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The association between neighbourhood characteristics and residential relocation is a classic topic in urban studies. In China, where gated communities (GCs) have become a highly popular residential form, how and to what extent residents' perceptions of GCs affect their relocation intention has not been quantitatively examined. Drawing on a large‐scale household survey conducted in Shanghai, we use multi‐level logistic regression models to examine the impact of the perceptions of neighbourhood environment, attachment and gatedness on relocation intention. Our findings are threefold: (1) the greater the perceived improvement of the neighbourhood environment, the lower the likelihood of relocation intention; (2) respondents with higher levels of neighbourhood attachment tend to have lower relocation intention and (3) respondents living in neighbourhoods with higher levels of gatedness are less likely to have relocation intention. This research contributes to the literature of neighbourhood studies and GCs by quantifying the ramification of entrenched 'gated mindset' in urban China. [ABSTRACT FROM AUTHOR]

This study investigates the factors influencing student academic performance in Somaliland, including school type, gender, region, and residence type. It utilizes a dataset of 14,342 students and employs a multi-level logistic regression model to analyze how these variables affect students’ performance in national secondary exams. The preliminary analysis reveals interesting trends, such as girls generally outperforming boys in most regions and rural students scoring higher than their urban counterparts. Private school students also achieve better grades than those in public schools. The multi-level logistic regression analysis uncovers unobserved heterogeneity at the school level, suggesting the presence of hidden factors influencing student outcomes. The regression analysis suggests that school type, residence type, and region significantly impact academic performance at the school level, with urban students in public schools having a higher likelihood of excelling. Surprisingly, gender does not appear to be a significant factor in student performance. These findings highlight the complex interplay of factors influencing education outcomes in Somaliland and emphasize the need for targeted interventions at the school level to enhance educational quality. However, it’s important to acknowledge the study’s limitations and the necessity for further research to uncover additional hidden variables affecting student outcomes.

Abstract Background The time between discharge from hospital and transition to community and home is a critical period for health status among patients with a mental illness, including patients with schizophrenia. This study aimed to investigate crucial patient factors (patient-level) and hospital factors (hospital-level) affecting health status and see whether patient factor effects on health status vary with hospital factors, 30 days after hospital discharge. Methods This is a prospective study of 1255 patients with schizophrenia and their primary caregivers from 13 public mental hospitals across Thailand. Logistic regression and multi-level logistic regression was used to investigate the effects of patient and hospital factors simultaneously on health status, 30 days after hospital discharge. Results The intraclass correlation coefficient indicated that 14% of the change in health status was explained by the differences between hospital. Poor health status was identified in 14.26% of patients, 30 days after hospital discharge. The majority of participant patients were male (69.8%), single (71.87%), and the average age was 38.09 (SD = 9.74). The finding also showed that the patient factors; being female (ORadj .53, 95%CI .31,.92), perceived moderate and high levels of positive aspect of caregiving (ORadj .24, 95%CI .14,.42 and ORadj .05, 95%CI .02,.09), perceived readiness for hospital discharge (ORadj .21, 95%CI .13,.33), partial and full adherence to treatment (ORadj .24, 95%CI .14,.42 and ORadj .31, 95%CI .20,.47) showed a reduced likelihood of developing poor health status except substance use (ORadj 1.55, 95%CI .98, 2.44). Hospital factors; discharge planning process and nurse-patient ratio (ORadj 1.64, 95%CI 1.17, 2.30 and ORadj 1.16, 95%CI 1.09, 1.22) showed an increased likelihood of developing poor health status, 30 days after hospital discharge. Conclusions Findings provide relevant information on how both patient and hospital factors determine health status. These results might lead to better targeting of mental health service policy and enable more precise information gathering and allocation of resources. However, future research should be more focused and continue investigating the pathways through which hospital factors influence health status post-discharge.

