Learning Electronic Polarizations in Aqueous Systems.

The polarization of periodically repeating systems is a discontinuous function of the atomic positions, a fact which seems at first to stymie attempts at their statistical learning. Two approaches to build models for bulk polarizations are compared: one in which a simple point charge model is used to preprocess the raw polarization to give a learning target that is a smooth function of atomic positions and the total polarization is learned as a sum of atom-centered dipoles and one in which instead the average position of Wannier centers around atoms is predicted. For a range of bulk aqueous systems, both of these methods perform perform comparatively well, with the former being slightly better but often requiring an extra effort to find a suitable point charge model. As a challenging test, we also analyze the performance of the models at the air-water interface. In this case, while the Wannier center approach delivers accurate predictions without further modifications, the preprocessing method requires augmentation with information from isolated water molecules to reach similar accuracy. Finally, we present a simple protocol to preprocess the polarizations in a data-driven way using a small number of derivatives calculated at a much lower level of theory, thus overcoming the need to find point charge models without appreciably increasing the computation cost. We believe that the training strategies presented here help the construction of accurate polarization models required for the study of the dielectric properties of realistic complex bulk systems and interfaces with ab initio accuracy.

Examining district-level disparity and determinants of timeliness of emergency medical services in Maharashtra, India.

The quality of emergency medical services remains a major public health issue in developing countries in terms of access, availability, or timely delivery, owing to high socio-economic and ethnic disparities. Particularly, the timeliness of EMS remains a drawback, leading to higher mortality and morbidity. The aim of the study is to assess the district-level differences and factors that influence ambulance travel time, as there was no study done in the Indian scenario. Sequential Explanatory Design was applied here, which involved a descriptive study and spatial analysis of the call volume and distribution to understand the operational challenges of MEMS, followed by in-depth interviews among medical officers and officials to explore the reasons for the challenges. The data, shared by the Department of Health, Government of Maharashtra, consisted of 38,823 records (emergency: 16,197 and hospital-to-hospital transfer: 22,626), including emergency and hospital-to-hospital transfer calls across 36 districts of Maharashtra for November 2022. Spatial analyses were performed to identify the districts with challenges of timeliness. The average ambulance response time (T) across the districts was reported at 134.5 min for emergency cases and 222.80 min for hospital-to-hospital transfer cases. The total ambulance response time, was classified as preparation time (t1:3.53 min for emergency, 3.69 min for hospital-to-hospital transfer), travel time from base to scene (t2: 23.15 min for emergency, 17.18 min for hospital-to-hospital transfer), time required at scene (t3: 12.12 min for emergency, 14.72 min for hospital-to-hospital transfer), travel time from scene to hospital (t4:39.41 min for emergency, 74.34 min for hospital-to-hospital transfer), patient handover time (t5: 10.85 min for emergency, 13.84 min for hospital-to-hospital transfer), and return from base to hospital (t6: 41.89 min for emergency, 94.72 min for hospital-to-hospital transfer). Multivariate linear regression was conducted to investigate the factors that influence ambulance travel time. The finding identifies that the ambulance travel time increased for the districts with lesser population density, lower road density, fewer hospitals, a higher district area served per ambulance, and a higher population served per ambulance. Additionally, socio-cultural reasons affecting health-seeking behaviour, early closing of healthcare centres, undercapacity and resource-deficit healthcare centres, and overloading of specialised tertiary hospitals were identified as determinants of delay in patient assessment and handover time in qualitative findings. A decisive and multi-sectoral approach is required to address the timeliness of EMS in the Indian context.

Spending to grow or growing to spend? Relationship between public health expenditure and income of Indian states.

