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Gifted education coordinators play critical roles in administration and supervision of gifted education and accelerated learning programs in their districts. However, these roles are ill-defined in the literature. During the COVID-19 pandemic, district leaders have been called upon to support educators and school administrators in a variety of ways. This exploratory study sought to investigate the experiences of district gifted education coordinators during the first year of the pandemic. Qualitative data were collected from a national sample of 11 district gifted education coordinators through semi-structured interviews. An inductive thematic analysis of transcripts revealed four categories that addressed their roles during this period: (a) professional responsibilities, (b) instructional leadership, (c) program management, and (d) communication and collaboration. The overarching theme across all interviews was the rapid need to pivot and adapt to constant change to ensure equitable access to advanced instruction. Implications for district administrators of gifted education and advanced academic programs and areas for future study are addressed.

To learn about the experiences of elementary gifted learners and teachers of the gifted during the first year of the pandemic and how instruction was adapted to meet the needs of gifted students, we surveyed 300 students in grade three through six and 312 elementary teachers of the gifted. We also held focus groups to explore what worked and how we might reimagine schools in a post-pandemic world. From the voices of teachers and gifted students, we discovered three practical lessons that can guide future instruction and support for gifted students in virtual and hybrid classrooms.

Introduction To evaluate factors of sex, age, and body mass index (BMI) on the bone marrow (BM) harvest collection outcomes of total nucleated cell (TNC) yield, anesthesia time, and sterility; a retrospective review of BM harvest donors at our institution from 2008 to 2017 was conducted. Donors were compared by sex and quartiles based on age and BMI. Materials and Methods Fifty-one donors underwent BM harvest. Thirty-three, 64.7%, of donors were male while 18, 35.3%, were female. Ages ranged from 20 to 72 years, median 33. BMI ranged from 18.7 to 43.4 kg/m2, median 27.7. BMI quartiles approximate WHO nutritional categories: first quartile, Normal weight; second and third quartiles, Overweight; fourth quartile, Obese. As TNC number targets are not donor dependent, outcomes were standardized by concentration: TNC/ml for TNC yield, seconds/ml for anesthesia time. Results There were no significant differences in TNC yield between sexes and between age quartiles. There was a significantly higher TNC yield in the fourth quartile of BMI (>32.5 kg/m2) compared to the first quartile of BMI (≤24.3), p = 0.032. There were trends towards longer median anesthesia times in females, highest BMI quartile, and youngest age quartile. Cultures were positive in 5, 9.8%, products; all occurred in the male donor group, 15.2% of male donors. Conclusion Selection biases might explain the greater number of male donors and donors with a greater BMI. There were no significant differences in TNC yields between sexes and between age quartiles. There was a significantly higher TNC yield in the fourth quartile of BMI compared to the first. Median anesthesia times were longest in female, youngest quartile of age, and Obese donors but did not approach statistical significance. BM products collected from male donors were significantly more likely to have positive cultures. Sample size limits the power of these analyses.

Introduction Per the National Cancer Institute epidemiological data, the incidence of multiple myeloma has not changed significantly over the past decade. Mortality from myeloma has not changed significantly between 2007-2016 with an estimated 5-year survival of 55.2 % between 2009-2015. The treatment of multiple myeloma has improved significantly over the past decade with the approval of several new drugs. In the recent IFM trial, the 4-year overall survival in a select group of myeloma patients was 82% when treated with bortezomib, lenalidomide and dexamethasone followed by autologous stem cell transplant and maintenance therapy. These numbers may further improve with approval of monoclonal antibodies and several new drugs in clinical trials. The cost of healthcare has been growing consistently for the past several years. Per CMS data, healthcare spending grew 3.7% in 2017 reaching $3.5 trillion, or $10,739 per person. National health spending is projected to grow at a rate of 5.5% per year from 2018-2027 reaching nearly $6.0 trillion. Health share of the GDP is expected to rise from 17.9% to 19.4%. Pharmaceutical costs have been rising consistently over the past several years with cancer therapies being some of the costliest. Most new cancer therapy costs more than $100,000 per year with the triplet combinations for myeloma costing upwards of $200,000 per year. Methods Our goal was to evaluate the utilization of the newer drugs approved for myeloma by the Medicare population and assess the economic burden of growing drug prices on the health care system. We queried the national CMS database from 2013-2017 to obtain information on Medicare payments made, number of providers making claims and consulting fees for bortezomib, carfilzomib, daratumumab, elotuzumab, ixazomib, lenalidomide, panobinostat and pomalidomide. Results Between 2013-2017 there has been a significant increase in the annual Medicare payments made for myeloma drugs. The amount of payments has tripled between 2013-2017. The number of claims made and providers making those claims have increased. There has also been an exponential increase in consulting fees paid by various pharmaceutical companies to promote prescription of the aforementioned drugs. The amount of money paid in consultation has nearly quadrupled since 2013. Results are consolidated in Table 1 and Figure 1. Discussion This past decade has been an exciting period in cancer research and drug approvals, with myeloma being one of the many malignancies benefitting from this progress. This was made possible by the collaboration between pharmaceutical companies and academic institutions. With the need for continuous combination therapy in multiple myeloma along with increasing prices of existing drugs and high upfront market prices for newly approved drugs, there is significant financial burden placed on the healthcare system. Based on the published literature substitution of carfilzomib for bortezomib or addition of monoclonal antibodies in induction would double cost. Some of these drug approvals are based solely on surrogate endpoints of overall response rates and progression free survival benefit of few months. This is without proven overall survival data while harboring significant toxicity. Conclusion: With pharmaceutical companies spending millions of dollars for drug development there has been a trend towards higher drug pricing. These companies also pay large amounts of consulting fees to physicians dedicated to aggressively market these newly approved drugs which are priced higher than existing therapy. Some of the current cancer guidelines include authors who have financial conflicts of interest and receive consulting fees from pharmaceutical companies. It would be interesting to investigate the correlation between the consulting fees and its effect on prescription patterns. Even the cancer care guidelines do not consider the cost effectiveness of equally effective regimens. There has been a push from various pioneers in the field to incorporate value-based recommends into their guidelines. Given the trajectory of rising costs within our healthcare system, it is imperative for all physicians to be mindful of value-based care while seeking therapy options that provide true benefit to their vulnerable patient populations. Disclosures No relevant conflicts of interest to declare.

