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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.

How does a modern woman react to being defined by the role of wife? In our study, the authors examined the experiences, benefits, and challenges encountered by wives of college and university presidents. In a relationship where the husband has a prestigious and well-defined role, the female partner may still be expected to play a traditional role on a regular basis, bringing both benefits and challenges. Through focus groups, interviews, and a survey, women shared their experiences. Cluster analytic techniques identified six groups of women that were involved in, adjusted to, or conflicted by serving in the presidential spouse role. The authors employ the voices of the women themselves to illuminate their experiences, satisfactions, challenges, and frustrations. Wives indicated that they had to deal with loss of privacy, conflicted personal relationships, and increased ambiguity about their own identity. Interestingly, wives did not allow these challenges to undermine their marriage; instead, for those who had difficulty meeting these demands, the loss was to their own sense of self-worth. The results suggest that the role of presidential wife should be examined through the intersectional lens of gender and class. This intersection can be seen to shape the expectations of the wife herself, as well as the demands made by her spouse and others in her community. Her previous experiences, education, and career preparation provide insights into how she approaches the public role. Recognizing and giving voice to the complex sociocultural issues involved may help wives thrive in their roles as a college or university president’s wife. Additional online materials for this article are available to PWQ subscribers on PWQ’s website at http://pwq.sagepub.com/supplemental

My mother died one month ago at the age of 89; it was her time to go. One would expect that this would be a religious or holy time for my Jewish family. Maybe a rabbi would be called on. Not so. Th...

Current atmospheric CO2 levels are about 400 μmol mol(-1) and are predicted to rise to 650 μmol mol(-1) later this century. Although the positive and negative impacts of CO2 on plants are well documented, little is known about interactions with pests and diseases. If disease severity increases under future environmental conditions, then it becomes imperative to understand the impacts of pathogens on crop production in order to minimize crop losses and maximize food production. Barley yellow dwarf virus (BYDV) adversely affects the yield and quality of economically important crops including wheat, barley and oats. It is transmitted by numerous aphid species and causes a serious disease of cereal crops worldwide. This study examined the effects of ambient (aCO2 ; 400 μmol mol(-1) ) and elevated CO2 (eCO2 ; 650 μmol mol(-1) ) on noninfected and BYDV-infected wheat. Using a RT-qPCR technique, we measured virus titre from aCO2 and eCO2 treatments. BYDV titre increased significantly by 36.8% in leaves of wheat grown under eCO2 conditions compared to aCO2 . Plant growth parameters including height, tiller number, leaf area and biomass were generally higher in plants exposed to higher CO2 levels but increased growth did not explain the increase in BYDV titre in these plants. High virus titre in plants has been shown to have a significant negative effect on plant yield and causes earlier and more pronounced symptom expression increasing the probability of virus spread by insects. The combination of these factors could negatively impact food production in Australia and worldwide under future climate conditions. This is the first quantitative evidence that BYDV titre increases in plants grown under elevated CO2 levels.

Contents Preface: The Beginning of a Journey * Section I. My Own Truths * Welcome to the World Beyond Size 10 * Doubt: Whistling in the Dark * For You, Jane, Too Late? * Who Do I See in Another's Eyes? * Tucking in My Blouse * Leafletting: Good Work Out There * I See My Insides/You See My Outsides * There's Good Work Out There: What Others Are Saying* I See My Insides/You See My Outsides * The Lifelong Diet * What's Funny About Fat? * Does "Old and Fat" Mean I've Given Up? * This Body I Live In * Section II. What the Outside World Believes * I Am Not Your Punching Bag! * Is Ugly True? * Screaming in the Face of the World, or What Does Acceptance Look Like? * Help! The Avalanche Roars Down on Us * The Birds * Why Do I Feel Like a Bull's Eye? * Weight Watchers: How They Want Us Back! * Don't Raise Your Head--They're Still Shooting! * Section III. Time to Move On * Love Letters * Raw Courage in Face of Horror Stories * Breaking Free * Trudging Through * Fighting Back * Images of Ourselves--Good and Awful * Steps to Freedom * Epilogue: 100-Plus Ways to Fight Ageism, Looksism, Sexism, Racism, Fatism * Index * Reference Notes Included

42 SYNTHETIC RED BERYL GEMS & GEMOLOGY SPRING 2001 both natural and synthetic, plus Ti, Co, and Ni in synthetic beryls; Sinkankas, 1981; Fritsch and Rossman, 1987). These elements substitute for Al. Alkali elements (Li, Na, K, Rb, Cs) can also occur in minor amounts by substituting for Be and Al (Sinkankas, 1981; Aurisicchio et al., 1988; Deer et al., 1997, pp. 378–386); however, these elements do not affect beryl coloration. The beryl crystal structure contains two different sites along “open” channels that can incorporate water molecules (Schaller et al., 1962; Wood and Nassau, 1968; Schmetzer, 1989; Deer et al., 1997). These variations in transition metal, alkali element, and water contents in beryls cause differences in physical properties (such as refractive index, specific gravity, and color), as well as in visible and infrared absorption spectra.

Summary In this article the author reflects on her upbringing, in which she was admonished to be cheerful and happy and not acknowledge unpleasantness. Consequently, as a young adult and a new psychotherapist she found herself detached from her own feelings as well as those of her clients. She recalls the evening that she became a more whole, more sensitive human being, and credits her therapy practice and her clients for keeping her that way.