SVN...prn Spring 2014

Vol 21, No. 2 – April | May | June 2014
The President’s Message
We were so fortunate to celebrate our 32nd Annual
Convention in the beautiful city of San Antonio. Local member
and President-elect Phyllis Gordon served as our hostess
and shared with us some local history, as well as, wonderful
suggestions for experiencing the flavor of the city. The beautiful
River Walk was just outside our hotel doors.
The Convention Planning committee organized a stellar
program. Attendees traveled from Brazil, Canada, Sweden, and many US cities,
with a total attendance of 140. Our meeting opened with an energetic and moving
presentation by Kevin Carroll, Vice President of Prosthetics with Hanger Clinic.
We traveled with Mr. Carroll through the stringent course of the amputee patient
and their difficult process to reach that goal of obtaining a prosthetic limb, allowing
them to experience functional independence. Fondly associated with the story,
Dolphin Tale, Mr. Carroll shared his research and development of a prosthetic
dolphin tail for Winter, an injured dolphin. She has been an inspiration for children
and adult amputees. This segued nicely in to our first general session, with Colonel
Todd Rasmussen, United States Air Force, discussing advances in medicine and
trauma care, lessons learned in the wars in both Afghanistan and Iraq. Although
certainly not expected, these advances are helping us to cope more efficiently with
multiple traumatic incidents within our United States borders.
Traveling from the University of São Paulo, Brazil, Rita de Cassia e Silva reviewed
a research study discussing intermittent claudication and cardiovascular risk. Our
first afternoon, presentations moved to more complex vascular surgery issues,
showcasing the expertise of our SVN members.
Dr. Joseph Ricotta, Northside Hospital Heart and Vascular Institute in Atlanta,
Georgia challenged us with an early bird session on day two, discussing AAA
detection and treatment. Our general session that followed was an intriguing
presentation by Dr. Dianna Milewicz reviewing the genetic basis of Thoracic Aortic
Aneurysm (TAA) and acute aortic dissection. Stepping up to the plate yet again, the
topics presented by SVN members continued to keep our rapt attention throughout
the conference.
Day two brought us to the very special moments of our President’s Luncheon
celebration. Founding member, Jeanne Doyle was present to assist in presenting
this year’s Jeanne Doyle award to our Journal of Vascular Nursing (JVN) editor,
Cindy Lewis, an active SVN member for more than 20 years and 13 years as JVN
editor. Debra Kohlman-Trigoboff shared smiles and tears with us in her address
as the outgoing President, challenging each of us to help our organization move
forward. Early risers on Day three, listened as Kate Obermiller, PTA, and a local
San Antonio resident reviewed treatment for lymphedema. Dr. Alan Lumsden,
Methodist Hospital, Houston, Texas then guided us through developing techniques
for complex TAA repair. Member experts shared the pre and post-operative care for
patients with Thoracic Endovascular repair (TEVAR).
continued on page 2
2014 - 2015
Board of Directors
PRESIDENT
Terry DeVeaux, RN, MS, ACNP, CV, CCRN
Maryland Vascular Center
Glen Burnie, MD
PRESIDENT-ELECT
Phyllis Gordon, MSN, ACNS, BC
UT Health Science Center,
San Antonio, TX
SECRETARY
Sharon Weinlein, ADN, RN
The Vascular Group
Albany, NY
TREASURER
Vickie Nimmer, RN
Iowa Health System
Cedar Rapids, IA
IMMEDIATE
PAST PRESIDENT
Debra Kohlman-Trigoboff, RN, MS,
ACNP-BC, CVN
Duke Heart and Vascular
Durham, NC
DIRECTORS
Patty Bozeman, APRN, CVN
Hartford Healthcare Medical Group
Hartford, CT
Jill Knutson, RN, BSN
Maine Medical Center, Portland, ME
Kathleen Rich, PhD, RN, CCRN-CSC, CNN
IU Health La Porte Hospital, LaPorte, IN
Marie Rossi, BS, RN
Vascular Group, Albany, NY
Tiffany Street, RN, MSN, ACNP
The Methodist Hospital, Houston, TX
WE’VE MOVED
NATIONAL OFFICE
SOCIETY FOR VASCULAR NURSING
N83 W13410 Leon Rd.,
Menomonee Falls, WI 53051
Tel: (414) 376-0001
Fax: (414) 359-1671
email: info@svnnet.org
www.svnnet.org

continued from page 1... Pres. Message
Our closing session, also provided by Hanger Clinic was
amazing. Katy Sullivan, actress and amputee, shared with
us her inspirational story of growing up without her legs.