Tutoring is an important and effective means of helping young readers and writers who are experiencing difficulties. However, little is known about what kinds of relational qualities might accompany successful tutoring or how we might identify them. To address these issues, we analyzed the reflective writings of tutors in 10 tutor‐student pairs classified as “very successful” or “less successful” by student achievement assessments. Results suggest that very successful tutoring pairs were deeply engaged in the human activity of caring and reciprocity. They also expressed a deep commitment by envisioning their students’ futures in a hopeful manner and engaged in continual revision of their teaching. Less successful tutors had more conflicted relationships. Results suggest that helping tutors with strategy instruction and developing strong positive relationships with those they tutor may increase benefits for children.

Introduction: According to the Commission on Cancer's 2012 program standards, patients diagnosed with cancer may experience psychological issues that can interfere with patient treatment plans and adversely affect outcomes. To address these issues, the Commission developed the following guidelines to accurately determine patient distress levels: 1) patients with cancer are offered screening for distress at least 1 time during a pivotal medical visit, 2) the mode of administration for the distress screening is to be determined by the program, and 3) facilities select the tool to be administered to screen for distress with preference being given to standardized, validated instruments. To meet this standard and plan future work in distress reduction for stem cell transplant recipients, the St. Louis University Blood and Marrow Transplant Program began implementing The State Trait Anxiety Inventory (STAI) with patients during pivotal medical visits. The STAI is a psychological inventory based on a 4-point Likert scale and consists of 40 questions on a self-report basis. The STAI differentiates between the temporary condition of "state anxiety" and the long-standing quality of "trait anxiety." The essential qualities evaluated by the STAI scale are feelings of apprehension, tension, nervousness, stress, and worry. Scores on the STAI scale increase in response to physical danger and psychological stress and decrease as a result of relaxation training. Average scores for working, male adults are 35.72 (state) and 34.89 (trait). Average scores for working, female adults are 35.20 (state) and 34.79 (trait). After implementing the STAI, it was realized that these screenings could be de-identified and analyzed in groups to determine if patterns emerged regarding patients' perceived anxiety levels throughout the bone marrow transplantation process. Method: The study team received Institutional Review Board approval to perform a retrospective examination of STAIs completed by patients throughout the bone marrow transplantation process at the St. Louis University Blood and Marrow Transplant Program from 03/11/2104 through 06/24/2014. A total of 30 inventories were collected, de-identified, and categorized by the following medical visits: arrival visit (the patient's first visit to the Blood and Marrow Transplant clinic), data review visit (the visit to review transplant related testing and sign consents), start of preparative regimen visit, day 0 visit, day +30 bone marrow biopsy visit for allogenic transplantation, day +30 bone marrow biopsy result visit for allogenic transplantation, and day +100 visit for auto transplantation. Averages for each medical visit category were determined by finding the mean score. Category averages were then compared to determine if a particular pivotal medical visit caused patients to experience an overall increase in anxiety level. Results: Results from the study indicate that patients experience the highest levels of anxiety during the early medical visits of the bone marrow transplantation process. Average state anxiety scores were 46 during the arrival visits, 41 during the data review visits, and 44 during the start of preparative regimen visits. Average trait anxiety scores were 38 during the arrival visits, 45 during the data review visits, and 39 during the start of preparative regimen visits. During the day 0 visits, patients' state anxiety scores decreased to an average of 36 and trait anxiety scores decreased to an average of 35. Day +30 and day +100 visits demonstrated even further decreases in state and trait anxiety scores. Conclusion: The surprising finding of this study was that patients demonstrated a higher level of distress in the period leading up to the transplant which gradually decreased once the preparative regimen was administered. The sample size for this study was small and could possibly skew results. However, this study does provide a starting basis for future study in bone marrow transplant recipient distress, and larger, multi-site studies are being planned to ensure the accuracy of the patterns, which emerged from this study. If patterns could be accurately identified and predicted, the study team may also be able to develop future studies to primitively lower patients' anxiety levels early in the bone marrow transplantation process and thus improve outcomes. Abstract 6006 Figure 1 Abstract 6006 Figure 1. Disclosures No relevant conflicts of interest to declare.