National Territory Research Articles

Características socioproductivas y económicas de productores de chile criollo de Teticic, Olinalá, Guerrero

The chilli is a crop of cultural, economic and social importance for Mexico, it is produced and consumed throughout the national territory. The objective of analyzing the socio-productive and economic characteristics of criollo chilli producers in the community of Teticic, Olinalá, Guerrero, México, in 2021, an interview with social, economic and productive variables was applied to 39 chilli producers in the community, the information was concentrated in Excel and a hierarchical cluster analysis was carried out in the statistical program SPSS version 21 where a factor analysis was applied for the selection of variables, the Ward method and the Euclidean distance were used, which allowed to obtain five groups of producers. Chilli cultivation is a subsistence agricultural system presided over mainly by men with an average age of 47 years with basic education, dedicated mainly to agriculture with an average of 21 years of experience, using family labor. This crop faces a series of productive, commercial, post-harvest, service and support problems from the government that limit its productivity and could put at risk the conservation of chilli crioles seeds.

Assessing phosphorus fluxes in Portugal

Phosphorus (P) has been shown essential in the food sector. Due to the global shortage of P nutrients and the dependence on imports of phosphorus products and by-products, many countries have developed strategies to track the flows of this nutrient in their national territory. This comprises assessing which sectors and subsectors are the most relevant and identifying potential interventions for its recovery with consequent reduction of imports. Previous studies estimated that the circularity of the supply chain offers the possibility of satisfying the demand for phosphorus and reduce significantly the European Union's dependence on imports. The present research focuses on estimating the value of P fluxes in the Portuguese territory through Substance Flow Analysis (SFA) methodology to evaluate phosphorus's circularity within its production/consumption chain, collecting demographic, spatial, and economic data. Due to the great diversity of information and sources, the accuracy and reliability of the calculated fluxes were evaluated. P flows were compared through indicators that measure the effectiveness of use, accumulation, and losses of P nutrients among other countries (the UK, USA, Australia, New Zealand, France, Finland, and Japan) that have assessed the chain of this nutrient. The results show that soil nutrient management in Portugal in 2013 was considerably efficient (Soil out/ Soil in = 79 %). However, the urban system appears with a high amount of P in landfills (35.38 kt) and in treated wastewater (0.87 kt). The solid waste sector has ongoing P recovery measures, as it already has organic material recovery activities and indirect P recovery (1.39kt). In the influent wastewater, there is a possibility of recovering 8.2 kt of P, however there are no efforts or policies aimed at valuing this nutrient, as the same time that infrastructure improvements are needed to reduce P discharges into water body.

Spatial optimization of agricultural production from the perspective of “Greater Food Concept” in Yangzhou, China

Global food security continues to face serious challenges. The “Greater Food” perspective can guarantee regional food security and the availability of basic agricultural products. However, there is still a lack of an appropriate methodology to optimize the spatial agricultural production system under the concept of “greater food.” In this study, we quantitatively analyzed agricultural production space’s quality and spatial distribution characteristics using multi-scale fusion and ecological niche suitability models. The results showed that The overall level of agricultural production function in Yangzhou was high, with firm spatial heterogeneity, high in the southeast and low in the southwest bounded by the line of Gaoyou Lake. The distribution pattern was closely related to the land use status, urban development, topography, and spatial functional positioning of the national territory. The natural quality of agricultural production was better, and the spatial form was more regular and compact. However, due to the coercion of urbanization and industrialization development, the overall ecological location suitability was average. The suitability around the built-up areas, Gaoyou Lake, Baoying Lake, and the Yangtze River was generally low. Based on the results of the comprehensive evaluation of agricultural production functions and ecological suitability, it could be divided into four areas: core protection area, integration and optimization area, comprehensive improvement area, and restricted development area. We plan to propose a classification and optimization strategy accordingly. The method of this study synthesized the multifunctionality and suitability of land use for agricultural production space identification. In this way, it may provide innovative ideas for delineating agricultural production space in economically developed areas, which could guide the optimization of agricultural production space with high quality.

