Background: NR4A orphan nuclear receptors are involved in multiple biological processes which are important in tumorigenesis such as cell proliferation, apoptosis, differentiation, and glucose utilization. The significance of NR4A family member NURR1 (NR4A2) in breast cancer etiology has not been elucidated. The purpose of this study was to ascertain the impact of NURR1 expression on breast transformation, tumor growth, and breast cancer patient survival. Methods: We determined the expression of NURR1 in normal breast versus breast carcinoma in tissue microarrays (immunohistochemistry), tissue lysates (immunoblot), and at the mRNA level (publically available breast microarrays). In addition NURR1 expression was compared among breast cancer patients in cohorts based on p53 expression, estrogen receptor α expression, tumor grade, and lymph node metastases. Kaplan-Meier survival plots were used to determine the correlation between NURR1 expression and relapse free survival (RFS). Using shRNA-mediated silencing, we determined the effect of NURR1 expression on tumor growth in mouse xenografts. Results: Results from breast cancer tissue arrays demonstrate a higher NURR1 expression in the normal breast epithelium compared to breast carcinoma cells (p ≤ 0.05). Among cases of breast cancer, NURR1 expression in the primary tumors was inversely correlated with lymph node metastases (p ≤ 0.05) and p53 expression (p ≤ 0.05). Clinical stage and histological grade were not associated with variation in NURR1 expression. In gene microarrays, 4 of 5 datasets showed stronger mean expression of NURR1 in normal breast as compared to transformed breast. Additionally, NURR1 expression was strongly correlated with increase relapse free survival (HR = 0.7) in a cohort of all breast cancer patients, but showed no significant difference in survival when compared among patients whom have not been treated systemically (HR = 0.91). Paradoxically, NURR1 silenced breast xenografts showed significantly decreased growth in comparison to control, underscoring a biphasic role for NURR1 in breast cancer progression. Conclusions: NURR1 function presents a dichotomy in breast cancer etiology, in which NURR1 expression is associated with normal breast epithelial differentiation and efficacy of systemic cancer therapy, but silencing of which attenuates tumor growth. This provides a strong rationale for the potential implementation of NURR1 as a pharmacologic target and biomarker for therapeutic efficacy in breast cancer.

Objective. The primary objective of this study was to determine if the exposure to sterile compounding in the pharmacy curriculum produces pharmacy graduates who are both competent and confident in the area of sterile compounding. Our secondary objective was to identify additional variables that may predict student performance. Methods. Participants were recruited from the fourth-year College of Pharmacy class of 2018. The students were asked to complete a questionnaire assessing the following domains: demographics, compounding performance confidence, prior experience and theoretical knowledge. A written assessment was followed by a faculty-evaluated practicum in which the students were required to prepare two sterile products using a standardized rubric. Results were analyzed with a student t-test and linear regression to determine differences in performance based upon prior experience, confidence and theoretical knowledge. Results. Overall the 158 students performed well on the knowledge and skill examination, with an average total score of 89.8%. Of the 158 total participants, the 122 survey respondents had an overall mean confidence score of 2.9 on a four point Likert scale, with 40.2% of students scoring in the confident (3) or very confident (4) range of the survey. In our analysis, we found that neither prior compounding experience or self-rated confidence were predictive of students’ total score. Conclusion. Our results indicate that the inclusion of sterile compounding education and training in all four years of the pharmacy curriculum produces graduates who are competent with varying levels of confidence in the area of sterile compounding.

Given the increasing integration of trusted leaders in public health science, including vaccination programs, context-specific understandings of community perceptions and levels of trust are critical to intervention. This study aimed to understand the perspectives and attitudes of the southeastern Louisiana community and inform the development of a community-engaged action plan. A cross-sectional survey of 555 southeastern Louisianans—including faith-based organization (FBO) members, community pharmacy (CommRx) customers, community-based organization (CBO) contacts, and Louisiana community-dwelling residents—was conducted from November 2020 to March 2021. Multivariable logistic regression was used to explore factors associated with COVID-19 vaccination likelihood. Of the participants, 89.9% were Black and 56.9% were women (mean age = 53.3 years). Doctors/healthcare providers (HCPs) were the most trusted COVID-19 information sources. Vaccination likelihood was associated with increasing age (odds ratio (OR) = 1.47; 95% confidence interval (CI): 1.27–1.72), trust in doctors/HCPs (OR = 2.83; 95% CI: 1.64–4.88), trust in government (OR = 4.26; 95% CI: 2.44–7.43), and motivations to keep one’s community safe (OR = 1.52; 95% CI: 1.36–1.70). CommRx customers (OR = 1.93; 95% CI: 1.02–3.65) and CBO contacts (OR = 2.57; 95% CI: 1.37–4.83) were more likely to receive a COVID-19 vaccine than FBO members. Engaging underserved communities and trusted stakeholders through collaborative Community–Academic—Public health—Practice (CAPP) partnerships such as the Louisiana Community Engagement Alliance can promote health and wellness and optimize health interventions.

Some of the lowest COVID-19 community vaccination rates in America are found in Louisiana. This study investigated: (1) barriers that Louisiana pharmacists encountered during the pandemic; and (2) the effect of pharmacists’ role and identity confidence on willingness to enforce vaccine mandates, and COVID-19 vaccine uptake. Fifty-four community pharmacists from nine regions of Louisiana participated in the study. Pharmacists completed questionnaires about: personal demographics, patient population, vaccination encouragement, COVID-19 concerns, and vaccination administration rates. The importance of feeling like a trusted voice in the community, as well as professional perception and self-assurance, were measured using Likert scale questions. During focus groups, participants discussed experiences with the COVID-19 vaccination rollout and vaccination-related obstacles. As the pandemic progressed, pharmacists reported being overworked, understaffed, and overburdened with new responsibilities. In regions with lower vaccination rates, pharmacists were less likely to feel at ease enforcing vaccine mandates. Independent pharmacists were less comfortable enforcing vaccine mandates than chain pharmacists but had more positive perceptions of their role and identity. This study contributes to further understanding of pharmacy workflow obstacles and pharmacists’ perceptions of their professional roles and identities in the community.

The purpose of this study was to explore the impact of eligibility for the coronavirus 2019 (COVID-19) vaccine at the time of the vaccine rollout as a predictor of vaccine intent within the African American community. Methods: Four hundred eighty-seven African American participants in southeastern Louisiana were surveyed from January–April of 2021, with follow-up surveys occurring in Fall 2021. Survey domains included demographics, vaccine hesitancy, discrimination in the healthcare setting, and knowledge and experiences with COVID-19. Descriptive statistics, Chi-square tests, and binary logistic regression were performed. Results: Participants eligible for the vaccine were 1.61 times as likely to express positive vaccine intent versus ineligible participants. Additional predictors of vaccine intent were age, insurance status and coverage, and female sex at birth. In the multivariable logistic analysis, eligible individuals were 2.07 times as likely to receive the vaccine versus ineligible individuals. Conclusions: Vaccine eligibility for the COVID-19 vaccine was a significant predictor of intent to vaccinate in the African American community. Younger individuals were less likely to have a positive intent, correlating with the eligibility of ages 16+ occurring 5 months post-vaccine approval.