Southeast Queensland Research Articles

What type of rainforest burnt in the South East Queensland's 2019/20 bushfires and how might this impact biodiversity

AbstractBushfires burnt over 18 million hectares across Australia's east coast, including rainforests, over the spring and summer 2019/2020 period. Rainforest harbours a large percentage of Australia's biodiversity and does not usually burn and therefore understanding the extent and biodiversity implications was a priority. The National Indicative Aggregated Fire Extent Dataset (NIAFED) combined with detailed regional ecosystem (RE) mapping was used to estimate the perimeter and area of each of the burnt rainforest types within South East Queensland (SEQ). Previous biodiversity estimates for each rainforest regional ecosystem type combined with remnant ecosystem mapping data then enabled an assessment of the potential biodiversity impacts of the fires for SEQ rainforest. We found that 12% of the rainforest estate in SEQ was within the burn footprint (29 031 ha) including parts of the UNESCO World Heritage Gondwana Rainforests of Australia. Fifty per cent of the total remnant area of the Endangered rainforest type, semi‐evergreen vine thicket on Mesozoic to Proterozoic igneous rocks (RE: 12.12.17) was potentially burnt. This rainforest type has high diversity. Burn severity analysis found that the rainforest primarily burnt with low severity, however, there were patches of high severity. Accuracy assessment of severity mapping resulted in a weak correlation (0.57) due to the underestimation of ground fires in rainforest. As expected, we found rainforest‐suppressed fires. However, in contrast to expectations, we found the wettest rainforest types and putative past refugia burnt more than other rainforest types. These results suggest that given drought conditions any rainforest could burn, and we can expect that the area of rainforest will contract if both incidences of drought and wildfires increase due to climate change.

Assessment of the Diversity, Distinctiveness and Conservation of Australia’s Central Queensland Coastal Rainforests Using DNA Barcoding

Globally threatened dry rainforests are poorly studied and conserved when compared to mesic rainforests. Investigations of dry rainforest communities within Australia are no exception. We assessed the community diversity, distinctiveness and level of conservation in Central Queensland coastal dry rainforest communities. Our three-marker DNA barcode-based phylogeny, based on rainforest species from the Central Queensland Coast, was combined with the phylogeny from Southeast Queensland. The phylogenetic tree and Central Queensland Coast (CQC) community species lists were used to evaluate phylogenetic diversity (PD) estimates and species composition to pinpoint regions of significant rainforest biodiversity. We evaluated the patterns and relationships between rainforest communities of the biogeographical areas of Central Queensland Coast and Southeast Queensland, and within and between Subregions. Subsequently, we identified areas of the highest distinctiveness and diversity in phylogenetically even rainforest communities, consistent with refugia, and areas significantly more related than random, consistent with expansion into disturbed or harsher areas. We found clear patterns of phylogenetic clustering that suggest that selection pressures for moisture and geology were strong drivers of rainforest distribution and species diversity. These results showed that smaller dry rainforests in Central Queensland Coast (CQC) represented areas of regional plant migration but were inadequately protected. To sustain species diversity and distribution under intense selection pressures of moisture availability and substrate type throughout this dry and geologically complex region, the future conservation of smaller patches is essential.

Eating Behaviours Among Healthcare Workers and Their Relationships With Work-Related Burnout

The current research describes the indicators of good nutrition among staff working in a hospital setting and determines if dietary indicators are associated with work-related burnout. In total, 501 staff of a large healthcare organization in SouthEast Queensland, Australia completed a health and wellbeing survey. Multiple regression models were constructed to describe the associations between dietary indicators and burnout, while controlling for age, gender, work role and level of employment. Among the total sample of healthcare workers, indicators of healthy eating were poor. Fewer than 40% reported their overall diet as very good and fewer than 15% of healthcare workers reported eating the recommended 5 or more servings of vegetables per day. There was an inverse relationship between good nutrition and burnout, across a range of indicators (including rating of overall diet, fruit and vegetable consumption and sharing meals with family), such that healthier eating indicators were associate with less burnout. Given that rates of both poor nutrition and burnout among healthcare professionals are high, findings from the current study suggest that efforts to promote better nutrition among healthcare workers are warranted. Future research may evaluate if improving the nutrition of healthcare workers has a positive impact on work-related burnout.

