Disease In Queensland Research Articles

Outcomes of Cardiac Transplantation in Adults With Congenital Heart Disease in Queensland from 2019–2023

Outcomes of Cardiac Transplantation in Adults With Congenital Heart Disease in Queensland from 2019–2023

The hospitalisation risk of chronic circulatory and respiratory diseases associated with coal mining in the general population in Queensland, Australia

Queensland is the main coal mining state in Australia where populations in coal mining areas have been historically exposed to coal mining emissions. Although a higher risk of chronic circulatory and respiratory diseases has been associated with coal mining globally, few studies have investigated these associations in the Queensland general population. This study estimates the association of coal production with hospitalisations for chronic circulatory and respiratory diseases in Queensland considering spatial and temporal variations during 1997–2014.An ecological analysis used a Bayesian hierarchical spatiotemporal model to estimate the association of coal production with standardised rates of each, chronic circulatory and respiratory diseases, adjusting for sociodemographic factors and considering the spatial structure of Queensland's statistical areas (SA2) in the 18-year period. Two specifications; with and without a space-time interaction effect were compared using the integrated nested Laplace approximation -INLA approach. The posterior mean of the best fit model was used to map the spatial, temporal and spatiotemporal trends of risk.The analysis considered 2,831,121 hospitalisation records. Coal mining was associated with a 4 % (2.4—5.5) higher risk of hospitalisation for chronic respiratory diseases in the model with a space-time interaction effect which had the best fit. An emerging higher risk of either chronic circulatory and respiratory diseases was identified in eastern areas and some coal-mining areas in central and southeast Queensland. There were important disparities in the spatiotemporal trend of risk between coal -and non-coal mining areas for each, chronic circulatory and respiratory diseases.Coal mining is associated with an increased risk of chronic respiratory diseases in the Queensland general population. Bayesian spatiotemporal analyses are robust methods to identify environmental determinants of morbidity in exposed populations. This methodology helps identifying at-risk populations which can be useful to support decision-making in health. Future research is required to investigate the causality links between coal mining and these diseases.

Aspergillus Species Causing Invasive Fungal Disease in Queensland, Australia

BackgroundAspergillus species are important causes of invasive fungal disease, particularly among those with an impaired immune system. Increasing reports have revealed a rising incidence of antifungal drug resistance among Aspergillus spp., particularly among cryptic species. Understanding local antifungal susceptibility patterns is paramount to delivering optimal clinical care.MethodsAspergillus spp. recovered from clinical specimens between 2000 and 2021 from Pathology Queensland were collected. Aspergillus spp. were identified routinely morphologically, and where there was ambiguity or a lack of sporulation, by sequencing of the internal transcribed spacer (ITS) region. All Aspergillus spp. that underwent antifungal susceptibility testing according to the CLSI M38-A3 method and were recorded and included in the study. Amphotericin B, voriconazole, posaconazole, isavuconazole, micafungin, caspofungin, and anidulafungin were tested. Pathology Queensland services all public healthcare facilities in Queensland, Australia.Results236 Aspergillus spp. were identified from clinical specimens during the study period. The most frequent species identified were Aspergillus section Fumigati (n = 119), Aspergillus section Flavi (n = 35), Aspergillus terreus (n = 32) and Aspergillus niger (n = 29). Overall, MIC50/90 values for voriconazole, posaconazole, itraconazole, and isavuconazole were 0.25/1, 0.25/0.5, 0.25/0.5, and 0.5/2 mg/L respectively. Echinocandins demonstrated low MIC values overall with micafungin and anidulafungin both having an MIC50/90 of 0.015/0.03 mg/L. A total of 15 cryptic species were identified; high triazole MIC values were observed with a voriconazole MIC50/90 of 2/8 mg/L. From 2017 to 2021 we observed an increase in incidence of isolates with high voriconazole MIC values. There was no difference in voriconazole MIC values between Aspergillus spp. acquired in North Queensland when compared to Southeast Queensland, Australia.ConclusionIncreasing reports of antifungal resistance among Aspergillus spp. is concerning and warrants further investigation both locally and worldwide. Active surveillance of both the emergence of different Aspergillus spp. and changes in antifungal susceptibility patterns over time is crucial to informing clinicians and treatment guidelines.

