Primary Units Research Articles

Pro-Ecological Energy Attitudes towards Renewable Energy Investments before the Pandemic and European Energy Crisis: A Segmentation-Based Approach

The household as the primary decision-making unit is founded on classical and neoclassical economics. However, household behaviour changes have been noticeable in the last decade, moving towards more green and sustainable patterns, which have been pronounced in EU countries striving for a more significant share of renewable energy sources (RES) in energy consumption. These behaviours can be attributed to sustainable economics and are an essential part of energy transformation, as they are focused on pro-ecological attitudes, considering both financial activities and those related to caring for the environment and future generations. This article aims to segment energy consumers and to determine what attitudes prevailed in the selected segments and to what extent consumers were pro-ecologically oriented when making decisions regarding RES management before the pandemic and the energy crisis outbreak in Europe. We propose a three-segment model for archetyping household energy consumers in Poland by considering the following groups of factors: environmental and energy goods protection (F1), the mirror effect (F2), and energy and devices profitability (F3). The segments are distinguished based on factor analysis and the fuzzy c-means method. The number of segments is determined based on the cluster validity measure. The presented results prove that the F1 factor plays the leading role in each segment. The percentage of positive responses for each segment, including a migrating group of households, oscillates over 80%. It gives strong hope for retaining sustainable attitudes regardless of the pandemic and energy crisis that occurred in 2022 in the EU.

Understanding the rise in traditional contraceptive methods use in Uttar Pradesh, India

BackgroundThe sustainable development goals (SDG) aim at satisfying three-fourths of family planning needs through modern contraceptive methods by 2030. However, the traditional methods (TM) of family planning use are on the rise, along with modern contraception in Uttar Pradesh (UP), the most populous Indian state. This study attempts to explore the dynamics of rising TM use in the state.MethodsWe used a state representative cross-sectional survey conducted among 12,200 Currently Married Women (CMW) aged 15–49 years during December 2020–February 2021 in UP. Using a multistage sampling technique, 508 primary sampling units (PSU) were selected. These PSU were ASHA areas in rural settings and Census Enumeration Blocks in urban settings. About 27 households from each PSU were randomly selected. All the eligible women within the selected households were interviewed. The survey also included the nearest public health facilities to understand the availability of family planning methods. Univariate and bivariate analyses were conducted. Appropriate sampling weights were applied.ResultsOverall, 33.9% of CMW were using any modern methods and 23.7% any TM (Rhythm and withdrawal) at the time of survey. The results show that while the modern method use has increased by 2.2 percentage points, the TM use increased by 9.9 percentage points compared to NFHS-4 (2015–16). The use of TM was almost same across women of different socio-demographic characteristics. Of 2921 current TM users, 80.7% started with TM and 78.3% expressed to continue with the same in future. No side effects (56.9%), easy to use (41.7%) and no cost incurred (38.0%) were the main reasons for the continuation of TM. TM use increased despite a significant increase (66.1 to 81.3%) in the availability of modern reversible methods and consistent availability of limiting methods (84.0%) in the nearest public health facilities.ConclusionInitial contraceptive method was found to have significant implications for current contraceptive method choice and future preferences. Program should reach young and zero-parity women with modern method choices by leveraging front-line workers in rural UP. Community and facility platforms can also be engaged in providing modern method choices to women of other parities to increase modern contraceptive use further to achieve the SDG goals.

Development and validation of a clinical rule for the diagnosis of chikungunya fever in a dengue-endemic area.