Drivers of Ecological Condition Identify Bright Spots and Sites for Management Across Coastal Seascapes

Disentangling natural and anthropogenic effects on ecosystem condition can uncover bright spots in urban landscapes that are performing above expectations and so are potential sites for conservation or benchmarking, as well as sites performing below expectations that should be the focus of management. In this study, we tested for correlations between metrics indexing ecological condition (focusing on habitat-forming species) and a suite of spatial and environmental variables at 373 sites across four ecosystems (mangroves, seagrass, saltmarsh and rocky outcrops) and 13 estuaries in southeast Queensland, Australia. Ten condition metrics across the four ecosystems correlated with variables indexing the seascape context of sites, with condition metrics typically higher at sites more connected to natural features including the estuary mouth and mangroves. Urbanisation affected only two metrics, with rocky outcrop oyster cover being 75% lower at sites near extensive urbanisation and algae cover being highest at sites with intermediate urbanisation. We identified patterns in at least two variables from each ecosystem, meaning that decisions need to be made regarding optimal ecosystem states. Overall, management sites were more common than bright spots, with 50% more management sites in mangroves, 42.8% more in seagrasses, 38.5% more in saltmarshes and no bright spots in rocky outcrops (however, 10.3% of rocky outcrop sites were bright spots under an alternate ecosystem state model). We found that patterns in habitat condition across coastal seascapes can be predicted using spatial modelling approaches, and that these models can be readily used to prioritise management actions across the entire regions.

Working from home 22 months on from the beginning of COVID-19: What have we learned for the future provision of transport services?

COVID-19 has delivered an unintended positive consequence through working from home (WFH). While it may be some time until we are able to indicate, with some confidence, the impact that WFH will have on traffic congestion and crowding on public transport, there is a sense already that it is a game changer, and indeed is one of the most effective policy levers that the transport sector has had for many years in ‘managing’ the performance of the transport network. This paper draws on multiple ways of survey data that have been collected since March 2020 when the pandemic first resulted in severe restrictions in Australia. We present the evidence up to December 2021 on the incidence of WFH in two geographical jurisdiction – the Greater Sydney Metropolitan Area (GSMA) and South-East Queensland (SEQ) - and how it has been received by employees and employers from the height of restrictions up to a period when restrictions were relaxed, followed by further lockdowns throughout Australia. We show what this might mean for work productivity, lifestyle, and the changing preferences for passenger modes. With a growing preference, within some occupation classes, to WFH 1–2 days a week, and a good spread through the weekdays, we discuss what this means for the way we analyse the impact of transport initiatives on the performance of the transport network with a particular emphasis on the growth in suburbanisation of transport improvements, less costly service and infrastructure improvements, and the changing role of public transport.

Prevalence of secondary insults and outcomes of patients with traumatic brain injury intubated in the prehospital setting: a retrospective cohort study

BackgroundPrehospital neuroprotective strategies aim to prevent secondary insults (SIs) in traumatic brain injury (TBI). This includes haemodynamic optimisation in addition to oxygenation and ventilation targets achieved through rapid sequence intubation...

Individual Responsibility and Disconnection: Practitioner Experiences of the First Wave COVID19 Lockdown

ABSTRACT The first wave of the COVID-19 pandemic in Australia called for a lockdown that impacted the delivery of social work and human services. This study investigated the experiences of 15 social work and human service practitioners in Southeast Queensland, Australia. Telephone and Zoom interviews were conducted with practitioners and analysed using interpretative phenomenological analysis (IPA). Three themes arose: 1) technology problems; 2) flexibility in work roles; 3) supportive and unsupportive organisations. Findings suggested that practitioners faced challenges due to poor technology, reduced role clarity, and in some cases limited organisational support. Findings also provided insight into benefits that included increased flexibility, regular communication from the organisation, and acts of kindness and care from individuals and organisations. A fundamental lesson from this study was the importance for organisations to nurture connections that demonstrated care for employees during times of crisis. IMPLICATIONS Social work and human service practitioners need continued support in accessing and using software and hardware in preparation for crisis. While practitioners displayed resilience and flexibility during the COVID19 lockdown, clarity about work roles and responsibilities is necessary. Employers play a vital role in maintaining practitioner wellbeing during crisis by showing care and connection between individuals and across the wider organisation.