Temporal variations of the association between summer season heat exposure and hospitalizations for renal diseases in Queensland, Australia, 1995–2016

To examine the temporal trends of the association between heat exposure and hospitalizations for renal disease in Queensland, Australia, between the summer season of 1 December 1995 and 31 December 2016. A total of 238 427 de-identified hospitalization records for renal disease were collected from Queensland Health. Meteorological data was obtained from the Scientific Information for Land Owners. Summer season means four consecutive months with higher daily mean temperatures. We conducted a time-stratified case-crossover study using conditional quasi-Poisson regression model and applied a time-varying distributed lag non-linear model were used to evaluate the temporal trends of the associations between 1 °C increase in daily mean temperatures (over 0–10 lags) and hospitalizations for renal diseases. We also conducted stratified analyses by sex, age, climate zone, socioeconomic status, and cause-specific renal diseases. Overall, the associations between high temperature and hospitalizations for renal diseases showed a decreasing trend during the summer seasons from 1995 to 2016. However, the heat-related effects in males increased from 3.0% (95% CI: 2.2%, 3.9%) in 1995 to 4.8% (95% CI: 3.9%, 5.6%) in 2016. In the elderly cohort (both sexes), there was a similar increase over time 2.0% (95% CI: 1.0%, 3.0%) in 1995 to 6.3% (95% CI: 5.4%, 7.3%) in 2016. People living in hotter climate zones and those living in relatively socioeconomically disadvantaged areas also showed an increasing trend. In the cause-specific disease analysis, the increasing trend was found in renal failure, with heat-related effects increased from 3.45% (95% CI: 2.31%, 4.60%) in 1995 to 8.19% (95% CI: 7.03%, 9.36%) in 2016. Although the association between temperature and hospitalizations for renal diseases showed a decreasing trend in Queensland’s hot season between 1995 and 2016, the susceptibility to high temperatures is increasing in males, the elderly of both sexes, those living in hotter climate areas, and socioeconomically disadvantaged areas. This increasing trend of susceptibility is a great concern and indicates a strong need for targeted public health promotion campaigns.

Attributable risks of hospitalizations for urologic diseases due to heat exposure in Queensland, Australia, 1995-2016.

BackgroundHeat exposure is a risk factor for urologic diseases. However, there are limited existing studies that have examined the relationship between high temperatures and urologic disease. The aim of this study was to examine the associations between heat exposure and hospitalizations for urologic diseases in Queensland, Australia, during the hot seasons of 1995–2016 and to quantify the attributable risks.MethodsWe obtained 238 427 hospitalized cases with urologic diseases from Queensland Health between 1 December 1995 and 31 December 2016. Meteorological data were collected from the Scientific Information for Land Owners—a publicly accessible database of Australian climate data that provides daily data sets for a range of climate variables. A time-stratified, case-crossover design fitted with the conditional quasi-Poisson regression model was used to estimate the associations between temperature and hospitalizations for urologic diseases at the postcode level during each hot season (December–March). Attributable rates of hospitalizations for urologic disease due to heat exposure were calculated. Stratified analyses were performed by age, sex, climate zone, socio-economic factors and cause-specific urologic diseases.ResultsWe found that a 1°C increase in temperature was associated with a 3.3% [95% confidence interval (CI): 2.9%, 3.7%] increase in hospitalization for the selected urologic diseases during the hot season. Hospitalizations for renal failure showed the strongest increase 5.88% (95% CI: 5.25%, 6.51%) among the specific causes of hospital admissions considered. Males and the elderly (≥60 years old) showed stronger associations with heat exposure than females and younger groups. The sex- and age-specific associations with heat exposure were similar across specific causes of urologic diseases. Overall, nearly one-fifth of hospitalizations for urologic diseases were attributable to heat exposure in Queensland.ConclusionsHeat exposure is associated with increased hospitalizations for urologic disease in Queensland during the hot season. This finding reinforces the pressing need for dedicated public health-promotion campaigns that target susceptible populations, especially for those more predisposed to renal failure. Given that short-term climate projections identify an increase in the frequency, duration and intensity of heatwaves, this public health advisory will be of increasing urgency in coming years.

