An exploration of national calls to Lifeline Australia: social support or urgent suicide intervention?
- Authors: Watson, Robert , McDonald, John , Pearce, Dora
- Date: 2006
- Type: Text , Journal article
- Relation: British Journal of Guidance & Counselling Vol. 34, no. 4 (Nov 2006), p. 471-482
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- Description: Lifeline Australia Inc. provides a free 24-hour telephone counselling and referral service to all Australians. The trained telephone counsellors of the service record information on many of their calls in Lifeline's Client Service Management Information System (CSMIS). This paper presents a descriptive summary of a national CSMIS data set, which was compiled during a 3-month period in 2003. The CSMIS data provided a clear national profile of the callers to the service. The results of this study support the hypothesis that callers are generally seeking social support from the service. The discussion explores the implications of this finding for Lifeline and other generalist counselling and referral services and their capacity to offer suicide intervention to the community.
- Description: C1
- Description: 2003001998
Access to stroke care units in Australian public hospitals : Facts and temporal progress
- Authors: Cadilhac, Dominique , Lalor, Erin , Pearce, Dora , Levi, Christopher , Donnan, Geoffrey
- Date: 2006
- Type: Text , Journal article
- Relation: Internal Medicine Journal Vol. 36, no. 11 (2006), p. 700-704
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- Description: Background: There is level I evidence that management of stroke patients in stroke units (SU) improves outcomes (death and institutionalization) by approximately 20%. In Australia, there is uncertainty as to the proportion of incident cases that have access to SU. Recent national and State-based policy initiatives to increase access to SU have been taken. However, objective evidence related to SU implementation progress is lacking. The aims of the study were (i) to determine the number of SU in Australian acute public hospitals in 2004, (ii) to describe hospitals according to national SU policy criteria and (iii) to compare results to the 1999 survey to track progress. Methods: The method used in the study was a cross-sectional, postal survey technique. The participants were clinical representatives considered appropriate to describe stroke care within survey hospitals. Results: The outcome of the study was presence of a SU according to an accepted definition. Response rate was 261/301 (87%). Sixty-one sites (23%) had either a SU and/or a dedicated stroke team. Fifty sites claimed to have a SU (19%). New South Wales with 23 had the most number of SU. Based on policy criteria, up to 64 sites could have a SU. In 1999, there were 35 public hospitals with a SU. Conclusion: Access to SU in Australian public hospitals remains low compared with other countries (Sweden, 70%). Implementation strategies supported by appropriate health policy to improve access are needed. © 2006 Royal Australasian College of Physicians.
Cancer incidence and arsenic in soil in a gold mining area of Australia
- Authors: Pearce, Dora , Dowling, Kim , Sim, Malcolm
- Date: 2008
- Type: Text , Journal article
- Relation: Epidemilogy Vol. 19, no. 6 (2008), p. S165-S165
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The accessibility/remoteness index of Australia (ARIA) and lifeline Australia's calls
- Authors: Watson, Robert , McDonald, John , Pearce, Dora
- Date: 2005
- Type: Text , Conference paper
- Relation: Paper presented at the 8th National Rural Health Conference, Alice Springs : 10th - 13th March, 2005
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- Description: Nationally there are more than 50 member centres and sub-centres of Lifeline Australia’s telephone counselling and referral service, providing an equitable, free, anonymous, and highly accessible primary health resource. The accessibility of this service may mean that it has a particularly important role to play in contributing to the health and well-being of rural and remote Australians. The trained volunteer counsellors of the service receive more than 400 000 calls annually. Information on many of these calls is recorded by telephone counsellors in Lifeline’s Client Service Management Information System (CSMIS). The purpose of this study was to establish if a relationship between the Accessibility/Remoteness Index of Australia (ARIA) and calls to Lifeline Australia could be found. Population standardised areal call rates to Lifeline Ballarat were compiled using Telstra exchange service area to test the hypothesis that a positive relationship between the call rates to the service and the ARIA would be found. 90 128 CSMIS cases from 2003 were examined to explore if any linear relationship between caller characteristics and a centre’s ARIA score were apparent. A number of significant associations with the ARIA scores and CSMIS call variables were observed. However, the hypothesis that a positive relationship between call rates to the service and the ARIA would be found was not supported. An important implication of this exploratory study is that Lifeline’s telephone counselling and referral service may need to be promoted more widely to rural clients and health care providers.
- Description: E1
- Description: 2003001236
Toenails : They know where you’ve been!