Smiles and laughter filled the room as she shared hope and
optimism, not sadness. As a parent, I could not help but
think of the challenges that her mother had faced and yet
as Katy explained, her Mom let her stumble and find her
way, giving her confidence and independence.
We cannot dismiss the importance of the social part of our
meeting, seeing old friends, reminiscing about the way
it was, making new friends, meeting new members and
sadly sometimes seeing colleagues off to new adventures.
Even in these sessions, the knowledge shared was evident.
We have an amazing organization and through shared
expertise the SVN has developed wonderful educational
materials for patients and nurses available through the
The President’s Updates…
March 2014
The Board reviewed and is focusing on these major themes from
the member satisfaction survey:
• Request for more CEU opportunities. SVN is exploring the cost
of increased on-line or webinar opportunities.
• Local interaction for members; explore the idea of regional
meetings, virtual chapters.
• Members are looking for more basic vascular education.
SVN is working on tool kits which will be a great resource.
• SVN is promoting membership to Magnet hospitals, reaching
out to 13 states without SVN members.
• Scope and Standards draft was sent out to members for review.
After final review by the Task Force the document will be sent
to ANA for publication.
• A new PAD position statement has been added to the SVN
website home page.
April 2014
• San Antonio convention program distributed to collaborating
organizations. Convention Planning Committee finalizing details
for the San Antonio meeting, with great excitement for our Keynote
and Invited speaker presentations.
• Collaboration continued with Vascular Endovascular and Surgical
Society (VESS) formerly PVSS, with a plan for joint participation
in future meetings of each society.
• ANCC Cardiac and Vascular Certification materials will be
available at the conference registration desk.
www.svnnet.org
SVN website. Congratulations to all of our talented award
winners this year. We continue active collaboration with our
physician colleagues and are spreading our wings with plans
in progress for international collaborations in South Africa
and India.
As Debra shared in her address, we need each of our members
to consider just one of many ways to be an active participant
in SVN. We need your help to move forward and to grow
our member numbers. I challenge you to think of Katy’s
mother and her success in stepping out of her comfort zone,
allowing her child to try and to succeed so amazingly. Let us
try coloring outside of the lines, approaching change with
creativity, not regimented ideas. We are challenged with the
economy, health care changes, and our individual concerns,
but together we can raise the bar, providing excellence, respect
and advocacy for vascular nurses and persons living with
vascular disease.
• Public Policy and Advocacy sending
out requests to state governors for the
proclamation of Vascular Nurses Week,
the second week in June.
• SVN very excited to receive a request for new
collaboration with the Intersocietal Accreditation Commission
(IAC). They have requested an SVN member for the Board of the
newly launched Accreditation of Vein Centers.
• SVN has also received a request to assist with development
of a Vascular Nursing Society in India.
May 2014
• San Antonio Convention a wonderful success.
• Your 2014-15 Board welcomes President-elect, Phyllis Gordon
and Director, Tiffany Street.
• Congratulations to all of our award winners. Welcome our three
new Chapters. Please share your comments to them on our
Facebook page and Twitter.
• The On-line courses via Course Park approved for reaccreditation
through May of 2016.
• SVN Board excited to explore new opportunities, poised to
share international collaboration and continue to advocate for
our members.
• We welcome new Association Acumen Management and
Association Manager, Leah Grunewald.
• Please stay tuned to the Website for new and exciting updates.
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The Society for Vascular Nursing
April | May | June 2014
PUBLIC POLICY & ADVOCACY
Screening for Peripheral Artery Disease:
Legs For Life
Peripheral artery disease (PAD) affects an estimated 10
million people in the United States aged 40 years and
older (Lin, Olson, Johnson, & Whitlock, 2013; Molher,
2012). Lin et al. (2013) discuss the the underdiagnosis
and undertreatment of PAD. This gap in care is in part,
because most patients either do not have symptoms or have
atypical symptoms. To decrease morbidity and mortality
related to PAD, an increase in awareness will contribute
to prevention and early treatment; screening for PAD is a
critical component for timely management. Screening for
PAD involves a non-invasive procedure which compares the
blood pressure at the ankle with the blood pressure in the
arm and a ratio is obtained- the Ankle-Brachial Index (ABI).
