Computed tomographic angiography in coronary artery disease.

Coronary computed tomographic angiography (CCTA) is becoming the first-line investigation for establishing the presence of coronary artery disease and, with fractional flow reserve (FFR <sub>CT</sub> ), its haemodynamic significance. In patients without significant epicardial obstruction, its role is either to rule out atherosclerosis or to detect subclinical plaque that should be monitored for plaque progression/regression following prevention therapy and provide risk classification. Ischaemic non-obstructive coronary arteries are also expected to be assessed by non-invasive imaging, including CCTA. In patients with significant epicardial obstruction, CCTA can assist in planning revascularisation by determining the disease complexity, vessel size, lesion length and tissue composition of the atherosclerotic plaque, as well as the best fluoroscopic viewing angle; it may also help in selecting adjunctive percutaneous devices (e.g., rotational atherectomy) and in determining the best landing zone for stents or bypass grafts

Recovery in Australia: marshalling strengths and living values

Clear national policy now exists in Australia regarding recovery. Personal accounts of recovery often include reference to meaning, purpose and issues regarding identity. Personal strengths and expression of personal values are closely related to the development of meaning, purpose and a stable sense of self, resulting in a sense of wellbeing. These constructs fall under the research umbrella of positive psychology. By combining aspects of the recovery policy with evidence from the science of positive psychology there are increasing attempts to include strengths and values work with mental health staff and consumers. This paper describes how the collaborative recovery model (CRM) with its emphasis on strengths and values, draws on the emerging evidence based on positive psychology. CRM has now been implemented in non-government community services in each mainland state of Australia. Implementation issues of the CRM as one example of recoveryorientated service provision are then described. Potential barriers and facilitators of growth-based approaches such as CRM moving to government clinical services is then discussed. Recent national reviews of recovery measurement instruments are also summarized. Specifi c recommendations are then provided to further national implementation of recovery-orientated service provision in Australia