Rio de Janeiro is a dengue-endemic city that experienced Zika and chikungunya epidemics between 2015 and 2019. Differential diagnosis is crucial for indicating adequate treatment and assessing prognosis and risk of death. This study aims to derive and validate a clinical rule for diagnosing chikungunya based on 3,214 suspected cases consecutively treated at primary and secondary health units of the sentinel surveillance system (up to 7 days from onset of symptoms) in Rio de Janeiro, Brazil. Of the total sample, 624 were chikungunya, 88 Zika, 51 dengue, and 2,451 were negative for all these arboviruses according to real-time polymerase chain reaction (RT-qPCR). The derived rule included fever (1 point), exanthema (1 point), myalgia (2 points), arthralgia or arthritis (2 points), and joint edema (2 points), providing an AUC (area under the receiver operator curve) = 0.695 (95% CI: 0.662-0.725). Scores of 4 points or more (validation sample) showed 74.3% sensitivity (69.0% - 79.2%) and 51.5% specificity (48.8% - 54.3%). Adding more symptoms improved the specificity at the expense of a lower sensitivity compared to definitions proposed by government agencies based on fever alone (European Center for Disease Control) or in combination with arthralgia (World Health Organization) or arthritis (Pan American Health Organization, Brazilian Ministry of Health). The proposed clinical rule offers a rapid, low-cost, easy-to-apply strategy to differentiate chikungunya fever from other arbovirus infections during epidemics.

Tunnel geothermal disaster susceptibility evaluation based on interpretable ensemble learning: A case study in Ya'an–Changdu section of the Sichuan–Tibet traffic corridor

An interpretable model based on the efficient combination of ensemble learning and permutation importance (PI), partial dependence plots (PDP), and the local interpretable model-agnostic explanations (LIME) algorithm was proposed in this work to facilitate the global and local interpretation of tunnel geothermal disaster susceptibility evaluations. The main goal was to provide more scientific theoretical support for the accurate evaluation of tunnel geothermal disaster susceptible areas. By considering the Ya'an–Changdu section of the Sichuan–Tibet traffic corridor as the research area – based on Landsat-8 images and other collected spatial data around the causes and distribution of the geothermal disasters in the tunnel – eight different evaluation factors were selected. Random forest (RF) and light gradient boosting machine (LightGBM) algorithms were used as the primary learning unit. In addition, a support vector machine (SVM) was used as the secondary learning unit. Through the implementation of the stacking algorithm, the susceptibility of tunnel geothermal disasters was evaluated. Then, the precision was verified by six evaluation indexes, and the interpretability of the ensemble learning model was studied by using three interpretation algorithms: PI, PDP, and LIME. From the extracted outcomes, it was demonstrated that the stacking algorithm for ensemble learning had the best performance and the highest prediction precision. The number of geothermal sample points in the high-susceptibility tunnel geothermal disaster area and the extremely highly susceptible area accounts for 85.57% of the total geothermal sample points, whereas the area accounts for 7.21% of the total area of the region. According to the model interpretation, land surface temperature (LST), fault density, and earthquake peak acceleration are regarded as the most important factors in the tunnel geothermal disaster susceptibility evaluation. The tunnel geothermal disaster susceptibility evaluation model based on interpretable ensemble learning has high precision, and is of great importance for the practical significance of the project route selection, construction, and operation of the Ya'an–Changdu section of the Sichuan–Tibet traffic corridor.

Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study.

Ethiopia has a national palliative care guideline, and palliative care is explicitly recognised in the country's healthcare policy and health sector transformation plans. However, palliative care is not fully delivered in the regional public hospitals and primary health care units. This study explores perceived policy barriers to deliver palliative care services in rural and regional healthcare settings, which primary healthcare units largely serve. Face-to-face interviews were conducted in a rural region of Ethiopia. Forty-two participants were recruited from a variety of health settings including primary, secondary and tertiary levels across the region. Interviews were conducted with policymakers from the regional health bureau, pharmacists, medical doctors, health officers (clinical officers) and nurses, including chief nursing officers in leadership roles at all levels of healthcare institutions. Data analysed using thematic analysis. Participants described several barriers related to healthcare policy, including lack of government priority and focus on palliative care; lack of health professionals' awareness of the national palliative care plans and guidelines; and lack of palliative care integration into the existing healthcare system and the national budget. Participants remarked that palliative care services in the region were mainly limited to HIV patients, often managed with external support and, hence unsustainable. Policy priority and focus is a fundamental component for the provision of palliative care because lack of focus and support from the government have led to inadequate access to palliative care for all in need. Hence, as participants suggested, palliative care should be integrated into all healthcare levels, particularly into the primary health care units and the health extension programme, to facilitate health extension workers to support millions living in rural areas.