Estimating the Role of Bank Flow to Stream Discharge Using a Combination of Baseflow Separation and Geochemistry

This study investigated the role of bank return flow to two medium size rivers in southeast Queensland using a combination of hydrograph separation techniques and geochemical baseflow separations. The main aims were to provide a case study to demonstrate spatial and temporal variability in groundwater contributions to two river systems in Southeast Victoria; the Avon River and the Mitchell River. The two rivers show large spatial and temporal variations in groundwater contributions with higher percentages during low flow periods and more surface runoff during wet years. At the end of the Australian millennium drought, groundwater discharge accounted for 60% of the total flow for the Avon River and 42% for the Michell River, whereas groundwater discharge only had a minor component to the total discharge in wetter years, ∼15% for the Avon River and only 3% for the Mitchell River. Radon and chloride were used for the geochemical baseflow separation and provide a means to separate regional groundwater discharge to the rivers from bank return flow. Bank return flow accounts for 2 to 5 times higher fluxes in certain areas. Geochemistry in combination with physical hydrogeology enhances the overall understanding of groundwater connected river systems over the river length.

'I'm having jelly because you've been bad!': A grounded theory study of mealtimes with siblings in Australian families.

Obesity prevention interventions have been designed to promote responsive feeding in early childhood. However, existing interventions primarily target first-time mothers without considering the complexities of feeding multiple children within a family unit. By applying principles of Constructivist Grounded Theory (CGT), this study aimed to explore how mealtimes are enacted in families with more than one child. A mixed-methods study was conducted with parent-sibling triads (n = 18 families) in South East Queensland, Australia. Data included direct mealtime observations, semistructured interviews, field notes, and memos. Data were analysed using open and focused coding, during which constant comparative analysis was applied. The sample comprised of two-parent families with children ranging in age from 12 to 70 months (median sibling age difference = 24 months). A conceptual model was developed to map sibling-related processes integral to the enactment of mealtimes in families. Notably, this model captured feeding practices used by siblings, such as pressure to eat and overt restriction, that previously had only been described in parents. It also documented feeding practices used by parents that may occur only in the presence of a sibling, such as leveraging sibling competitiveness and rewarding a child to vicariously condition their sibling's behaviour. The conceptual model demonstrates complexities in feeding that give shape to the overall family food environment. Findings from this study can inform the design of early feeding interventions that support parents to remain responsive, particularly when their perceptions and expectations of siblings differ.

Variability analysis of monthly precipitation vector time series in Australia by a new spatiotemporal entropy statistic

Changing climate in Australia has significant impacts on the country’s economy, environment and social well-being. Addressing such impacts, particularly that of precipitation change, entails immediate action due to the more frequent occurrence of extreme dry or wet events in Australia in recent decades. In this paper we investigate the intra-annual Australian precipitation variability and how it changes over space and time. We quantify this variability using information entropy—a statistical tool for measuring the uncertainty of a random variable over its sample space, and propose a compositional data model to compute optimal spatiotemporal estimators of this entropy using 1/1979-to-3/2022 monthly satellite precipitation estimates from the National Oceanic and Atmospheric Administration. The results enable us to identify those locations/times where/when extreme intra-annual precipitation variation or unevenness occurred. We find this variability has been changing over time in large regions of southeastern Queensland and on the coast of South Australia, which would be difficult to find without using the proposed approach. We uncover the development of extreme entropy in the months leading up to, and in the location of, four extreme precipitation events in Australia where inter-annual precipitation amounts and/or trends proved insignificant. In marked contrast to annual precipitation, we found entropy has a weak association with the El Niño Southern Oscillation cycle.

Longing for a Forever Home: Ontological insecurity is collectively produced in fixed-term supportive housing for families

ABSTRACT Increasingly unaffordable housing means that family homelessness represents an urgent issue for social policy and practice. Targeting families at risk of homelessness, Supportive Housing for Families (SHF) subsidizes leases and offers support aimed at sustaining tenancies and family unity. We explore how short-term funding cycles in an advanced welfare system impacts experiences with service delivery. Building on housing scholarship employing an ontological security lens, we interrogate the temporal dimensions of SHF, and how these are intertwined with understandings of home in spatial terms. The analyses are based on research conducted to examine a 12-month SHF pilot in Southeast Queensland, Australia. We analyse qualitative interviews conducted with families (n=17), statutory child protection officers (n=7), and SHF support workers (n=10) involved in this pilot. Findings indicate that fixed-term funding impacts every aspect of service delivery, resulting in the collective production of ontological insecurity, as families continue to long for a forever home.

