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2025-10-29 A Haunting Fable on The Amazon River, Cornish Playhouse Presents ‘The River Bride’
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The Impact of Standardizing Radial Over Femoral Access for Coronary Angiography on Hospital Costs and Length of Stay.
No full textLocal Problem: Trans-femoral Access (TFA) has traditionally been the preferred route for coronary angiography (CA) due to ease of use. However, TFA is associated with complications, extended hospital stays, and increased costs. A quality improvement (QI) project was launched in May 2021 to promote Trans-radial Access (TRA) and same-day discharge (SDD) for elective CA procedures, aiming to reduce complications and improve patient outcomes.
Purpose: The purpose of this QI project was to compare and contrast patient outcomes and length of stays for patients undergoing elective coronary angiography (CA) utilizing Trans-radial Access (TRA) versus Transfemoral Access (TFA).
Methods: A retrospective chart review of 100 patients’ charts from the Interventional Radiology Department was conducted, dividing them into pre-intervention (n=50, July 2020-April 2021) and post-intervention (n=50, November 2023-June 2024) cohorts. Inclusion criteria consisted of elective percutaneous coronary intervention (PCI) cases on adult patients (ages 18-99 years), excluding emergencies, CABG history, and other specific conditions such as the presence of AV fistula or previous surgical interventions to the extremity. The review compared TRA and TFA groups for bleeding complications, access site, and length of hospital stay, with cost data obtained from the American PCI-registry and Medicare claims reports.
Results: The results showed significant improvements in outcomes associated with Trans-radial Access (TRA) for coronary angiography (CA). TRA usage increased by 34 percentage points, from 52% to 86%, between the pre-intervention and post-intervention cohorts. Hospital stays decreased for TRA patients, with a mean hospital stay of 0.54 nights compared to femoral access 1.76 nights (p \u3c 0.05). Bleeding complications were lower in the post-intervention cohort, including hematoma rates with TRA (1 case in Cohort 2) compared to TFA (2 cases in Cohort 1). A cost analysis revealed lower average costs for same-day discharge (16,914.50). Overall, the QI project demonstrated improved outcomes and cost savings associated with increased TRA usage for CA.
Conclusion: Use of Trans-radial Access (TRA) for elective coronary angiography procedures can enhance patient outcomes and improve hospital efficiency
Ketamine-Assisted Psychotherapy for Patients with Cancer
No full textPatients with cancer confront not only physical challenges but also deep emotional and psychological distress experiences. Depression, anxiety, and existential distress often accompany a cancer diagnosis and negatively affect quality of life, response to medical treatment, and survival outcomes. Traditional psychiatric pharmacologic treatments are slow to work and often inadequate at reducing symptoms. There is an urgent need for fast and effective treatment options that improve mental health outcomes for patients facing life-threatening illnesses, highlighting the importance of exploring innovative approaches to mental health care in oncology settings. This Doctor of Nursing Practice project examined via retrospective analysis how ketamine-assisted psychotherapy (KAP) impacted depression, anxiety, and existential distress symptoms of patients with cancer. Available pre- and post-treatment screening scores (PHQ-9, GAD-7, and NIH-HEALS) from six patients who received KAP from the AIMS Institute in Seattle, WA were analyzed using the Wilcoxon Signed-Rank Test. Results showed that five out of six patients had improved depression and anxiety symptoms and all four patients with data showed improvement to their perceptions of existential distress. Due to the small sample size, these changes were not calculated as statistically significant; regardless, there were meaningful clinical improvements observed. KAP could improve emotional well-being, treatment adherence, and overall outcomes for cancer patients. However, further research with larger samples are needed to support KAP’s potential as a fast-acting and effective treatment option for cancer patients experiencing psychological distress. KAP may help fill a critical gap in care, especially for those with limited time to wait for traditional medications to take effect
Exploring Leadership Capabilities Developed as a Mother: Toward a New Theory of Mother-Leader Intuitionship
No full textYour perspective as a Mom changes the way you lead in every aspect.
— Liuba Grechen Shirley, VoteMama Founder
Throughout the history of the United States, there has never been such a substantial rise in the number of Mothers in the paid workforce as in the last 3 decades. Yet, despite this growth they remain underrepresented in leadership positions. This underscores why we, as both researchers and Mothers, believe it is critical to apply a Mother\u27s lens to conversations about workplace leadership. Our research begins by examining contemporary leadership theories, focusing on parallels between Motherhood and four of the popular leadership frameworks: Trait Approach, Skills Approach, Transformational Leadership, and Adaptive Leadership. With these frameworks in mind, we conducted a mixed-methods study to explore connections between Motherhood and leadership qualities. A total of 964 Mothers responded to a survey, and the data show links between leadership skills perceived to be cultivated in Motherhood and those recognized in the paid workplace. In addition, interviews with 10 accomplished Mother-Leaders were conducted. Their narratives revealed capabilities typically not reflected in established leadership theories, such as Mothers’ intuition and resilience, sharing how these capabilities influence their leadership in both formal and informal settings. Grounded in these findings, we consider implications for theory and practice, proposing a new foundational concept that reflects the lived experience that Mothers bring to the leadership conversation: Mother-Leader Intuitionship