While there are concerns about low public health expenditure in most developing countries, the evidence on the linkage between public health expenditure and income is limited. In countries such as India, where massive public health programmes have been implemented over a period that experienced high economic growth, the relationship between two is a question of interest. We examine the relationship between two at sub-national level, as decisions regarding health are prerogative of the state government. We use data on gross state domestic product and public health expenditure over 1981-2017. Using a robust version of Granger causality that produces reliable results even in presence of parameter instabilities, we find presence of non-linear and bi-directional relationship between the two variables. We report inter-state differences in the income elasticity of health expenditure. These differences can be traced to the differing institutional set up, partly rooted in the administrative decisions taken in colonial India.

What is in a Meter? A Qualitative Exploration into the Implementation of Electricity Metering Across Mumbai Communities Using Normalisation Process Theory.

Metering is fundamental in the efficient operation of electricity networks, as meters facilitate controlled usage and improve health and well-being. However, across the Global South, meters have often been found to be lacking or not fit for purpose. Therefore, this study sought to determine residents' perceptions and access to electricity metering across a community in Mumbai, with the goal of developing recommendations to support the implementation of meters in the future. Fifty semi-structured interviews were conducted by phone, with participants from different areas and socioeconomic classes, within Greater Mumbai. The sample consisted of 20 low-income, 20 middle-income, and 10 high-income participants. The Normalisation Process Theory (NPT) was used to inform the interview schedule and to organise the thematic analysis. Meter accessibility and location was variable across the participant groups, as was the education and awareness of metering technology. Socio-political factors were found to directly affect the use of meters, specifically in the low-income group. The high cost associated with metering was a prominent finding; with a preconception that introducing meters would only increase utility expenditure. Future work should focus around ensuring meters are easy to use, practical and accessible to all residents and supporting education programmes around how to use a meter and how they can reduce utility expenditure. The cost of meters should also be investigated, to establish that the costs, associated with introducing new meters, are not passed disproportionately to consumers. Supplementary Information: The online version contains supplementary material available at 10.1007/s43477-022-00059-y.

Physical distancing on public transport in Mumbai, India: Policy and planning implications for unlock and post-pandemic period.

COVID-19 outbreak affected the daily lives of people around the globe, and authorities proposed numerous interventions to make activity participation and traveling safer during the pandemic period. This study investigates the potential implication of such interventions on executing physical distancing on public transport in Mumbai, India. The study reviews the demand-supply gap of public transport during the pre-pandemic and pandemic period and evaluates the challenges in practicing physical distancing with the short-term interventions, such as lockdown guidelines at different phases and long-term interventions, such as flexible work arrangements, on public transport. The study findings indicate that physical distancing on public transport is difficult to achieve at peak hours, even with the very high travel restrictions and lockdown measures, unless flexible work arrangements are implemented. The flexible work arrangements, such as staggered working hours and work from home, can significantly reduce peak-hour demand and total excess demand without altering the supply pattern. The study can guide in constituting transport and broader policy decisions, including developing low-risk public transport for the post-pandemic period.

Evolution of sustainable energy policies in India since 1947: A review.

India's Intended Nationally Determined Contributions in 2015 toward the Two-Degree Celsius climate change goal has endorsed 15% of renewable integration in the primary energy mix by 2020. The energy space is strategy to meet the target without affecting its immediate sustainable development goals. This study documents this strategic effort by tracking the historical trajectory of energy policy planning since its independence in 1947. An objective ontological approach was adopted in reviewing the evolution of energy policy into five distinct phases. Phase I (1947-1970), focused on supply adequacy with the overall thrust on infrastructure development as the pillar of Indian economy. In Phase II (the 1970s) the focus shifted in addressing the energy access crisis. Phase III (the 1980s) was based on increment, diversification, and streamlining on supplies for energy security purposes. Phase IV (the 1990s) is the period of modernization of the overall Indian electricity system. Phase V (the 2000s) is the present phase of market transformation and climate change mitigation energy policies. A co-assessment of India's policy to the international climate negotiations showed that India remained responsive to international climate goals. It became reactive in the planning for sustainable energy policy after its ratification of Kyoto Protocol in 2001. Since then, India has been instrumental in administering strict emission reduction norms and efficiency measures. This review concludes that the country needs to upgrade its inefficient transmission and distribution networks, which was broadly neglected. The subsidy allocations in domestic energy resources should be well-adjusted without compromising on its social costs.