According to the American and International guidelines,
persons 50 years of age or older with a history of diabetes
mellitus or smoking should have an ankle-brachial index
(ABI) to evaluate for PAD ( Lin et al.; Mohler; Vascular
Disease Foundation, 2014). The guidelines are the same for
women and men. PAD is found to be more prevalent in men
than women (Lin et al.; Molher). Treatment of PAD involves
treating the risk factors and improving mobility.
The risk factors for developing PAD align with the risk
factors for heart attack and stroke, namely smoking,
diabetes, hypertension, hypercholesterolemia, obesity and
decreased physical activity (Lin et al.; Molher; Vascular
Disease Foundation). The classic symptom of PAD is
claudication which is discomfort in the affected leg with
activity which resolves almost immediately with rest. The
severity of PAD is dependent on how extensive the disease
is, as well as any pre-existing health factors (Molher,
Vascular Disease Foundation). With critical limb ischemia
(CLI), rest pain is present; revascularization is attempted for
limb salvage and if unsuccessful or if there are no treatment
options, then amputation may be required (Vascular Disease
Foundation).
The Society of Interventional Radiology (SIR) founded a
program, Legs for Life, in 1997 dedicated to improving the
cardiovascular health of the community. “Legs for Life is a
public education/community wellness program that screens
people who may be at risk for PAD and helps them take
the next step in resolving the pain they are experiencing”
(Society of International Radiology, 2013). The mission
of the program is to improve the cardiovascular health
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of people in our communities. The primary goals of the
program are to “educate primary care physicians and the
medical community to identify patients at risk and to
strengthen collaborative relationships among health care
providers” (Society of International Radiology).
The SIR has declared September as Legs For Life National
Screening Month for PAD Leg Pain. The Society of
International Radiology is one of several professional groups
lobbying for screening for PAD.
Sherida Ingram RN MScN(c)
CNS Vascular Surgery
SVN Public Policy & Advocacy Committee Member
References
Lin, J. S., Olson, C. M., Johnson, E. S., & Whitlock, E. P. (2013). The
Ankle-Brachial Index for Peripheral Artery Disease Screening and
Cardiovascular Disease Prediction Among Asymptomatic Adults:
A Systematic Evidence Review for the U.S. Preventative Services
Task Force. Annals of Internal Medicine (159), 333-341.
Mohler, E. R. (2012). Screening for Peripheral Artery Disease.
Circulation, (126), 111-112.
Society of International Radiology (2013). Legs for Life. National
Screening For Vascular Disease. Retrieved from www.legsforlife.org
U.S. Preventive Services Task Force (2013). Screening for
Peripheral Artery Disease and Cardiovascular Disease Risk
Assessment with Ankle Brachial Index in Adults. Task Force
Final Recommendation, September 2013. Retrieved from
uspreventiveservicestaskforce.org
Vascular Disease Foundation (2014). PAD Coalition. Peripheral
Artery Disease. Retrieved from www.vasculardisease.org
Do you “Like” the SVN?
Are you a “Fan”?
We are hoping to increase our Social Medial visibility and need your help.
As more people “Like” us on Facebook, our web presence will increase and
SVN will be ranked the #1 resource for Vascular Nursing.
Please go to the SVN home page and click on the Facebook Icon. We have a
NEW Facebook Page. If you are currently a fan of the old page please become a fan
of the new page. (Due to cyberspace issues beyond our control the old page will be
deactivated soon)

RESEARCH CORNER
Conflicting Research Findings:
What Should One Believe?
www.svnnet.org
Oxygen was considered in 2004 to be one of the baseline
therapies recommended by the American Heart Association
guideline in the care of the patient experiencing ST-segment
elevation myocardial infarction (STEMI). During acute coronary
occlusion, myocardial perfusion is absent; therefore it is not
oxygenated. Theoretically, delivering supplemental oxygen
(O2) via the blood will increase oxygenation to the endangered
myocardium until a more definitive reperfusion therapy (such
as a percutaneous coronary intervention or fibrinolysis) is
available. This is a standard practice by pre-hospital providers and
Emergency Departments. Interestingly, O2 is not mentioned in
the 2013 AHA STEMI guideline.1 The question is: why?