The Study Plans and Programs of Rural Normal Schools in Colombia 1934-1953

Objective: The main objective of this article is to analyze the study plans and programs implemented in the rural normal schools of Colombia during the period between 1934 and 1953, describing the stages that marked the training of rural teachers in the pedagogical context and the guidelines. international standards of the time that marked the general training standards for future rural teachers in the national territory. Method: This research is based on the Social History of Education, using a qualitative approach that allows us to understand the social and political dynamics that influenced rural education between the period 1934 to 1953. Primary and secondary sources were used, including brochures. , newspapers, magazines and memoirs of ministers of education, to build a robust theoretical framework that supports the historical analysis of the time, which made it possible to identify the key stages in the training of rural teachers and the challenges faced due to political and budgetary changes. Results and Discussion: The results of the study reveal three key stages in the training of rural teachers in Colombia: a) First Stage (1934-1945): Characterized by the implementation of liberal educational policies that promoted the expansion of rural normal schools, b ) Second Stage (1946-1950): Marked by a period of transition and adjustments in study programs due to political changes and c) Third Stage (1951-1953): Influenced by conservative policies that affected the financing and structure of schools rural normals. The discussion focuses on the impact of these policies on the quality of rural education and teacher training, highlighting the challenges and opportunities that arose during each stage. Research Implications: This study highlights the importance of the comprehensive training of rural teachers and its impact on rural education in Colombia. The findings contribute to the understanding of the evolution of rural education and offer a historical perspective that highlights the need for sustainable educational policies that support the continuous training of rural teachers. Originality/Value: The research provides a detailed and unique view of the evolution of rural normal schools in Colombia, contributing to the field of History of Education with a specific focus on rural education and teacher training. This study not only enriches historical knowledge, but also offers valuable lessons on the development and implementation of educational policies in the rural educational field.

The Identification of Land Use Conflicts and Policy Implications for Donghai County Based on the “Production–Living–Ecological” Functions

The rapid development of urbanization has continuously encroached on people’s living space and ecological space, leading to an imbalance in territorial spatial functions. Identifying potential land use conflicts and optimizing land use structure are conducive to carrying out territorial spatial planning rationally. In this paper, we adopt the suitability assessment method to evaluate the suitability of land for production, living, and ecological functions and then use the land use conflict identification matrix to identify land use conflicts in Donghai County and make relevant suggestions according to the intensity of land use conflicts. The results of this study show the following: (1) the areas of suitable land use zones, strong conflict zones, medium conflict zones, and weak conflict zones in Donghai County are, respectively, 58.83%, 10.62%, 26.31%, and 4.24%. (2) The spatial distribution differences in the different conflict zones could determine the pertinence of conflict mitigation and spatial planning. In the process of the urbanization of Donghai County, ecological environmental protection is still the top priority. (3) It is necessary to economically and intensively use construction land, improving its fine management level. Land use efficiency should be maximized, and the spatial distribution of national territory should be reasonably optimized while strengthening the guiding role of planning. This study addresses land conflicts from the perspective of spatial planning rather than economic behavior. It also provides significant insight into land use layout at the county level, which is exactly what China is exploring in the new era.

Dynamic coupling coordination of territorial spatial development intensity and comprehensive disaster-carrying capability: A case study of Beijing-Tianjin-Hebei urban agglomerations, China

The effectiveness of the modernization of the governance system is significantly impacted by the interaction between the territorial spatial development intensity (TSDI) and the comprehensive disaster-carrying capacity (CDCC). It is of great significance to investigate the intrinsic interaction between the TSDI and the CDCC. Identifying the disaster risks induced by the intensity of the territorial spatial development and their constraints promotes synergistic development to cope with the uncertainty. The study explored the degree of coupling, the level of coordinated development, and the dynamic development trend between TSDI and CDCC from the perspective of coupling coordination. Beijing-Tianjin-Hebei (BTH) Region was used as a case study and it was found 1) there is a higher degree of coupling, and high correlation between TSDI and CDCC in the BTH urban agglomeration region; 2) the BTH region has the highest number of cities with coordination levels on the verge of maladjustment, followed by ones with barely coordinated cities; 3) while the overall level of coordination gradually increases, the overall deviation degree of development of TSDI and CDCC in the BTH urban agglomeration region is gradually decreasing; 4) there is an interactive coercion relationship between TSDI and CDCC in the BTH urban agglomeration region. This study may help provide a decision-making basis for the BTH urban agglomeration on improving the pertinence of urban disaster prevention and mitigation construction, adjusting the spatial structure of the national territory, and promoting the coordinated development of different cities. Moreover, technical support and theoretical guidance for similar regions was also developed to assess the land suitability, establish an integrated defense system of the national territory and space, and exercise resilient city planning.

