Jianghong Li - Academia.edu (original) (raw)
Talks by Jianghong Li
There is evidence that working non-standard hours can impact on health and developmental outcomes... more There is evidence that working non-standard hours can impact on health and developmental outcomes for the workers themselves and their families. In Western Australia it is relatively common for men to work away from home for extended periods of time in the mining industry. These fly-in fly-out (FIFO) workers are thought to be especially vulnerable to psychological disturbances and relationship problems that affect themselves and their families. This study uses data from a longitudinal pregnancy cohort study to examine mental health and relationship adjustment in FIFO and non-FIFO men and their partners during pregnancy. It is of interest to know if FIFO men or their partners tend to report higher rates of: mental health difficulties (stress, anxiety or depression); couple or family relationship difficulties; and job dissatisfaction.
The Peel Child Health Study (www.peelchildhealthstudy.com.au) recruited 450 women at 18-weeks in pregnancy and follow-ups were completed at 26 weeks and 34 weeks of pregnancy and at the birth of the child. A total of 289 couples completed questionnaires administered at the time of recruitment, which included 70 men that identified as working away from home (FIFO) as part of their job.
Pregnancy is a time of heightened risk of social and emotional health difficulties for men and women, however this period of vulnerability has received little attention in FIFO literature. This study seeks to inform industry and workforce policy makers of the potential risks and challenges of the FIFO lifestyle. It is anticipated that the results will inform employers as well as those who provide support services and build a better understanding of potential strengths or vulnerabilities for FIFO families.
Papers by Jianghong Li
Women and Birth, Aug 1, 2019
Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch ge... more Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may be saved and copied for your personal and scholarly purposes. You are not to copy documents for public or commercial purposes, to exhibit the documents publicly, to make them publicly available on the internet, or to distribute or otherwise use the documents in public.
Acta Paediatrica, 2008
Downie provided substantive comments on multiple drafts of the paper, regarding the background, a... more Downie provided substantive comments on multiple drafts of the paper, regarding the background, analysis and interpretation of the results. Dr Oddy also contributed to the editorial improvement. Dr Henderson provided a literature research and review and useful comments on the paper. Ms Landsborough contributed to the analysis and provided important comments on the manuscript.
Social science & medicine (1982), Nov 1, 2016
Extensive evidence has shown that working nonstandard hours, such as evening or night shifts, imp... more Extensive evidence has shown that working nonstandard hours, such as evening or night shifts, impacts negatively on workers' own health, and a growing literature suggests such impacts extend to the health of workers' children. Using matched parent and child data from a large Australian panel survey this paper explores the effects of parental work schedules on the mental and physical health of adolescents aged 15-20 in sole-parent families. Random-effects models indicate adolescents have marginally worse emotional and physical health when their parent works nonstandard hours, based on SF-36 component summary scores, associated primarily with emotional or physical role limitations. Parental weekend schedules are particularly detrimental to adolescent physical health. Evidence is found that the effects of nonstandard work schedules on adolescent wellbeing are transmitted through increased work-family conflict and exacerbated where parents have low job control.
Health Sociology …, 2009
Social determinants of child health and well-being S trong associations between socioeconomic sta... more Social determinants of child health and well-being S trong associations between socioeconomic status, measured by such factors as level of education, income, and occupational status, greater access to resources and political power, and an individual's health and well-being are well established and evident throughout the whole life course. Clearly, social factors are fundamental elements of the causal pathways to ill health and disease (Link and Phelan 1995; Marmot and Wilkinson 1999; CSDH 2008) and indirectly through their impact on early child development. Hence they also infl uence our current and future wealth (Keating and Hertzman 1999). With the growing evidence of the impact of social inequalities on health, policy makers in all countries are showing an increased interest in understanding them and in seeking ways to create more equitable societies. The importance of this trend is charted in two editions of Social Determinants of Health by Michael Marmot and Richard Wilkinson (1999, 2006), the establishment of the Commission on the Social
Housing and children's development and wellbeing: a scoping study ISBN 978-1-921610-45-5
Socioeconomic adversity in childhood is associated with lower educational attainment. What is les... more Socioeconomic adversity in childhood is associated with lower educational attainment. What is less known, however, is that health, too, plays an important role in the process of educational attainment. Poor health in early life potentially has life-long negative effects on learning. Early health interventions have a potential to help break the cycle of social adversity and poor educational outcomes.