At face value, the above statements make sense. In reality, there
is research that differs regarding the effects of supplemental O2
to the heart. Several studies have implicated that O2 (especially
delivering high-flows/high FiO2 concentrations) may actually cause
harm to the myocardium. The harm is through a paradoxical
effect of reducing coronary blood flow, increasing coronary artery
resistance, reducing stroke volume and decreasing cardiac output.
2, 3 High-flow/high FiO2 oxygen is speculated to cause hyperoxia,
which has a strong vasoconstrictor stimulus to the coronary
circulation at the microvascular level.4 In the larger arteries,
delivering 100% O2 has been shown in the laboratory setting to
affect vasomotor activity by altering the baroreceptor reflex, thus
increasing vascular resistance.5
Is there really such as risk when administering oxygen? When
examining research & making practice decisions based upon
the findings, remember there is a hierarchical pyramid in
categorizing the strengths of the research based upon the study
type. Considered the strongest evidence, meta-analyses and
systematic reviews are at the top of this pyramid. These two either
synthesize appropriate research results or combine similar studies
together (targeting randomized controlled trials) to examine for
significant findings. Progressing further down the pyramid in
order of strength (strongest to weakest) are randomized, then
un-randomized controlled trials, well designed case-control,
observational and cohort studies, systematic reviews of qualitative
and descriptive studies, single descriptive or qualitative study
and lastly, expert opinion.6 The studies described in the previous
paragraph are examples of small, un-randomized controlled trials.
One should ask, “Are there any stronger types of evidence on
this topic?” The answer is yes. An updated meta-analysis by
Cabello, et.al.7 examined 4 randomized controlled trials with a
total of 430 subjects to determine if routine use of O2 compared
to room air in acute myocardial infarction (MI) improved patient
outcomes. The outcomes measured were pain (through analgesic
administration) and death. Findings were that the evidence for O2
in MI was sparse and of poor quality. The evidence was suggestive
of harm (higher mortality in the O2 group), but findings were not
statistically significant. There was no difference in analgesic use.
The conclusion was that more research is needed.
In summary, oxygen is a drug and like all drugs there can be
adverse side effects with administration. When a practitioner
orders a medication, the lowest effective dose that results in
patient improvement is prescribed. The same holds true with
administering O2. Do not change practice based upon isolated
research studies, look for those at the top of the evidence pyramid:
the meta-analyses and systematic reviews as a guide in making
these decisions. In the case of O2 administration in an acute
STEMI: further research is indicated. Use of supplemental O2
should be based upon clinical evidence of need, not the diagnosis.
Kathleen Rich, PhD, RN, CCNS, CCRN-CSC, CNN
Cardiovascular Clinical Specialist
IU Health La Porte Hospital
References
O’Gara, P., Kushner, F., Ascheim, D., et.al. 2013 ACCF/AHA Guideline
for the management of st-elevation myocardial infarction. Circulation.
2013; 127(4): e362-e425. Available at: http://circ.ahajournals.org/
content/127/4/e362.full.pdf+html. Accessed 5-21-14.
McNulty, P., King, N., Scott, S., et.al. Effects of supplemental oxygen
administration on coronary blood flow in patients undergoing cardiac
catheterization. Am J Physiol Heart Circ Physiol. 2005; 288: H1057-1062.
Rousseau, A., Bak, Z., Janerot-Sjoberg, B., Sjoberg, F. Acute hyperoxaemiainduced
effects on regional blood flow, oxygen consumption and central
circulation in man. Acta Physiol Scand. 2005; 183(3): 231-240.
Farquhar, H., Weatherall, M., Wijesinghe, M., et.al. Systematic review of
studies of the effect of hyperoxia on coronary blood flow. Am Heart J.
2009; 158: 371-377.
Crawford, P., Good, P., Guitierrez, E., et.al. Effects of supplemental oxygen
on forearm vasodilation in humans. J Appl Physiol. 1997; 82: 1601-1606.
Melnyk, B., Fineout-Overholt, E. Evidence-based practice in nursing and
healthcare. 2011. (2nd Ed). Philadelphia: Wolters Kluwer/Lippincott
Williams & Wilkins. pp.12-14.