Integrating management of marine activities in Australia

Integrated management (IM) has been widely proposed, but difficult to achieve in practice, and there remains the need for evaluation of examples that illustrate the practical issues that contribute to IM success or failure. This paper synthesises experiences of academics and practitioners involved in seven Australian case studies in which there have been attempts to integrate or take a broader, holistic perspective of management. The evaluative framework of Stephenson et al. (2019a) was used as a lens to explore, through workshops and a questionnaire survey, the nine key features and five anticipated stages of IM in the Gladstone Harbour Project, the Great Barrier Reef, the Northern Prawn fishery and regional development, the South-East Queensland Healthy Waterways Partnership, the Australian Oceans Policy, the New South Wales Marine Estate reforms, and progress toward Integrated Management in the Spencer Gulf. Workshops involving experts with direct experience of the case studies revealed that most of the key features (recognition of the need; a shared vision for IM; appropriate legal and policy frameworks; effective process for appropriate stakeholder participation; comprehensive suite of objectives (ecological, social, cultural, economic and institutional); consideration of trade-offs and cumulative effects of multiple activities; flexibility to adapt to changing conditions; process for ongoing review, evaluation and refinement; and effective resourcing) were seen as important in all case studies. However, there are only a few examples where key features of IM were implemented ‘fully’. A subsequent questionnaire of participants using ‘best-worst’ scaling indicated that an appropriate legal and institutional framework is considered to have most influence on IM outcomes, and therefore is the most important of the key features. This is followed in salience by effective stakeholder participation, effective resourcing, capacity and tools, and recognition of the need for IM. Key features may change in relative importance at different stages in the trajectory of IM.

Identifying optimal values of coastal habitat condition for management and restoration

Fish assemblages are considered valuable monitoring targets for coastal and marine ecosystems because their populations can reflect ecosystem condition. Human impacts to coastal seascapes are pervasive, necessitating management and restoration actions that are assessed against quantitative targets. Relationships between metrics of habitat condition and animal assemblages can be used to identify where management interventions should aim to maximise outcomes for key functions and services. In this study, we surveyed fish assemblages (using underwater videography) and habitat condition (focusing on the size, composition and complexity of habitats) of five estuarine ecosystems (mangrove forests, seagrass meadows, saltmarsh, log snags and rocky outcrops) across 13 estuaries over two years (for n = 981 sites) in southeast Queensland, Australia. We used generalised additive models to quantify relationships and identify thresholds between metrics indexing habitat condition and key metrics of fish assemblages (species richness and abundance), and used these models to calculate optimal habitat condition values that maximise habitat value for fish and fisheries. We also identified indicator fish species whose abundance correlated with these optimal values. Metrics of habitat condition that index food availability for fish (such as algae and oyster cover) or broader habitat complexity (such as seagrass height or mangrove canopy cover) were consistently important for fish biodiversity and abundance. Relationships were readily translated into optimal values for key metrics of habitat condition for four of the five ecosystems surveyed. We propose that incorporating optimal values of habitat condition into management would maximise the abundance of key indicator fish species, including several which are important fisheries targets. The findings of this study will help managers to identify the optimal condition requirements of coastal ecosystems, thereby maximising the effectiveness and efficiency of often sparse management resources.

Koala conservation in South East Queensland: A grey literature review analysis

AbstractThis grey literature review documents koala (Phascolarctos cinereus) conservation initiatives applied across 12 local government areas in South East Queensland, Australia. To overcome threats to koalas' survival, the grey literature indicates that local governments in this region focus on wildlife management solutions, wildlife signage, habitat restoration projects and koala awareness campaigns. Despite these measures, land clearing of koala habitat to cater for urban population growth combined with recent bushfires and floods have contributed to the decline of koalas in this region. Recommendations to enhance progress include greater usage of the grey literature in peer review work and further application of social marketing to encourage residents to uptake behaviors that can mitigate threats to koalas, including slowing down when driving in koala zones, participating in citizen science, and leashing dogs when walking in native bush areas. The need for collaborative efforts aimed at conserving the koala from potential extinction is indicated. This paper provides an approach that can be applied to track progress on coordinated efforts to conserve koalas.

Diagnostic accuracy of the Composite International Diagnostic Interview (CIDI 3.0) in an urban Indigenous Australian sample.