The long-term effects of ambient PM2.5 and chemical constituents on childhood pneumonia were still unknown. A cross-sectional study was conducted in 30,315 children in the China Children, Homes, Health (CCHH) project, involving 205 preschools in six cities in China, to investigate the long-term effects of PM2.5 constituents on lifetime-ever diagnosed pneumonia. Information on the lifetime-ever pneumonia and demographics were collected by validated questionnaires. The lifetime annual average ambient PM2.5, ozone and five main PM2.5 constituents, including SO42−, NO3−, NH4+, organic matter (OM) and black carbon (BC), were estimated according to preschool addresses by a combination of satellite remote sensing, chemical transport modeling and ground-based monitors. The prevalence of lifetime-ever diagnosed pneumonia was 34.5% across six cities and differed significantly among cities (p = 0.004). The two-level logistic regression models showed that the adjusted odds ratio for PM2.5 (per 10 µg/m3) and its constituents (per 1 µg/m3)-SO42−, NO3−, NH4+, and OM were 1.12 (95% CI:1.07–1.18), 1.02 (1.00–1.04), 1.06 (1.04–1.09), 1.05 (1.03–1.07) and 1.09 (1.06–1.12), respectively. Children in urban area, aged

(1) Background: It is important to improve vaccination strategies and immunization programs to achieve herd immunity to infectious diseases. (2) Methods: To assess the acceptance of COVID-19 vaccination, we conducted face-to-face surveys and online surveys in Shanghai, Zhejiang, and Qinghai provinces. A fixed-effect model and a random effects model were used to analyze factors associated with the acceptance of COVID-19 vaccination. (3) Findings: We initially recruited 3173 participants, 3172 participants completed the full questionnaire (the response rate was nearly 100%), of which 2169 were valid questionnaires, with an effective rate of 87.3%. The results indicated that 82.6% of participants were willing to receive vaccination when it was available in the community, and 57.2% of deliverymen, 43.3% of medical workers, 78.2% of parents of primary and secondary school children, and 72.2% of parents of preschool children were willing to receive vaccination. The models showed that participants who were male (female vs. male: OR = 1.49, 95% CI (1.12, 1.98)), 60 to 69 years-old (60–69 vs.

Background: The time between discharge from hospital and transition to community and home is a critical period for health status among patients with a mental illness, including patients with schizophrenia. This study aimed to investigate crucial patient factors (patient-level) and hospital factors (hospital-level) affecting health status and see whether patient factor effects on health status vary with hospital factors, 30 days after hospital discharge. Methods: This is a prospective study of 1255 patients with schizophrenia and their primary caregivers from 13 public mental hospitals across Thailand. Logistic regression and multi-level logistic regression was used to investigate the effects of patient and hospital factors simultaneously on health status, 30 days after hospital discharge. Results: The intraclass correlation coefficient indicated that 14% of the change in health status was explained by the differences between hospital. Poor health status was identified in 14.26% of patients, 30 days after hospital discharge. The majority of participant patients were male (69.8%), single (71.87%), and the average age was 38.09 (SD = 9.74). The finding also showed that the patient factors; being female (ORadj.53, 95%CI.31,.92), perceived moderate and high levels of positive aspect of caregiving (ORadj.24, 95%CI.14,.42 and ORadj.05, 95%CI.02,.09), perceived readiness for hospital discharge (ORadj.21, 95%CI.13,.33), partial and full adherence to treatment (ORadj.24, 95%CI.14,.42 and ORadj.31, 95%CI.20,.47) showed a reduced likelihood of developing poor health status except substance use (ORadj 1.55, 95%CI.98, 2.44). Hospital factors; discharge planning process and nurse-patient ratio (ORadj 1.64, 95%CI 1.17, 2.30 and ORadj 1.16, 95%CI 1.09, 1.22) showed an increased likelihood of developing poor health status, 30 days after hospital discharge. Conclusions: Findings provide relevant information on how both patient and hospital factors determine health status. These results might lead to better targeting of mental health service policy and enable more precise information gathering and allocation of resources. However, future research should be more focused and continue investigating the pathways through which hospital factors influence health status post-discharge. [ABSTRACT FROM AUTHOR]

This paper assesses concordance and inconsistency among three small area estimation methods that are currently providing county-level health indicators in the United States. The three methods are multi-level logistic regression, spatial logistic regression, and spatial Poison regression, all proposed since 2010. Diabetes prevalence is estimated for each county in the continental United States from the 2012 sample of Behavioral Risk Factor Surveillance System. The mapping results show that all three methods displayed elevated diabetes prevalence in the South. While the Pearson correlation coefficients among three model-based estimates were all above 0.60, the highest one was 0.80 between the multilevel and spatial logistic methods. While point estimates are apparently different among the three small area estimate methods, their top and bottom of quintile distributions are fairly consistent based on Bangdiwala’s B-statistic, suggesting that outputs from each method would support consistent policy making in terms of identifying top and bottom percent counties.

