The "HEALTH" model- part 1 : treatment program guidelines for complex PTSD

This paper outlines the development and piloting of the “HEALTH” model for treatment of Complex PTSD in clients who have experienced multiple traumas across childhood and adulthood - particularly child sexual abuse and sexual assault in adulthood. As a guideline-based treatment model, HEALTH outlines six stages of intervention: (1) having a supportive therapist; (2) ensuring personal safety; (3) assisting with daily functioning; (4) self-regulation - learning to manage core PTSD symptoms; (5) treating Complex PTSD symptoms; and, finally, (6) having patience and persistence to enable “ego strengthening”. Using a case study approach, we provide both qualitative and quantitative assessment data for the individuals in the study, all of whom displayed numerous pre-treatment symptoms of Complex PTSD. Such programs are different to standard PTSD treatment programs that focus predominantly on core PTSD symptoms of re-experiencing, avoidance and arousal. The results of this study provided support for the use of guideline-based treatment programs that cater specifically for the needs of those who have suffered long-term/multiple trauma experiences by targeting Complex PTSD symptoms.

'I don't really care about what someone else's studied' : Drinking guidelines and the government of pleasure

This paper examines data from a Drinkwise Australia funded research project that investigated the cultural drivers of drinking in 14-24 year-old Australians. The research included two studies. In one we conducted interviews and focus groups with administrators and young people in a range of sporting clubs and in the other we interviewed 60 young people aged 20-24 about their drinking biographies. The drinking biographies study is the focus of this paper. At the time of interviewing the draft guidelines on low-risk drinking were released by the NH&MRC and we asked our participants what they knew about them and if they would affect their drinking patterns. The responses to these questions are examined in light of O’Malley and Valverde’s claim that pleasure is silenced and/or deployed strategically in liberal governance discourses about drugs and alcohol (2004: 25). This is despite the fact that research indicates that pleasure is an important motivation for drinking.

Teaching EBP : part 2 – making sense of clinical practice guidelines

Previously, we indicated that we wanted to address the dialogue pertaining to education and teaching approaches to increase the use of specific types of evidence that exist to guide and inform practice, and began this by focusing on Clinical Practice Guidelines (CPG). This column builds on that knowledge to highlight how educators can use CPGs in practice and change situations whilst also raising awareness of the limitations of these tools in terms of their impact on practice.

The money laundering risk posed by low-risk financial products in South Africa : findings and guidelines

Purpose – The purpose of this paper is to investigate the level and nature of criminal abuse of financial products that are classified as posing a low anti-money laundering/combating of financing of terrorists (AML/CFT) risk in South Africa to determine the effectiveness of the simplified due diligence measures that apply to these products.

Design/methodology/approach – The paper presents empirical research on the views of bank officials and law enforcement officials regarding the criminal abuse of South African financial products that are subject to simplified customer due diligence controls.

Findings – South Africa's AML/CFT laws allow certain deposit-taking institutions and money remitters to implement simplified customer due diligence measures in relation to specific low-risk products that are mainly designed to allow previously unbanked persons to access financial services. The paper finds that the products have been abused by criminals but that the incidence of such abuse and the amounts involved are low. The paper investigates possible weaknesses in the current system that allow limited criminal abuse to occur. It concludes with a number of guidelines that emerge from the study and are of value to regulators that wish to implement a similar system.

Originality/value – The South African AML/CFT scheme in relation to low-risk products is of interest to many international regulators that are grappling with the interplay between effective AML/CFT controls and the impact of strict controls on the ability of socially and economically excluded persons to access appropriate financial services. This paper provides evidence that appropriately designed controls can facilitate financial inclusion while limiting the risk of criminal abuse.

Management of lipids in rural Australia : are the guidelines being followed?

Background: Hypercholesterolaemia is ranked seventh among the major factors contributing to the overall burden of disease in Australia. Guidelines for evidence-based lipid management were released in 2001 and updated in 2005, however little population level data has been published on the current gap between recommended management and actual practice in Australia.