The Composite International Diagnostic Interview 3.0 is a standardised diagnostic interview commonly used in population-based mental health surveys, but has not been used in community-residing Indigenous Australians. This paper seeks to determine whether the Composite International Diagnostic Interview 3.0 can produce valid diagnostic information when compared with a diagnostic interview in an urban Indigenous Australian sample. This research was conducted over 10 weeks with adult Indigenous clients of two participating Aboriginal Medical Services in South-East Queensland. Using a cross-sectional, repeated-measures design, participants were administered the Composite International Diagnostic Interview 3.0 by an Indigenous interviewer and within 2 weeks attended a second appointment with an Indigenous clinical psychologist, who produced a diagnostic summary. The Composite International Diagnostic Interview 3.0 diagnoses were compared with the diagnostic summaries and clinical concordance between the two measures was calculated. The diagnostic accuracy of the Composite International Diagnostic Interview 3.0 differed by module. The Post-traumatic Stress Disorder and Major Depression modules had good utility in diagnosing post-traumatic stress disorder and major depressive episodes, respectively; however, the Mania module that provides diagnoses of bipolar disorder was found to be unsuitable for this population. Although there were no identified contraindications for the use of the Generalised Anxiety and Alcohol Use Disorder modules, further research on the diagnostic accuracy of these modules is warranted. The Composite International Diagnostic Interview 3.0 can accurately diagnose some common mental disorders in an Indigenous Australian population, but was found to be unsuitable for others. Given these findings, care should be taken when using the Composite International Diagnostic Interview 3.0 in epidemiological prevalence studies with Indigenous Australian populations.

Patient presentations to an after-hours general practice, an urgent care clinic and an emergency department on Sundays: a comparative, observational study

PurposeThe purpose of this paper is to determine which factors are associated with 6,065 patient presentations with non-life-threatening urgent conditions (NLTUCs) to an after-hours general practice, an urgent care clinic (UCC) and an emergency department (ED) on Sundays in Southeast Queensland (Qld).Design/methodology/approachA retrospective, comparative and observational study was conducted involving the auditing of medical records of patients with NLTUCs consulting three medical services between 0,800 and 1,700 h, on Sundays, over a one-year period. The study was limited to 6,065 patients.FindingsThere were statistically significant differences in choice of location according to age, number of postcodes from the patient's residence, time of the day, season, patient presentations for infection and injury, non-infectious, non-injurious conditions of the circulatory, gastrointestinal and genitourinary systems, and need for imaging, pathology, plastering/back-slab application, splinting and wound closure. Older adults were more likely to be admitted to the hospital and Ed Short Stay Unit, compared with other age groups.Research limitations/implicationsBased on international models of UCC healthcare systems in United Kingdom (UK), USA and New Zealand (NZ) and the results of this study, it is recommended that UCCs in Australia have extended hours, walk-in availability, access to on-site radiology, ability to treat fractures and wounds and staffing by medical practitioners able to manage these conditions. Recommendations also include setting a national standard for UCC operation (National Urgent Care Centre Accreditation, 2018; NHS, 2020; RNZCUC, 2015) and requirements for vocational registration for medical practitioners (National Urgent Care Centre Accreditation, 2018; RNZCUC, 2015; The Royal College of Surgeons of Edinburgh, 2021a, b).Practical implicationsThis study has highlighted three key areas for future research: first, research involving general practitioners (GPs), emergency physicians, urgent care physicians, nurse practitioners, urgent care pharmacists and paramedics could help to predict the type of patients more accurately, patient presentations and associated comorbidities that might be encouraged to attend or be diverted to Urgent Care Clinics. Second, larger studies of more facilities and more patients could improve the accuracy and generalisability of the findings. Lastly, studies of public health messaging need to be undertaken to determine how best to encourage patients with NLTUCs (especially infections and injuries) to present to UCCs.Social implicationsThe Urgent Care Clinic model has existed in developed countries since 1973. The adoption of this model in Australia close to a patient's home, open extended hours and with onsite radiology could provide a community option, to ED, for NLTUCs (especially patient presentations with infections and injuries).Originality/valueThis study reviewed three types of medical facilities for the management of NLTUCs. They were an after-hours general practice, an urgent care clinic and an emergency department. This study found that the patient choice of destination depends on the ability of the service to manage their NLTUCs, patient age, type of condition, postcodes lived away from the facility, availability of testing and provision of consumables. This study also provides recommendations for the development of an urgent care healthcare system in Australia based on international models and includes requirements for extended hours, walk-in availability, radiology on-site, national standard and national requirements for vocational registration for medical professionals.

