Intra-regional Level Research Articles

Пространственные аспекты развития этноконтактной зоны в Карелии

The significant diversity of ethnic dynamics in Karelia at the level of its districts is of interest from the standpoint of the concept of ethno-contact zones being developed in the national science. The aim of the study is to classify the districts of Karelia on the basis of the concept of ethno-contact zones according to the peculiarities of the dynamics of the titular population for three periods: from 1933 to 1959, from 1959 to 1989 and from 1989 to 2010. The article carried out approbation of the methodology of identifying the phases of development of ethno-contact zones at the intra-regional level. In total, eight types of ethnic dynamics have been identified, corresponding to positive or negative values in the change in the share of titular population (waves of titularization and detitulization) and four phases of development of ethno-contact zones (initial, growth of contact, beginning of dissolution and complete dissolution). In the period from 1933 to 1959, most districts of the republic entered the initial phase of dissolution of the ethno-contact zone on the wave of detitulization of the population. In the period from 1959 to 1989, in the northern part of the republic, there was a belt of districts, passing to the complete dissolution of the ethno-contact zone. In the period from 1989 to 2010, all eastern districts of Karelia and northern Ladoga were in the phase of complete dissolution of the ethno-contact zone. The districts in the western part of the republic retained the type of ethnic dynamics corresponding to the beginning of dissolution of the ethno-contact zone. Throughout all three periods, Olonetskiy district, located in the south of the republic, demonstrated a type of ethnic dynamics atypical for Karelia. In 2010, it remained the only district of the Republic of Karelia where the share of the titular ethnic group exceeded half of the population.

Dynamics of Ethnocontact Zones in the Turkic Republics of the Ural-Volga Region in the Post-Soviet Period

Introduction. The interest of world science in assessing the ethnic diversity of countries and regions predetermines the development of the concept of ethnocontact zones. To test new methods within the framework of the concept, there is a need to conduct research not only at the regional, but also at the intraregional levels. The purpose of the study is to classify the municipalities of Chuvashia, Tatarstan and Bashkortostan according to ethnic dynamics in the post-Soviet period using the methodology developed by the authors in accordance with the concept of ethno-contact zones. Materials and Methods. The empirical basis of the study is ethnic statistics at the level of municipalities of the republics based on the results of the population censuses of 1989, 2002 and 2010. The authorsʼ method of identifying the phases of development of ethnocontact zones, which was first applied at the municipal level, is presented. Results. The general trend of ethnic processes in the last decade of the 20th century was the titularization of the population of the republics (with the exception of Chuvashia), and in the first decade of the 21st century – detitularisation of the population (except for Tatarstan). The processes of titularisation and detitularisation at the level of municipalities are determined both by the general trend in the change in the share of the titular population of the republics, and by ethnogeographic features associated with the different proportion of titular peoples in municipalities, which is largely due to their central, semi-peripheral or peripheral position within the republics. Discussion and Conclusion. The spatial patterns of ethnic dynamics revealed in the course of the study, corresponding to certain phases of development of ethnocontact zones, make it possible to forecast ethnic processes at the intraregional level. However, such a forecast is possible only if the general trend of ethnic processes at the level of national formations is known. For this reason, the new task in the course of developing the concept of ethnocontact zones was to study the dynamics of ethnocontact zones on a regional scale over a long time interval, which will allow us to proceed to predicting the development of these ethnocontact zones in the medium and long term.

Enhancing environmental sustainability and biodiversity conservation in agrarian-oriented districts of Bryansk Oblast

The paper presents the results obtained from analysis of spatial disproportions arising due to distribution of ecosystems with protective and destabilizing features during agricultural development in Bryansk Oblast. The goal of the research is to reveal a contemporary ratio of such ecosystems at the intra-regional level on the basis of approaches that minimise vulnerability for the environment. Also, to set the tasks for strengthening biodiversity conservation in areas involved in agricultural use. It was determined that environmental sustainability of agroecosystem can be achieved by means of increasing of territories with protective features. Protective ecosystems are viewed as ecological cores of the ecological framework supporting landscape sustainability and preventing loss of biodiversity during agricultural activities. In total, 110 sites or ecological cores have been identified by comparing they spatial distribution in all agrarian-oriented districts of Bryansk Oblast. Since agricultural activity leads to environmental instability and affects biota, ecological cores can enhance environmental sustainability. The significance of this study is to find natural-based solutions that have to be grounded on calculation method applied in this research. A more detailed picture of environmental sustainability is highlighted via location of ecological belts consisting of high-priority sites for biodiversity conservation.