Method: Three population stratified surveys were undertaken in the Greater Green Triangle. Three thousand three hundred and twenty adults aged 25–74 years were randomly selected, stratified by gender and 10-year age groups. Anthropometric, clinical and self-administered questionnaire data relating to cardiovascular disease risk were collected in accordance with the WHO MONICA protocol. Blood samples were collected for lipid profile analysis. Participants were divided into four groups—Group 1: treated, high CVD risk; Group 2: treated, primary prevention; Group 3: untreated, high CVD risk; Group 4: untreated, low CVD risk. For each of these groups we compared cholesterol, HDL cholesterol, triglyceride and LDL cholesterol with targets recommended by the National Heart Foundation's 2005 guidelines.

Results: All lipids were at target in 39.4% of the study population with marked differences between groups: Group 1, 11.2%; Group 2, 38.5%; Group 3, 1.8%; Group 4, 47.6%.

Only 50.8% of the untreated high CVD risk group reported having blood cholesterol measured within the last 12 months.

Conclusion: Current rates of detection and treatment practices in rural Australia are suboptimal. Although one-third of the study population age 25–74 years are at sufficiently high risk to warrant consideration of lipid lowering medication only just over half of these were on treatment at the time of the study. These results suggest that an intensive implementation plan is required for the management of hyperlipidaemia in rural Australia.

A practical strategy for discovering, evaluating and exploiting entrepreneurial opportunity : research based action guidelines

It has been argued that entrepreneurship researchers do not place sufficient emphasis on making their research findings relevant to entrepreneurs and their advisors. The paper utilises five general principles introduced by Hindle, Anderson and Gibson (2004) to convert a complex range of entrepreneurship research findings into useful action guidelines for practicing entrepreneurs. The existing research-based knowledge concerning opportunity assessment is distilled into a diagrammatic framework. This framework and a sequence of ten, plain-English questions, provides entrepreneurs and SME operators with a strategic tool (nick-named the '4/10 strategy') for discovering, evaluating and exploiting entrepreneurial opportunities.

A practical strategy for discovering, evaluating and exploiting entrepreneurial opportunity : research based action guidelines

It has been argued that entrepreneurship researchers do not place sufficient emphasis on making their research findings relevant to entrepreneurs and their advisors. The paper utilises five general principles introduced by Hindle, Anderson and Gibson (2004) to convert a complex range of entrepreneurship research findings into useful action guidelines for practicing entrepreneurs. The existing research-based knowledge concerning opportunity assessment is distilled into a diagrammatic framework. This framework and a sequence of ten, plain-English questions, provides entrepreneurs and SME operators with a strategic tool (nick-named the "4/10 strategy") for discovering, evaluating and exploiting entrepreneurial opportunities.

From what we know to how we use it : five principles for turning entrepreneurship research and practitioner action guidelines

This and the companion paper that follows owe their existence to a paper presented by Kevin Hindle at the AGSE Regional Entrepreneurship and Innovation Research Exchange in February 2004. In his paper, Hindle (2004) argued passionately that entrepreneurship researchers must ensure that the best of their hardwon wisdom does not find its beginning motivation and final resting place in the pages of arcane journals that practitioners never read. He suggested that if every entrepreneurship researcher committed, say once every two years, to write a "how to" article it would significantly enhance the status of the research community in the eyes of practising entrepreneurs and those who provide support and services to them.

The argument was well-received, particularly by two people in the audience, Robert Anderson, the managing editor of the Journal of Small Business and Entrepreneurship, the journal of the Canadian Council for Small Business and Entrepreneurship/Conseil Canadien des PME et de l'entrepreneuriat (CCSBE/ CCPME), and Brian Gibson, the editor of Small Enterprise Research, the journal of the Small Enterprise Association of Australia and New Zealand (SEAANZ). For both editors, Hindle's argument was a familiar one. The membership of CCSBE/CCPME and SEAANZ consists of academic researchers, educators, government employees in both policy and program areas, and those offering support and services to entrepreneurs and the managers of small enterprises. In both organizations, there is a general consensus that the needs of "academics" are well met, but not so the needs of the non-academic constituents.