World Development, 2013
ABSTRACT We investigated the causal effects of female empowerment (female educational attainment,... more ABSTRACT We investigated the causal effects of female empowerment (female educational attainment, female labor force participation, and total fertility rates) on democratic development for 97 countries from 1980 to 2005. Using Polity IV as an indicator of levels of democracy, our results show that female empowerment was strongly associated with democratic development over this period. The effect of female education increased with lags of 5 and 10 years, suggesting that democracy is more likely to occur in nations with a history of educating girls and a longer experience of the social and economic conditions that have occurred because of this investment.
Sexually transmitted infections, Jan 4, 2015
HIV testing is mandatory in re-education-through-labour camps (laojiaosuo) in China yet no studie... more HIV testing is mandatory in re-education-through-labour camps (laojiaosuo) in China yet no studies have reported on the process. The survey response rate was 100% although 29 detainees were excluded because they were under 18 years of age. A cross-sectional face-to-face survey was conducted in three labour camps in Guangxi, located in the south-western region of China. Of the 755 detainees surveyed, 725 (96%) reported having a blood test in the labour camps of whom 493 (68%) thought this included an HIV test. 61 detainees self-reported they were HIV infected, their status confirmed by medical records, if available. Of these, 53 (87%) recalled receiving post-test HIV education, and 15 (25%) were currently receiving HIV antiretroviral therapy. Pretest education on HIV was provided to 233/725 (32%) detainees. The study further reports on detainees' reactions and feelings towards non-disclosure and disclosure of their HIV test results in the labour camps. Mandatory testing is almost...
Journal of Insect Physiology, 2011
Journal of Community Psychology, 2011
Nutrients, 2015
The aim of this study was to investigate cross-sectional associations between dietary patterns an... more The aim of this study was to investigate cross-sectional associations between dietary patterns and academic performance among 14-year-old adolescents. Study participants were from the Western Australian Pregnancy Cohort (Raine) Study. A food frequency questionnaire was administered when the adolescents were 14 years old, and from the dietary data, a 'Healthy' and a 'Western' dietary pattern were identified by factor analysis. The Western Australian Literacy and Numeracy Assessment (WALNA) results from grade nine (age 14) were linked to the Raine Study data by The Western Australian Data Linkage Branch. Associations between the dietary patterns and the WALNA (mathematics, reading and writing scores) were assessed using multivariate linear regression models adjusting for family and socioeconomic characteristics. Complete data on dietary patterns, academic performance and covariates were available for individuals across the different analyses as follows: n = 779 for mat...
International Journal of Gynecology & Obstetrics, 2012
Objective: To determine whether common perinatal complications could explain variation in risk of... more Objective: To determine whether common perinatal complications could explain variation in risk of cesarean among foreign-born and Australian-born women in Western Australia (WA). Methods: Complication prevalence was calculated using the linked records of 208 982 confinements to non-indigenous women in WA between 1998 and 2006. Logistic regression was used to estimate differences in risk of elective cesarean and emergency cesarean compared with vaginal delivery for foreign-born women from different regions. Results:
Social science & medicine (1982), 2004
This study examines the determinants of prenatal and obstetric care utilization within the contex... more This study examines the determinants of prenatal and obstetric care utilization within the context of recent social and economic changes in contemporary rural China. The aim of this study is to test the general hypothesis that gender inequality (women's status and son preference) and the state's family planning policy have a significant influence on maternal and childcare utilization. Both qualitative and quantitative data from a field survey in 1994 in rural Yunnan were used in the study. The findings lend support to this hypothesis. For example, the extent to which the husband shares housework and childcare, as an important marker of rural Chinese women's position within the family, is positively associated with the likelihood that a woman receives prenatal examinations, stops heavy physical work before birth, and gives birth under aseptic conditions. Also, a woman's exposure to the larger world beyond the village increases her chances of giving birth with the assi...