Examining the changing health care seeking behavior in the era of health sector reforms in India: evidences from the National Sample Surveys 2004 & 2014.

BACKGROUND: Health policy formulations in India have witnessed a shift from a reactive approach to a more proactive approach over the last decade. It is therefore important to understand the effectiveness of recent national health policies (such as the National Rural Health Mission and the National Urban Health Mission) in addressing the varied needs of the heterogeneous population of India. METHODS: We use datasets from the National Sample Surveys carried out in 2004 and 2014 to understand the change in the health seeking behavior as a result of these policies. The choice of health care facilities and the associated expenditures are compared through descriptive analyses. A multinomial logistic regression is used to identify the significant parameters which contribute towards the share of health care providers in India. The health status of two economically disparate Indian states (Bihar and Kerala) are also compared through specific metrics of performance. RESULTS: It is seen that due to increased availability of facilities in close proximity, both rural and urban residents prefer to avail of those facilities which will result in minimization of transportation cost. The effectiveness of national health policies is found to vary on a regional scale. Literacy and health status have a strong correlation, thereby reinforcing that Bihar still lags far behind Kerala in terms of access to equitable health care. CONCLUSION: Therefore, a hierarchical system, incorporating medical pluralism and tailor-made policies targeted at diverse health care demands, needs to be put in place to achieve Goal 3 of the Sustainable Development Goals as decreed by the United Nations, i.e., "health for all".

Medical Requirements During a Natural Disaster: A Case Study on WhatsApp Chats Among Medical Personnel During the 2015 Nepal Earthquake.

OBJECTIVE: The objective of this study was to explore a log of WhatsApp messages exchanged among members of the health care group Doctors For You (DFY) while they were providing medical relief in the aftermath of the Nepal earthquake in April 2015. Our motivation was to identify medical resource requirements during a disaster in order to help government agencies and other responding organizations to be better prepared in any upcoming disaster. METHODS: A large set of WhatsApp (WhatsApp Inc, Mountain View, CA) messages exchanged among DFY members during the Nepal earthquake was collected and analyzed to identify the medical resource requirements during different phases of relief operations. RESULTS: The study revealed detailed phase-wise requirements for various types of medical resources, including medicines, medical equipment, and medical personnel. The data also reflected some of the problems faced by the medical relief workers in the earthquake-affected region. CONCLUSIONS: The insights from this study may help not only the Nepalese government, but also authorities in other earthquake-prone regions of the world to better prepare for similar disasters in the future. Moreover, real-time analysis of such online data during a disaster would aid decision-makers in dynamically formulating resource-mapping strategies. (Disaster Med Public Health Preparedness. 2017;11:652-655).

Exploring the role of social interactions and supports in overcoming accessibility barriers while undertaking health tours in India.

This article explores the phenomenon of companionship as an adaptation strategy to counter the existing barriers to health care access in developing nations. Companionship is argued to be an outcome of "inter" and "intra" household collaboration to offer diverse supports in addition to altruism. The analysis of the household survey conducted in West Bengal, India, exhibited different patterns of health care tours and the associated dependencies. In addition to support in terms of mobility while traveling and companionship while waiting for the opportunity, support in terms of refuge is also found to be essential, especially for the poor while they undertake regional tours. Causal models focusing on aggregated general health tours and specific regional tours were estimated separately to comprehend the implicit social interactions and their effects on the patient as well as the companions. The research demonstrated that accessibility barriers affect not only the ill, but also those associated with them and at times adversely. Segregation of regional tours illustrated the gaps, which instigated such tours and also might aid in health infrastructure planning as a whole.