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Patients with myelodysplastic syndrome (MDS) require expert, consistent monitoring and management of their blood counts, disease status, and treatment regimens. Understanding how MDS presents and progresses as well as understanding treatment options and how to implement them on an individualized patient basis is essential for patients to receive optimal care. Nurse practitioners play a central role in the care of MDS patients. They have an opportunity to develop trusting relationships with their patients and are crucial parts of the health care team in helping to coordinate care, facilitate treatment, improve quality of life, and avoid life-threatening complications of the disease.

Esther Rothblum and Ellen Cole were coeditors of Women & Therapy from 1984-1995. In this article we describe the process of editing a feminist journal in the 1980s and 1990s, including how ...

The spread of non-native aquatic species among waterbodies has become a major social, environmental, and economic concern. An important mechanism of this spread is the inadvertent transport of organisms on recreational boats as they are moved among waterbodies. Organisms can survive on the exterior of the boat, the interior, attached to fishing tackle, and can be intentionally moved by boaters. In response, local, state, and federal U.S. agencies have invested in outreach campaigns to educate boaters about the impacts of invasive aquatic species and the ways that boaters can reduce the risk of spread. We surveyed boaters in the U.S. state of Illinois to determine their travel patterns and how frequently they clean different parts of their boats. A majority of boaters reported that they always take recommended actions to clean their boat exterior (72% of respondents), boat interior (78%), and fishing tackle (55%), and only 4% reported that they intentionally move organisms. We used network methods to analyze the movement of recreational boaters and found strong connections among 28 highly visited waterbodies. When we removed the 38% of respondents who Always take recommended actions to reduce risk of species spread by all four mechanisms this network was minimally altered and still contained all 28 waterbodies. This indicates that despite high adoption of conservation behaviors there is a continuing risk of non-native species transport among all waterbodies. This work shows that further action is necessary if the impacts of invasive aquatic species are to be reduced in the future.

As agricultural acreage expanded and came to dominate landscapes across the world, viruses gained opportunities to move between crop and wild native plants. In the Midwestern USA, virus exchange currently occurs between widespread annual Poaceae crops and remnant native perennial prairie grasses now under consideration as bioenergy feedstocks. In this region, the common aphid species Rhopalosiphum padi L. (the bird cherry-oat aphid) transmits several virus species in the family Luteoviridae, including Barley yellow dwarf virus (BYDV-PAV, genus Luteovirus) and Cereal yellow dwarf virus (CYDV-RPV and -RPS, genus Polerovirus). The yellow dwarf virus (YDV) species in these two genera share genetic similarities in their 3'-ends, but diverge in the 5'-regions. Most notably, CYDVs encode a P0 viral suppressor of RNA silencing (VSR) absent in BYDV-PAV. Because BYDV-PAV has been reported more frequently in annual cereals and CYDVs in perennial non-crop grasses, we examine the hypothesis that the viruses' genetic differences reflect different affinities for crop and non-crop hosts. Specifically, we ask (i) whether CYDVs might persist within and affect a native non-crop grass more strongly than BYDV-PAV, on the grounds that the polerovirus VSR could better moderate the defenses of a well-defended perennial, and (ii) whether the opposite pattern of effects might occur in a less defended annual crop. Because previous work found that the VSR of CYDV-RPS possessed greater silencing suppressor efficiency than that of CYDV-RPV, we further explored (iii) whether a novel grass-associated CYDV-RPS isolate would influence a native non-crop grass more strongly than a comparable CYDV-RPV isolate. In growth chamber studies, we found support for this hypothesis: only grass-associated CYDV-RPS stunted the shoots and crowns of Panicum virgatum L. (switchgrass), a perennial native North American prairie grass, whereas crop-associated BYDV-PAV (and coinfection with BYDV-PAV and CYDV-RPS) most stunted annual Avena sativa L. (oats). These findings suggest that some of the diversity in grass-infecting Luteoviridae reflects viral capacity to modulate defenses in different host types. Intriguingly, while all virus treatments also reduced root production in both host species, only crop-associated BYDV-PAV (or co-infection) reduced rooting depths. Such root effects may increase host susceptibility to drought, and indicate that BYDV-PAV pathogenicity is determined by something other than a P0 VSR. These findings contribute to growing evidence that pathogenic crop-associated viruses may harm native species as well as crops. Critical next questions include the extent to which crop-associated selection pressures drive viral pathogenesis.