Spatial and Temporal Patterns of Ross River Virus in Queensland, 2001-2020.

Ross River virus (RRV), the most common human arbovirus infection in Australia, causes significant morbidity and substantial medical costs. About half of Australian cases occur in Queensland. We describe the spatial and temporal patterns of RRV disease in Queensland over the past two decades. RRV notifications, human population data, and weather data from 2001 to 2020 were analysed by the Statistical Area Level 2 (SA2) area. Spatial interpolation or linear extrapolation were used for missing weather values and the estimated population in 2020, respectively. Notifications and incidence rates were analysed through space and time. During the study period, there were 43,699 notifications in Queensland. The highest annual number of notifications was recorded in 2015 (6182), followed by 2020 (3160). The average annual incidence rate was 5 per 10,000 people and the peak period for RRV notifications was March to May. Generally, SA2 areas in northern Queensland had higher numbers of notifications and higher incidence rates than SA2 areas in southern Queensland. The SA2 areas with high incidence rates were in east coastal areas and western Queensland. The timely prediction may aid disease prevention and routine vector control programs, and RRV management plans are important for these areas.

Impact of COVID-19 Mitigation Measures on Mosquito-Borne Diseases in 2020 in Queensland, Australia.

We describe the impact of COVID-19 mitigation measures on mosquito-borne diseases in Queensland, Australia, during the first half of 2020. Implementation of restrictions coincided with an atypical late season outbreak of Ross River virus (RRV) characterized by a peak in notifications in April (1173) and May (955) which were greater than 3-fold the mean observed for the previous four years. We propose that limitations on human movement likely resulted in the majority of RRV infections being acquired at or near the place of residence, and that an increase in outdoor activities, such as gardening and bushwalking in the local household vicinity, increased risk of exposure to RRV-infected mosquitoes. In contrast, the precipitous decline in international passenger flights led to a reduction in the number of imported dengue and malaria cases of over 70% and 60%, respectively, compared with the previous five years. This substantial reduction in flights also reduced a risk pathway for importation of exotic mosquitoes, but the risk posed by importation via sea cargo was not affected. Overall, the emergence of COVID-19 has had a varied impact on mosquito-borne disease epidemiology in Queensland, but the need for mosquito surveillance and control, together with encouragement of personal protective measures, remains unchanged.

Temporal trends of the association between ambient temperature and cardiovascular mortality: a 17-year case-crossover study

Aim. To examine the temporal variations of the association between ambient temperature and mortality for cardiovascular diseases in Queensland, Australia between 1997 and 2013. Methods. We obtained 147 238 cardiovascular deaths data from Queensland Health between 1 January 1997 and 31 December 2013. Time-stratified case-crossover design was fitted via the conditional quasi-Poisson regression with time-varying distributed lag non-linear model to estimate the associations between temperature and cardiovascular mortality. Stratified analyses were performed by age, sex, climate zone, and socioeconomic status. Results. We found a substantial decrease in the cold effect, while there was no significant change in the heat effect. Results of subgroup analyses showed an increasing trend for heat effects in men, people ⩽84 years old, those living in low and middle socioeconomic areas and those living in hot climate areas. There was a decreasing trend for the magnitude of associations between temperature (both cold and hot temperatures) and cardiovascular mortality in people ⩾85 years old and in areas of high socioeconomic status. Conclusions. The associations between cold temperature and cardiovascular mortality decreased in Queensland, Australia between 1997 and 2013, but no declines were observed for hot temperatures. Men, people ⩽84 years old, people living in low and middle socioeconomic score areas and people living in hot climate areas demonstrated increased susceptibility to hot temperatures. Our findings suggest a need for heat awareness health promotion campaigns to enhance adaptation to a warming climate among vulnerable population.

Herpes Simplex Virus Infection in Infants: 13 Year Evaluation (2005-2017) of Laboratory Confirmed Cases in Queensland, Australia.