Ecological networks as a means for maintaining the sustainability of agroecosystems in Bryansk Oblast

Bryansk Oblast is one of the most vulnerable regions to the effects of agricultural and industrial activities resulting in ecosystems’ sustainability decreasing. For the last decade, agricultural sector has been developing rapidly and now overtakes the industrial one. The dynamics of agricultural lands has positive trends in spite of the rising fragility of agroecosystems exposing them to further degradation. The goal of the study is to show a spatial distribution of the most vulnerable ecosystems involved in agricultural use on the territory of Bryansk Oblast and to propose an optimal structure of ecological networks that is able to support landscape sustainability during agricultural activity. Based on the technique for identifying the combination of agroecosystems with destabilizing features and protective properties, four ecological belts that form ecological networks were revealed. These belts consist of 65 sites of high nature concentration. The results of this research correlate well with the modern territorial planning scheme of Bryansk Oblast. Ecological networks are viewed as a necessary element of this scheme, as they will be able to mitigate the environmental impact of agriculture and to maintain the sustainability of agroecosystems at both the regional and intraregional level.

Trade and competitiveness of African sugar exports

IntroductionSugar ranks among the most widely consumed, traded, sensitive, and protected commodities on the global and intra-regional stages. Recent developments in the sugar industry, inclusive of price distortions in the global sugar market, the liberalization of the European sugar sector, and the globalization of international agricultural trade, have amplified the need to comprehend the evolution of competitiveness in African sugar exports. Consequently, this study aims to provide a comprehensive analysis of the patterns, trends, and shifts in the inter- and intra-regional competitiveness of African sugar exports.MethodsThis paper employed the Normalized Revealed Comparative Advantage (NRCA) index and the Harris-Tzavalis panel-data unit-root test to assess the stability and structural changes in the competitive patterns of sugar exports for 34 African countries. The analysis is based on panel data spanning the period from 2001 to 2021.Results and discussionThe NRCA indices unveil certain dynamics and shifts in the competitiveness of country-specific sugar exports. Overall, the number of countries exhibiting competitive sugar exports has marginally increased, rising from 14 in 2001 to 17 in 2021. However, only eight African countries, predominantly from the southern region, have consistently maintained competitiveness in both the global and intra-regional markets throughout the entire analysis period. A significant portion of sugar exports from African countries has remained non-competitive on the global market, with a select few oscillating between periods of comparative advantage and disadvantage. Notably, the North African nations of Morocco, Algeria, and Egypt have transitioned from a position of comparative disadvantage to one of comparative advantage. At the intra-regional level, the presence of tariff and non-tariff trade barriers, including tariff escalations and trade embargoes, has rendered sugar exports non-competitive. These barriers augment the challenges faced by producers in other African nations seeking to exploit economies of scale.ConclusionThe sustained competitiveness of sugar exports from the Southern African region to other African regions underscores the significance and increasing impact of Foreign Direct Investment (FDI) in bolstering the competitiveness and development of the sugar industry.

