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The ongoing COVID-19 pandemic has been taxing to healthcare workers, no less for those serving on the front lines in schools. From initial school closures and online learning to gradual reopening with hybrid learning models, to full in-person learning, school nurse administrators provided guidance in collaboration with public health officials, based on evolving information. Infection control was at the forefront, while government and scientists partnered to quickly develop effective vaccines. Technology provided new virtual platforms for learning, conducting meetings, and socialization, while also being widely used to deliver information, misinformation, and disinformation. Challenges have been numerous, but school nurse administrators and school nurses in general, with a commitment to the health and safety of their populations, continue to adapt to the ever-changing demands. The journal’s Editorial Advisory Board interviewed five school nurse administrators, representative of diverse geographic locations, school population size, and employer models, to capture their reflections on school health leadership during the COVID-19 pandemic. History is deserving of their stories.

The stages of the preparation and subsequent allograft of haematopoietic stem cells are particularly demanding in terms of quality and safety and require the mobilisation of a multidisciplinary nursing team. Working closely with the patients, the nurse ensures hygiene measures are respected in order to minimise the risks of aplasia. She supports them in the prevention and management of the side effects linked to the treatment and surrounds them with all the relational support they need in this difficult stage of their care pathway.

Background: Compared to their white counterparts, Black women with breast cancer suffer from earlier onset of diagnosis, more aggressive histology, higher mortality rates, and are at risk of racial bias from healthcare providers and treatment plans that do not align with the standard of care. Place of death can be considered a metric for high quality end-of-life care as hospital death is associated with both physical and emotional distress. Given Black patients' particular vulnerability, the purpose of this study was to investigate place of death as a surrogate for end-of-life healthcare disparities. Methods: The National Center for Health Statistics database was used to determine the place of death for all US women with primary-breast cancer death from 1999-2019. Place of death (home, hospital, and hospice) and race (white and Black) were considered; the subset of women who died Citation Format: Sarah Marion, Fumiko Chino. Should place of death be added to the index of disparities between Black and White breast cancer patients? [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-124.

The stages of the preparation and subsequent allograft of haematopoietic stem cells are particularly demanding in terms of quality and safety and require the mobilisation of a multidisciplinary nursing team. Working closely with the patients, the nurse ensures hygiene measures are respected in order to minimise the risks of aplasia. She supports them in the prevention and management of the side effects linked to the treatment and surrounds them with all the relational support they need in this difficult stage of their care pathway.

To describe patient- and practice-related factors that physicians report affect their clinical decision to administer prophylactic pegfilgrastim to patients

For decades, it was believed that the diameter of gastrointestinal smooth muscle cells is sufficiently narrow, and that the diffusion of calcium across the plasma membrane is sufficient, to support contractile activity. Thus, depolarization-triggered release of intracellular calcium was not believed to be operative in gastrointestinal smooth muscle. However, after the incubation of muscle segments in solutions devoid of calcium and containing the calcium chelator ethylene glycol tetraacetic acid, an alternative electrical event occurred that was distinct from normal slow waves and spikes. Subsequently, it was demonstrated in gastrointestinal smooth muscle segments that membrane depolarization associated with this alternative electrical event triggered rhythmic contractions by release of intracellular calcium. Although this concept of depolarization-triggered calcium release was iconoclastic, it has now been demonstrated in multiple gastrointestinal smooth muscle preparations. On the basis of these observations, we investigated whether a rhythmic electrical and mechanical event would occur in aortic smooth muscle under the same calcium-free conditions. The incubation of aortic segments in a solution with no added calcium plus ethylene glycol tetraacetic acid induced a fast electrical event without corresponding tension changes. On the basis of the frequency of these fast electrical events, we pursued, contrary to what has been established dogma for more than three centuries, the question of whether the smooth muscle wall of the aorta undergoes rhythmic activation during the cardiac cycle. As with depolarization-triggered contractile activity in gastrointestinal smooth muscle, it was "well known" that rhythmic activation of the aorta does not occur in synchrony with the heartbeat. In a series of experiments, however, it was demonstrated that rhythmic contractions occur in the aortic wall in synchrony with the heartbeat and share a common pacemaker with the heart. We conclude that important observations in the vascular system became derivative from those in the gastrointestinal system. The challenging of scientific dogma potentially leads to the expansion of our fundamental knowledge base.