Early Years, 2007
... 09575140701594384 Jianghong Li a * , Amedeo D'Angiulli b & Garth E. ... more ... 09575140701594384 Jianghong Li a * , Amedeo D'Angiulli b & Garth E. Kendall c pages 221-235. ... Developmental Psychology , 35: 10791090. [CrossRef], [PubMed], [Web of Science ®], [CSA] View all references; Gutierrez & Rogoff, 200318. Gutierrez, K. and Rogoff, B. 2003. ...
Cancer Biology & Therapy, 2009
Claudin proteins are frequently overexpressed in various tumors such as breast, prostate and ovar... more Claudin proteins are frequently overexpressed in various tumors such as breast, prostate and ovarian cancer. While their functions in cancer have not been completely elucidated, roles in survival, adhesion, and invasion have been suggested. In order to clarify the roles of claudins in ovarian cancer, we have performed gene expression profiling of ovarian surface epithelial cells overexpressing claudin-4 and compared the expression patterns to the parental, non-expressing cells. Claudin-4 expression leads to the differential expression of several genes, including many that have previously been implicated in angiogenesis. In particular, angiogenic cytokines, such as IL-8, were found elevated while genes of the angiostatic interferon pathway were found down-regulated. In vitro assays show that claudin-4-expressing cells produce factors that can stimulate angiogenesis as measured by tube formation and migration in HUVEC cells. In addition, an in vivo mouse dorsal skinfold assay confirms that cells expressing claudin-4 secrete factors that can mediate angiogenesis in the dorsal skin of mice. Our data suggest a novel function for claudin-4 in cancer and provide an additional rationale for its common overexpression in human tumors.
Annals of Epidemiology, 2011
This study describes social and racial inequalities in poor fetal growth in Western Australia bet... more This study describes social and racial inequalities in poor fetal growth in Western Australia between 1984 and 2006. Multilevel multivariate logistic regression was used to investigate relative differences in fetal growth restriction between socioeconomic groups. Fetal growth restriction was defined as having a proportion of optimal birth weight corresponding to less than the 10th percentile for the population. Aboriginal (N = 50,395) and non-Aboriginal (N = 517,073) infants were analyzed separately. There has been an overall decrease in the rate of poor fetal growth during the last 23 years, with a plateau reached in recent years. Aboriginal infants were significantly more likely to have fetal growth restriction than non-Aboriginal infants and social inequalities increased over time, particularly among non-Aboriginal infants. After stratifying by Aboriginality and accounting for important parental sociodemographic characteristics, the community-level socioeconomic gradient remained. This study highlights the misleading nature of observing aggregated rates of poor fetal growth that mask increasing inequalities, and the importance of monitoring trends by social and racial characteristics. It also highlights the concerning finding that almost all improvements in poor fetal growth have occurred in the least disadvantaged communities, with almost no change in the most disadvantaged communities, which is likely to result in further increases in social and racial inequalities.