Turning entrepreneurship research findings into practical action guidelines : the example of opportunity assessment

It is argued that entrepreneurship researchers do not place sufficient emphasis on making their research findings relevant to entrepreneurs and their advisors. The paper provides a Specific example demonstrating five general principles that can be used to turn a complex range of entrepreneurship research findings into useful action guidelines for practising entrepreneurs. The existing research-based knowledge concerning opportunity assessment is distilled into a diagrammatic framework. This framework and a sequence of ten, plain-English questions, provides entrepreneurs and SME operators with a tool for discovering, evaluating and exploiting entrepreneurial opportunities.

Developing Clinical Practice Guidelines for violence risk assessment in mental health triage : a systematic review

Background : On a global level, there is a growing trend to utilise mental health triage service systems as a way of providing consumers with access to 24 hour mental health care. At present, violence risk assessment in mental health triage lacks a suitable evidence base and clear guidelines. This presentation provides an overview of a Clinical Practice Guideline for violence risk assessment at point of entry to health services.
Aims : The objective of this study was to develop Clinical Practice Guidelines for violence risk assessment in mental health triage, and to pilot test the Clinical Guidelines in two major hospitals in Melbourne.
Method : The method employed in the study was a systematic review, as per the Australian National Health and Medical Research Council’s methodology for developing Clinical Guidelines. Research was conducted at the Royal Melbourne Hospital and the Alfred Hospital to establish the utility of the Guideline in practice.
Results : The systematic review established the highest level of evidence for violence risk assessment. Clinical Practice Guidelines for mental health triage were developed from these findings.
Conclusions : Evidence based Clinical Guidelines maximise the potential for creating safer outcomes for consumers, families/carers, and health care workers.

Dyslipidaemia in rural Australia : prevalence, awareness, and adherence to treatment guidelines in the Greater Green Triangle risk factor study

Objectives: To determine population lipid profiles, awareness of hyperlipidaemia and adherence to Australian lipid management guidelines.
Design and setting: Population survey in rural south-eastern Australia, 2004–2006.
Participants: Stratified random sample from the electoral roll. Data from 1274 participants (40%) aged 25–74 years were analysed.
Main outcome measures: Population mean total, low-density lipoprotein and high-density lipoprotein cholesterol (TC, LDL-C and HDL-C) and triglyceride (TG) concentrations, prevalence of dyslipidaemia, and treatment according to 2001 and 2005 Australian guideline target levels.
Results: Population-adjusted mean TC, TG, LDL-C and HDL-C concentrations were 5.38 mmol/L (95% CI, 5.30–5.45), 1.50 mmol/L (95% CI, 1.43–1.56), 3.23 mmol/L (95% CI, 3.16–3.30) and 1.46 mmol/L (95% CI, 1.44–1.49), respectively. Prevalence of hypercholesterolaemia (TC > 5.5 mmol/L or on treatment) was 48%. Lipid-lowering medication use was reported by 12%. Seventy-seven of 183 participants with established cardiovascular disease (CVD) or diabetes were untreated, and of the 106 treated, 59% reached the target LDL-C. Of those without CVD or diabetes already treated, 38% reached target LDL-C, and 397 participants at high absolute risk did not receive primary prevention. Ninety-five per cent of treated individuals with CVD or diabetes and 86% of others treated had cholesterol measured in the previous year. Sixty-nine per cent of individuals at low risk aged over 45 years had their cholesterol measured within the previous 5 years.
Conclusions: A comprehensive national strategy for lowering mean population cholesterol is required, as is better implementation of absolute risk management guidelines — particularly in rural populations.