Appraisal of Provision Structures of Nursing Homes for Old Persons—Illustrated by Cross-Sectional Data for East Tyrol

(1) Background: In Austria, stationary long-term care facilities for old persons in need of care are increasingly at the centre of the discussion on sustainable long-term care for old persons. So far, there is a lack of research addressing problems of fit from a spatial planning perspective. This case study on East Tyrol aims to appraise provision structures of stationary long-term care for old persons focusing on nursing homes (LTC) with regard to any intra-regional disparities. (2) Methods: Catchments and Bradshaw’s taxonomy of social needs serve as the conceptual framework. Real-world data on residents and applicants up to a certain cut-off date in 2022 for four nursing homes are statistically analysed at different spatial reference levels. The GIS mapping of catchments focuses on the intra-regional level. The findings are discussed transdisciplinarily. (3) Results: Intra-regional disparities with regard to the level of provision are evident. There are: 1) LTC-specific differences related to catchments with regard to LTC residents and applicants and travel efforts for visitors; and 2) valley-related differences with regard to nursing home choice. Normatively determined catchments broadly match the actual catchments. (4) Conclusions: This study could serve as a starting point for discussing methodological limitations of waiting lists as a parameter for unmet demand. Shortcomings of provision in relation to (future) demand as well as the significance of longitudinal studies for assessing the stability of catchments and area-wide coverage become apparent.

Asian regionalism and the shaping of state-owned enterprises rules in trade agreements

ABSTRACT This article explores Asian regionalism in the context of rule-making for cross-border regulation of State-owned enterprises (SOEs). Asian regionalism is defined by the normative integration of the Association of Southeast Asian Nations (ASEAN) which features a ‘hard-law obligations with structured flexibility’ paradigm in handling systematic conflicts. On the intra-regional level, the ASEAN aims to create a level-playing field through soft harmonization of competition law and policy. On the multilateral level, several ASEAN countries joined the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP), which contains a set of rules dedicated to SOEs. These rules are paradigmatic of the emerging trend in cross-border SOE regulation. This article investigates whether and how the ASEAN way of structured flexibility is manifest in the emerging international rules on SOEs and its implications for cross-border SOE regulation.

The problem of excessive inequality as an obstacle to the realization of the functions of the social state (on the example of the Volga Federal District)

The aim of the work is to determine the extent of regional differentiation in living standards (based on the analysis of monetary indicators) within the Volga Federal District, as well as the determination of the intraregional level of socio-economic inequality. The object of the study is the phenomenon of inequality as an antipode of the criterion of the social state. The subject of the study is the parameters of socio-economic inequality by income of the population of the regions of the Volga Federal District. The research methodology is based on an interdisciplinary approach to the study of the phenomenon of inequality as a limiter of the target function of the social state. Results of the study and scientific novelty. 1. The author proposes to determine the degree of distancing society from the practical realization of the idea of the social state, defining the state of equality as a blue marker of the social state, and excessive inequality as a red marker of the social state. 2. The paper presents an analysis of the level of socio-economic inequality of the regions of the Volga Federal District. 3. In the author's opinion, one of the trigger mechanisms for solving the problem of socio-economic inequality should be social elevators that reduce the degree of distancing from the blue marker of the social state. 4. The author sees the root of solution in the structural transformation of the economy.

SOME THEORETICAL AND PRACTICAL ASPECTS OF REGIONAL INTEGRATION IN CENTRAL ASIA. ASSESSMENT OF ECONOMIC POTENTIAL

Integration issues in Central Asia have been on the agenda both at the national and regional levels for three decades. New geo-economic and geopolitical realities that have arisen along the perimeter of the region and affect the region itself actualize the need for more confident and intensive integration. Despite the sufficient potential for cooperation and common problems in the region, the process of rapprochement between countries is rather slow. Along with this, there is a constant discourse both at the intergovernmental level and at the level of the expert community about the main factors and approaches. The key factor, which is not yet a priority at the regional and bilateral levels, is the economic one. This article is devoted to some theoretical aspects of the analysis of integration in Central Asia through elements of a systematic approach, factor and event analysis, and focuses on the economic factor at the intraregional level.