Ophthalmic Epidemiology, 2003
As an initial phase of the Endophthalmitis Population Study of Western Australia (EPSWA), this pa... more As an initial phase of the Endophthalmitis Population Study of Western Australia (EPSWA), this paper reports the results from an intensive comparative validation of all possible surgery-related endophthalmitis cases identified for the period from 1980 to June 1999 from the Hospital Morbidity Data System (HMDS) of the WA Record Linkage Project with external sources. The external sources were the microbiology and anaesthetic databases from Royal Perth Hospital (where most of the cases of endophthalmitis were treated) and surgeon logbooks of two vitreoretinal surgeons treating endophthalmitis in Perth over the study period. As it was discovered that a large proportion of all cases coded with endophthalmitis did not have any ocular surgery, the validation also included a sample from these cases. The purpose of validating these cases was to ensure that our count of post-operative endophthalmitis had not excluded any cases whose surgery might not have been recorded in the HMDS database. It was also intended to provide an estimate of all miscoded endophthalmitis cases as a first step towards future improvement of coding accuracy. Since we suspected that phaco-emulsification was under-coded, we also examined a sample of cataract procedures. Of all surgery-related endophthalmitis cases coded in the HMDS, only 50.9% (274 of 538) were found to be valid cases. External sources identified 83 cases of endophthalmitis, 49 did not have endophthal-mitis codes but were in the HMDS file with an associated code. Of the remaining externally identified cases, 13 were missing altogether from the HMDS file, 7 of which were correctly coded in the notes while the other 6 were coded with associated codes, and 21 were diagnosed after the date the HMDS file was extracted. The validation of a random sample of the non-surgery-related cases coded with endophthalmitis suggested that the vast majority of them were miscoded (88%, 139 of 158 sampled from 1474 cases). The systematic coding errors reported in this paper may be attributed to both the clinical and the coding departments of the hospital. In any case, coding inaccuracy itself is a serious concern for data quality of any linked database systems and for epidemiological researchers using such data. The increased use of aggregated data in epidemiological research further underscores the importance of coding accuracy and thus data validation. The use of external sources for case identification and case validation are two ways of ensuring data completeness/quality and validity of results.
There is evidence that working non-standard hours can impact on health and developmental outcomes... more There is evidence that working non-standard hours can impact on health and developmental outcomes for the workers themselves and their families. In Western Australia it is relatively common for men to work away from home for extended periods of time in the mining industry. These fly-in fly-out (FIFO) workers are thought to be especially vulnerable to psychological disturbances and relationship problems that affect themselves and their families. This study uses data from a longitudinal pregnancy cohort study to examine mental health and relationship adjustment in FIFO and non-FIFO men and their partners during pregnancy. It is of interest to know if FIFO men or their partners tend to report higher rates of: mental health difficulties (stress, anxiety or depression); couple or family relationship difficulties; and job dissatisfaction.
The Peel Child Health Study (www.peelchildhealthstudy.com.au) recruited 450 women at 18-weeks in pregnancy and follow-ups were completed at 26 weeks and 34 weeks of pregnancy and at the birth of the child. A total of 289 couples completed questionnaires administered at the time of recruitment, which included 70 men that identified as working away from home (FIFO) as part of their job.
Pregnancy is a time of heightened risk of social and emotional health difficulties for men and women, however this period of vulnerability has received little attention in FIFO literature. This study seeks to inform industry and workforce policy makers of the potential risks and challenges of the FIFO lifestyle. It is anticipated that the results will inform employers as well as those who provide support services and build a better understanding of potential strengths or vulnerabilities for FIFO families.
Women and Birth, Aug 1, 2019
Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch ge... more Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may be saved and copied for your personal and scholarly purposes. You are not to copy documents for public or commercial purposes, to exhibit the documents publicly, to make them publicly available on the internet, or to distribute or otherwise use the documents in public.
Acta Paediatrica, 2008
Downie provided substantive comments on multiple drafts of the paper, regarding the background, a... more Downie provided substantive comments on multiple drafts of the paper, regarding the background, analysis and interpretation of the results. Dr Oddy also contributed to the editorial improvement. Dr Henderson provided a literature research and review and useful comments on the paper. Ms Landsborough contributed to the analysis and provided important comments on the manuscript.
