Mobile Health, mHealth, Wearable Devices) + (Oncology, Cancer Care). CONCLUSION: There are many current applications of telehealth and mobile health in the oncology setting. IMPLICATIONS FOR NURSING PRACTICE: Nurses who care for patients with cancer should be aware of the pervasiveness and impact of telehealth and mobile health to this unique population.

Underage Drinking: A Review of Trends and Prevention Strategies.

Underage drinking and its associated problems have profound negative consequences for underage drinkers themselves, their families, their communities, and society as a whole, and contribute to a wide range of costly health and social problems. There is increased risk of negative consequences with heavy episodic or binge drinking. Alcohol is a factor related to approximately 4,300 deaths among underage youths in the U.S. every year. Since the mid-1980s, the nation has launched aggressive underage drinking prevention efforts at the federal, state, and local levels, and national epidemiologic data suggest that these efforts are having positive effects. For example, since 1982, alcohol-related traffic deaths among youth aged 16-20 years have declined by 79%. Evidence-based or promising strategies for reducing underage drinking include those that limit the physical, social, and economic availability of alcohol to youth, make it illegal for drivers aged <21 years to drive after drinking, and provide mechanisms for early identification of problem drinkers. Strategies may be implemented through a comprehensive prevention approach including policies and their enforcement, public awareness and education, action by community coalitions, and early brief alcohol intervention and referral programs. This paper focuses on underage drinking laws and their enforcement because these constitute perhaps the most fundamental component of efforts to limit youth access to and use of alcohol.

Assessing the learning needs of oncology nurses.

The Nurse Oncology Education Program (NOEP) is a nonprofit organization of the Texas Nurses Foundation that develops and provides education for nurses in all fields of practice on cancer prevention, detection, treatment, and survivorship. To meet the most current educational needs of nurses, NOEP conducts a biannual needs assessment survey to better understand its audience and inform its course development. The 2013 NOEP needs assessment survey used a convenience sample of licensed nurses throughout the United States. Nurses completed the online survey, and results revealed several priority areas for educational programs, including management of cancer symptoms and treatment side effects, complementary and alternative or integrative medicine, and screening recommendations. Time was noted as the largest barrier to educating patients and families about primary prevention practices. Results from this survey can be compared to those from previous surveys, particularly the 2009 and 2011 surveys, to determine changes in the demographics of NOEP's constituency, as well as consistencies in educational gaps. The results from the 2013 NOEP needs assessment survey offer valuable information about the learning needs of nurses across the country. The data can be used by the nurse educators and faculty who are responsible for providing cancer-specific education to nurses.

Transporting Young Passengers While Impaired: The State of the Law.

OBJECTIVE: This study sought to expand public health knowledge about the legal and policy aspects of DUI-child endangerment laws, and analyze the extent to which jurisdictions give priority to the protection of children. METHODS: We performed original legal research to locate and code driving-under-the-influence (DUI)-child endangerment laws across the 50 states and the District of Columbia, enabling us to compile a baseline legal dataset. RESULTS: Only 42 of the 51 jurisdictions address DUI-child endangerment in their statutes. Of the jurisdictions that do, the most comprehensive policies and those most protective of the safety of child passengers are not available in many jurisdictions. However, we found no significant relationship between the strength (comprehensiveness) of DUI-child endangerment laws and the proportion of child fatalities by a driver with a BAC ≥.08. CONCLUSIONS: Additional work needs to be done to improve state laws on DUI-child endangerment. The 9 jurisdictions that do not directly address this public health harm can enact laws to do so, and the 42 jurisdictions that already have laws can enhance their approaches to prioritize the protection of children. We suggest that future research include a close examination of the impact of DUI-child endangerment laws.

Death happens every day.