ДО ПИТАНЬ РОЗВИТКУ ФЕРМЕРСЬКИХ ГОСПОДАРСТВ У ЛЬВІВСЬКІЙ ОБЛАСТІ

As evidenced by the experience of developed foreign countries, small-scale farms are one of the most progressive and highly effective forms of agricultural production. As for our country, we believe that the effectiveness of their functioning, the scale of their dissemination, are directly dependent on the depth of penetration of market relations in all spheres of public production. This is the main theme of the proposed article. Its most important features are: firstly, we considered it appropriate, even necessary, to examine the features of the development of small-scale farms in Lviv region against the backdrop of changes that took place in the dynamics at the national level during the corresponding period. In our opinion, this contributed to a relatively deep understanding of the specifics of the dissemination of small-scale farms within the country and on their background in Lviv region. Secondly, it was specified mainly by examining the place and role of small-scale farms in the agricultural sector of the economy of the region, including an analysis of their relative weight in the production of the most important types of agricultural products. Thirdly, the dynamics of the development of small-scale farms during 2010–2020 were considered and analyzed, mainly in terms of the specifics of the development of the most important sub-sectors such as crop and livestock production. This was the main focus of the proposed article. Fourthly, an important addition was the consideration of the structure of the sale of products by small-scale farms in Lviv region at the intra-regional level, in terms of districts. Due to many reasons, we consider it appropriate to separately highlight one of the peculiarities of the dynamics of the development of farms in Ukraine. It has been estimated that since the introduction of farms of this type, approximately 60 regulatory acts have been adopted by the legislative bodies of the country. At the same time, according to our data, the share of farms in the majority of regions of Ukraine is at the level of 2.0-7.0% of the total volumes of agricultural production, and interestingly, it has remained relatively stable throughout the entire period, showing little change. At the end, we consider it necessary to separately focus on such general provisions from the practice of functioning of farming enterprises: firstly, farming enterprises are a fundamentally new type of agricultural production in Ukraine, generated perhaps not so much by economic prerequisites as by the idea of establishing market relations in the agrarian sector of our country; secondly, we believe it is appropriate to separately highlight the following: the mechanical introduction and simple borrowing of basic elements of the activities of farming enterprises from the functioning practice of such enterprises in developed foreign countries is unacceptable, as there are other necessary corresponding prerequisites that have emerged in those countries compared to our reality; thirdly, we would like to highlight the fact that the entire system of economic instruments used in practical activities has its, if not main, role to play in the spread of farming enterprises, and there is a need for their comprehensive use, taking into account and implementing on practice that the nature, target functions, and character of practically each of them have changed radically in the conditions of market relations, as well as the most important change that the role and place of the state in managing economic processes have changed.

ОСОБЕННОСТИ И ПЕРСПЕКТИВЫ РАЗВИТИЯ СФЕРЫ ТРУДА И ЗАНЯТОСТИ В ВОЛОГОДСКОЙ ОБЛАСТИ

The relevance of the study is determined by the imbalances in territorial development, which, in the context of modern challenges, lead to increased central-peripheral differences. This is typical for Russia, where, against the backdrop of a long-term demographic decline, there is a compression of the developed space and a polarization of the settlement system. The purpose of the paper is to identify the features and determine the prospects for the development of labor and employment in the Vologda region at the intraregional level. The subject of the research is social and labor relations that develop in the process of functioning of local labor markets. To achieve this purpose, methods of expert survey and multidimensional frequency distribution of features (data processing and visualization) were used. A distinctive feature of the paper is the use of an agglomeration approach to identifying the features of spatial development. The results of the study showed that as one moves away from regional centers, opportunities for professional fulfillment are noticeably reduced, and the problem of economic stagnation becomes more pronounced. According to the experts surveyed, residents of the periphery not only more often resort to the practice of commuting labor migration and fly-in/fly-out work, but also treat their place of residence worse and trust each other less. The scientific novelty of the research lies in expanding the understanding of the characteristics and prospects for the development of labor and employment in large cities and beyond.

Astrocyte heterogeneity within white matter tracts and a unique subpopulation of optic nerve head astrocytes.