- Authors: Pearce, Dora , Dowling, Kim , Sim, Malcolm , McOrist, Gordon , Russell, Robert
- Date: 2007
- Type: Text , Conference paper
- Relation: Nuclear and Complementary Techniques of Analysis (NCTA) Conference Abstracts volume, Melbourne
- Full Text: false
- Description: 2003006916
Spatial modelling of the relationship between respiratory admissions and ambient air pollution
- Authors: Pearce, Dora
- Date: 2002
- Type: Text , Thesis , Masters
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- Description: "The aims of this research were to investigate the association between air pollution and respiratory health effects using a spatial approach, and to derive a composite indicator of ambient air pollution."
- Description: Master of Information Technology by Research
Toenail arsenic : Incorporation patterns and biomarker potential
- Authors: Dowling, Kim , Pearce, Dora , Gerson, Andrea , Sim, Malcolm , Sutton, Stephen , Newville, Matthew
- Date: 2008
- Type: Text , Conference paper
- Relation: Paper presented at 3rd Conference on Developments in Victorian Geology and Mineralisation, Melbourne : 3rd-4th February 2008
- Full Text: false
Areal call rates to a rural Lifeline centre
- Authors: Watson, Robert , McDonald, John , Pearce, Dora
- Date: 2004
- Type: Text , Conference paper
- Relation: Paper presented at TASA '04 Refereed Conference Proceedings: Revisioning institutions: Change in the 21st century, Beechworth, Victoria : 8th November, 2004
- Full Text: false
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- Description: This study investigated the relationship between areal call rates to Lifeline Ballarat’s telephone counselling service and the Socio-economic Indexes for Australia. Successful calls for the period of January, February, March, and April 2002 (N=3767) were geospatially referenced to small areas. It was hypothesised that call rates would increase with greater socio-economic disadvantage as measured by the Socio-economic Indexes for Australia. Population adjusted call rates in each exchange service area in the study region were produced and their relationship with the corresponding Socio-economic Indexes for Australia scores were investigated. Significant correlations were observed for the call rate indicator, named the Lifeline Indicator of Social Need, and the Socio-economic Indexes for Australia advantage/disadvantage, disadvantage, and education/occupation indices. The results support Johnston’s (1979) finding of a relationship between socio-economic status of an area and local utilization of telephone counselling. The results support the idea that social factors such as the socio-economic climate of the area can have a significant association with seeking support from telephone counselling services such as the Lifeline service. An implication of the study may be that the calls to telephone counselling and referral centres could be used as a functional social indicator of the expressed need for psychosocial support or as a contributor to other social indices.
- Description: E1
- Description: 2003000971
Arsenic microdistribution and speciation in toenail clippings of children living in a historic gold mining area
- Authors: Pearce, Dora , Dowling, Kim , Gerson, Andrea , Sim, Malcolm , Sutton, Stephen , Newville, Matthew , Russell, Robert , McOrist, Gordon
- Date: 2010
- Type: Text , Journal article
- Relation: Science of the Total Environment Vol. 408, no. 12 (2010), p. 2590-2599
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- Description: Arsenic is naturally associated with gold mineralisation and elevated in some soils and mine waste around historical gold mining activity in Victoria, Australia. To explore uptake, arsenic concentrations in children's toenail clippings and household soils were measured, and the microdistribution and speciation of arsenic in situ in toenail clipping thin sections investigated using synchrotron-based X-ray microprobe techniques. The ability to differentiate exogenous arsenic was explored by investigating surface contamination on cleaned clippings using depth profiling, and direct diffusion of arsenic into incubated clippings. Total arsenic concentrations ranged from 0.15 to 2.1
Quality of stroke care within a hospital: Effects of a mobile stroke service
- Authors: van der Walt, Anneke , Gilligan, Amanda , Cadilhac, Dominique , Brodtmann, Amy , Pearce, Dora , Donnan, Geoffrey
- Date: 2005
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 182, no. 4 (2005), p. 160-163
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- Description: Objective: An Australian stroke services study (SCOPES) has developed a framework to compare different forms of acute stroke services, the gold standard being localised stroke units. We aimed to use this framework to assess changes in the quality of stroke care over time as a sequential audit process. Design and setting: A retrospective medical record audit comparing 100 sequential stroke admissions (July 2002 to June 2003) two years after institution of a mobile stroke service (MSS) with 100 historical controls (September 1998 to October 1999) at a 260-bed hospital in Melbourne. The MSS results were also compared with stroke units in SCOPES. Main outcome measures: Adherence to quality indicators and standard measures of outcome (complications, length of stay and discharge disability) after implementing the MSS. Results: Significant improvements were seen in prophylaxis for deep-vein thrombosis, incontinence management, premorbid function documentation, frequent neurological observations and early occupational therapy. The MSS demonstrated fewer severe complications (9% versus 24%; P=0.004), reduced median length of stay (discharged patients: 12.0 days versus 18.5 days; P=0.003) and more patients were independent at discharge (32% versus 9%; P<0.001). Comparison with SCOPES stroke units showed our MSS could improve in incontinence management and appropriate use of antiplatelet therapy. Conclusion: Institution of the MSS was associated with improvements in the quality of stroke care. This study demonstrates application of an audit procedure for quality improvement in hospital stroke management and the potential to improve stroke services in smaller centres.