I finally got to read my pile of journals that had been occupying my coffee table for the summer. I usually take a few volumes and hole up on the couch absorbing the new research that has come out. I was personally touched by Dr. Anne Katz's (2013) editorial in the July issue of the Oncology Nursing Forum titled "Scar Tissue in the Heart." It has happened before with her articles, but this time was a little more poignant than ever before. I felt like she was articulating thoughts that I have in my own head in a clearer way than I could ever express them myself. Dr. Katz, stop reading my mind.

Underage alcohol policies across 50 California cities: an assessment of best practices.

BACKGROUND: We pursue two primary goals in this article: (1) to test a methodology and develop a dataset on U.S. local-level alcohol policy ordinances, and (2) to evaluate the presence, comprehensiveness, and stringency of eight local alcohol policies in 50 diverse California cities in relationship to recommended best practices in both public health literature and governmental recommendations to reduce underage drinking. METHODS: Following best practice recommendations from a wide array of authoritative sources, we selected eight local alcohol policy topics (e.g., conditional use permits, responsible beverage service training, social host ordinances, window/billboard advertising ordinances), and determined the presence or absence as well as the stringency (restrictiveness) and comprehensiveness (number of provisions) of each ordinance in each of the 50 cities in 2009. Following the alcohol policy literature, we created scores for each city on each type of ordinance and its associated components. We used these data to evaluate the extent to which recommendations for best practices to reduce underage alcohol use are being followed. RESULTS: (1) Compiling datasets of local-level alcohol policy laws and their comprehensiveness and stringency is achievable, even absent comprehensive, on-line, or other legal research tools. (2) We find that, with some exceptions, most of the 50 cities do not have high scores for presence, comprehensiveness, or stringency across the eight key policies. Critical policies such as responsible beverage service and deemed approved ordinances are uncommon, and, when present, they are generally neither comprehensive nor stringent. Even within policies that have higher adoption rates, central elements are missing across many or most cities' ordinances. CONCLUSION: This study demonstrates the viability of original legal data collection in the U.S. pertaining to local ordinances and of creating quantitative scores for each policy type to reflect comprehensiveness and stringency. Analysis of the resulting dataset reveals that, although the 50 cities have taken important steps to improve public health with regard to underage alcohol use and abuse, there is a great deal more that needs to be done to bring these cities into compliance with best practice recommendations.

Relationships between local enforcement, alcohol availability, drinking norms, and adolescent alcohol use in 50 California cities.

OBJECTIVE: This study investigated relationships between local alcohol policies, enforcement, alcohol outlet density, adult alcohol use, and underage drinking in 50 California cities. METHOD: Eight local alcohol policies (e.g., conditional use permit, social host ordinance, window/billboard advertising) were rated for each city based on their comprehensiveness. Local alcohol enforcement was based on grants received from the California Alcoholic Beverage Control agency for enforcement of underage drinking laws. Outlet density was based on the number of on- and off-premise outlets per roadway mile. Level of adult alcohol use was ascertained from a survey of 8,553 adults and underage drinking (frequency of past-year alcohol use and heavy drinking) from surveys of 1,312 adolescents in 2009 and 2010. Multilevel regression analyses were conducted to examine the effects of policies, enforcement, and other community-level variables on adolescent drinking, controlling for youth demographic characteristics. Mediating effects of adolescents' perceived ease of obtaining alcohol, perceived enforcement, and perceived acceptability of alcohol use also were examined. RESULTS: None of the eight local alcohol-policy ratings were associated with adolescent drinking. Funding for underage drinking enforcement activities was inversely related to frequency of past-year alcohol use, whereas outlet density and adult drinking were positively related to both past-year alcohol use and heavy drinking. These relationships were attenuated when controlling for perceived ease of obtaining alcohol, enforcement, and acceptability of alcohol use, providing evidence formediation. CONCLUSIONS: Adolescent alcohol use and heavy drinking appear to be influenced by enforcement of underage drinking laws, alcohol outlet density, and adult alcohol use. These community-level influences may be at least partially mediated through adolescents' perceptions of alcohol availability, acceptability of alcohol use, and perceived likelihood of getting in trouble with local police.