Introduction: Granulocyte colony-stimulating factors such as pegfilgrastim (Neulasta®) can reduce the incidence of febrile neutropenia, a life-threatening side effect of myelosuppressive chemotherapy. According to current FDA-approved prescribing information, pegfilgrastim should not be administered between 14 days before and 24 hours after administration of myelosuppressive chemotherapy. Previous research indicates that same- vs next-day administration of pegfilgrastim may be associated with worse patient outcomes, and current guidelines from both ASCO and NCCN recommend use of pegfilgrastim 1-3 days after chemotherapy. A recent health care claims database analysis has shown that same-day pegfilgrastim was administered in ~13% of chemotherapy cycles, but little is known about physician rationale for administering same-day pegfilgrastim. Here, we describe the results of a cross-sectional, web-based physician survey describing the practice- and patient-related factors that physicians report to have affected their decision to administer same-day pegfilgrastim. Methods: Survey invitations were sent via e-mail to a sample of US medical oncologists, hematologists, and hematologist-oncologists who were enrolled in a national physician panel. Physicians who reported experience prescribing same-day pegfilgrastim within the last 6 months and provided informed consent were included. Physician reasons for prescribing same-day pegfilgrastim were assessed. The analysis was descriptive; summary statistics are presented. Results: Of 17,478 physicians who were invited to participate, 386 were screened, and 186 (48%) reported administering same-day pegfilgrastim within the previous 6 months. A total of 183 physicians (47%) agreed to participate in the survey, and 151 (39%) completed the survey. Mean (SD) years in practice was 14.6 (8.2) years. Most physicians practiced in a private group practice (39%), at a cancer hospital/referral center (25%), or at other types of academic hospitals/clinics (23%). Physicians were relatively evenly distributed across the US and most (54%) practiced in towns with a population ≥250,000. Breast cancer and non-small cell lung cancer were the most common primary cancers in patients followed by the physicians. Physicians estimated that ~41% of their patients received pegfilgrastim, and that among patients who received pegfilgrastim, ~32% received same-day pegfilgrastim, with ~43% of those patients receiving same-day pegfilgrastim across all chemotherapy cycles. 36% of physicians relied primarily on clinical judgment when deciding to administer same-day pegfilgrastim. The most common patient risk factors reported by physicians as moderately or very important when deciding to administer same-day pegfilgrastim were previous febrile neutropenia (78%), presence of infection or open wounds (70%), and poor ECOG performance status (67%). When asked to rank 7 different clinical and logistic reasons to administer same-day pegfilgrastim (with 1 being most important), "it was more practical for the patient" was the most important reason (mean rank = 3.0; SD = 1.7), and "it was more practical for the practice due to patient scheduling burden/load" was the least important (mean rank = 4.2; SD = 1.7). 85% of physicians reported travel distance for the patient/caregiver and 79% reported method or availability of transportation for the patient/caregiver as moderately or very important patient-related factors for same-day administration of pegfilgrastim. The most important administrative consideration for same-day administration of pegfilgrastim was burden of actual prophylactic administration of pegfilgrastim on the next day and follow-up (65% of physicians cited as moderately or very important). Conclusions: Physicians rely primarily on clinical judgment when deciding whether to administer same-day pegfilgrastim, and clinical risk factors such as previous febrile neutropenia affect the decision to administer same-day pegfilgrastim. Additional physician considerations include patient/caregiver travel distance, method or availability of transportation, and burden of actual prophylactic administration of pegfilgrastim on the next day and follow-up. Continued education of patients and physicians on the potential risks of same-day pegfilgrastim administration could increase compliance and improve patient outcomes. Disclosures Darden: Amgen Inc: Research Funding; RTI Health Solutions: Employment. Off Label Use: This abstract assesses physician rationale for same-day administration of pegfilgrastim, which is an off-label use of pegfilgrastim. As noted in the abstract text, "According to current FDA-approved prescribing information, pegfilgrastim should not be administered between 14 days before and 24 hours after administration of myelosuppressive chemotherapy.". Price:Amgen Inc.: Research Funding; RTI Health Solutions: Employment. Kaye:Amgen Inc.: Research Funding; RTI Health Solutions: Employment. Sherif:Amgen Inc.: Research Funding; RTI Health Solutions: Employment. Marion:RTI Health Solutions: Employment; Amgen Inc.: Research Funding. Tzivelekis:Amgen Inc.: Employment, Equity Ownership. Garcia:Amgen Inc: Employment, Equity Ownership. Chandler:Amgen Inc.: Employment, Equity Ownership.

This thesis explores the disparate yet complementary roles filled by potters at Silver Dollar City (SDC), an 1880s Ozarks theme park in Branson, Missouri. As apprentices, the potters learn a spectrum of skills, kinesthetic through aesthetic. As production potters, they maintain a high output of sellable wares. The potters balance the constraints they see in production (its threats to creativity, individuality, and dialogue with other ceramicists) by claiming the freedoms of studio potters (who value these goals). The potters' ability to demonstrate at the park and participate in its 1880s-Ozarks heritage production sets the SDC potters apart. Understanding how the potters balance or, as potters do, find the center amongst these roles shows the uniqueness of their work. Daily contact with the potters as an apprentice informed my interviews. Following a collaborative ethnographic model, my consultants critiqued my developing understanding of their work from my early research through final drafts.

Relations between self-injuring behavior (SIB), the hypothalamic-pituitary-adrenal (HPA) stress axis, and response to an opiate antagonist were examined. Subjects were observed in their residential settings, while behavior was recorded. Blood was collected in the morning, evening, and immediately after SIB. Plasma beta-E was uncoupled from ACTH after SIB but not during the morning baseline. A significant number of the subjects (a) reduced their SIB at least 25% at all doses of naltrexone (NTX) and (b) reduced their SIB over 50% for at least one dose of NTX. The lowest dosage of NTX significantly reduced SIB in subjects with baseline levels of beta-E higher than after SIB. Results support previous reports that the HPA axis is disturbed among subjects exhibiting SIB.