Social science & medicine (1982), Nov 1, 2016
Extensive evidence has shown that working nonstandard hours, such as evening or night shifts, imp... more Extensive evidence has shown that working nonstandard hours, such as evening or night shifts, impacts negatively on workers' own health, and a growing literature suggests such impacts extend to the health of workers' children. Using matched parent and child data from a large Australian panel survey this paper explores the effects of parental work schedules on the mental and physical health of adolescents aged 15-20 in sole-parent families. Random-effects models indicate adolescents have marginally worse emotional and physical health when their parent works nonstandard hours, based on SF-36 component summary scores, associated primarily with emotional or physical role limitations. Parental weekend schedules are particularly detrimental to adolescent physical health. Evidence is found that the effects of nonstandard work schedules on adolescent wellbeing are transmitted through increased work-family conflict and exacerbated where parents have low job control.
Health Sociology …, 2009
Social determinants of child health and well-being S trong associations between socioeconomic sta... more Social determinants of child health and well-being S trong associations between socioeconomic status, measured by such factors as level of education, income, and occupational status, greater access to resources and political power, and an individual's health and well-being are well established and evident throughout the whole life course. Clearly, social factors are fundamental elements of the causal pathways to ill health and disease (Link and Phelan 1995; Marmot and Wilkinson 1999; CSDH 2008) and indirectly through their impact on early child development. Hence they also infl uence our current and future wealth (Keating and Hertzman 1999). With the growing evidence of the impact of social inequalities on health, policy makers in all countries are showing an increased interest in understanding them and in seeking ways to create more equitable societies. The importance of this trend is charted in two editions of Social Determinants of Health by Michael Marmot and Richard Wilkinson (1999, 2006), the establishment of the Commission on the Social
Housing and children's development and wellbeing: a scoping study ISBN 978-1-921610-45-5
Socioeconomic adversity in childhood is associated with lower educational attainment. What is les... more Socioeconomic adversity in childhood is associated with lower educational attainment. What is less known, however, is that health, too, plays an important role in the process of educational attainment. Poor health in early life potentially has life-long negative effects on learning. Early health interventions have a potential to help break the cycle of social adversity and poor educational outcomes.
World Development, 2013
ABSTRACT We investigated the causal effects of female empowerment (female educational attainment,... more ABSTRACT We investigated the causal effects of female empowerment (female educational attainment, female labor force participation, and total fertility rates) on democratic development for 97 countries from 1980 to 2005. Using Polity IV as an indicator of levels of democracy, our results show that female empowerment was strongly associated with democratic development over this period. The effect of female education increased with lags of 5 and 10 years, suggesting that democracy is more likely to occur in nations with a history of educating girls and a longer experience of the social and economic conditions that have occurred because of this investment.
Sexually transmitted infections, Jan 4, 2015
HIV testing is mandatory in re-education-through-labour camps (laojiaosuo) in China yet no studie... more HIV testing is mandatory in re-education-through-labour camps (laojiaosuo) in China yet no studies have reported on the process. The survey response rate was 100% although 29 detainees were excluded because they were under 18 years of age. A cross-sectional face-to-face survey was conducted in three labour camps in Guangxi, located in the south-western region of China. Of the 755 detainees surveyed, 725 (96%) reported having a blood test in the labour camps of whom 493 (68%) thought this included an HIV test. 61 detainees self-reported they were HIV infected, their status confirmed by medical records, if available. Of these, 53 (87%) recalled receiving post-test HIV education, and 15 (25%) were currently receiving HIV antiretroviral therapy. Pretest education on HIV was provided to 233/725 (32%) detainees. The study further reports on detainees' reactions and feelings towards non-disclosure and disclosure of their HIV test results in the labour camps. Mandatory testing is almost...
Journal of Insect Physiology, 2011
Journal of Community Psychology, 2011
Nutrients, 2015
The aim of this study was to investigate cross-sectional associations between dietary patterns an... more The aim of this study was to investigate cross-sectional associations between dietary patterns and academic performance among 14-year-old adolescents. Study participants were from the Western Australian Pregnancy Cohort (Raine) Study. A food frequency questionnaire was administered when the adolescents were 14 years old, and from the dietary data, a 'Healthy' and a 'Western' dietary pattern were identified by factor analysis. The Western Australian Literacy and Numeracy Assessment (WALNA) results from grade nine (age 14) were linked to the Raine Study data by The Western Australian Data Linkage Branch. Associations between the dietary patterns and the WALNA (mathematics, reading and writing scores) were assessed using multivariate linear regression models adjusting for family and socioeconomic characteristics. Complete data on dietary patterns, academic performance and covariates were available for individuals across the different analyses as follows: n = 779 for mat...