National neonatal surveillance for herpes simplex virus (HSV) disease suggests that the incidence of HSV disease may be higher in Queensland (QLD) than in other Australian States. We sought to investigate the incidence via a retrospective 13-year evaluation of statewide laboratory data, autopsy data and linked clinical records of infants with laboratory confirmed infection. All positive polymerase chain reaction HSV 1 and 2 results were obtained for infants 0-3 months of age from January 1, 2005 to December 31, 2017. Clinical data were obtained from patient records and parent questionnaires were used to evaluate long-term sequelae. One hundred seventy-two infants with HSV positive polymerase chain reaction results: 121 (70.3%) with HSV 1. Of 104 (60.5%) infants with signs of HSV disease, 76 (73.1%) were neonates (≤28 days of age) [incidence 9.6 (95% confidence interval, 7.0-11.5) per 100,000 live births] and 28 (26.9%) were young infants (29-90 days of age) [3.6 (95% confidence interval, 2.4-5.4) per 100,000 live births]. The annual incidence of neonatal HSV disease increased significantly in Queensland over the study period (P < 0.01). Of the 76 neonates with HSV disease, 58 (76.3%) presented with the skin, eye, mouth (SEM) disease, 17 (22.4%) with HSV encephalitis and 11 (14.5%) had disseminated disease. Young infants presented with HSV skin, eye, mouth disease (21, 75.0%) or HSV encephalitis (6, 21.4%). Death occurred in 12/104 (11.5%) infants (all neonates) with 10 attributable to HSV disease. The incidence of neonatal HSV disease in QLD is almost 3 times the national reported incidence. Further research is being undertaken to explore reasons for this change and implications for practice.

Temporal trends of the association between ambient temperature and hospitalisations for cardiovascular diseases in Queensland, Australia from 1995 to 2016: A time-stratified case-crossover study.

BackgroundIn the context of global warming, studies have turned to assess the temporal trend of the association between temperature and health outcomes, which can be used to reflect whether human beings have adapted to the local temperature. However, most studies have only focused on hot temperature and mortality. We aim to investigate the temporal variations in the association between ambient temperature and hospitalisations for cardiovascular diseases in Queensland, Australia from 1995 to 2016.Methods and findingsWe obtained data on 1,855,717 cardiovascular hospitalisations (mean age: 65.9 years, 42.7% female) from all 443 postal areas in Queensland, Australia between January 1, 1995 and December 31, 2016. Grid-level meteorological data were downloaded from scientific information for landowners. We used a time-stratified case-crossover design fitted with a conditional quasi-Poisson regression model and time-varying distributed lag nonlinear model (DLNM) to evaluate the association between temperature and cardiovascular hospitalisations and the temporal trends of the associations. Stratified analyses were performed in different age, sex, and climate zones. In all groups, relative risks (RRs) of cardiovascular hospitalisations associated with high temperatures (heat effects) increased, but cold effects showed a decreasing trend from 1995 to 2016. The increasing magnitude of heat effects was larger (p = 0.002) in men than in women and larger (p < 0.001) in people aged ≤69 years than in those aged ≥70 years. There was no apparent difference amongst different climate zones. The study was limited by the switch from ICD-9 to ICD-10 coding systems, by being unable to separate first-time hospitalisation from repeated hospitalisations, and possibly by confounding by air pollution or by influenza infections.ConclusionThe impacts of cold temperatures on cardiovascular hospitalisations have decreased, but the impacts of high temperatures have increased in Queensland, Australia. The findings highlight that Queensland people have adapted to the impacts of cold temperatures, but not high temperatures. The burden of cardiovascular hospitalisations due to high temperatures is likely to increase in the context of global warming.

