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Background: Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Methods: Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Results: Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Conclusion: Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services. [ABSTRACT FROM AUTHOR]

The spatial distribution of income shapes the structure and organisation of cities and its understanding has broad societal implications. Despite an abundant literature, many issues remain unclear. In particular, all definitions of segregation are implicitely tied to a single indicator, usually rely on an ambiguous definition of income classes, without any consensus on how to define neighbourhoods and to deal with the polycentric organization of large cities. In this paper, we address all these questions within a unique conceptual framework. We avoid the challenge of providing a direct definition of segregation and instead start from a definition of what segregation is not. This naturally leads to the measure of representation that is able to identify locations where categories are over- or underrepresented. From there, we provide a new measure of exposure that discriminates between situations where categories co-locate or repel one another. We then use this feature to provide an unambiguous, parameter-free method to find meaningful breaks in the income distribution, thus defining classes. Applied to the 2014 American Community Survey, we find 3 emerging classes—low, middle and higher income—out of the original 16 income categories. The higher-income households are proportionally more present in larger cities, while lower-income households are not, invalidating the idea of an increased social polarisation. Finally, using the density—and not the distance to a center which is meaningless in polycentric cities—we find that the richer class is overrepresented in high density zones, especially for larger cities. This suggests that density is a relevant factor for understanding the income structure of cities and might explain some of the differences observed between US and European cities. [ABSTRACT FROM AUTHOR]

This paper first reviews the descriptions and structural explanations for variations, in urban population densities in the United States over several decades. The research reviewed focuses on shifts in the technology and economics of travel as being the major influences on urban density distributions. These variables appear to be somewhat less adequate as explanations of the process in recent decades. After reviewing these findings and suggesting several research questions, we attempt to assess the evidence relating variations in population density to several other aspects of human behavior. A review of the research relating high population densities to various "social pathologies" indicates that little of the variance in rates of these pathologies can be attributed to density independently of other social structural variables. Some important consequences of population density have been reported, however, and possible research directions are outlined. [ABSTRACT FROM AUTHOR]

Many studies have explored the relationship between housing prices and environmental characteristics using the hedonic price model (HPM). However, few studies have deeply examined the impact of scene perception near residential units on housing prices. This article used house purchasing records from and open access geolocation data (including massive street view pictures, point of interest (POI) data and road network data) and proposed a framework named “open-access-dataset-based hedonic price modeling (OADB-HPM)” for comprehensive analysis in Beijing and Shanghai, China. A state-of-the-art deep learning framework and massive Baidu street view panoramas were employed to visualize and quantify three major scene perception characteristics (greenery, sky and building view indexes, abbreviated GVI, SVI and BVI, respectively) at the street level. Then, the newly introduced scene perception characteristics were combined with other traditional characteristics in the HPM to calculate marginal prices, and the results for Beijing and Shanghai were explored and compared. The empirical results showed that the greenery and sky perceptual elements at the property level can significantly increase the housing price in Beijing (RMB 39,377 and 6011, respectively) and Shanghai (RMB 21,689 and 2763, respectively), indicating an objectively higher willingness by buyers to pay for houses that provide the ability to perceive natural elements in the surrounding environment. This study developed quantification tools to help decision makers and planners understand and analyze the interaction between residents and urban scene components. [ABSTRACT FROM AUTHOR]

Introduction: Low back pain (LBP) is highly prevalent in Nigeria and is more devastating in rural Nigeria due to adverse living and working conditions, reinforced by maladaptive illness beliefs. There is a need to develop measures for assessing such beliefs in this population. This study aimed to cross-culturally adapt the Fear Avoidance Beliefs Questionnaire (FABQ) and test its psychometric properties in mixed rural and urban Nigerian populations with chronic LBP. Methods: Translation, cultural adaptation, test–retest, and cross-sectional psychometric testing. FABQ was forward and back translated by clinical/non-clinical translators. A review committee evaluated the translations. Twelve people with chronic LBP in a rural Nigerian community pre-tested the questionnaire. Cronbach’s alpha assessing internal consistency; intra-class correlation coefficient and Bland–Altman plots assessing test–retest reliability; and minimal detectable change were investigated in a convenient sample of 50 chronic low back pain sufferers in rural and urban Nigeria. Construct validity was examined using Pearson’s correlation analyses with the eleven-point box scale and Igbo Roland Morris Disability Questionnaire (Igbo-RMDQ), and exploratory factor analysis in a random sample of 200 adults with chronic low back pain in rural Nigeria. Ceiling and floor effects were investigated in all samples. Results: Amendments allowed interviewer-administration. Item 8 was modified to ‘I have a compensation or gains I get from having my pain’ as there is no benefit system in Nigeria. Igbo phrase for ‘physical activity’ could also mean ‘being active’, ‘moving the body’ or ‘moving about’ and was used in the items with ‘physical activity’. The Igbo-FABQ had good internal consistency (α = 0.80–0.86); intra class correlation coefficients (ICC = 0.71–0.72); standard error of measurements (3.21–7.40) and minimal detectable change (8.90–20.51). It correlated moderately with pain intensity and disability, with a two-factor structure and no floor and ceiling effects. Conclusions: Igbo-FABQ is valid, reliable, and can be used clinically and for research. [ABSTRACT FROM AUTHOR]