International Journal of Gynecology & Obstetrics, 2012
Objective: To determine whether common perinatal complications could explain variation in risk of... more Objective: To determine whether common perinatal complications could explain variation in risk of cesarean among foreign-born and Australian-born women in Western Australia (WA). Methods: Complication prevalence was calculated using the linked records of 208 982 confinements to non-indigenous women in WA between 1998 and 2006. Logistic regression was used to estimate differences in risk of elective cesarean and emergency cesarean compared with vaginal delivery for foreign-born women from different regions. Results:
Social science & medicine (1982), 2004
This study examines the determinants of prenatal and obstetric care utilization within the contex... more This study examines the determinants of prenatal and obstetric care utilization within the context of recent social and economic changes in contemporary rural China. The aim of this study is to test the general hypothesis that gender inequality (women's status and son preference) and the state's family planning policy have a significant influence on maternal and childcare utilization. Both qualitative and quantitative data from a field survey in 1994 in rural Yunnan were used in the study. The findings lend support to this hypothesis. For example, the extent to which the husband shares housework and childcare, as an important marker of rural Chinese women's position within the family, is positively associated with the likelihood that a woman receives prenatal examinations, stops heavy physical work before birth, and gives birth under aseptic conditions. Also, a woman's exposure to the larger world beyond the village increases her chances of giving birth with the assi...
Early Years, 2007
... 09575140701594384 Jianghong Li a * , Amedeo D'Angiulli b & Garth E. ... more ... 09575140701594384 Jianghong Li a * , Amedeo D'Angiulli b & Garth E. Kendall c pages 221-235. ... Developmental Psychology , 35: 10791090. [CrossRef], [PubMed], [Web of Science ®], [CSA] View all references; Gutierrez & Rogoff, 200318. Gutierrez, K. and Rogoff, B. 2003. ...
Cancer Biology & Therapy, 2009
Claudin proteins are frequently overexpressed in various tumors such as breast, prostate and ovar... more Claudin proteins are frequently overexpressed in various tumors such as breast, prostate and ovarian cancer. While their functions in cancer have not been completely elucidated, roles in survival, adhesion, and invasion have been suggested. In order to clarify the roles of claudins in ovarian cancer, we have performed gene expression profiling of ovarian surface epithelial cells overexpressing claudin-4 and compared the expression patterns to the parental, non-expressing cells. Claudin-4 expression leads to the differential expression of several genes, including many that have previously been implicated in angiogenesis. In particular, angiogenic cytokines, such as IL-8, were found elevated while genes of the angiostatic interferon pathway were found down-regulated. In vitro assays show that claudin-4-expressing cells produce factors that can stimulate angiogenesis as measured by tube formation and migration in HUVEC cells. In addition, an in vivo mouse dorsal skinfold assay confirms that cells expressing claudin-4 secrete factors that can mediate angiogenesis in the dorsal skin of mice. Our data suggest a novel function for claudin-4 in cancer and provide an additional rationale for its common overexpression in human tumors.