Prevalence and Cost of Managing Paediatric Cardiac Disease in Queensland

There is a paucity of contemporary information regarding the prevalence and related health care expenditure of the most common cardiac conditions in Australian children, including congenital heart disease (CHD). The 10 most common cardiac conditions managed by Queensland Paediatric Cardiac Service during 2014-2015 were identified from an electronic database: ventricular septal defect (VSD), pulmonary stenosis, aortic stenosis, tetralogy of Fallot, atrioventricular septal defect, transposition, Ebstein's anomaly, long QT syndrome, dilated cardiomyopathy, and rheumatic carditis. Demographic data, clinic attendance, investigational procedures, and therapeutic interventions were extracted from the electronic health records to derive indicative population estimates and direct health care expenditure relating to CHD. A total of 2,519 patients diagnosed with the 10 target conditions were being actively managed, including 456 (18.1%) new-born and 787 prevalent cases (2.5/1,000 population) aged <5 years. A total of 12,180 (4.8/case) investigations were performed (6,169 echocardiographic and 279 cardiac catheterisation procedures) costing $2.25 million/annum. A further 5,326 clinic visits (2.1/case, 22% regional) were conducted at a cost of $550,000/annum. A combined total of 804 catheter-based interventions and surgical procedures were performed in 300 cases (11.9%) at a cost of $13.6 million/annum. VSD (38.6% of cases) was the single greatest contributor ($5.1 million/annum) to total combined direct health care costs of $13.6 million/annum for the 2,519 patients. These pilot data indicate a significant patient population and health care burden imposed by CHD in Queensland. Future initiatives to better quantify this burden, from an individual to health system perspective, are urgently needed.

Congenital Heart Disease Long-term Improvement in Functional hEalth (CHD LIFE): A partnership programme to improve the long-term functional health of children with congenital heart disease in Queensland.

Children who undergo open-heart surgery in the first year of life for congenital heart disease (CHD) are at high-risk for impaired development across multiple domains. International recommendations include systematic periodic developmental surveillance into adolescence and the establishment of long-term follow-up programmes. This article describes the establishment and evolution of the Queensland Paediatric Cardiac Service neurodevelopmental follow-up programme - CHD LIFE (Long-term Improvement in Functional hEalth). Contextualising best practice recommendations to ensure a family-centred and sustainable approach to understand and support the long-term functional health needs of high-risk children with CHD as standard care was needed. We describe the transition from a centralised pilot Programme to the implementation of an integrated statewide approach aimed at delivering consistent high-level standards of care and a platform to evaluate therapeutic interventions.

The Ckd. Qld fabRy Epidemiology (aCQuiRE) study protocol: identifying the prevalence of Fabry disease amongst patients with kidney disease in Queensland, Australia

BackgroundFabry disease (FD) is a rare, lysosomal storage disorder caused by the absence or deficiency of the enzyme alpha-galactosidase A (α-Gal A) that leads to the abnormal accumulation of the lipid globotriaosylceramide (GB3) in a variety of cell types and tissues throughout the body. FD has an x-linked inheritance pattern. Previously thought to be only carriers, females can also experience FD symptomatology. Symptoms vary in type and severity from patient to patient and tend to increase in severity with age. FD symptoms are non-specific and may be shared with those of other diseases. Misdiagnoses and diagnostic delays are common, often resulting in progressive, irreversible tissue damage. The estimated prevalence of FD in the general population is 1:40,000 to 1:117,000 individuals. However, it is estimated that the prevalence of FD in the dialysis population is 0.12 to 0.7%. Little is known about the prevalence of FD in the broader Chronic Kidney Disease (CKD) population.MethodsThis is an epidemiological study of the prevalence of FD in CKD patents identified from the public renal speciality practices in Queensland, Australia. A cascade approach to screening is being employed with dried blood spot testing for blood levels of alpha-galactosidase A (Alpha-Gal), with follow-up testing for patients with abnormal results by plasma levels of globotriaosylsphingosine (Lyso-GB3) for females and non-definitive cases in males. A diagnosis of FD is confirmed through genetic testing of the GLA gene in cases suspected of having FD based upon Alpha-Gal and Lyso-GB3 testing.DiscussionExpected outcomes of this study include more information about the prevalence of FD at all stages of CKD, including for both males and females. The study may also provide information about common characteristics of FD to assist with diagnosis and optimal management/treatment. Screening is also available for family members of diagnosed patients, with potential for early diagnosis of FD and intervention for those individuals.Trial registrationQueensland Health Database of Research Activity (DORA, https://dora.health.qld.gov.au) pj09946 (Registered 3rd July 2017).