The Italian registry of therapeutic apheresis in SISTRA: Year of activity 2023

The Italian Registry of Therapeutic Apheresis (IRTA) collects clinical data on patients undergoing therapeutic apheresis procedures throughout the national territory, with the main objective of improving the quality and safety of the care provided to the patient. Given the importance of centralizing the collection and analysis of information on therapeutic apheresis, the National Blood Center (NBC), at the request of the Italian Scientific Society of Hemapheresis and Cellular Manipulation (SIdEM), has included IRTA in the Information System of Transfusion Services (SISTRA), which is the information system of the Ministry of Health for the exchange of data on blood and its derivatives between the Italian Regions and the NBC. This manuscript reports IRTA activity data for 2023 maintaining the general approach introduced in previous manuscripts to facilitate comparison with already published activity data (2020–2022). For each therapeutic apheresis procedure (more than 15) we reported the number of procedures, the number of patients treated, and adverse effects. Furthermore, for each pathology belonging to more than 8 specialized clinical areas we reported the number of procedures, the number of patients treated, the number of patients at first diagnosis and the outcome of the patients. More than 36000 procedures in more than 8500 patients were included in the 2023 database. The aim of the IRTA 2023 activity data is to provide an updated snapshot of the use of therapeutic apheresis in the treatment of human diseases in Italy and a strategic resource for institutions and scientific societies.

Spatial-temporal patterns and driving mechanism of rural vulnerability at county level：A case study of 117 counties in Heilongjiang Province, China

Rural vulnerability is used to understand the potential multi-hazard threats and describe the fragile state of rural areas, which engage decision-makers in developing policies and strategies to reduce vulnerability. Existing studies about rural vulnerability focused on the single exogenous disturbance but paid inadequate attention to the multi-disturbances of rural coupled human-environment system. In addition, current studies mainly analyzed the spatial differentiation of vulnerability degree, ignoring the temporal evolution and the internal elements’ relationships of rural systems. In this study, we structured the cognition of rural vulnerability with a framework for understanding coupled human-environment system, evaluated rural vulnerability with the dimensions of exposure, sensitivity and adaptability, and analyzed the driving mechanism based on spatial-temporal heterogeneity. Taking 117 county units in Heilongjiang Province as study cases, we found that (1) rural vulnerability was indeed significant, as the area of county units with extreme or high vulnerability levels accounts for 50.4% of the total area, indicating a trend of high vulnerability in the counties on the north and south sides and low vulnerability in the center. (2) The spatial-temporal heterogeneity of rural vulnerability presented a clustering trend, shifting from a relatively balanced spatial distribution from 2010 to 2013 to a state of vulnerability aggregation at all levels from 2016 to 2019. (3) Rural vulnerability was mainly affected by changes in the principal factors of sensitivity and adaptability, and driving sources mainly generated by human activities, which was largely derived from rural construction activities and government policy guidance on rural regulation. Based on the results, we classified county units into different rural vulnerability types, put forward a rural resilience planning mode of “General + Special” with planning strategies for each type, which can be used as a reference for rural planning positioning of county and township level land spatial planning in the national territory spatial planning.

Język polski w jednoklasowych szkołach podstawowych w guberni grodzieńskiej po 1906 roku: niespełnione obietnice rządu

This article examines the implementation of one paragraph of the Tsar’s decree of 22 April 1906, to which historians have paid little attention. It stipulated that in those one-class schools that were located in the Polish populated part of Grodna Province, the Polish language could be taught as a subject and used to teach arithmetic. The overseer of the Vil’na school district, Boris Wolf, and some other local officials tried their best to implement the decree not only because the regulations passed by the higher authorities had to be enforced but also because they believed that the loyalty of non-Russians could be ensured by meeting their cultural requirements. In the end their efforts were in vain. The official version was that the‚ ethnographic expeditions’ and meetings of local administration officials did not indicate the exact area where Poles would dominate numerically, but this interpretation was a pretext, not a cause. The Polish language in primary school was seen by many officials as a tool for the Polonisation of Belarusian Catholics, so those close to the principles of nationalist nationality politics obstructed the implementation of the decree of 22 April 1906 in the Grodno Governorate. They would also have been aware that the introduction of the Polish language in primary schools, together with other measures confirming that the area was a Polish ‚national territory’, could lead to parts of the Białystok and Bielsk districts being included to the Kingdom of Poland in the event of future territorialization of ethnicity. The likelihood of the implementation of such projects on the western borderlands of the Romanov empire grew in the early 20th century, until their eventual implementation in the Soviet Union.