6541 Background: Oral anticancer drug (OACD) prescriptions require coordination between clinicians, payers, specialty pharmacies, and financial assistance (FA) groups, which may delay patient receipt of the drug. Factors associated with delay in receipt of OACDs are unknown. Methods: We prospectively collected data on all new OACD prescriptions (RXs) from the medical oncology practice at the Herbert Irving Comprehensive Cancer Center from 1/1/2018 to 12/1/2018. We collected patient demographic, insurance and clinical information; date of prescription; date of drug delivery; and staff interactions with payers and FA groups. Federal Drug Association (FDA) labels and Micromedex were reviewed for initial drug approval dates, approved indications and average wholesale price. We used multivariable linear and logistic regression to determine factors associated with number of days from prescription to receipt of OACD. Results: During the study period 510 OACD RXs were evaluated. Of these, 84 (16%) were never filled. The most common OACDs were capecitabine (90, 18%), abiraterone (45, 9%), palbociclib (35, 7%) and osimertinib (28, 6%). Of 426 filled RXs, the median time from prescription to receipt was 8 days (IQR 5-13), with 193 RXs (46%) received in ≤7 days, 145 (34%) in 8-14 days and 65 (15%) in 14-28 days, and 23 (5%) at > 28 days. Linear regression showed time to receipt of OACD (log transformed) was associated with having commercial primary insurance (p = 0.02), pursing FA (p = < 0.001), RX of a drug approved by the FDA < 2 years earlier (p = 0.008), drugs without an approved indication for the primary tumor (p = 0.03) and estimated drug cost (p = 0.002). The other included covariates, patient age and prior authorization, were not associated with time to receipt. Logistic regression comparing receipt at ≤14 versus > 14 days found association with FA (OR 3.17; 95%CI 1.78-5.65), FDA approval within 2 years (OR 3.52; 95%CI 1.31-9.45) and off-label use (OR 2.30; 95%CI 1.18-4.50). Conclusions: Over 20% of new OACDs were received 14 days or longer from the date of RX. Financial and insurance related factors; and more expensive and recently approved drugs were associated with longer delays in receipt of therapy. Policy changes to improve the timeliness of OACD access are needed.

Aquatic invasive species (AIS) pose major conservation challenges in freshwater ecosystems. In response, conservation organizations invest considerable resources in outreach to encourage AIS prevention behaviors among recreational boaters. Despite this, remarkably little is known about whether these efforts catalyze significant changes in boaters' perceptions, or whether they cause changes in behaviors that reduce AIS risk. We interviewed managers at the 14 Illinois organizations active in AIS outreach to determine regional priorities for, and investment in, AIS outreach. The results show a network of collaboration that reinforces a limited set of conservation messages. Next, we surveyed 515 recreational boaters to evaluate access to outreach, knowledge of AIS, and consistency of prevention behavior. Boater recognition of prevention slogans and knowledge of AIS and AIS prevention behavior was similar across Illinois regions despite large regional differences in investment in outreach. Most boaters (94%) report never intentionally moving organisms among waterbodies. Fewer reported that they Always perform recommended actions to reduce risk of AIS spread on their boat interior (68%), boat exterior (63%), or fishing tackle (47%). Recognition of prevention slogans and the number of AIS recognized were significantly, positively, associated with Always performing AIS prevention behavior on the vectors of the boat exterior, and fishing tackle, respectively. Our results suggest that increasing knowledge may be a necessary condition for higher adoption of AIS prevention behaviors, but that this alone may not be sufficient. Instead, efforts targeted at boaters who do not currently practice the recommended actions are likely to be necessary.