Blood pressure management in hypertensive people with non-dialysis chronic kidney disease in Queensland, Australia

BackgroundHigh blood pressure is the most significant risk factor for the development and progression of chronic kidney disease (CKD). Lowering blood pressure is a goal to prevent CKD progression. This study of adults with CKD who have hypertension aimed to determine blood pressure control rates and the treatment patterns of hypertension and to explore factors associated with control of hypertension.MethodsThis cross-sectional study included all non-dialysis people with CKD stages 3A to 5 under nephrology care in three public renal clinics in Queensland, who joined the CKD.QLD registry from May 2011 to Dec 2015 and had a history of hypertension. Demographic information, other health conditions, laboratory markers and anti-hypertensive medications in use at consent were extracted from the registry.ResultsAmong 1814 CKD people in these three sites in the registry who were age ≥ 18 years and had CKD stage 3A to 5, 1750 or 96% had a history of hypertension. Of these, the proportion with BP control to < 140/90 mmHg was 61.7% and to < 130/80 mmHg was 36.3%. With target BP < 140/90 mmHg or < 130/80 mmHg, participants aged ≥65 years were 1.23 (95% CI 1.06–1.42) or 1.12 (1.03–1.22) times more likely to have uncontrolled BP compared to those < 65 years old. Participants with severe albuminuria or proteinuria were 1.58 (1.32–1.87) or 1.28 (1.16–1.42, p < 0.001) more likely to have uncontrolled BP compared to those without significant albuminuria or proteinuria. Participants who had cardiovascular disease (CVD) were less likely to have uncontrolled BP compared to those without CVD (0.78, 0.69–0.89 or 0.86, 0.80–0.92). Factors associated with use of more classes of antihypertensive medicines among participants with uncontrolled BP (> 140/90 mmHg) were older age, diabetes, CVD, obesity and severe albuminuria/proteinuria (p < 0.05). Renin Angiotensin Aldosterone System inhibitors were the most frequently used medicines, regardless of the number of medicine classes an individual was prescribed.ConclusionsBlood pressure control rates in these hypertensive people with CKD was still far from optimal. People with CKD and hypertension aged 65 or older or with severe albuminuria or proteinuria, a group at risk of progression of kidney disease, have higher rates of uncontrolled BP.

Global distribution of white spot syndrome virus genotypes determined using a novel genotyping assay

White spot disease, caused by infection with white spot syndrome virus (WSSV), is a serious panzootic affecting prawn aquaculture. The disease has spread rapidly around the prawn-culturing regions of the world through a number of previously identified mechanisms. The ability to distinguish and trace strains of WSSV is of great benefit to identify, and then limit, the translocation routes of the disease. Here, we describe a novel genotyping method using 34 short tandem repeat regions of the viral genome concurrently. This technique is highly sensitive to strain differences when compared to previous methods. The efficacy of the described method is demonstrated by testing WSSV isolates from around the globe, showing regional genotypic differences. The differences in the genotypes were used to create a global minimum spanning network, and in most cases the observed relationships were substantiated with verification of transboundary movement. This novel panel of STR markers will provide a valuable epidemiological tool for white spot disease. We have applied this to an outbreak of the disease in Queensland, Australia, that occurred in 2016. While the results indicate that the source of this outbreak currently remains cryptic, the analyses have provided valuable insights with which to further study the origins of the strains involved.

Determining Key Influences on Patient Ability to Successfully Manage Noncommunicable Disease After Natural Disaster

Introduction:Natural disasters often damage the public health infrastructure required to maintain the wellbeing of people with noncommunicable diseases. This increases the risk of an acute exacerbation or complications, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of noncommunicable diseases will continue, if not increase, due to an increasing disease prevalence, sustained rise in the frequency and intensity of disasters, and rapid unsustainable urbanization in disaster-prone areas. However, the traditional focus of public health and disaster systems remains on communicable diseases, despite a low risk. There is now an urgent need to expand the public health response to include noncommunicable diseases.Aim:To explore the key influences on patient ability to successfully manage their noncommunicable disease after a natural disaster.Methods:A survey of people with noncommunicable diseases in Queensland, Australia, collected data on demographics, disease/condition, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with Bonferroni-adjustment were used to analyze data.Results:There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue and shortness of breath were common concerns for all noncommunicable diseases. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster.Discussion:The key influences on successful self-management post disaster for people with noncommunicable diseases must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.

