An assessment of prevalence for systemic lupus erythematosus (SLE) has been attempted for the population of far north Queensland in Australia. This huge area has a majority Caucasian population living in a tropical environment. Roughly 10% of the population comprises people of Australian Aboriginal or Torres Strait Islander descent. The prevalence of disease was high (45.3 per 100000) overall and particularly so in the indigenous population (92.8 per 100000) where the disease appears to be more severe. The pattern of organ involvement and laboratory anomalies did not vary between the populations examined. Disease duration however was different, being longer by comparison in the Caucasian population due to many premature deaths in the indigenous groups. The reasons for such high prevalence figures and some problems encountered in practice are discussed.

Systemic lupus erythematosus (SLE) is a chronic illness that usually follows a fluctuating course and, therefore, can be difficult to diagnose. Consequently, individuals with SLE often hold beliefs about the nature and course of the illness that are at odds with medical opinion. Clearly, a shared understanding of the illness would be beneficial to illness management. In this study, the authors used semistructured interviews and interpretative phenomenological analysis to explore the content of the illness representations held by 36 individuals diagnosed with SLE. They also identified the ways in which these illness representations were generated initially and attempted to determine whether changes occurred over time in these illness representations, as predicted by the self-regulatory model.

There is evidence to suggest that illness representations are associated with chronic illness outcomes. Accordingly, several authors have recommended that interventions aimed at improving illness outcomes should include an illness-representations component. While a few researchers have attempted to develop such interventions for chronic illness and chronic pain, no such intervention has been developed for individuals with systemic lupus erythematosus (SLE), a chronic auto-immune illness which results in a variety of negative physical and psychological symptoms. This article reports on a pilot program that investigated the feasibility of a cognitive and behavioural—based intervention for treating SLE which included an illness-representations-change component. The effectiveness of the intervention compared to usual treatment for SLE was evaluated. Also investigated was whether changed illness representations had a beneficial effect on physical health and psychological wellbeing. It was found that the intervention did change participants' treatment control and emotional representations, and that perceived stress was reduced following the intervention. The importance of these findings is discussed, two rival hypotheses for the findings obtained are explored and directions for future research are suggested.

Objective: To describe the natural history of rheumatic manifestations of Ross River virus (RRV) disease. Design: Prospective longitudinal clinical review. Setting: North Queensland local government areas of Cairns, Douglas, Mareeba and Atherton during January to May 1998. Participants: General practice patients diagnosed with RRV disease on the basis of symptoms and a positive RRV IgM result. Main outcome measures: Rheumatic symptoms and signs assessed as soon as possible after disease onset and on two subsequent occasions (up to 6.5 months after onset). Results: 57 patients were recruited, 47 of whom were reviewed three times (at means of 1.1, 2.4 and 3.6 months after disease onset). Results are reported for these 47: 46 (98%) complained of joint pain at first review, with the ankles, wrists, fingers, knees and metacarpophalangeal joints (II–IV) most commonly involved. Prevalence of joint pain decreased progressively on second and third reviews, both overall (92% and 68% of patients, respectively), and in the five joints most commonly affected. The prevalence of other common rheumatic symptoms and signs, and use of non‐steroidal anti‐inflammatory drugs, also progressively declined over the three reviews. Conclusions: Earlier studies may have overestimated the prevalence and duration of symptoms in RRV disease. Progressive resolution over 3–6 months appears usual.

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