Cancer incidence and soil arsenic exposure in a historical gold mining area in Victoria, Australia : A geospatial analysis
- Authors: Pearce, Dora , Dowling, Kim , Sim, Malcolm
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Exposure Science and Environmental Epidemiology Vol. 22, no. 3 (2012), p. 248-257
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- Description: Soil and mine waste around historical gold mining sites may have elevated arsenic concentrations. Recent evidence suggests some systemic arsenic absorption by residents in the goldfields region of Victoria, Australia. Victorian Cancer Registry and geochemical data were accessed for an ecological geographical correlation study, 1984-2003. Spatial empirical Bayes smoothing was applied when estimating standardised incidence ratios (SIRs) for cancers in 61 statistical local areas. The derived soil arsenic exposure metric ranged from 1.4 to 1857 mg/kg. Spatial autoregressive modelling detected increases in smoothed SIRs for all cancers of 0.05 (95% confidence interval (CI), 0.02-0.08) and 0.04 (0.01-0.07) per 2.7-fold increase in the natural log-transformed exposure metric for males and females, respectively, in more socioeconomically disadvantaged areas; for melanoma in males (0.05 (0.01-0.08) adjusted for disadvantage) and females (0.05 (0.02-0.09) in disadvantaged areas). Excess risks were estimated for all cancers (relative risk 1.21 (95% CI, 1.15-1.27) and 1.08 (1.03-1.14)), and melanoma (1.52 (1.25-1.85) and 1.29 (1.08-1.55)), for males and females, respectively, in disadvantaged areas in the highest quintile of the exposure metric relative to the lowest. Our findings suggest small but significant increases in past cancer risk associated with increasing soil arsenic in socioeconomically disadvantaged areas and demonstrate the robustness of this geospatial approach. Journal of Exposure Science and Environmental Epidemiology advance online publication, 21 March 2012.
Ongoing soil arsenic exposure of children living in an historical gold mining area in regional Victoria, Australia: Identifying risk factors associated with uptake
- Authors: Martin, Rachael , Dowling, Kim , Pearce, Dora , Bennett, John , Stopic, Attila
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Asian Earth Sciences Vol. 77, no. (2013), p. 256-261
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- Description: Elevated levels of arsenic have been observed in some mine wastes and soils around historical gold mining areas in regional Victoria, Australia. Arsenic uptake from soil by children living in these areas has been demonstrated using toenail arsenic concentration as a biomarker, with evidence of some systemic absorption associated with periodic exposures. We conducted a follow-up study to ascertain if toenail arsenic concentrations, and risk factors for exposure, had changed over a five year period in an historical gold mining region in western regional Victoria, Australia. Residential soil samples (N= 14) and toenail clippings (N= 24) were analyzed for total arsenic using instrumental neutron activation analysis, including 19 toenail clippings samples that were obtained from the same study cohort in 2006. Toenail arsenic concentrations in 2011 (geometric mean, 0.171. μg/g; range, 0.030-0.540. μg/g) were significantly lower than those in 2006 (geometric mean, 0.464. μg/g; range, 0.150-2.10. μg/g; p<. 0.001). However, toenail arsenic concentrations were again correlated with soil arsenic levels (Spearman's rho= 0.630; p= 0.001). Spending time outdoors more often and for longer periods correlates with increased arsenic uptake (p< 0.05). Mining-influenced residential soils represent a long-term continuing source for potential arsenic exposure for children living in this historical mining region. © 2013.