Radiological appearance of coal mine dust lung diseases in Australian workers.

Coal Mine Dust Lung Disease (CMDLD) encompasses a spectrum of lung diseases caused by prolonged exposure to coal mine dust. This review presents high-resolution computed tomography (HRCT) images from men diagnosed with a CMDLD since the resurgence of these diseases in Queensland in 2015.

B.strong: development and delivery of integrated health promotion in the Queensland Health Brief Intervention Training Program

Background: Aboriginal and Torres Strait Islander Queenslanders have a 10-year life expectancy gap compared with non-Indigenous Queenslanders.[1] Chronic disease in Queensland continues to have a significant impact on Aboriginal and Torres Strait Islander peoples and on the broader health system. Major areas to reduce morbidity and mortality for chronic disease through modifiable risk factors include smoking cessation, nutrition and physical activity. Combining brief interventions for multiple risk factors can improve health outcomes, especially when brief interventions are integrated into the regular client pathway in primary health care. Objectives: Key aspects are presented of the development and delivery of the culturally appropriate, evidence-based B.strong brief intervention training program based on current Australian guidelines. The program includes a one-day face-to-face training workshop, six E-modules, new client resources, a practitioner guide and tools, trainee help desk, and organisational support. Method: B.strong builds on the foundation of two former Queensland Health programs, SmokeCheck and the Lifestyle Program, covering nutrition and physical activity. It was informed by a scoping review of Australian resources and a literature review. Program branding was co-designed with a community worker and elder focus group. Delivery is to Indigenous health workers and practitioners across all Queensland Hospital and Health Services, for government and non-government health and community services. Trainees and services are encouraged to integrate brief interventions as a routine part of the annual Adult Health Check, and opportunistically at every client contact. Monitoring and evaluation are key program components. Results: From 2017-2019 B.strong is training over 1,100 Aboriginal and Torres Strait Islander health workers and other health and community workers, through training workshops in each Hospital and Health Service. Lessons from the development and implementation of B.strong will be discussed along with the wider potential benefit of this novel multiple risk factor approach in Australia.

CKD.QLD: establishment of a chronic kidney disease [CKD] registry in Queensland, Australia

BackgroundChronic kidney disease [CKD] is recognised as a global public health problem. Until recently, the majority of information informing on CKD has been generated from renal registries reporting on patients with end-stage kidney disease [ESKD] and on renal replacement therapy [RRT]. There has been a paucity of information on pre-dialysis CKD cohorts, and many issues related to these poorly described populations are unresolved. To this end, international organizations have called for CKD surveillance systems across all countries.DescriptionIn Australia, we have responded by developing the Chronic Kidney Disease in Queensland [CKD.QLD] with three main platforms consisting of CKD Registry, clinical trials and development of biobank. This registry which is the core component of CKD surveillance was conceptualized specifically for the pre-dialysis population in the public health system in Queensland, Australia. Recruitment started in May 2011, and to date the Registry has evolved as one of the largest CKD cohorts in the world with recruitment close to 7000 patients. The Registry has had many outcomes, including being the nidus for Australia’s first National Health and Medical Research Council [NHMRC] CKD Centre of Research Excellence [CKD.CRE].ConclusionsThe Registry, with its linkage to Queensland Health datasets, is reporting, and is expected to continue generating, significant information on multiple aspects of CKD, its trajectory, management and patient outcomes. Intent of the CKD.CRE is to facilitate an expanded Registry network that has representation from health services, both public and private, across Australia.

Three cases of ocular syphilis and the resurgence of the disease in Queensland.

The past few years has seen a resurgence of syphilis. It is predominantly associated within men who have sex with men and also within heterosexual Indigenous Australians. Possessing the ability to mimic a variety of ocular diseases, it typically manifests as uveitis, although it can affect any structure within the eye. Thus, a high degree of clinical suspicion by ophthalmologists is required to prevent disease progression and ocular morbidity. Patients require prolonged antibiotic treatment with intravenous benzylpenicillin and outpatient monitoring to successfully resolve the infection. We describe a case series of ocular syphilis presentations in Queensland, Australia.