Land-use change is intertwined with tourism because land is used as a resource for human activities. Land-use change also provides an opportunity to evaluate the status of the eco-environment. Understanding the relationship between tourism and land use change would help to predict the effect of tourism on land use and encourage sustainable tourism development. Using the Li River Basin as a case study, a hybrid approach using multilevel modeling and logistic regressions was employed to analyze the distribution of land-use-change between 1989 and 2010 to examine potential driving factors. Results reveal that rapid tourism development and construction expansion expose this area to risk of deforestation and forest degradation. Construction increased by 141% between 1989 and 2000 and by 195% between 2000 and 2010. The primary driving force for construction expansion shifted from population growth between 1989 and 2000 to investment growth after 2000. New construction primarily occurred on crop and woodlands areas, with shares of 81.25% and 6.38%, respectively, between 1989 and 2000, and with shares of 57.79% and 15.29%, respectively, between 2000 and 2010. Moreover, these drastic increases in construction also led to frequent transitions between croplands, woodlands, and grasslands. Traits including distances to urban areas and roads and scenic locations exerted significant effects on land-use change. Woodland regrowth in the areas that surround scenic locations consisted of fluctuating woodlands, whereas stable woodland regrowth was often absent in these areas. Likewise, permanent woodland clearing tended to be closed to near scenic locations. That is, construction at scenic locations negatively affected forest conservation in the Li River Basin. [ABSTRACT FROM AUTHOR]

Objectives: To analyze inappropriate prescriptions at the market and hospital levels by examining antihypertensive medication ordering quality in out-patient departments (OPD) in Taiwan hospitals. Methods: Our sample included 398 accredited acute hospitals located in 23 regions. Information about hospital's ownership, rank, teaching status, OPD visits and hospital number published by the Department of Health (DOH) and information from the 2009-2011 Quality Database of Medications Indicators published by National Health Insurance were collected. The population density (PD) and physician density per 10000 population (PDPP) in the 23 regions were generated from DOH data. Two inappropriate prescription indicators were defined as duplicate medications of oral blood pressure-lowering agents or hypertension patients with a history of hyperkalemia using PSD or AA. We used MLLR models to assess multilevel effects on the probability of good or bad hospital quality for medications. The market concentration in the 23 regions was calculated by Herfindahl-Hirschman Index (H) using OPD visits to measure hospital competition. Results: Our study showed that higher H and PD led to greater probability of low duplicate medications. A higher PDPP led to lower probability of low duplicate medications. When compared to hospitals located in the Eastern region, the probability of low duplicate medications in Taipei, Southern, Kaohsiung-Pingtung areas is lower. The probability of low duplicate medications in teaching hospitals is lower than non-teaching hospitals and medical centers are higher than local hospitals. The probability of appropriately treating patients with hyperkalemia in Taipei, Northern, Southern, and Kaohsiung-Pingtung areas was higher than that of Eastern areas. Overall, the variation of medication quality can be explained 10.25%-17.63% by hospital-level variables and 73.40%-82.52% by market-level variables. Conclusions: Hospital and market characteristics impacted inappropriate prescriptions of anti-hypertensive drugs in the OPD setting over the past 3 years. [ABSTRACT FROM AUTHOR]

Using national data, this study examined out-migration behavior of college graduates who attended in-state institutions in the United States. Unlike previous studies on the issue of student migration, in which researchers used a single equation approach, the present study employed a multi-level technique to assess the effects of factors from individual, institutional, and state levels on post-graduation migration. The study findings suggest that grant recipients, students who applied to multiple institutions, and college graduates from highly selective institutions are more likely to leave their native states, while Hispanics, college graduates from doctoral institutions, and students who reside in states with higher gross domestic product are more likely to remain in their native states. [ABSTRACT FROM AUTHOR]

