The updated NICE guidelines: Cardiac CT as 1st line test for coronary artery disease

Purpose of Review Cost-effective care pathways are integral to delivering sustainable healthcare programmes. Due to the overestimation of coronary artery disease using traditional risk tables, non-invasive testing has been utilised to improve risk stratification and initiate appropriate management to reduce the dependence on invasive investigations. In line with recent technological improvements, cardiac CT is a modality that offers a detailed anatomical assessment of coronary artery disease comparable to invasive coronary angiography. Recent Findings The recent publication of the National Institute for Health and Care Excellences (NICE) Clinical Guideline 95 update assesses the performance and cost utility of different non-invasive imaging strategies in patients presenting with suspected anginal chest pain. The low cost and high sensitivity of cardiac CT makes it the non-invasive test of choice in the evaluation of stable angina. This has now been ratified in national guidelines with NICE recommending cardiac CT as the first-line investigation for all patients presenting with chest pain due to suspected coronary artery disease. Additionally, randomised controlled trials have demonstrated that cardiac CT improves diagnostic certainty when incorporated into chest pain pathways. Summary NICE recommend cardiac CT as the first-line test for the evaluation of stable coronary artery disease in chest pain pathways

Moon bears [Image no. 12527]

Artist statement: “How cute are these moon bears? Also known as Asian black bears, moon bear homes are tiny cages for one. They can easily learn to do cool tricks and enjoy having time out to perform! Large communities of moon bears live on farms. Their bile has special healing properties that will be passed on to you! For a bargain price, you can have a moon bear of your very own!".Copyright of the artist. Photographer: Chantal Labbé, SCA Images Online.For more information about this item, browse to http://hdl.handle.net/102.100.100/424

Moon bears [Image no. 12489]

Artist statement: “How cute are these moon bears? Also known as Asian black bears, moon bear homes are tiny cages for one. They can easily learn to do cool tricks and enjoy having time out to perform! Large communities of moon bears live on farms. Their bile has special healing properties that will be passed on to you! For a bargain price, you can have a moon bear of your very own!".Copyright of the artist. Photographer: Chantal Labbé, SCA Images Online.For more information about this item, browse to http://hdl.handle.net/102.100.100/424

Exhibition view: Souvenirs from a journey to the south of China [Image no. 15522]

Copyright of the artist. Photographer: Chantal Labbé, SCA Images Online.For more information about this item, browse to http://hdl.handle.net/102.100.100/538

Exhibition view: Souvenirs from a journey to the south of China (detail) [Image no. 15525]

Copyright of the artist. Photographer: Chantal Labbé, SCA Images Online.For more information about this item, browse to http://hdl.handle.net/102.100.100/538

New year in Yunnan [Image no. 14696]

For more information about this item, browse to http://hdl.handle.net/102.100.100/538

Exhibition view: Souvenirs from a journey to the south of China (detail) [Image no. 15524]

Copyright of the artist. Photographer: Chantal Labbé, SCA Images Online.For more information about this item, browse to http://hdl.handle.net/102.100.100/538

Untitled [Image no. 8390]

Don't I know those dudes from somewhere?.For more information about this item, browse to http://hdl.handle.net/102.100.100/352

Do Spirituality, Resilience and Hope Mediate Outcomes among Family Caregivers After Traumatic Brain Injury or Spinal Cord Injury? A Structural Equation Modelling Approach

BACKGROUND: A deficits approach to understanding psychological adjustment in family caregivers of individuals with a neurological disability is extensive, but further research in the field of positive psychology (spirituality, resilience, hope) may provide a potential avenue for broadening knowledge of the family caregiver experience after traumatic brain injury (TBI) or spinal cord injury (SCI). OBJECTIVE: To test a proposed model of spirituality among family caregivers of individuals with TBI or SCI, using structural equation modelling (SEM). METHODS: A cross-sectional design was employed to survey ninety-nine family participants (TBI = 76, SCI = 23) from six rehabilitation units from NSW and Queensland. Assessments comprised Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale-Expanded, Connor –Davidson Resilience Scale, Herth Hope Index, and three measures of psychological adjustment including Caregiver Burden Scale, Positive and Negative Affect Scale, and Depression Anxiety Stress Scale. RESULTS: SEM showed the proposed model was a good fit. The main findings indicated spirituality had a direct negative link with burden. Spirituality had a direct positive association with hope which, in succession, had a positive link with resilience. Spirituality influenced positive affect indirectly, being mediated by resilience. Positive affect, in turn, had a negative association with depression in caregivers. CONCLUSIONS: This study contributes to better targeting strength-based family interventions