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esidents may have different expectations and perceptions. Published by Elsevier Inc.PURPOSE The purpose of the study was to investigate changes in the anxiety levels of patients receiving preoperative Reiki. MATERIAL AND METHODS This study used a quasi-experimental model with a pretest-posttest control group. METHODS Subjects (n = 210) were recruited from a hospital in Turkey, from June 2013 to July 2014. GSK1210151A Subjects were then assigned to experimental (n = 105) and control (n = 105) groups. RESULTS The level of anxiety of experimental group patients did not change according to their state anxiety scores (p > 0.10); however, the anxiety level of control group patients increased (p less then 0.001). CONCLUSION The results of this study imply that the administration of Reiki is effective in controlling preoperative anxiety levels and in preventing them from increasing. BACKGROUND Percutaneous coronary intervention (PCI) is increasingly performed in patients with chronic kidney disease (CKD), including in end-stage renal disease (ESRD), however studies on vascular access are limited. OBJECTIVE We sought to describe vascular access choice and outcomes of PCI from transfemoral (TFA) compared to transradial access (TRA) in ESRD patients on dialysis. METHODS Patients with ESRD on dialysis undergoing PCI from October 2010 to January 2017 at two hospitals in a health system reporting to the National Cardiovascular Data Registry (NCDR) CathPCI registry as well as their respective electronic medical records (Epic) were analyzed. Baseline characteristics, procedural and in-hospital outcomes were compared according to access site, TFA versus TRA. RESULTS There were 270 patients with ESRD on dialysis who underwent PCI, 234 via the TFA and 36 via the TRA. Mean age of the patients was 67 and 67.4% were male. The TFA patients had a lower body-mass-index (BMI) (P  less then  0.001) and were more likely to have prior coronary artery bypass graft (CABG) (P  less then  0.001) and PCI of the left main coronary artery (LM) (P = 0.04). Access site cross over only occurred in one patient in each group. Bleeding within 72 h was seen in 3.8% of the TFA group and in 2.8% of the TRA group (P = 0.75). CONCLUSION Use of TRA is uncommon in patients with ESRD on dialysis, but is feasible and associated with low complication rates, similar to TF. SUMMARY FOR THE ANNOTATED TABLE OF CONTENTS While PCI is being increasingly performed in patients with end-stage renal disease, there are is a lack of data on vascular access for this group. This study shows that while a transradial approach TRA is less common than transfemoral (TFA), it is still a feasible option and is associated with low complications similar to TFA. OBJECTIVE To describe the system-wide implementation of integrated electronic prior authorization (ePA) and its impact within a centralized prior authorization (PA) department in an academic health system. SETTING Prescription drugs have been among the fastest growing areas of health care and continue to advance; therefore, costs associated with medications are continually rising. Pharmacy benefit managers implement tools such as PAs in an effort to manage costs. PAs are often viewed as inconvenient and irritating by both patients and clinical staff. PRACTICE DESCRIPTION The pharmacy ambulatory clinical care center (PAC3), a centralized PA department, provides PA services to some clinics within the system. Since 2014, the system has worked to optimize the manual (by telephone and fax) PA process. However, it is still a time-consuming, multistep process. PRACTICE INNOVATION A resolution to the PA problems that health systems face is ePA, which involves processing PAs electronically through an online portal or integrated within an electronic health record (EHR). The system began the implementation process with the selection of an ePA vendor, followed by implementation within the EHR. Once the software was ready, the system took a phased rollout approach and implemented ePA in a few specialty and primary care clinics at a time. EVALUATION An average of 24% of PAs processed by PAC3 were completed by ePA. The system saw a 25% increase in the number of PAs processed per month by 1 PA coordinator full-time equivalent. In addition, a 62% decrease in the PA turnaround time allowed patients to receive medications faster. RESULTS Not applicable. CONCLUSION ePA offers several benefits to the system including decreased turnaround time. This allows patients to receive medications and start therapy earlier. The ePA process also increased efficiency, allowing PAC3 to centrally manage PAs for additional clinics, thereby decreasing the workload in the clinic. OBJECTIVE To evaluate the impact of a substance use disorder (SUD) elective curriculum on students' perceptions of treating patients with SUDs using the Drug and Drug Problems Perceptions Questionnaire (DDPPQ). METHODS In 2017, a third-year pharmacy elective, conceptualizing SUD as a chronic, relapsing brain disease with psychosocial and societal influencers, was introduced. A linked pre- and postcourse assessment using the DDPPQ was carried out for the following categories role adequacy, role support, job satisfaction, role-related self-esteem, and role legitimacy. RESULTS A total of 63 students were enrolled in the elective and 54 paired questionnaires were available for analysis. There was a statistically significant improvement in attitude across all 5 categories of the DDPPQ. CONCLUSION Students' attitudes toward working with patients with SUD improved after completing the elective. This study indicates that teaching student pharmacists about effectively recognizing and treating SUDs may result in more willingness to work with these patients in the future. BACKGROUND There is conflicting data on the effect of carotid revascularization on cognitive function. OBJECTIVE To examine cerebral blood flow and cognitive function after carotid revascularization. METHODS Patients with unilateral, asymptomatic hemodynamically significant carotid artery stenosis (80% by computed tomography angiography or magnetic resonance angiography) were eligible. Cerebral blood flow was measured preoperatively and 1 month postoperatively using quantitative phase contrast magnetic resonance angiography. Preoperative flow impairment was defined as ipsilateral flow at least 20% less than contralateral flow (ie, an ipsilateral and/or contralateral flow ratio ≤0.8). Significant improvement in blood flow was defined as at least a 0.15 increase in flow ratio from pre- to postoperative. A control group was managed medically. Four cognitive domains were assessed at baseline, 1 month, and 6-12 months postoperatively. RESULTS Seventy-five patients were enrolled at 6 sites; 53 carotid endarterectomy, 11 carotid artery stenting, and 11 medical management only controls.
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