Much of what we know about astrocyte form and function is derived from the study of gray matter protoplasmic astrocytes, whereas white matter fibrous astrocytes remain relatively unexplored. Here, we used the ribotag approach to isolate ribosome-associated mRNA and investigated the transcriptome of uninjured fibrous astrocytes from three regions: unmyelinated optic nerve head, myelinated optic nerve proper, and corpus callosum. Astrocytes from each region were transcriptionally distinct and we identified region-specific astrocyte genes and pathways. Energy metabolism, particularly oxidative phosphorylation and mitochondrial protein translation emerged as key differentiators of astrocyte populations. Optic nerve astrocytes expressed higher levels of neuroinflammatory pathways than corpus callosum astrocytes and we further identified CARTPT as a new marker of optic nerve head astrocytes. These previously uncharacterized transcriptional profiles of white matter astrocyte types reveal their functional diversity and a greater heterogeneity than previously appreciated.

Tertiary industries’ value-added as a linkage’s engine: An interstate input-output application for Brazilian regions

Tertiary industries’ value-added have been considered an essential input for any production chain, as they have the potential to connect regions and services activities across networks. Moreover, spatially, services move more straightforward than the manufacturing of resource-based industries. This study estimates the interregional and inter-industry linkages regarding a set of services-related economic sectors and accounts for the trade in value-added (TiVA) measures, considering intraregional and interregional trade based on an interstate input-output application for Brazil. The main findings reveal that the poorest Brazilian states tend to lose linkages opportunities in services activities, remaining hostages to supply natural resources to production networks for subnational and foreign demand. On the other hand, the potential for gains from connections in the services’ networks reveals greater spatial dispersion across regional hierarchies, increasing the concentration in large urban agglomerations. In this regard, the paper concludes that the connectivity potential of services at the intraregional level can be an essential starting point to promote innovative systems away from large urban areas in the wealthiest regions inside Brazil, potentially reducing value-added imbalances in internal geography trade flows.

A composite index of avoidable hospitalization to assess primary care quality: an Italian experience

Abstract Background In Italy, primary care (PC) ensures universal health coverage while containing costs. However, the assessment of its quality still remains an issue. Evidence has shown that high-quality outpatient care, through timely interventions to prevent complications of “ambulatory care sensitive conditions”, may avoid hospitalization. Aim of the study is to analyse the performance of PC in the Italian regions, using a composite and synthetic index of avoidable hospitalizations. Methods Hospital discharge data from 119 Italian geopolitical areas were analysed for the 2017-2019 triennium and for 2020, separately. According to the “Italian National Outcomes Evaluation Programme” methodology, 9 avoidable hospitalization indicators covering 5 nosological fields (infectious, respiratory, metabolic, cardiovascular and mental diseases) were combined in a synthetic index, calculated as the weighted mean of their standardized scores (with equal weights for each field). Using “natural breaks” technique, the areas were grouped into 5 clusters: “high”, “medium-high”, “medium”, “medium-low” and “low”. Results The analysis showed a marked heterogeneity at intra-regional level for the pre-pandemic triennium, with areas of homogeneity in regions with higher levels of hospitalization. The “medium” cluster, which is the widest, included 36 areas variously distributed across regions. The comparison with 2020 confirmed the geographical patterns observed for the previous triennium, despite a general reduction in hospitalizations due to the pandemic. Conclusions As a proxy indicator of PC quality, this index can aid decision makers in prioritizing quality improvement actions. However, in order to obtain a comprehensive evaluation, a joint reading of this index with other healthcare indicators is recommended. Key messages • High-quality PC is essential in maintaining appropriate hospitalization levels. • The composite synthetic index proposed could aid PC quality assessment.

