An evaluation of tobacco brief intervention training in three Indigenous health care settings in north Queensland

Objective: To evaluate the pilot phase of a tobacco brief intervention program in three Indigenous health care settings in rural and remote north Queensland. Methods: A combination of in-depth interviews with health staff and managers and focus groups with health staff and consumers. Results: The tobacco brief intervention initiative resulted in changes in clinical practice among health care workers in all three sites. Although health workers had reported routinely raising the issue of smoking in a variety of settings prior to the intervention, the training provided them with an additional opportunity to become more aware of new approaches to smoking cessation. Indigenous health workers in particular reported that their own attempts to give up smoking following the training had given them confidence and empathy in offering smoking cessation advice. However, the study found no evidence that anybody had actually given up smoking at six months following the intervention. Integration of brief intervention into routine clinical practice was constrained by organisational, interpersonal and other factors in the broader socio-environmental context. Conclusions/implications: While modest health gains may be possible through brief intervention, the potential effectiveness in Indigenous settings will be limited in the absence of broader strategies aimed at tackling community-identified health priorities such as alcohol misuse, violence, employment and education. Tobacco and other forms of lifestyle brief. intervention need to be part of multi-level health strategies. Training in tobacco brief intervention should address both the Indigenous context and the needs of Indigenous health care workers.

An adaptive and dynamic dimensionality reduction method for high-dimensional indexing

The notorious "dimensionality curse" is a well-known phenomenon for any multi-dimensional indexes attempting to scale up to high dimensions. One well-known approach to overcome degradation in performance with respect to increasing dimensions is to reduce the dimensionality of the original dataset before constructing the index. However, identifying the correlation among the dimensions and effectively reducing them are challenging tasks. In this paper, we present an adaptive Multi-level Mahalanobis-based Dimensionality Reduction (MMDR) technique for high-dimensional indexing. Our MMDR technique has four notable features compared to existing methods. First, it discovers elliptical clusters for more effective dimensionality reduction by using only the low-dimensional subspaces. Second, data points in the different axis systems are indexed using a single B+-tree. Third, our technique is highly scalable in terms of data size and dimension. Finally, it is also dynamic and adaptive to insertions. An extensive performance study was conducted using both real and synthetic datasets, and the results show that our technique not only achieves higher precision, but also enables queries to be processed efficiently. Copyright Springer-Verlag 2005

Family, work and health - The impact of marriage, parenthood and employment on self-reported health of Australian men and women

We investigate multiple-burden and multiple-attachment hypotheses for the association among marriage, parenthood, employment and health for Australian men and women. Using longitudinal data from the Australian panel survey, 'Negotiating the Lifecourse', we find that men and women employed full time report better health than those employed part time or not employed. Previously married women report worse health than married women, but there is no association between marital status and health for men. We also find that men with preschool children in the household report worse health than men with older children, whereas women with preschool children report better health than women with older children. In addition for women we find evidence of a role-burden where combining full-time employment and children has a negative impact on health, but combining children with part-time or no employment has a beneficial health effect. There are no health effects of combining roles for men.

On aggregation issues in spatial data management

Large amounts of information can be overwhelming and costly to process, especially when transmitting data over a network. A typical modern Geographical Information System (GIS) brings all types of data together based on the geographic component of the data and provides simple point-and-click query capabilities as well as complex analysis tools. Querying a Geographical Information System, however, can be prohibitively expensive due to the large amounts of data which may need to be processed. Since the use of GIS technology has grown dramatically in the past few years, there is now a need more than ever, to provide users with the fastest and least expensive query capabilities, especially since an approximated 80 % of data stored in corporate databases has a geographical component. However, not every application requires the same, high quality data for its processing. In this paper we address the issues of reducing the cost and response time of GIS queries by preaggregating data by compromising the data accuracy and precision. We present computational issues in generation of multi-level resolutions of spatial data and show that the problem of finding the best approximation for the given region and a real value function on this region, under a predictable error, in general is "NP-complete.

10,000 Steps Rockhampton: A Whole Community Approach to Increasing Levels of Physical Activity

10,000 Steps Rockhampton is a multi-strategy health promotion program which aims to develop sustainable community-based strategies to increase physical activity.The central coordinating focus of the project is the use of pedometers to raise awareness of and provide motivation for physical activity, around the theme of '10,000 steps/day - Every step counts.' To date, five key strategies have been implemented: (1) a media-based awareness raising campaign; (2) promotion of physical activity by health professionals; (3) improving social support for physical activity through group-based programs; (4) working with local council to improve environmental support for physical activity; and (5) establishment of a ‘micro-grants’ fund to which community groups could apply for assistance with small, innovative physical activity enhancing projects. Strategies were introduced on a rolling basis beginning in February 2002 with 'layering' of interventions designed to address the multi-level individual social and environmental determinants of physical activity. The project was quasi-experimental in design, involving collection of baseline and two year follow-up data from community based surveys in Rockhampton and in a matched regional Queensland town. In August 2001,the baseline CATI survey (N=1281)found that 47.9% of men and 33.0% of women were meeting the national guidelines for physical activity. In August 2002, a smaller survey (N=400) found an increase in activity levels among women (39.7% active) but not in men (48.5%). Data from the two year follow up survey, to be conducted in August 2003, will be presented, with discussion of the major successes and challenges of this landmark physical activity intervention. Acknowledgement: This project is supported by a grant from Health Promotion Queensland