Oneiros: The Sports Club: navigating the growth path

Learning outcomes After completion of the case study, the students will be able to analyze the challenges and opportunities associated with business expansion in any business, assess the significance of leveraging existing strengths versus exploring new markets for organizational growth, evaluate the implications of regional consolidation versus national expansion strategies, develop strategic thinking and decision-making skills in a competitive business landscape and understand the nuances of market dynamics, brand recognition and operational challenges in diverse geographical regions. Case overview/synopsis Oneiros – The Sports Club stood poised at a pivotal juncture, grappling with a strategic quandary that encapsulates the divergent visions of its leadership. The narrative unfolded in Surat, a vibrant city in the state of Gujarat where contrasting viewpoints champion the familiar stability of local success against the lure of uncharted state and national territories. Ms Hemali Shah advocated for consolidating the club’s triumphs in Gujarat, emphasizing on the parameters of brand loyalty and operational mastery. In stark contrast, Mr Robin Patel envisioned a bold expansion strategy across the state, aiming for brand recognition and a paradigm shift to regional prominence. Caught amidst these competing visions, Mr Sumit Lathia who was aspiring for the club’s national presence navigated the complexities of market dynamics and business model, oscillating between preserving familiarity and embracing the allure of ambition. This case study highlights the nuanced strategic dilemmas faced by Oneiros, offering a captivating exploration of growth strategies in a competitive landscape. With insights from various perspectives within the organization, this case study navigates the complexities of growth, market dynamics and the balance between familiarity and ambition. This case study offers valuable insights and practical applications for students pursuing regular Master of Business Administration (MBA) and executive MBA programs, as well as undergraduate and postgraduate studies in entrepreneurship and strategic management. By examining the strategic decisions and operational challenges faced by Lathia and Oneiros – The Sports Club, students can gain a deeper understanding of key concepts such as public–private partnerships, market expansion strategies, customer segmentation and revenue diversification. Complexity academic level This case study is positioned within the decision-making or business development modules of the curriculum. It serves as a platform to apply theoretical concepts of strategic decision-making, market analysis and growth strategies to a real-world scenario. This case study prompts students to critically evaluate expansion dilemmas and devise strategic solutions. Supplementary materials Teaching notes are available for educators only. Subject code Strategy.

Discourse Analysis of Conflict and Resolution in History Textbooks: Representations of the Referendum in Indonesia

This study explores how Indonesian history textbooks represent conflict and its resolution with a focus on the theme of East Timor. The research applies the methodology of Historical Discourse Analysis, examining various elements of representation, including nomination, predication, argumentation, perspective, and intensification. The primary objects of study are two Indonesian history textbooks that are currently used in schools. The results show that textbook I adopts a pragmatic and binary approach, framing the Indonesian government as the protagonist that seeks to include East Timor as part of its national territory. In this narrative, the East Timorese people are portrayed as the antagonists who resist the integration process with Indonesia. This approach reflects a polarized view of the conflict, emphasizing the roles of both parties in opposition. On the other hand, Textbook II takes a more constructive and reconciliation-oriented approach. It presents a vision for future cooperation and understanding between Indonesia and East Timor, highlighting possibilities for peaceful resolution and long-term collaboration between the two countries. Despite these different approaches, this study identifies an ongoing challenge in the writing of Indonesian history textbooks, which can be termed as "schizo-history." This concept refers to the paradox faced by historians in balancing efforts to reconstruct historical events with the anxiety surrounding the potential impact of those narratives on national unity. The study argues that Indonesian historians must continue to seek alternative methodologies that can address these tensions while providing more nuanced and balanced representations of historical events. This research contributes to broader discussions on the role of history textbooks in shaping national identity and calls for further investigation into the challenges and opportunities in writing history textbooks in post-conflict contexts.

