Tuberculosis Control Program and patient satisfaction, Rio de Janeiro, Brazil

OBJECTIVE To evaluate factors associated with users’ satisfaction in the Tuberculosis Control Program. METHODS A cross-sectional study of 295 patients aged ≥ 18 years, with two or more outpatient visits in the Tuberculosis Control Program, in five cities in the metropolitan region of Rio de Janeiro, RJ, Southeastern Brazil, in 2010. Considering an estimated population of 4,345 patients, the sampling plan included 15 health care units participating in the program, divided into two strata: units in Rio de Janeiro City, selected with probability proportional to the monthly average number of outpatient visits, and units in the other four cities. In the units, four temporal clusters of five patients each were selected with equal probability, totaling 300 patients. A questionnaire investigating the users’ clinical and sociodemographic variables and aspects of care and service in the program relevant to user satisfaction was applied to the patients. Descriptive statistics about users and their satisfaction with the program were obtained, and the effects of factors associated with satisfaction were estimated. RESULTS Patients were predominantly males (57.7%), with a mean age of 40.9 and with low level of schooling. The mean treatment time was 4.1 months, mostly self-administered (70.4%). Additionally, 25.8% had previously been treated for tuberculosis. There was a high level of satisfaction, especially regarding medication provision, and respect to patients by the health professionals. Patients who were younger (≤ 30), those on self-administered treatment, and with graduate level, showed less satisfaction. Suggestions to improve the services include having more doctors (70.0%), and offering exams in the same place of attendance (55.1%). CONCLUSIONS Patient satisfaction with the Tuberculosis Control Program was generally high, although lower among younger patients, those with university education and those on self-administered treatment. The study indicates the need for changes to structural and organizational aspects of care, and provides practical support for its improvement

Unveiling relationships between crime and property in England and Wales via density scale-adjusted metrics and network tools

Scale-adjusted metrics (SAMs) are a significant achievement of the urban scaling hypothesis. SAMs remove the inherent biases of per capita measures computed in the absence of isometric allometries. However, this approach is limited to urban areas, while a large portion of the world’s population still lives outside cities and rural areas dominate land use worldwide. Here, we extend the concept of SAMs to population density scale-adjusted metrics (DSAMs) to reveal relationships among different types of crime and property metrics. Our approach allows all human environments to be considered, avoids problems in the definition of urban areas, and accounts for the heterogeneity of population distributions within urban regions. By combining DSAMs, cross-correlation, and complex network analysis, we find that crime and property types have intricate and hierarchically organized relationships leading to some striking conclusions. Drugs and burglary had uncorrelated DSAMs and, to the extent property transaction values are indicators of affluence, twelve out of fourteen crime metrics showed no evidence of specifically targeting affluence. Burglary and robbery were the most connected in our network analysis and the modular structures suggest an alternative to "zero-tolerance" policies by unveiling the crime and/or property types most likely to affect each other

The origin and evolution of Lyα blobs in cosmological galaxy formation simulations

High-redshift Lyα blobs (LABs) are an enigmatic class of objects that have been the subject of numerous observational and theoretical investigations. It is of particular interest to determine the dominant power sources for their luminosity, as direct emission from H ii regions, cooling gas, and fluorescence due to the presence of active galactic nuclei (AGNs) can all contribute significantly. In this paper, we present the first theoretical model to consider all of these physical processes in an attempt to develop a model for the origin of LABs. This is achieved by combining a series of high-resolution cosmological zoom-in simulations with ionization and Lyα radiative transfer models. We find that massive galaxies display a range of Lyα luminosities and spatial extents (which strongly depend on the limiting surface brightness used) over the course of their lives, though regularly exhibit luminosities and sizes consistent with observed LABs. The model LABs are typically powered from a combination of recombination in star-forming galaxies, as well as cooling emission from gas associated with accretion. When AGNs are included in the model, the fluorescence caused by active galactic nucleus-driven ionization can be a significant contributor to the total Lyα luminosity as well. Within our modeled mass range, there are no obvious threshold physical properties that predict the appearance of LABs, and only weak correlations of the luminosity with the physical properties of the host galaxy

JWST Photometric Time-delay and Magnification Measurements for the Triply Imaged Type Ia “SN H0pe” at z = 1.78

Supernova (SN) SN H0pe is a gravitationally lensed, triply imaged, Type Ia SN (SN Ia) discovered in James Webb Space Telescope imaging of the PLCK G165.7+67.0 cluster of galaxies. Well-observed multiply imaged SNe provide a rare opportunity to constrain the Hubble constant (H 0), by measuring the relative time delay between the images and modeling the foreground mass distribution. SN H0pe is located at z = 1.783 and is the first SN Ia with sufficient light-curve sampling and long enough time delays for an H 0 inference. Here we present photometric time-delay measurements and SN properties of SN H0pe. Using JWST/NIRCam photometry, we measure time delays of Δt ab = − 116.6 − 9.3 + 10.8 observer-frame days and Δt cb = − 48.6 − 4.0 + 3.6 observer-frame days relative to the last image to arrive (image 2b; all uncertainties are 1σ), which corresponds to a ∼5.6% uncertainty contribution for H 0 assuming 70 km s−1 Mpc−1. We also constrain the absolute magnification of each image to μ a = 4.3 − 1.8 + 1.6 , μ b = 7.6 − 2.6 + 3.6 , μ c = 6.4 − 1.5 + 1.6 by comparing the observed peak near-IR magnitude of SN H0pe to the nonlensed population of SNe Ia