MODERN DETERMINANTS OF UKRAINIAN GEOPOLITICAL SPACE: NATIONAL AND EUROPEAN ASPECTS

Objective determinants of geopolitical space of Ukraine are characterised, which at the present stage is manifested from geospatial position in economic, ideological, information- cybernetic and sociopolitical dimensions. Accordingly, appropriate characteristics and typical features of analysis are proposed for each of these directions. Thanks to them there is a possibility of multilateral consideration of those determinants which define today a place of the Ukrainian space on the European geopolitical arena.
 Philosophical methods (in particular, principles of interdependence, interrelation, causality), comparative-geographical and comparative-historical methods as well as method of system analysis and content analysis were used to observe features of clarity, effectiveness and validity of research results.
 The article analyzes organizational arrangements and institutional mechanisms of implementation of European integration policy of Ukraine, defines the intermediary role of the European Union countries in this policy, and studies the influence of the European vector on structural changes of economic, social and political environment of Ukraine. The attention is focused on the place of Ukraine in the geopolitical concept of the leading countries of the world. The features of internal geopolitical situation formation in the context of large related macro-regions are reflected in detail. In each of the macro-regions some specific mental and behavioral features that determine its uniqueness, but not isolation, are pointed out. The features of territorial and political consolidation of the state at the present stage are defined. The modern determinants of economic nature on the immediate prospects of development of the national economy are highlighted. The role of information component in the formation of geopolitical features of space as a source of influence and popularization of certain behavioral content is noted. Indicators of electoral sympathies, which embody certain ideological and social preferences of the population, were used to assess the socio-political determinant. The impact of recent political events in Ukraine, in particular, the results of the parliamentary elections, on the strengthening of the country's European policy and overcoming the dependencies caused by geopolitical factors is monitored.
 The determinants of the geopolitical space of Ukraine should be assessed from the standpoint of considering the so-called internal and external conditions. Domestic determinants are determined along with the morphology of the territory, political and cultural unity of the country, its retrospective review, consistency and efficiency of public administration, natural resource and economic potential and features of socio-economic development, features of militarization, experience of national diplomacy and more. The external determinants of the national geopolitical space include the influence of foreign states and their union formations, the nature and relationship of political and economic processes in the world and in the region to which it belongs geographically, the validity of transit flows, threats of armed conflict and other negative challenges.
 Based on the priority task of considering the geopolitical space of Ukraine, we note its importance, referring to world geopolitical concepts (F. Fukuyama, S. Huntington, Z. Brzezinski), which emphasize the role of our state as a promising geopolitical player, which should be part of influential economic security supranational structures. At the intra-regional level, the perception of Ukraine's geolocation is largely correlated with linguistic, ethnic, religious and other identifying features, but in contrast to the significant number of historical, socio-cultural and economic components that influenced the implementation of systemic domestic geopolitics. Therefore, the issue of territorial and political consolidation, although raised, was not systemic, and therefore requires the development of a strategy for the development of the state on ideological grounds as a nation-state of the European type with minimization of cultural and civilizational contrasts in the regional space. The economic determinant is emphasized by the possibility of rethinking the status quo (the energy intensity of space needed to reproduce society and the consumer type of functioning of the corporation, both global and transnational) and the possibility of using the chance to build a national economy (postwar recovery) based on progressive European experience. Information and cyber determinants of geopolitical space are determined by the scale and direction of the military-political and socio-economic situation, the goals of state policy of national security, social and economic structures involved in information warfare. Socio-political determinants of the geopolitical space of Ukraine are reflected in the results of the electoral commitment of voters, who thus embodied a certain ideological content. Based on the definition of these determinants, a strategy of geopolitical space should be developed on the basis of a nationally oriented state.
 Keywords: geopolitical space, national manifestations of geopolitics, determinants, geopolitical factors, economic factors, sociopolitical factors, information-cybernetic factors.

Nothing But Depopulation? Lateral Rural Migration In The Old-Developed Forest Non-Chernozem Territories

—In the article, the author poses the question of what migration processes took place in the post-Soviet period at the intraregional level against depopulation and spatial polarization inherent to areas of the old-developed Non-Chernozem Region, and how this influenced the current state of populated areas and the overall rural settlement pattern. Totemsky district of Vologda Oblast was chosen as the research site for the study. Field research materials and analysis of local-level statistics made it possible to trace the rural population dynamics and identify the resettlement of rural residents within the district. The territorial units considered by the author were administrative rural units (sel’sovets) within the old borders, before the municipal reform and consolidation of the 2010s, which corresponded to individual rural clusters or large logging centers. Territories with different geographic positions and economic conditions were selected. Depopulation in the post-Soviet period proceeded unevenly, but its territorial projection did not just obey the center–periphery logic. The rural population grew in size both in district center and village near gas compressor stations, as well as in a number of other settlements with different characteristics. The post-Soviet dynamics of population numbers and transformation of the economy of the settlements were influenced by the peculiarities of their microlocation, buildings development, neighborhoods, and other local and almost nonparameterizable factors. They also often affect the attractiveness of rural settlements for the seasonal population, which fosters temporary support of the historical settlement network and generates some small potential for the redevelopment of certain territories.

