Court rulings on local efforts to manage growth by initiative and referendum in California
unusually broad and well-entrenched in California. As a result of that right, residents of that state have employed both of these tools of direct democracy to manage local growth. In this article the initiative will be treated as the power of voters to draft and implement growth control measures within local governmental settings. The local growth control referendum will, in turn, represent their power to rescind local governmental actions that fail to promote a desired level of growth control. This article describes how courts in California have developed a body of case law governing such local efforts to control growth by direct legislation.
Trends in Local Growth Control Ballot Measures in California
This article began as a background resource paper to provide information and analysis for a discussion of local growth control by initiative and referendum. It was used in conjunction with the first annual LAND USE LAW AND PLANNING CONFERENCE presented by the Public Policy Program, UCLA Extension, on February 20, 1987. The research for this article was designed to assess several prevalent perceptions about the use of land use ballot measures. First, there has been a growing and widespread perception that attempts at planning by initiative have dramatically increased in cities and counties throughout California in the last two years. It is also perceived that more and more voters favor these ballot measures as a means of controlling growth. There is a belief that the use of initiatives and referenda to achieve local growth controls is not only increasing in frequency, but that the range of land use issues addressed by these measures is changing in significant ways. Last, there has been considerable discussion about the likely future of land use ballot measures. In order to determine the accuracy of these perceptions, we collected and analyzed information about all identified local land use ballot measures in California since 1971. The "Methodology" section of this article describes how the data was collected and compiled in the Matrix of Land Use Planning Measures. Using the data in this Matrix, we analyzed the frequency of ballot
Nurse responsiveness to cancer patient expressions of emotion.
OBJECTIVE
This theoretically based study examined nurse responses to cancer patient expressions of emotion using a videotaped, simulated cancer patient.


METHODS
This study used an experimental crossover design with a videotaped patient expressing anger, sadness, and neutral emotion to elicit nurse responses. Seventy-four nurses from eight sites participated. Responses were coded using Roter interaction analysis system. Correlations explored relationships between variables that impact communication (age, gender, work experience, trait anxiety, work stress, self-efficacy). Regression models explored the effect of variables on nurse affective responsiveness.


RESULTS
Patient expressions of sadness elicited more affective responses than anger. Expressions of anger or neutral emotion elicited more instrumental behaviors than sadness. Variables such as age, work stress and work experience were significantly correlated. No variables predicted affective responsiveness to patient expressions of anger or sadness.


CONCLUSION
Nurse communication showed significant variation in response to patient emotional expressions. Understanding the relationships between demographic, personality, and work variables, and identification of new variables that influence nurse-patient communication, has implications for interventional studies.


PRACTICE IMPLICATIONS
Over 90% of the participants indicated that the videotape simulation would be a useful method for teaching and practicing communication skills with patients expressing emotions.