Epidemiological analysis of the incidence of COVID-19 among the population of the Republic of Cameroon using the quantum Geographic Information System (QGIS)

The results of a retrospective epidemiological analysis of the incidence of COVID-19 in the regions of the Republic of Cameroon in dynamics from 2020 to 2023 are presented. It was noted that COVID-19 cases were first reported in the Central Region of Cameroon, and then spread to the remaining 9 administrative regions of the country with an average weekly growth rate of 38.1 ± 18.6% in 2020, 15.3 ± 13.1% in 2021, and 13.4 ± 12.2% in 2022, respectively, however, the incidence rate varied significantly in time and space. Epidemiological analysis made it possible to rank the territory of Cameroon by the magnitude of the incidence rate. The highest rate was recorded in the North region (233.1‰), in the Coastal region (204.9‰) and in the Center region (173.7‰). The regions of Adamawa and the Far North had the lowest incidence rates (25.6‰ and 22.5‰, respectively). The results of a comparative analysis of the incidence of COVID-19 infection by time and territory and factors contributing to the rapid spread of infection are presented. Comparative mapping of reported COVID-19 cases in space and time was performed for the 10 administrative regions of the country using the full version of the QGIS (quantum GIS) LTR program; with the help of which the distribution of cases across the territory and dynamics over time was clearly shown. During the study period, the link between COVID-19 cases reported in Cameroon and neighboring African countries was demonstrated. It has been shown that the distribution of cases in the national territory does not always depend on the population density in administrative areas, but is also associated with other risk factors that may affect the occurrence and spread of COVID-19 cases.

Carbon Emission Trajectory and Eco-environment Effects in the Aksu River Basin Based on Agriculture-town-ecological Space Changes

Due to the expansion of artificial oases in these areas, scientific assessment of the carbon emission and eco-environment effects caused by changes in agriculture, towns, and ecological space is of great significance in grasping the carbon emission characteristics of various land use types, formulating land use emission reduction strategies, promoting the construction of ecological civilization, and optimizing the spatial pattern of the national territory. Based on land use data and socio-economic data, taking the inland river basin of the arid zone of the Xinjiang-Aksu River Basin as the research object, the carbon emission coefficient method was used to measure land-use carbon emissions, and spatial autocorrelation analysis and standard deviation ellipse were used to analyze the spatial evolution characteristics of carbon emissions from agriculture-town-ecological space in the Aksu River Basin. Based on the eco-environment quality index and ecological contribution rate, the impact of the agriculture-town-ecological space transformation on the eco-environment effects in the Aksu River Basin was explored. The results showed that： ① The scale of agricultural space and town space continued to rise, while the overall scale of ecological space was shrinking. The carbon source provided by agricultural space and town space showed a continuous upward trend, while the carbon sink provided by ecological space showed a trend of first increasing and then decreasing, with an overall downward trend. ② There was a positive spatial correlation between the net carbon emissions and the carbon emissions provided by the agriculture-town-ecological space. The center of gravity of carbon emissions in the basin generally moved to the southwest except for the ecological space, whereas the other space and net carbon emissions moved to the southeast. ③ The eco-environment quality index in the basin increased first and then decreased and generally showed a downward trend. From 1990 to 2000, the ecological environment quality improved overall； from 2000 to 2010, it deteriorated severely； and from 2010 to 2020, it deteriorated slowly.

Integrated Theatre Command: Strategic Synergy between the Armed Forces of India

The changing dynamics of the modern warfare, advancement of critical and emerging technology, changing geopolitical scenario and political instability in the neighboring countries, for example, the situations in Bangladesh, Myanmar and Sri Lanka. Further, the evolving multidimensional security challenges from multiple fronts such as the border dispute with Pakistan and China, standoffs in India-China borders, presence of Chinese Navy in the Indian Ocean Region, Geo-Political influence of China in Maldives’s Government and Sri Lankan Government are posing significant threat to the India’s National Security, Sovereignty and Territorial Integrity. To address these security challenges and potential threat from multiple fronts such as Land, Air, Surface water, Underwater, Space and Cyber, an integrated approach is needed for effectively countering the multidimensional security challenges emerging from multiple fronts in multi domains. Therefore, an integration of armed forces and strategic synergy between the armed forces of India is paramount important for India’s National Security and Interest. This gives special impetus towards the creation of an Integrated Theatre Command in India. Further, an integrated Theatre Command is crucial for tackling the multidimensional defence challenges in future.