Geology and Geophysics of Talumopatu Geothermal Manifestation Area of Mootilango District, Gorontalo Regency, Indonesia

The research aims to assess the geothermal potential and provide a better understanding of the geology and geophysics of the area. The study utilizes various methods, including geological mapping, geochemical analysis, and magnetic and electromagnetic data analysis, to gain insights into the subsurface structures and characteristics of the geothermal system. The study area can be divided into three geomorphological units: Alluvial Plain Unit, Near Plains Unit, and Isolated Hill Unit. The study area exhibits a stratigraphy consisting of three primary units: Talumopatu granite units, Talumopatu sandstone units, and alluvial deposit units. The subsurface lithologies of the Talumopatu manifestation area were analyzed using the Wenner – Alpha configuration ERT method, revealing two distinct lithologies. The first lithology consists of sandstones with a resistivity value ranging from 4.2 to 39.0 Ωm and a thickness of 1.25 to 12.4 m, which act as a permeable layer capable of transmitting water. The second lithology is granite with a resistivity value ranging from 118 to 360 Ωm and a thickness of 3.75 to 15.9 m. This information provides valuable insights into the subsurface characteristics of the area, including the presence of permeable layers and the geological composition of the lithologies

Adding a back care package to the primary healthcare; a community-based cluster-randomized trial

IntroductionThe clinical course of LBP is complex and chronicity is more frequent than once thought. Moreover, insufficient evidence was found in support of any specific approach at the level of the general population. Research questionThis study aimed to evaluate the effectiveness of providing a back care package through the primary healthcare system in decreasing the rate of CLBP in the community. Material and methodsClusters were primary healthcare units with the covered population as participants. The intervention package comprised both exercise and educational content in the form of booklets. Data regarding LBP were collected at baseline, 3 and 9-month follow-ups. The LBP prevalence and the incidence of CLBP in the intervention group compared to the control group were analyzed using logistic regression through GEE. ResultsEleven clusters were randomized including 3521 enrolled subjects. At 9 months, the intervention group showed a statistically significant decrease in both the prevalence and the incidence of CLBP, compared to the control group (OR ​= ​0.44; 95% CI ​= ​0.30–0.65; P ​< ​0.001 and OR ​= ​0.48; 95% CI ​= ​0.31–0.74; P ​< ​0.001, respectively). Discussion and conclusionThe population-based intervention was effective in reducing the LBP prevalence and CLBP incidence. Our results suggest that preventing CLBP through a primary healthcare package including exercise and educational content is achievable.

Hypertension from the patient's perspective: contributions to the care offered by health professionals and self-care - a qualitative study.

Hypertension is the most common disease in primary care settings. Only 30% of cases were adequately controlled. To analyze the knowledge and understanding of patients with hypertension regarding the factors that facilitate and limit adherence to treatment and, based on the results, build specific guidelines on hypertension self-care and control. This qualitative study was conducted in a primary healthcare setting. Patients with hypertension who were followed at a primary healthcare unit were interviewed through focus groups, and a qualitative interpretation of their statements according to Bardin's content analysis was performed. Three focus groups were formed (21 participants), from whose analysis emerged 74 core ideas related to the concept of hypertension, causes of increase in blood pressure, clinical consequences of hypertension, and possible patients' contributions to help control blood pressure, arising from eating habits, psychosocial conditions, and lifestyle. Patients tend to accept the concept of "high blood pressure" as an inherent condition of the disease in their lives. Eating habits are strongly related to life history and self-perception of health. The association between high blood pressure and nervousness or stress appears to be strong. The experience of having "pressure problem" is unique for each person. It is necessary to optimize listening, recognizing that, for the patient to understand what hypertension is and its management, there must be understanding and convergence of proposals, adjustments, and changes in a positive and personalized way. As a result of this study, we implemented educational actions in primary healthcare units.

Targeting DNA Methylation in Podocytes to Overcome Chronic Kidney Disease.