- Description: C1
Size-dependent characterisation of historical gold mine wastes to examine human pathways of exposure to arsenic and other potentially toxic elements
- Authors: Martin, Rachael , Dowling, Kim , Pearce, Dora , Florentine, Singarayer , Bennett, John , Stopic, Attila
- Date: 2016
- Type: Text , Journal article
- Relation: Environmental Geochemistry and Health Vol. 38, no. 5 (2016), p. 1097-1114
- Full Text: false
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- Description: Abandoned historical gold mining wastes often exist as geographically extensive, unremediated, and poorly contained deposits that contain elevated levels of As and other potentially toxic elements (PTEs). One of the key variables governing human exposure to PTEs in mine waste is particle size. By applying a size-resolved approach to mine waste characterisation, this study reports on the proportions of mine waste relevant to human exposure and mobility, as well as their corresponding PTE concentrations, in four distinct historical mine wastes from the gold province in Central Victoria, Australia. To the best of our knowledge, such a detailed investigation and comparison of historical mining wastes has not been conducted in this mining-affected region. Mass distribution analysis revealed notable proportions of waste material in the readily ingestible size fraction (aecurrency sign250 A mu m; 36.1-75.6 %) and the dust size fraction (aecurrency sign100 A mu m; 5.9-45.6 %), suggesting a high potential for human exposure and dust mobilisation. Common to all mine waste types were statistically significant inverse trends between particle size and levels of As and Zn. Enrichment of As in the finest investigated size fraction (aecurrency sign53 A mu m) is of particular concern as these particles are highly susceptible to long-distance atmospheric transport. Human populations that reside in the prevailing wind direction from a mine waste deposit may be at risk of As exposure via inhalation and/or ingestion pathways. Enrichment of PTEs in the finer size fractions indicates that human health risk assessments based on bulk contaminant concentrations may underestimate potential exposure intensities.
In vitro assessment of arsenic mobility in historical mine waste dust using simulated lung fluid
- Authors: Martin, Rachael , Dowling, Kim , Nankervis, Scott , Pearce, Dora , Florentine, Singarayer , McKnight, Stafford
- Date: 2018
- Type: Text , Journal article
- Relation: Environmental Geochemistry and Health Vol. 40, no. 3 (2018), p. 1037-1049
- Full Text: false
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- Description: Exposure studies have linked arsenic (As) ingestion with disease in mining-affected populations; however, inhalation of mine waste dust as a pathway for pulmonary toxicity and systemic absorption has received limited attention. A biologically relevant extractant was used to assess the 24-h lung bioaccessibility of As in dust isolated from four distinct types of historical gold mine wastes common to regional Victoria, Australia. Mine waste particles less than 20 µm in size (PM20) were incubated in a simulated lung fluid containing a major surface-active component found in mammalian lungs, dipalmitoylphosphatidylcholine. The supernatants were extracted, and their As contents measured after 1, 2, 4, 8 and 24 h. The resultant As solubility profiles show rapid dissolution followed by a more modest increasing trend, with between 75 and 82% of the total 24-h bioaccessible As released within the first 8 h. These profiles are consistent with the solubility profile of scorodite, a secondary As-bearing phase detected by X-ray diffraction in one of the investigated waste materials. Compared with similar studies, the cumulative As concentrations released at the 24-h time point were extremely low (range 297 ± 6–3983 ± 396 µg L−1), representing between 0.020 ± 0.002 and 0.036 ± 0.003% of the total As in the PM20.
Health effects associated with inhalation of airborne arsenic arising from mining operations
- Authors: Martin, Rachael , Dowling, Kim , Pearce, Dora , Sillitoe, Jim , Florentine, Singarayer
- Date: 2014
- Type: Text , Journal article
- Relation: Geosciences (Switzerland) Vol. 4, no. 3 (2014), p. 128-175
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- Description: Arsenic in dust and aerosol generated by mining, mineral processing and metallurgical extraction industries, is a serious threat to human populations throughout the world. Major sources of contamination include smelting operations, coal combustion, hard rock mining, as well as their associated waste products, including fly ash, mine wastes and tailings. The number of uncontained arsenic-rich mine waste sites throughout the world is of growing concern, as is the number of people at risk of exposure. Inhalation exposures to arsenic-bearing dusts and aerosol, in both occupational and environmental settings, have been definitively linked to increased systemic uptake, as well as carcinogenic and non-carcinogenic health outcomes. It is therefore becoming increasingly important to identify human populations and sensitive sub-populations at risk of exposure, and to better understand the modes of action for pulmonary arsenic toxicity and carcinogenesis. In this paper we explore the contribution of smelting, coal combustion, hard rock mining and their associated waste products to atmospheric arsenic. We also report on the current understanding of the health effects of inhaled arsenic, citing results from various toxicological, biomedical and epidemiological studies. This review is particularly aimed at those researchers engaged in the distinct, but complementary areas of arsenic research within the multidisciplinary field of medical geology. © 2014 by the authors; licensee MDPI, Basel, Switzerland.
