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Estrogen receptor positive (ER+) breast cancer is the most common breast cancer subtype, and therapeutic management relies primarily on inhibiting ER signaling. In the metastatic setting, ER signaling is typically targeted by selective estrogen receptor degraders (SERDs) or aromatase inhibitors (AIs), the latter of which prevent estrogen production. Activating ESR1 mutations are among the most common emergent breast cancer mutations and confer resistance to AIs. Until 2023, fulvestrant was the only approved SERD; fulvestrant is administered intramuscularly, and in some cases may also have limited efficacy in the setting of certain ESR1 mutations. In 2023, the first oral SERD, elacestrant, was approved for use in ESR1-mutated, ER+/HER2- advanced breast cancer and represents a new class of therapeutic options. While the initial approval was as monotherapy, ongoing studies are evaluating elacestrant (as well as other oral SERDs) in combination with other therapies including CDK4/6 inhibitors and PI3K inhibitors, which parallels the current combination uses of fulvestrant. Elacestrant's recent approval sheds light on the use of biomarkers such as ESR1 to gauge a tumor's endocrine sensitivity. Ongoing therapeutic and correlative biomarker studies will offer new insight and expanding treatment options for patients with advanced breast cancer. [ABSTRACT FROM AUTHOR]

Friendships are developmentally important and personally beneficial relationships for all children and youth. Despite emphasis from families and educators of students with severe disabilities on the importance of promoting and supporting friendships with their typically developing (TD) peers in inclusive settings, such relationships remain infrequent. We conducted an integrative thematic literature review of research that directly examined the nature of friendship between students with and without severe disabilities to better understand how researchers define friendship, identify participants, and confirm participants' friendships. Implications for future research are discussed. We also sought to identify themes in extant research to guide future intervention. The thematic findings point to the importance of adults providing direct support while fading their proximity to students, and of TD peers negotiating the ongoing tension between the roles of helper and friend.

PURPOSE There is a demand for improved care delivery surrounding genomic testing and clinical trial enrollment among patients with metastatic breast cancer (MBC). We sought to improve the current process via real-time informal consultation and prescreening assessment for patients with MBC treated by community and academic medical oncologists by implementing a virtual molecular and precision medicine (vMAP) clinic. METHODS The vMAP program used a virtual referral system directed to a multidisciplinary team with precision medicine expertise. Providers contacted vMAP regarding patients with MBC, and on receipt of referral, the vMAP team engaged in discussion to identify if further diagnostics were needed (including genomic testing) and to identify potential clinical trials or standard treatment options. Recommendations were then sent to the referring provider within 72 hours. Pre-/postsurveys were issued to network physicians to assess for barriers, clinical trial access, and vMAP referral experience. Program implementation was evaluated with the Squire 2.0 reporting guidelines for quality improvement in health care as a framework. RESULTS Eighty-one cases from 22 providers were referred to vMAP over a 26-month period. The average response time to the referring provider with a finalized recommendation was 1.90 ± 1.82 days. A total of 86.4% of cases had clinical trial options on vMAP prescreen, with 40.7% initiating formal screening assessments and 27 patients (33.3%) ultimately enrolling on trials. On resurvey, 92% of survey responses across community oncology referring providers said that they were very likely to use vMAP again. CONCLUSION In the initial 2-year period, vMAP demonstrated an efficient means to offer real-time interpretation of genomic testing and identification of clinical trials for patients with MBC, with effective clinical trial enrollment and high rates of referring provider satisfaction. [ABSTRACT FROM AUTHOR]

Researchers are beginning to explore the impact of the COVID-19 pandemic on island populations, but little is known about the experiences of the residents of Nantucket and Martha's Vineyard in the Northeast region of the United States. In this study, islanders (N=41) provide insight into how spending time in nature influenced their well-being, especially their mental well-being, during this unprecedented time. For the majority of participants, the influence of nature on their well-being increased during the pandemic. Additionally, participants shared benefits of island living such as isolation from the mainland, as well as challenges such as food and supply shortages. Results from this study indicate that further research is needed around the importance of nature on well-being, especially mental health, for island residents. [ABSTRACT FROM AUTHOR]