The AfCFTA and the Promise of Intra-Continental Trade in Africa

This article takes stock of the state of intra-continental trade in Africa by reviewing trends in the continent’s five sub-regional trading blocs in terms of their strengths and shortcomings, in order to assess the continent’s trade efficiency on an intra-regional level ahead of the rollout of a continent-wide free trade area. Thereafter, the article assesses trade indicators seen over the past decade to illustrate the amount of goods traded to prognosticate the future of intra-continental trade on the continent in the wake of discussing the African Continental Free Trade Area (AfCFTA). Implications for youth are cast in the wider imperatives of the continent’s developmental agenda and post-Covid-19 economic recovery.

The unevenly absorbed and induced intra-regional Facebook adoption in Western Ukraine

This paper aims to reveal and explain the spatial pattern of Facebook adoption in Western Ukraine. It discusses how to trace the fragmented nature of social networking services’ (SNS) penetration at the intra-regional level using Facebook data analysis. This study has confirmed the expectation that in Western Ukraine Facebook adoption is predominantly an urban phenomenon, but with some peculiarities depending on the local context. The largest cities and regional centers attract the highest number of users, while peripheral and the economically least developed places have the lowest Facebook penetration rate. However, there are some areas with a higher number of Facebook adopters caused by a specific rural settlement system and the location in the Carpathians with no large cities ‘pulling’ the audience. The spatial pattern of Facebook adoption in Western Ukraine is an intricate and intertwined mosaic of ‘SNS hubs’ and peripheries, suggesting a ‘digital differentiation’ rather than a ‘digital divide’.

Geographical variations and factors associated with recent HIV testing prevalence in Ghana: spatial mapping and complex survey analyses of the 2014 demographic and health surveys

ObjectiveTo examine the factors associated with recent HIV testing and to develop an HIV testing prevalence surface map using spatial interpolation techniques to identify geographical areas with low and high...

Non-specific symptoms and signs of cancer: different organisations of a cancer patient pathway in Denmark

Objective We aimed to investigate the Non-specific Symptoms and Signs of Cancer-Cancer Patient Pathway (NSSC-CPP) in order to describe organisational and clinical practice similarities and differences in the diagnostic work-up of suspected cancer in Denmark. Material and methods A questionnaire on the organisation and practice pertaining to the NSSC-CPP was completed by all 21 diagnostic units in the five healthcare regions in Denmark. Results The questionnaire responses revealed regional and intraregional differences in the organisation and clinical practice of the NSSC-CPP. CT scan was the most often used imaging in the NSSC-CPP but there was no consensus whether the CT scan should be ordered and evaluated by general practitioners (GPs) or by the diagnostic units. Two regions were consistent but had different modalities regarding referrals from GPs. Three regions had intra-regional differences. The units reported on different types and frequency of forum for patient plan discussion and how to end a NSSC-CPP. Conclusion The NSSC-CPP is implemented with great regional and intra-regional differences in Denmark. GPs face different requirements when referring to the NSSC-CPP, which indicates that the division of role and responsibility between GPs and the diagnostic units is not well defined. KEY POINTS In Denmark, the cancer patient pathway for non-specific symptoms and signs of cancer (NSSC-CPP) has been implemented with variations, but little is known about these different modalities. This study showed that both at a regional and an intra-regional level: •General practitioners meet different implementation of national guidelines in the diagnostic units when referring to the NSSCP-CPP •The suitable patient group for the NSSC-CPP is not well defined •Quality criteria are needed to monitor, evaluate and improve the diagnostic work-up for patients with non-specific symptoms and signs of cancer