‘[A] very improbable and imaginative fiction’: Fictionalising the French invasion of Fishguard

In the years leading up to the centenary of the last invasion of the British mainland, several historical novels in Welsh and English chronicled the events of the French landing near Fishguard in 1797. These fictional explorations throw Welsh national identity into relief at a time when Britain consolidated its domestic and overseas territories against its main rival, France. While ostensibly set in the historical past, the novels under observation share significant traits with the popular genre of the invasion novel that came to the fore in the second half of the nineteenth century as the British Empire neared its largest extent. Published during a time of cultural and political revivals in late-Victorian Wales, these historical invasion novels offer a different, literary way to examine past discourses around Welsh nationhood and national territory as well as coloniality and sovereignty.

Brushes with History

Against a backdrop of other murals marking national territories and Manifest Destiny—notably, William Leutze’s stereochrome Westward the Course of Empire Takes Its Way completed for the U.S. Capitol during the Civil War, with its iconic depiction of a mostly monochrome van of westward migrants on their way over mountains to California’s Golden Gate—this article focuses on the way artists Judy Baca and Ana Teresa Fernández have both deconstructed physical and symbolic walls to open up a view of migrations across the U.S.–Mexico border as natural. The essay examines how each artist’s work gets to the same end vision but through different starting points in relation to history. Baca—in her ongoing History of California (a.k.a., the Great Wall of Los Angeles), and in her mural La Memoria de Nuestra Tierra, California—has brought repressed or erased history and people to light, and she explicitly envisions the border wall as unnatural. By contrast, Fernández optically erases the border wall at Tijuana / San Ysidro / the Pacific and other places along la frontera, employing Martha Stewart paint to create chinks and gashes in the wall’s ideological veneer, brushing blue onto corroding iron to, she says, pull “down the sky to kiss the ground again.” Baca represents what has been erased while Fernández erases what has been represented, but both do so to reconnect a California landscape that has been bifurcated by the border wall. Considered in relation to the history and historiography of the U.S.–Mexico borderlands—and in particular to work on the physical manifestation of the border through markers, monuments, fences and walls designed to split lands and peoples—this article considers these artists’ work as powerful demurrals, defiant visual protests and imaginaries that affirm inclusion, empathy, and human and ecological connections across the border between Alta and Baja California.

Use of sea wave containment techniques

This work makes a comparison between different wave control methods applied in coastal cities, using a small-scale experimental model. The coastal zone of Brazil extends over a considerable area and covers a significant portion of the national territory. It is common to find a variety of constructions on the seashore, from large buildings to small kiosks, many of which are irregular, as they do not follow the proper authorizations from the competent authorities, resulting in environmental, social and economic problems. The coastal environment is dynamic, subject to constant changes in its configuration, since the waves transport and deposit sand, even in small quantities. However, human activity has accelerated this process, although it is natural. Therefore, some methods have been developed to mitigate it.

Inter-regional Hospital Patients’ mobility: Is co-operation better than competition?

Abstract Background According to Italian law, citizens are free to choose their preferred place of care across the national territory. This study aims to analyze the associations between patients’ mobility between Tuscany (Italy) and other Italian regions and the complexity of Diagnosis Related Groups (DRGs) provided for these hospitalizations. Methods A retrospective study was conducted using 2019 Hospital Discharge Cards data of Tuscany provided by the Italian Ministry of Health. The surgical DRGs of each Major Diagnostic Categories (MDCs) were considered according to high specialty (HS) and non-high specialty (N-HS). For each MDCs, patients’ attractions, and escapes to bordering and non-bordering regions with Tuscany were associated with HS and N-HS surgical discharge DRGs by using the Odds Ratio. The analysis was performed using STATA software, and the significance level was set at 95%. Results For Digestive Diseases, patients from non-border regions were more likely to be attracted to Tuscan hospitals for HS DRGs (OR: 1.37 95%CI: 1.08-1.74; p < 0,05), while for Musculoskeletal Diseases those from non-border regions were less likely to be attracted for HS DRGs (OR: 0.51 95%CI: 0.47-0.56; p < 0,05). For Nervous Diseases (OR: 3.08 95%CI: 2.18-4.37; p < 0,05), for Ear, Nose, Mouth And Throat Diseases (OR: 2.41 95%CI: 1.52-5.03; p < 0,05) and for Hepatobiliary And Pancreas Diseases (OR: 4.55 95%CI: 2.71-7.68; p < 0,05), Tuscan patients were more likely to escape to non-border regions for HS DRGs, while for Musculoskeletal Diseases (OR: 0.76 95%CI: 0.68-0.84; p < 0,05) they were less likely to be admitted to non-border regions for HS DRGs. Conclusions The results suggest the necessity of establishing mobility agreements between regions, particularly for high-specialty DRGs. In fact, the provision of mobility care economically benefits the receiving (creditor) region, which provides the medical service, but is not advantageous to the patient’s region of residence (debtor). Key messages • Monitoring mobility flows is critical to improve identify possible lack of supply of resources. • There is a need to develop interregional mobility agreements to ensure better cooperation between different regional health systems.