A project developed to increase public and professional awareness of fragile X syndrome in New Jersey resulted in increased efforts at diagnostic screening, provision of client and family support services, and prevention. The program proved to be a cost-effective method for increasing community awareness of a genetic disease on a statewide level. (Author/JDD)

Triple-negative breast cancer (TNBC) is a heterogeneous disease that is historically difficult to treat, but advances in molecular targeted therapies, including the use of antibodies, are changing the standard of care. Translational research over the years has revealed various actionable targets allowing TNBC to be subtyped in novel ways. In this article, we review the molecular targets that guide current management of patients with metastatic TNBC (mTNBC), including programmed death-ligand 1, germline BRCA1 and BRCA2 mutations, and the transmembrane glycoprotein Trop-2. These targets allow for the treatment of mTNBC with immunotherapy, poly(ADP-ribose)polymerase inhibitors, and antibody-drug conjugates (ADC), such as sacituzumab govitecan, the first ADC approved for the treatment of breast cancer. We also review upcoming therapies, such as datopotamab deruxtecan and trastuzumab deruxtecan. Although mTNBC is complex in nature, molecular studies are making treatments more personalized by identifying actionable targets in what was once thought to be a nontargetable disease. [ABSTRACT FROM AUTHOR]

Friendships are developmentally important and personally beneficial relationships for all children and youth. Despite emphasis from families and educators of students with severe disabilities on the importance of promoting and supporting friendships with their typically developing (TD) peers in inclusive settings, such relationships remain infrequent. We conducted an integrative thematic literature review of research that directly examined the nature of friendship between students with and without severe disabilities to better understand how researchers define friendship, identify participants, and confirm participants' friendships. Implications for future research are discussed. We also sought to identify themes in extant research to guide future intervention. The thematic findings point to the importance of adults providing direct support while fading their proximity to students, and of TD peers negotiating the ongoing tension between the roles of helper and friend. [ABSTRACT FROM AUTHOR]

Hypothesis/Issue: Quality education programs in the health professions require an effective clinical education (CE) component. To be effective, the management of both the educational and administrative aspects of CE is essential. We realized that faculty were spending extensive time on the administrative aspects of CE (e.g., negotiating contracts, background checks, database maintenance), which detracted from their ability to devote time to the educational aspects of CE (e.g., preceptor mentoring, site quality assurance, student assessment). Additionally, we recognized the redundancy of the educational and administrative requirements of CE across disciplines. We sought a solution to maximize administrative efficiency and to free faculty to focus on developing and improving the educational aspects of CE. Method: We addressed this challenge by centralizing our clinical education operations into the Office of Clinical Education. This office, run by a staff director with oversight from a faculty director, serves all professional programs and streamlines CE operations. Observations/Outcomes: In addition to administrative efficiency and improved services to students, benefits of this reorganization include increased faculty collaboration, additional interprofessional education opportunities, improved staff job satisfaction, and standardized communication with students, clinical site personnel, and preceptors. Conclusion: Centralized operations are pivotal to effective and efficient CE. [ABSTRACT FROM AUTHOR]

Teachers are a primary source of referral to mental health services for children and adolescents. However, studies find that students identified by teachers differ from those identified by standardized screening scales. This suggests possible discrepancies in conceptualizations of student emotional and behavioral challenges. The current article describes results of a study that explores how teachers conceptualize the emotional and behavioral challenges of adolescents. Middle and high school teachers across the U.S. were identified using a stratified random sampling process and recruited for participation. Twenty-nine teachers (26% of those recruited) were interviewed and asked to describe markers that indicated to them that a student was experiencing emotional and behavioral challenges. Themes in teacher responses were identified and coded. Teachers identified multiple, diverse markers that they perceived were indicators of emotional and behavioral challenges among their students. Markers described by teachers were compared to those typically measured by standardized screening scales. Discrepancies between markers identified by teachers and screening scales are highlighted as potential areas for professional development and enhanced school-based intervention efforts. These findings underscore the importance of integrating teacher perspectives in understanding the referral process for students., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interests.