Cabello, J., Burls, A., Emparanza, J., Bayliss, S., Quinn, T. Oxygen therapy
for acute myocardial infarction. Cochrane Database of Systematic
Reviews 2013, Issue 8. Art. No.: CD007160. DOI: 10.1002/14651858.
CD007160.pub.3.
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The Society for Vascular Nursing
April | May | June 2014
RESEARCH CORNER
Articles of interest from evidence based practice. Because we are all too busy to read everything, some of the articles may
be of interest to vascular nurses. They are evidence based articles. Some are systematic reviews and/or meta analysis and
others are well conducted clinical trials or long term studies
Carlson DJ, Dieberg G, Hess NC,
et al. Isometric exercise training
for blood pressure management:
a systematic review and metaanalysis.
Mayo Clin Proc. 2014
Mar;89(3):327-34.
Chamberlain C, O`Mara-Eves
A, Oliver S, et al. Psychosocial
interventions for supporting
women to stop smoking in
pregnancy. Cochrane Database Syst
Rev. 2013 Oct 23;10:CD001055
Cicolini G, Simonetti V, Comparcini
D, et al. Efficacy of a nurse-led
email reminder program for
cardiovascular prevention risk
reduction in hypertensive patients:
A randomized controlled trial. Int
J Nurs Stud. 2013 Oct 25. pii: S0020-
7489(13)00302-7
Ennis H, Anderson ME, Wilkinson
J, et al. Calcium channel
blockers for primary Raynaud`s
phenomenon. Cochrane Database
Syst Rev. 2014 Jan 30;1:CD002069.
Gellis ZD, Kenaley BL, Have TT.
Integrated Telehealth Care for
Chronic Illness and Depression in
Geriatric Home Care Patients: The
Integrated Telehealth Education
and Activation of Mood (I-TEAM)
Study. J Am Geriatr Soc. 2014 Mar 21.
Hughes JR, Stead LF, Hartmann-
Boyce J, et al. Antidepressants
for smoking cessation. Cochrane
Database Syst Rev. 2014 Jan
8;1:CD000031.
Kavousi M, Leening MJ, Nanchen D,
et al. Comparison of Application of
the ACC/AHA Guidelines, Adult
Treatment Panel III Guidelines, and
European Society of Cardiology
Guidelines for Cardiovascular
Disease Prevention in a European
Cohort. JAMA. 2014 Mar 29.
Likis FE, Andrews JC, Fonnesbeck
CJ, et al. Smoking Cessation
Interventions in Pregnancy
and Postpartum Care. Evidence
Report/Technology Assessment
No.214. AHRQ Comparative
Effectiveness Review. Rockville
(MD): Agency for Healthcare
Research and Quality (US); 2014
Feb. Report No.: 14-E001-EF.
Liu JJ, Wabnitz C, Davidson E, et al.
Smoking cessation interventions for
ethnic minority groups-A systematic
review of adapted interventions.
Prev Med. 2013 Sep 27
Pannucci CJ, Laird S, Dimick JB,
et al. A Validated Risk Model to
Predict 90-Day VTE Events in
Postsurgical Patients. Chest. 2014
Mar 1;145(3):567-73.
Rees K, Dyakova M, Wilson N, et
al. Dietary advice for reducing
cardiovascular risk. Cochrane
Database Syst Rev. 2013 Dec
6;12:CD002128.
Sun Y, Chen D, Xu Z, et al. Deep
Venous Thrombosis After Knee
Arthroscopy: A Systematic Review
and Meta-Analysis. Arthroscopy.
2014 Mar;30(3):406-412
Taylor-Piliae RE, Hoke TM,
Hepworth JT, et al. Effect of Tai Chi
on Physical Function, Fall Rates
and Quality of Life Among Older
Stroke Survivors. Arch Phys Med
Rehabil. 2014 Jan 17
Thomsen T, Villebro N, Moller AM.
Interventions for preoperative
smoking cessation. Cochrane
Database Syst Rev. 2014 Mar
27;3:CD002294.
White AR, Rampes H, Liu JP,
et al. Acupuncture and related
interventions for smoking
cessation. Cochrane Database Syst
Rev. 2014 Jan 23;1:CD000009.
Janice D. Nunnelee PhD RN
Practice and Research Committee
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www.svnnet.org
2014 SVN AWARD RECIPIENTS
On behalf of the Society Promotion & Member Recognition
Committee and the Board of Directors, the SVN would like to
congratulation the following individuals:
Convention Travel Scholarship:
PRESENTER AWARDS
We would like to thank Keith Wali-Ware and Osborn Medical
for their continued support of these awards.