Evaluating perinatal health in Europe: a comparison of routine population birth data sources

Abstract Background International comparisons provide essential benchmarks for evaluating perinatal health policies, but these rely on the availability of routine national birth data. This study aimed to describe population birth data sources in Europe by their ability to provide core perinatal health indicators. Methods The Euro-Peristat Network collected routine national data on a recommended set of core indicators from 2015 to 2021 using a federated protocol based on a common data model with 17 data items. Data providers filled in an on-line questionnaire to describe the sources used in each country. We classified countries by the number of data items they provided (all 16, 15-14, <14). Results 28 out of the 31 countries that provided data responded to the survey. Routine data sources included birth certificates (14 countries), electronic medical records (EMR) from delivery hospitalizations (14 countries), direct entry by health providers (9 countries), EMR from other care providers (6 countries) and Hospital Discharge Summaries (7 countries). Completeness of population coverage was at least 98%, with 15 countries reporting 100%. These databases most often included mothers giving birth on the national territory, regardless of nationality or place of residence (19 countries). In 20 countries, routine sources were linked, including linkage between birth and death certificates (15 countries). Countries providing all 16 items (N = 8) were more likely to use EMRs from delivery hospitalizations, 88%, compared to 50% and 13% in countries with 15-14 items (N = 13) and <14 items (N = 8). Linkage was also more common in these countries, 100%, versus 75% and 50% respectively. Other data source characteristics did not differ by the ability to provide data for the common data model. Conclusions There is high diversity in the data sources used to construct perinatal health indicators in Europe. Countries using EMR with linkage to other sources had the best data availability. Key messages • There is high diversity in the data sources used to construct perinatal health indicators in Europe. • Countries using Electronic Medical Records with linkage to other sources had the best data availability.

Determinants of health prevention behaviors in Portugal

Abstract Background One of the main causes of death in developed societies are chronic non-communicable diseases, often originated by risky behaviors as tobacco consumption, poor diet, excessive alcohol consumption and lack of physical activity. Changing lifestyles can thus lead to a reduction in chronic diseases and in their economic costs. The objective of this study is to understand what the main factors associated with health behaviors are. Methods We used the data collected through the Portuguese National Health Surveys from 2014 and 2019. The sample analyzed was composed of individuals aged 15 or more years old living in the national territory at the time the surveys were conducted. Data on demographics, socio-economic variables and health related variables was used. A maximum likelihood estimation was performed using a multivariate probit model, by using health behaviors (weekly exercise, healthy diet, non-smoking, and prudent alcohol consumption) as the outcomes of the analysis. Results The results point to a strong association between social class and health behaviors, particularly between higher income and healthy diet. It is important to highlight that having an appointment with a General Practitioner is positively associated with all healthy behaviors. For all behaviors but healthy diet, the coefficients are statistically significant at a 5% significance level and non-smoking displays the highest one (0.135). Conclusions This study presents the first step to understand the determinants of health prevention behaviors, which is important to design policies targeting lifestyles. One of its main conclusions indicates that social class (income and education) and GP appointments are associated with health behaviors. Further research would be needed to study the underlying mechanisms through which some of these factors impact behaviors. This presentation was supported by National Funds through FCT, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020). Key messages • This study is an important step in the formulation of policies targeting lifestyles since it allows us to understand which factors are associated with health behaviors. • From this study one can conclude that social class characteristics, particularly income, and access to GP appointments are associated positively with health behaviors.