Annals of Epidemiology, 2011
This study describes social and racial inequalities in poor fetal growth in Western Australia bet... more This study describes social and racial inequalities in poor fetal growth in Western Australia between 1984 and 2006. Multilevel multivariate logistic regression was used to investigate relative differences in fetal growth restriction between socioeconomic groups. Fetal growth restriction was defined as having a proportion of optimal birth weight corresponding to less than the 10th percentile for the population. Aboriginal (N = 50,395) and non-Aboriginal (N = 517,073) infants were analyzed separately. There has been an overall decrease in the rate of poor fetal growth during the last 23 years, with a plateau reached in recent years. Aboriginal infants were significantly more likely to have fetal growth restriction than non-Aboriginal infants and social inequalities increased over time, particularly among non-Aboriginal infants. After stratifying by Aboriginality and accounting for important parental sociodemographic characteristics, the community-level socioeconomic gradient remained. This study highlights the misleading nature of observing aggregated rates of poor fetal growth that mask increasing inequalities, and the importance of monitoring trends by social and racial characteristics. It also highlights the concerning finding that almost all improvements in poor fetal growth have occurred in the least disadvantaged communities, with almost no change in the most disadvantaged communities, which is likely to result in further increases in social and racial inequalities.
Ophthalmic Epidemiology, 2003
As an initial phase of the Endophthalmitis Population Study of Western Australia (EPSWA), this pa... more As an initial phase of the Endophthalmitis Population Study of Western Australia (EPSWA), this paper reports the results from an intensive comparative validation of all possible surgery-related endophthalmitis cases identified for the period from 1980 to June 1999 from the Hospital Morbidity Data System (HMDS) of the WA Record Linkage Project with external sources. The external sources were the microbiology and anaesthetic databases from Royal Perth Hospital (where most of the cases of endophthalmitis were treated) and surgeon logbooks of two vitreoretinal surgeons treating endophthalmitis in Perth over the study period. As it was discovered that a large proportion of all cases coded with endophthalmitis did not have any ocular surgery, the validation also included a sample from these cases. The purpose of validating these cases was to ensure that our count of post-operative endophthalmitis had not excluded any cases whose surgery might not have been recorded in the HMDS database. It was also intended to provide an estimate of all miscoded endophthalmitis cases as a first step towards future improvement of coding accuracy. Since we suspected that phaco-emulsification was under-coded, we also examined a sample of cataract procedures. Of all surgery-related endophthalmitis cases coded in the HMDS, only 50.9% (274 of 538) were found to be valid cases. External sources identified 83 cases of endophthalmitis, 49 did not have endophthal-mitis codes but were in the HMDS file with an associated code. Of the remaining externally identified cases, 13 were missing altogether from the HMDS file, 7 of which were correctly coded in the notes while the other 6 were coded with associated codes, and 21 were diagnosed after the date the HMDS file was extracted. The validation of a random sample of the non-surgery-related cases coded with endophthalmitis suggested that the vast majority of them were miscoded (88%, 139 of 158 sampled from 1474 cases). The systematic coding errors reported in this paper may be attributed to both the clinical and the coding departments of the hospital. In any case, coding inaccuracy itself is a serious concern for data quality of any linked database systems and for epidemiological researchers using such data. The increased use of aggregated data in epidemiological research further underscores the importance of coding accuracy and thus data validation. The use of external sources for case identification and case validation are two ways of ensuring data completeness/quality and validity of results.
American Journal of Community Psychology, 2009
Peer delivered, social oriented HIV prevention intervention designs are increasingly popular for ... more Peer delivered, social oriented HIV prevention intervention designs are increasingly popular for addressing broader contexts of health risk beyond a focus on individual factors. Such interventions have the potential to affect multiple social levels of risk and change, including at the individual, network, and community levels, and reflect social ecological principles of interaction across social levels over time. The iterative and feedback dynamic generated by this multi-level effect increases the likelihood for sustained health improvement initiated by those trained to deliver the peer intervention. The Risk Avoidance Partnership (RAP), conducted with heroin and cocaine/crack users in Hartford, Connecticut, exemplified this intervention design and illustrated the multi-level effect on drug users' risk and harm reduction at the individual level, the social network level, and the larger community level. Implications of the RAP program for designing effective prevention programs and for analyzing long-term change to reduce HIV transmission among high-risk groups are discussed from this ecological and multi-level intervention perspective.