The number of patients with chronic kidney disease (CKD) is on the rise worldwide, and there is urgent need for the development of effective plans against the increasing incidence of CKD. Podocytes, glomerular epithelial cells, are an integral part of the primary filtration unit of the kidney and form a slit membrane as a barrier to prevent proteinuria. The role of podocytes in the pathogenesis and progression of CKD is now recognized. Podocyte function depends on a specialized morphology with the arranged foot processes, which is directly related to their function. Epigenetic changes responsible for the regulation of gene expression related to podocyte morphology have been shown to be important in the pathogenesis of CKD. Although epigenetic mechanisms include DNA methylation, histone modifications, and RNA-based regulation, we have focused on DNA methylation changes because they are more stable than other epigenetic modifications. This review summarizes recent literature about the role of altered DNA methylation in the kidney, especially in glomerular podocytes, focusing on transcription factors and DNA damage responses that are closely associated with the formation of DNA methylation changes.

Strengthening Millet Value Chain through Farmer Producer Organizations

Millets are a group of small-seeded “Nutri-Cereals” that are grown as food crops in many parts of the world and is need of hour for achieving nutritional security. In the traditional supply chain, millet farmers were not getting remunerative prices but being the members in Farmers’ Producer Organizations, the share in the consumer rupee was increased. The value chain approach was used for analyzing the supply chain aspects of millets to strengthen the linkages, increase efficiency, competitiveness, and profitability. The study was conducted during 2022-23 with ICAR-IIMR promoting FPOs. The establishment of a primary processing unit by ICAR-IIMR at the FPO farm gate through the FPO strengthened the millet value chain by engaging FPOs/SHGs/rural women/unemployed youth in preparing value-added products and delivering them through the GeM portal, ONDC, FPO Bazar, and e-commerce platforms. To meet the millet value chain challenges overall adoption of improved technologies, better market linkages, and increased investment in infrastructure were the key strategies. Primary processing, value-added technology adoption by FPOs and declaring minimum support price by the state government, and creating facilities to procure at MSP by establishing millet food parks, millet shakti cafes, and millet bazar were found key sources to generate better income.

Role and usage of reliability indices in computer application having a primary and secondary unit

Role and usage of reliability indices in computer application having a primary and secondary unit

Factors Related to Suicidal Ideation by Gender and Age Group in Korean Adults.

According to the results of the age-standardized suicide rate (suicide deaths per 100,000 population) published by Organization for Economic Cooperation and Development countries from 2003 to 2019, the suicide rate in Korea is ranked first almost every year, so it should be managed at the national level. To reduce the suicide rate, many scholars are studying suicide. The suicidal process begins with suicidal ideation, progresses through suicide attempts, and ends with suicide. Among them, the frequency of suicidal thoughts was found to be highly correlated with suicide plans and attempts, and it is said that 60% of those who change from suicidal ideation to attempts appear within one year. Therefore, research related to suicidal ideation to lower the suicide rate will contribute to preventing suicide at an early stage. This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). Among them, data from 2013, 2015, 2017, and 2019 surveyed adults were compared for suicidal ideation among 18,339 adults. Considering the characteristics of the KNHANES data, complex sample analysis was performed considering the primary extraction unit (region), stratification variables, and weights. The Rao-Scott χ² test was stratified by age group to confirm the distribution of suicidal ideation according to general characteristics. Univariate and multiple logistic regression analyses were performed to understand the effect on suicidal ideation. Among all subjects, the rate of suicidal ideation was 4.75%, and among the age groups, the rate of suicidal thoughts was the highest among those over 80 years old (10.39%). Compared to those who were 50s, those in their 30s had the lowest suicidal ideation (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.39-0.70), and those in their 80s had the highest rate of suicidal ideation (OR, 1.97; 95% CI, 1.38-2.82). Except for those in their 20s, the rate of suicidal ideation tends to increase with age. Overall, the lower 25% of the Euro Quality of Life-5 Dimensions (EQ-5D) index, depression lasting more than two weeks, and subjects with poor subjective health or high stress were more likely to have suicidal ideation. In particular, EQ-5D Index (OR, 5.86; 95% CI, 3.73-9.20), depressive symptoms (OR, 19.65; 95% CI, 9.94-38.83) in 20s, and stress in 80s (OR, 10.87; 95% CI, 5.63-20.96) was the highest, and those had the good subjective health perception in 30s (OR, 0.10; 95% CI, 0.05-0.20) was lowest. Participants in their 30s, 40s, and 60s who were divorced or widowed and those in their 50s and 60s who had never married or lived together were more likely to consider suicide ideation. Except for those in their 20s and 80s, the rate of suicidal ideation tends to increase with lower household income levels. In the results of this study, it can be seen that a combination of factors such as a person's personality traits, stress or coping ability to various events, social support, and mental or physical limitations influence suicidal behavior. Suicidal ideation is not simply affected by a single factor but may be influenced by multiple factors.