Objectives: The effects of disasters on mental health are well documented, but very little is known about the short to long-term effects of human-made disasters on wage and employment security careers of the affected residents. Methods: Residents affected by a major fireworks disaster (May 13, 2000) in a Dutch residential area were all anonymously identified, based on postal codes of the affected area. To gain insight in these effects, data were derived from Statistics Netherlands that records all individual demographic, gross annual wages and employment security data of the entire Dutch population since 1999. A quasi-experimental matched control group design was used by constructing two pair-wise matched groups of non-affected residents of the city of Tilburg and the general Dutch population. Matching was based on nine demographic variables such as gender, age, education level and gross annual wage in 1999 (Ntotal = 12,648). The effects of the disaster on wage and employment security from 1999 to 2016 among the total group and among those with low wages in 1999, were assessed using fixed-effects panel regression analyses. Results: Affected residents had significant lower gross annual wages in the medium and long term than the non-affected groups from the Netherlands, but differences were (very) small. Compared to the Tilburg group the significant differences were trivial in the medium term. Among the low-wage groups, no relevant differences were found between affected and non-affected residents. With respect to employment security, no or trivial differences were found between the total group of affected and matched comparison groups. Among those with low wages in 1999, in 2001 and especially 2002 affected residents worked fewer weeks per year than non-affected from Tilburg. In 2002 the difference with the Tilburg group was above moderate. Conclusions: These results speak to the resilience of affected residents, given the mental health problems and PTSD-symptomatology they suffered from, as shown in previous research. [ABSTRACT FROM AUTHOR]

Objectives: To compare the biomedical health profile and morbidity of adult carers with non-carers. Methods: The North West Adelaide Health Study (NWAHS) is a representative population-based longitudinal biomedical cohort study of 4056 participants aged 18 years and over at Stage One. Informal (unpaid) carers were identified in Stage 3 of the project (2008–2010). Risk factors, chronic medical conditions and biomedical, health and demographic characteristics using self-report and blood measured variables were assessed. Data were collected through clinic visits, telephone interviews and self-completed questionnaires. Risk factors included blood pressure, cholesterol/lipids, body mass index (BMI), smoking and alcohol intake. Chronic medical conditions included cardiovascular and respiratory diseases, diabetes, and musculoskeletal conditions. Blood measured variables were routine haematology, biochemistry, Vitamin D, and the inflammatory biomarkers high sensitivity C-Reactive Protein (hs-CRP), Tumor Necrosis Factor alpha (TNFα) and Interleukin-6 (Il-6). Results: The prevalence of carers aged 40 years and over was 10.7%, n = 191. Carers aged 40 years and over were more likely to assess their health status as fair/poor and report having diabetes, arthritis, anxiety and depression. They also reported insufficient exercise and were found to have higher BMI compared with non-carers. Significant findings from blood measured variables were lower serum Vitamin D and haemoglobin. Male carers had raised diastolic blood pressure, higher blood glucose, lower haemoglobin and albumin levels and slightly elevated levels of the inflammatory biomarkers TNFα and hs-CRP. Discussion and conclusions: This study confirms informal carers had different biomedical profiles to non-carers that included some chronic physical illnesses. It identifies that both female and male carers showed a number of risk factors which need to be considered in future caregiver research, clinical guidelines and policy development regarding carer morbidity. [ABSTRACT FROM AUTHOR]

Cities are arguably both the cause, and answer, to societies’ current sustainability issues. Urbanization is the interplay between a city’s physical growth and its socio-economic development, both of which consume a substantial amount of energy and resources. Knowledge of the underlying driver(s) of urban expansion facilitates not only academic research but, more importantly, bridges the gap between science, policy drafting, and practical urban management. An increasing number of researchers are recognizing the benefits of innovative remotely sensed datasets, such as nighttime lights data (NTL), as a proxy to map urbanization and subsequently examine the driving socio-economic variables in cities. We further these approaches, by taking a trans-pacific view, and examine how an array of socio-economic ind0icators of 25 culturally and economically important urban hubs relate to long term patterns in NTL for the past 21 years. We undertake a classic econometric approach—panel causality tests which allow analysis of the causal relationships between NTL and socio-economic development across the region. The panel causality test results show a contrasting effect of population and gross domestic product (GDP) on NTL in fast, and slowly, changing cities. Information derived from this study quantitatively chronicles urban activities in the pan-Pacific region and potentially offers data for studies that spatially track local progress of sustainable urban development goals. [ABSTRACT FROM AUTHOR]