(1) Background: It is important to improve vaccination strategies and immunization programs to achieve herd immunity to infectious diseases. (2) Methods: To assess the acceptance of COVID-19 vaccination, we conducted face-to-face surveys and online surveys in Shanghai, Zhejiang, and Qinghai provinces. A fixed-effect model and a random effects model were used to analyze factors associated with the acceptance of COVID-19 vaccination. (3) Findings: We initially recruited 3173 participants, 3172 participants completed the full questionnaire (the response rate was nearly 100%), of which 2169 were valid questionnaires, with an effective rate of 87.3%. The results indicated that 82.6% of participants were willing to receive vaccination when it was available in the community, and 57.2% of deliverymen, 43.3% of medical workers, 78.2% of parents of primary and secondary school children, and 72.2% of parents of preschool children were willing to receive vaccination. The models showed that participants who were male (female vs. male: OR = 1.49, 95% CI (1.12, 1.98)), 60 to 69 years-old (60–69 vs. <30: OR = 0.52, 95% CI (0.29, 0.92)), had less education (medium vs. low: OR = 1.50, 95% CI (1.05, 2.23)), had good health status (good vs. low: OR = 0.36, 95% CI (0.15, 0.88)), and had positive attitudes and trust (OR = 0.14, 95% CI (0.10, 0.20)) in vaccines approved by the National Health Commission were more likely to accept vaccination. Participants also had an increased vaccination acceptance if it was recommended by government sources, doctors, relatives, or friends. Most participants learned about COVID-19 vaccination from television, radio, and newspapers, followed by community or hospital campaigns and the internet. (4) Conclusions: Government sources and doctors could increase the acceptance of vaccination by promoting the efficacy and safety of COVID-19 vaccination by the use of mass media and emphasizing the necessity of vaccination for everyone. [ABSTRACT FROM AUTHOR]

A growing between- and within-country literature suggests that the association between income inequality and health reflects individual- or area-level characteristics with which income inequality is associated, rather than the effects of income inequality per se. These studies also suggest that the association between income inequality and health is country-specific. Unresolved methodological issues include the geographical level at which to model the effects of income inequality, and the appropriate statistical methods to use. This study compares the results of single-level and multi-level logistic regression models estimating the association between income inequality and self-assessed health in local authorities in Scotland. The results suggest that there is a significant positive association between income inequality and health across local authorities in Scotland, even after adjusting for individual-level socio-economic status. They also suggest that there is significant local authority-level variation in self-assessed health, but this is small compared to the variation at the individual level. Income and other measures of individuals' socio-economic status are more strongly associated with self-assessed health than income inequality. This study provides further evidence that the income inequality:health association is place-specific. It also suggests that methodological choices regarding the ways of estimating the association between self-assessed health, individual-level socio-economic status and area-level income inequality may not make a substantive difference to the results when contextual effects are small. Further work is required to test the sensitivity of these conclusions to alternative levels of geographical aggregation. [ABSTRACT FROM AUTHOR]

The long-term effects of ambient PM 2.5 and chemical constituents on childhood pneumonia were still unknown. A cross-sectional study was conducted in 30,315 children in the China Children, Homes, Health (CCHH) project, involving 205 preschools in six cities in China, to investigate the long-term effects of PM 2.5 constituents on lifetime-ever diagnosed pneumonia. Information on the lifetime-ever pneumonia and demographics were collected by validated questionnaires. The lifetime annual average ambient PM 2.5 , ozone and five main PM 2.5 constituents, including SO 4 2- , NO 3 - , NH 4 + , organic matter (OM) and black carbon (BC), were estimated according to preschool addresses by a combination of satellite remote sensing, chemical transport modeling and ground-based monitors. The prevalence of lifetime-ever diagnosed pneumonia was 34.5% across six cities and differed significantly among cities (p = 0.004). The two-level logistic regression models showed that the adjusted odds ratio for PM 2.5 (per 10 µg/m 3 ) and its constituents (per 1 µg/m 3 )-SO 4 2- , NO 3 - , NH 4 + , and OM were 1.12 (95% CI:1.07-1.18), 1.02 (1.00-1.04), 1.06 (1.04-1.09), 1.05 (1.03-1.07) and 1.09 (1.06-1.12), respectively. Children in urban area, aged < 5 years and breastfeeding time < 6 months enhanced the risks of pneumonia. Our study provided robust results that long-term levels of ambient PM 2.5 and its constituents increased the risk of childhood pneumonia, especially NH 4 + , NO 3 - and OM., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)