Implementation of a nursing strategy for self-transcendence in older adults: an experience report.

to report the experience of implementing a nursing strategy to promote self-transcendence in older adults attended at a Primary Health Care center. an experience report on the implementation of a strategy addressing the Theory of Self-Transcendence by nursing to older adults in a primary health unit, in San Luis Potosí, Mexico, from October to November 2022. fourteen older adults and three nurses participated. From the expression of feelings, speeches about self-transcendence, spirituality and physical activity promotion, the strategy was satisfactory. Emotional, cognitive and spiritual changes were observed in the different dimensions of the Theory of Self-Transcendence. the nursing strategy on self-transcendence made it possible to identify significant moments that helped to identify the key points in which older adults were; it helped to intervene from a person-to-person care perspective.

Robust dual-cross-linked networks enable stable silicon anodes.

The simultaneous attainment of long cycle life and high energy in Si anodes remains challenging. Herein, we introduce the concept of primary building units as organizing units to construct durable and conductive electrode architectures, which helps to facilitate the coalescence of Si nanoparticles with conductive pathways and prevent nanoparticle aggregation.

Teleconsultation, a tool for the future? - The Portuguese Family Doctors' perspective

ObjectiveThe COVID-19 pandemic led to a mass use of teleconsultation. The aim of this study is to understand the family doctors' perspective over the utility of teleconsultation in their future clinical practice. MethodsA cross-sectional study was realized through the application of an online survey, between September 18th and December 4th, 2020. The target population were family medicine physicians and residents who worked in a primary health unit belonging to the portuguese National Healthcare Service. A descriptive analysis of the characteristics of the participants and of their answers to the survey was performed. Results377 responses were received. It was identified as the main advantage the greater accessibility (68,7%), as the main disadvantage the impossibility to perform physical examination (81,2%) and as the main obstacle the lack of appropriate resources to teleconsultation (70,0%). The majority of the participants acknowledge that teleconsultation represents a valuable asset to the future of medicine (83,6%). 80,6% of the doctors would like to implement a teleconsultation period in their schedule and 76,1% think that teleconsultation will become essential to future clinical practice. ConclusionPublished studies support our findings, regarding advantages, disadvantages and obstacles. It is acknowledged that currently neither portuguese population nor family medicine are ready for teleconsultation, although this is considered to be a useful tool to future clinical practice.

Disability types, determinants and healthcare utilisation amongst Afghan adults: a secondary analysis of the Model Disability Survey of Afghanistan

ObjectivesThe needs of people with disability in Afghanistan are not well understood. We describe the characteristics, healthcare utilisation patterns, and experience of care among Afghan adults with moderate or severe...

Forensic pathological diagnostics of rare T-cell leukemia in re-examination

A forensic pathological case of rare T-cell leukemia is reported. Autopsy samples (paraffine blocks and slides) from 32 years old female with long-term existing anemia and leukopenia, number of chronic inflammatory diseases, died from fulminant pneumonia, were presented for forensic pathological re-examination. A routine histological examination was done using standard H&E stain. Additionally, we used IHC stain with antibodies to CD3 and CD20 when examining bone marrow and liver samples. The T-cell infiltration in bone marrow (interstitial and intrasinusoidal type) were found. The next step was IHC bone marrow examination with CD4, CD5, CD8, CD56 antibodies. We concluded that the patient had unrecognized T-cell leukemia, based on anamnestical, clinical data and results of our histological and IHC examination. In this case, the T-cell leukemia was not found neither vitally nor at primary forensic pathological examination after autopsy. The necessity of minimal IHC stain sets usage in primary forensic pathology units and IHC's decisive role in bone marrow pathological examination are discussed.

Dynamic mathematical modelling and simulation of a primary oil separation unit

Dynamic mathematical modelling and simulation of a primary oil separation unit

Type 2 Diabetes and Precursors in Community Dwelling Asian Indian Adult Youth.