Sustainability and Regional Development: When Brownfields become playing fields sustainability in the mineral and energy sectors
- Authors: Dowling, Kim , Florentine, Singarayer , Martin, Rachael , Pearce, Dora
- Date: 2016
- Type: Text , Book chapter
- Relation: Sustainability in the Mineral and Energy Sectors Chapter 17 p. 305-321
- Full Text: false
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- Description: Human activity has, in the recent past, resulted in substantial changes in land cover, ecosystem health, and the ability of affected ecosystems to return to their orginal state. This necessitates further human intervention to recreate the systems functions than the present. Earlier restoration activities have not been documented extensively. This hinders our efforts to identify approaches that might support further work. "From Abstract"
Prevalence and risk factors of ischaemic stroke in the young : a regional Australian perspective
- Authors: Siriratnam, Pakeeran , Godfrey, Amelia , O’Connor, Ellie , Pearce, Dora , Hu, Chih , Low, Ashlea , Hair, Casey , Oqueli, Ernesto , Sharma, Anand , Kraemer, Thomas , Sahathevan, Ramesh
- Date: 2020
- Type: Text , Journal article
- Relation: Internal Medicine Journal Vol. 50, no. 6 (2020), p. 698-704
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- Description: Background: There is no universally accepted age cut-off for defining young strokes. Aims: We aimed to determine, based on the profile of young stroke patients in our regional centre, an appropriate age cut-off for young strokes. Methods: A retrospective analysis of all ischaemic stroke patients admitted to our centre from 2015 to 2017. We identified 391 ischaemic stroke patients; 30 patients between the ages of ≤50, 40 between 51–60 inclusive and 321 ≥ 61 years of age. We collected data on demographic profiles, risk factors and stroke classification using the Trial of Org 10 172 in Acute Stroke Treatment criteria. Results: We found significant differences between the ≤50 and ≥61 age groups for most of the risk factors and similarities between the 51–60 inclusive and ≥ 61 age groups. At least one of the six risk factors assessed in the study was present in 86.7% of the youngest group, 97.5% of the intermediate age group and 97.2% in the oldest group. In terms of the mechanisms of stroke, the youngest and oldest age groups in our study differed in the prevalence of cryptogenic, cardioembolic and other causes of stroke. The middle and older age groups had similar mechanisms of stroke. Conclusions: The prevalence of vascular risk factors and mechanisms of stroke likewise differed significantly across age groups. This study suggests that 50 years is an appropriate age cut-off for defining young strokes and reinforces the importance of primary prevention in all age groups. © 2019 Royal Australasian College of Physicians
Asymptomatic carotid stenosis is associated with circadian and other variability in embolus detection
- Authors: Abbott, Anne , Merican, Julia , Pearce, Dora , Juric, Ana , Worsnop, Christopher
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Neurology Vol. 10, no. (2019), p.
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- Description: Background and Purpose: Variability in transcranial Doppler (TCD) detection of embolic signals (ES) is important for risk stratification. We tested the effect of time of day on ES associated with 60–99% asymptomatic carotid stenosis. Materials and Methods: Subjects were from the Asymptomatic Carotid Stenosis Embolus Detection (ASED) Study such that half were previously ES-positive and half ES-negative with 6-monthly 60-min TCD monitoring. All underwent bilateral TCD monitoring for two 12-h sessions separated by 24 h. ES detection rates were calculated using 6 and 4-h intervals from midnight and effective TCD monitoring time. Results: Ten subjects (8 male, mean age 79.5 years) were monitored. Over 24 h, 5/10 study arteries with 60–99% asymptomatic carotid stenosis were ES-positive (range 1–28 ES/artery, 56 total ES from 177.9 total effective monitoring hours). The remaining five study arteries and all eight successfully monitored contralateral arteries were ES-negative. Using 6-h intervals the mean ES detection rate peaked at 0600-midday (0.64/h) and was lowest 1800-midnight (0.09/h) with an incidence rate ratio of 7.26 (95% CI 2.52–28.64, P ≤ 0.001). Using 4-h intervals the mean ES detection rate peaked at 0800-midday (0.64/h) and was lowest midnight-0400 (0.12/h) with an incidence rate ratio of 5.51 (95% CI 1.78–22.67, P = 0.001). Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. © Copyright © 2019 Abbott, Merican, Pearce, Juric, Worsnop, Foster and Chambers.