Best Poster Presenter:
Recipient: Olga Nilsson for
her poster on “Delivering
Information to Patients with
AAA: Lessons Learned and
Thoughts for the Future”
Lf-Rt: Vickie Beach, Pam Mahaffey, Patty Flanagan, Vickie Nimmer
Recipients: Pamela Mahaffey and Patty Flanagan
Established to provide financial assistance to an SVN member
to attend the annual convention.
Clinical Excellence in
Vascular Nursing Award:
Recipient: Melissa Swallie
Established to recognize a Registered Nurse for outstanding
clinical skill and direct patient care delivery.
Distinguished Service Award:
Recipient: Diane Treat-
Jacobson. Established to
recognize an SVN member
for outstanding leadership,
participation, and contributions
toward achieving the goal of SVN.
Chapter of the Year Award:
Recipient: Northeast (New
York) Chapter (Dawn Paty
accepting award)
Established to honor the chapter
that best promotes the goals of
the SVN through their member
relationships, community
activities and promotion of
community health issues.
Best First Time Presenter:
Recipient: Chris Owen
for her presentation on
“Learning to Love Lysis”
Best Overall Presenter:
Recipient: Pam Mahaffey
for her presentation on
“EBP and Smoking Cessation
for Vascular Patients”
Judith Troyer-Caudle Award:
Recipient: Patty Flanagan
for her presentation on
“Differentiating Lower
Extremity Ulcers”
This award is given in memory
of a former SVN member for
the best presentation on Wound
Care or Research.
We congratulate all of the presenters and encourage
members to answer the Call for Abstracts for the
33rd Annual Convention scheduled for April 29 - May 1, 2015
at Ballys Resort in Las Vegas, NV!!
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The Society for Vascular Nursing
April | May | June 2014
2014 SVN AWARD
RECIPIENTS
Jeanne Doyle Award Winner
SVN Announces
New Management
Partner, Association
Acumen, LLC
Cindy Lewis MSN, RN, ACNS-BC has contributed to our
nursing profession for 37 years. Cindy is a Perioperative
Clinical Nurse Specialist for Aurora Health Care St. Luke’s
Medical Center in Milwaukee, Wisconsin. Cindy has been
an active member of SVN since the mid 80’s; serving on
our practice and research committees, SVN Board of
Directors in the 90’s and Past-President in 1996-97. Cindy
served on the certification and item writing taskforce to
coordinate and develop our first certification exam with
Professional Exam Services (PES). Cindy also served on
the Editorial Board for our Journal of Vascular Nursing for
10 years before her appointment as the Editor in 2000.
The SVN would like to congratulate
and welcome three new Society Chapters:
Central Ohio, Coastal Carolina
& Mid-Atlantic
Menomonee Falls, WI – The Society for Vascular
Nursing is pleased to announce that Association
Acumen, LLC has been selected as its new partner to
provide association management services. Acumen
assumed management of SVN on May 1, 2014. “We
are very excited to make the transition to the Acumen
team. We are in good hands and envision a prosperous
future as we move our organization forward to be all
that it can be!” Debra Kohlman-Trigoboff, ACNP,
CVN, President, said. “SVN was fortunate to find a top
quality accredited association management company
like Association Acumen after much deliberation
during the search process. Acumen possesses the
enthusiasm, skills and infrastructure to help advance
SVN’s mission,” she said.
“SVN is a dynamic, multi-faceted organization with
excellent educational and outreach programs aimed
at its membership, patients and the public,” Gail Bast,
Association Acumen’s President, said. “Its collaborative
efforts with other organizations demonstrate the
strong commitment of its leaders to provide the
best in patient care and nursing education. This new
partnership is a wonderful fit for us and we look
forward to working together with SVN to nurture its
organizational growth.” Bast added.
Central Ohio
Coastal Carolina
Association Acumen has just moved to a larger suite of
offices, located in Menomonee Falls, WI and will serve
as SVN’s new headquarters. SVN’s new address is:
N83 W13410 Leon Road, Menomonee Falls, WI, 53051
All members will be receiving an email in the coming
weeks with more detailed contact information.
Please help us welcome Association Acumen!
Mid-Atlantic
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