Recent studies have shown a high prevalence of Type-2-diabetes (T2DM) (24%) and prediabetes (18.1%) in Kerala. There is no community based study from South Asia regarding the prevalence of type 2 diabetes and its precursors in the young adult population. This community based study was done to find the prevalence of type 2 diabetes and its precursors in South Indian adult youth (18-30 years age) of Thiruvananthapuram district. Cross sectional design was used for this study. Multistage cluster sampling was used to enrol community dwelling youth of 18 to 30 years, residing in Thiruvananthapuram district. Six panchayath wards from rural and urban regions and 4 from coastal area were randomly selected as the primary sampling units. Trained staff nurses conducted the survey with the help of accredited-social-health-activists (ASHA). Socio-demographic data, anthropometry, clinical features of insulin resistance, and random capillary glucose (CG) and blood pressure were assessed and recorded. Oral Glucose tolerance test or HbA1c was done for participants with a CG ≥130 mg/dl for diagnosis of diabetes and prediabetes. A total of 1031 participants were included from the rural (n = 394), coastal (n = 269) and urban (n = 368) areas. Prevalence of hyperglycaemia i.e., T2DM and pre-diabetes was 0.48% (n = 5) and 2.4% (n = 25) respectively. Family-history of T2DM was present in 35.1% subjects. Prevalence of overweight, obesity and abdominal-obesity was 28.2%, 16.1% and 28.4% respectively. Clinical-features of insulin resistance (CFIR) were present in 27.1% subjects (acanthosis [17.7%], skin tags [1.7%] and PCOS phenotype [10.7%]). Among various anthropometric measurements and their derivatives, CFIR correlated best (r = 0.24, P < 0.01) with the product of BMI and the sum of abdominal circumference and hip circumference (Trivandrum Medical College [TMC] -adiposity-index), which is a newly proposed parameter. Hyperglycaemia was more common in males, did not correlate with waist hip ratio, and correlated best again with TMC-adiposity-index ((r = 0.13, P < 0.01). The burden of insulin resistance in the young South Indian population, hitherto unknown in any community based study, has been studied for the first time. The prevalence of precursors of T2DM is high in this population. Early identification of 'at risk' individuals could provide a window of opportunity for preventing or delaying future diabetes and its long term complications. TMC adiposity index could become a valuable tool in the anthropometric assessment for predicting future T2DM.

Междометия и междометные комплексы в пьесах А.Н. Островского

An analysis of the use of interjections and interjection complexes in the plays of A.N. Ostrovsky was carried out, whose 200th birthday is celebrated all over the world this year. The playwright’s works significantly changed the Russian theater; ordinary people, representatives of the merchant class and the lower social classes appeared on the stage. They spoke the folk language, in which dialectisms, vernacular units, proverbs, sayings, and phraseological units were widely used. There important component of folk speech are interjections. They represent a complex part of speech with contradictory lexical-semantic and grammatical properties. Among them there are units with non-standard phonetic composition. Attempts to convey such interjections by means of the alphabet lead to the use of traditional notation, which very approximately reflects their real sound appearance (ugh), which becomes the cause of ethnospecific forms of transmission of such physical phonations in different languages, and this causes difficulties in their translation. At the same time, it is hardly worth talking about a special phonetic system of interjections, since the overwhelming majority of primary units (well, ah, ah, ba, wow, alas, and many others) consist of standard phonemes of the language, and their prosody generally corresponds to the prosodic characteristics vocatives and other lingual units. Interjections are widely represented in the texts of A.N. Ostrovsky’s plays. A significant place in the speech of the characters is occupied by primary interjections, with the help of which the author reflects the diversity of feelings and experiences of the characters. Among the most frequent words in plays by A.N. Ostrovsky includes interjections, well, ah. In almost all works there are also primary interjections oh, eh, hey, etc. Secondary interjections in the plays of A.N. Ostrovsky is mainly represented by the interjectivated words God, God, Lord, used both independently and as part of interjectional constructions (God bless, God be with you, etc.). In many cases, it is not easy to draw a line between interjection and religious use of these units in the speech of characters.