‘Engendering social inclusion and success for refugee women through place-based empowering practices’

ABSTRACT The 3Es to Freedom was a program for women from refugee and migrant backgrounds, operating in northern New South Wales and South East Queensland, Australia, from 2016 to 2021. The program offered a welcoming space where the women could build on their skills to develop confidence, enabling them to pursue their ambitions. This article focuses on how the program’s responsiveness supported the needs of refugee women in regional communities. Place making and a place-based approach provided a theoretical framework to analyse the ways in which the staff embedded the program in local, distinctive regional communities, which provided opportunities for the women to forge bonds to build bridges into their broader communities. The place-based approach can be identified in how the women walked together to discover local places of interest, secured a plot in the community garden, and connected to social groups and local services. Involvement in art exhibitions acknowledged and gave voice to the women’s presence in the community, enhancing their sense of belonging and increasing public understanding of how these newcomers enriched their chosen communities. By investing in these local connections, a sense of place was established, contributing to the women’s adaptation, resilience and social inclusion in their region.

Koala conservation in South East Queensland: a shared responsibility

ABSTRACT The koala (Phascolarctos cinereus) is an iconic Australian animal. Its recent reclassification to endangered in locations such as South East Queensland, New South Wales and the Australian Capital Territory indicates urgent and further conservation actions are required. This article proposes that a downstream social marketing approach can be applied to encourage South East Queensland residents to take preventative actions to protect koalas in their region. This article reports the results of an online survey that was completed by 2,592 South East Queensland residents. The data was cluster analysed using TwoStep cluster analysis, resulting in three valid segments. Active koala enthusiasts are knowledgeable and active in koala conservation. City residents were aware of koalas’ decline but are unfamiliar with conservation actions. Young dog owners do not know about the decline of koalas and they do not currently perform conservation actions. Respondents agreed that koala conservation is a shared responsibility between residents, organisations and governments and too many are not aware of actions they can take. Tailored approaches should be applied in the future, including citizen science initiatives such as completing online koala sightings to broaden understanding of koala habitats.

Syphilis in pregnancy: a qualitative investigation of healthcare provider perspectives on barriers to syphilis screening during pregnancy in south-east Queensland.

Increasing rates of syphilis in pregnancy (SiP) in Australia and other high-income countries, has led to the resurgence of congenital syphilis. Suboptimal syphilis screening during pregnancy has been identified as a key contributing factor. This study aimed to explore, from the perspective of multidisciplinary healthcare providers (HCPs), the barriers to optimal screening during the antenatal care (ANC) pathway. Semi-structured interviews conducted with 34 HCPs across multiple disciplines practising in south-east Queensland (SEQ) were analysed through a process of reflexive thematic analysis. Barriers were found to occur at the system level of ANC, through difficulties in patient engagement in care, limitations in the current model of health care delivery and limitations in the communication pathways across health care disciplines; and at the individual HCP level, through HCP knowledge and awareness of epidemiological changes in syphilis in SEQ, and adequately assessing patient risk. It is imperative that the healthcare systems and HCPs involved in ANC address these barriers to improve screening in order to optimise management of women and prevent congenital syphilis cases in SEQ.

Barriers to optimal management of syphilis in pregnancy and congenital syphilis in south-east Queensland: a qualitative investigation.

Australia, like many high-income countries, is experiencing a resurgence of infectious syphilis in pregnancy and congenital syphilis. Evaluations of public health notifications and clinical records suggest that healthcare systems may not be providing optimal care to women and their neonates. This study aims to explore the barriers to optimal management of syphilis in pregnancy and congenital syphilis to identify key areas for improvement. Between 2021 and 2022, 34 healthcare workers (HCW) practicing in south-east Queensland (SEQ) Australia were recruited to complete semi-structured interviews regarding their perceptions towards management of syphilis in pregnancy and congenital syphilis. Interviews were analysed thematically. Thematic analysis identified four themes related to the management of syphilis in pregnancy. These included poor communication between disciplines, services, and teams from delivery through to management and post-delivery, lack of formal internal and external referral pathways, unclear and often complex maternal and congenital syphilis management procedures, and limited HCW knowledge of infectious syphilis in pregnancy and congenital syphilis. As congenital syphilis numbers continue to rise in SEQ, it is imperative that healthcare systems and HCWs identify and address gaps in the provision of health care.