Cone-beam CT acquisition during transradial TACE made easy; use of the swivel arm board.

OBJECTIVE: Transradial access for peripheral intervention often requires certain modification from its coronary counterparts. One of the challenges during transradial transarterial chemoembolization (TACE) is the need for the access arm to be repositioned during cone-beam CT (CBCT) acquisition to allow for C-arm rotation. We recently introduced a swivel arm board to allow seamless repositioning of the access arm during and after CBCT acquisition. The purpose of this study is to detail the technique and feasibility of this useful adjunct to transradial TACE. METHODS: We performed a retrospective study of consecutive cases of transradial TACE between November 2015 and March 2016, which represented the period where we introduced the swivel arm board to our transradial procedure. A total of 20 transradial TACE using the swivel arm board was performed in 17 patients. There were 13 males and 4 females. The mean age was 69.5 years old (range 48-82 years). Indications for TACE included hepatocellular carcinoma (n = 14) and metastatic liver disease (n = 3). RESULTS: Transradial TACE was successful in all cases. A total of 40 successful arm repositioning using the swivel arm board for CBCT acquisitions were performed (100% success rate). There was no catheter or sheath dislodgement associated with the arm movements. No change in the microcatheter tip position was detected as a result of the arm repositioning. Hemostasis was successfully achieved in all the patients. There was no access related complication. CONCLUSION: The swivel arm board is a useful adjunct to enable CBCT acquisition during transradial TACE. Advances in knowledge: Transradial TACE is a novel technique, and adaptation to allow for CBCT acquisition is currently challenging. This manuscript illustrates how to overcome the positioning difficulties with the use of the swivel arm board.

Toward Mentoring in Palliative Social Work: A Narrative Review of Mentoring Programs in Social Work.

BACKGROUND: Mentoring by an experienced practitioner enhances professional well-being, promotes resilience, and provides a means of addressing poor job satisfaction and high burnout rates among medical social workers. This is a crucial source of support for social workers working in fields with high risk of compassion fatigue and burnout like palliative care. Implementing such a program, however, is hindered by differences in understanding and application of mentoring practice. AIM: This narrative review of mentoring practice in social work seeks to identify key elements and common approaches within successful mentoring programs in social work that could be adapted to guide the design of new mentoring programs in medical social work. Methodology and Data Sources: A literature search of mentoring programs in social work between January 1, 2000, and December 31, 2015, using Pubmed, CINAHL, OVID, ERIC, Scopus, Cochrane and ScienceDirect databases, involving a senior experienced mentor and undergraduate and/or junior postgraduates, was carried out. A total of 1302 abstracts were retrieved, 22 full-text articles were analyzed, and 8 articles were included. RESULTS: Thematic analysis of the included articles revealed 7 themes pertaining to the mentoring process, outcomes and barriers, and the characteristics of mentoring relationships, mentors, mentees, and host organizations. DISCUSSION AND CONCLUSION: Common themes in prevailing mentoring practices help identify key elements for the design of an effective mentoring program in medical social work. We conclude with a discussion of the implications of these findings upon clinical practice in palliative care and on sustaining such a program.

Sleep time and pattern of adult individuals in primary care in an Asian urbanized community: A cross-sectional study.

Sleep norms vary between individuals, being affected by personal, communal, and socioeconomic factors. Individuals with sleep time which deviate from the population norm are at risks of adverse mental, cardiovascular, and metabolic health. Sleep-related issues are common agenda for consultation in primary care. This study aimed to determine the sleep time, pattern, and behavior of multiethnic Asian individuals who attended public primary care clinics in an urban metropolitan city-state.Standardized questionnaires were assistant-administered to adult Asian individuals who visited 2 local public primary care clinics in north-eastern and southern regions of Singapore. The questionnaire included questions on demographic characteristics, self-reported sleep time, patterns, and behavior and those originated from the American National Sleep Foundation Sleep Diary. The data were collated, audited, rectified, and anonymized before being analyzed by the biostatistician. Individuals with 7 h sleep time or longer were deemed getting adequate sleep. Chi-squared or Fisher exact test was used to test the association between the demographic and behavioral variables and sleep time. Next, regression analysis was performed to identify key factors associated with their sleep time.A total of 350 individuals were recruited, with higher proportion of those of Chinese ethnicity reporting adequate sleep. Almost half (48.1%) of those who slept <7 h on weekdays tended to sleep ≥7 h on weekends. More individuals who reported no difficulty falling asleep, had regular sleep hours and awakening time, tended to sleep adequately. Those who slept with children, studied, read leisurely, used computer or laptops in their bedrooms, drank caffeinated beverages or smoked had inadequate sleep. Those who perceived sufficient sleep and considered 8 h as adequate sleep time had weekday and weekend sleep adequacy.Sleep time varied according to ethnicity, employment status, personal behavior, and perception of sleep sufficiency. Awareness of sleep time and pattern allows the local physicians to contextualize the discussion of sleep adequacy with their patients during consultation, which is a prerequisite to resolve their sleep-related issues.