The Young Open Cluster NGC 2129

The first charge‐coupled device UBV(RI)C photometric study in the area of the doubtful open cluster NGC 2129 is presented. Photometry of a field offset 15 arcmin northwards is also provided, to probe the Galactic disc population towards the cluster. Using star counts, proper motions from the UCAC2 catalogue, colour–magnitude and colour–colour diagrams, we demonstrate that NGC 2129 is a young open cluster. The cluster radius is 2.5 arcmin, and across this region we find evidence of significant differential reddening, although the reddening law seems to be normal towards its direction. Updated estimates of the cluster fundamental parameters are provided. The mean reddening is found to be E(B−V) = 0.80 ± 0.08 and the distance modulus is (m−M)0= 11.70 ± 0.30. Hence, NGC 2129 is located at 2.2 ± 0.2 kpc from the Sun inside the Local spiral arm. The age derived from 37 photometrically selected members is estimated to be approximately 10 Myr. These stars are used to provide new estimates of the cluster absolute proper‐motion components

The Associations of Autonomy Support and Conceptual Press with Engaged Reading and Conceptual Learning from Text

This study examined the associations of autonomy support and conceptual press, with reading engagement and conceptual learning from text. When students perceive their teacher to be supporting autonomy, it means that student choice, ownership, and personal goals are emphasized. When students perceive their teacher to be supporting conceptual press, it means that the teacher (a) promotes understanding of the substantial principles of a domain; (b) helps students use information integration strategies during reading, such as concept mapping, and (c) promotes persistence on moderately challenging tasks. Based on the self-process model of motivation (Connell & Wellborn, 1990) and an engagement perspective of reading (Baker, Dreher & Guthrie, 2000), it was hypothesized that as students perceived their instruction to be motivating, their reading engagement would increase. In turn, as engaged reading increases, conceptual learning from text would increase. For this investigation, 244 fourth- and fifth-grade students reported their perceptions of their teachers' use of conceptual press and autonomy support in reading instruction. Multifaceted components of reading engagement were measured. Reading engagement was defined as the manifestations of affective, behavioral, and cognitive processes during reading. In addition, participants completed a reading performance assessment in the domain of science designed to measure prior knowledge, strategic reading, and conceptual learning from text. Structural equation modeling was used to compare alternative theoretical models depicting the relations among motivated reading instruction, engaged reading, and conceptual learning from text. The direct effects model had a direct path connecting motivating reading instruction with conceptual learning from text whereas the hypothesized indirect effects model contained an indirect path from motivating reading instruction to conceptual learning from text via engaged reading. Results confirmed the hypothesis that the model including an indirect effect of motivating reading instruction on conceptual learning from text through engaged reading explained the data more fully than a direct effect model. This is consistent with the self-process model of motivation (Connell & Wellborn, 1990). These results have implications for theories of the role of social contexts in engagement and achievement, particularly in the domain of reading, and also suggest ways by which teachers might foster reading engagement among students

Barriers to guideline-concordant antibiotic use among inpatient physicians: A case vignette qualitative study

BACKGROUND: Greater adherence to antibiotic-prescribing guidelines may promote more judicious antibiotic use, which could benefit individual patients and society at large. OBJECTIVE: To assess physician knowledge and acceptance of antibiotic-prescribing guidelines through the use of case vignettes. DESIGN: We conducted semistructured interviews with 30 inpatient physicians. Participants were asked to respond to 3 hypothetical case vignettes: (1) a skin and soft tissue infection (SSTI), (2) suspected hospital-acquired pneumonia (HAP), and (3) asymptomatic bacteriuria (ASB). All participants received feedback according to guidelines from the Infectious Diseases Society of America (IDSA) and were asked to discuss their level of comfort with following these guidelines. SETTING: Two acute care teaching hospitals for adult patients. INTERVENTION: None. MEASUREMENTS: Data from transcribed interviews were analyzed using emergent thematic analysis. RESULTS: Participants were receptive to guidelines and believed they were useful. However, participants' responses to the case vignettes demonstrated that IDSA guideline recommendations were not routinely followed for SSTI, HAP, and ASB. We identified 3 barriers to guideline-concordant care: (1) physicians' lack of awareness of specific guideline recommendations; (2) tension between adhering to guidelines and the desire to individualize patient care; and (3) skepticism of certain guideline recommendations. CONCLUSIONS: Case vignettes may be useful tools to assess physician knowledge and acceptance of antibiotic-prescribing guidelines. Using case vignettes, we identified 3 barriers to following IDSA guidelines. Efforts to improve guideline-concordant antibiotic prescribing should focus on reducing such barriers at the local level

Antibiotic stewardship implementation and patient-level antibiotic use at hospitals with and without on-site Infectious Disease specialists.

Many US hospitals lack Infectious Disease (ID) specialists, which may hinder antibiotic stewardship efforts. We sought to compare patient-level antibiotic exposure at Veterans Health Administration (VHA) hospitals with and without an on-site ID specialist, defined as an ID physician and/or ID pharmacist. This retrospective VHA cohort included all acute-care patient-admissions during 2016. A mandatory survey was used to identify hospitals' antibiotic stewardship processes and their access to an on-site ID specialist. Antibiotic use was quantified as days of therapy (DOT) per days-present and categorized based on National Healthcare Safety Network definitions. A negative binomial regression model with risk adjustment was used to determine the association between presence of an on-site ID specialist and antibiotic use at the level of patient-admissions. Eighteen of 122 (14.8%) hospitals lacked an on-site ID specialist; there were 525,451 (95.8%) admissions at ID hospitals and 23,007 (4.2%) at non-ID sites. In the adjusted analysis, presence of an ID specialist was associated with lower total inpatient antibacterial use [OR 0.92, (95% CI, 0.85-0.99)]. Presence of an ID specialist was also associated with lower use of broad-spectrum antibacterials [OR 0.61 (95% CI, 0.54-0.70)] and higher narrow-spectrum beta-lactam use [OR 1.43 (95% CI, 1.22-1.67)]. Total antibacterial exposure (inpatient plus post-discharge) was lower among patients at ID versus non-ID sites [OR 0.92 (95% CI, 0.86-0.99)]. Patients at hospitals with an ID specialist received antibiotics in a way more consistent with stewardship principles. The presence of an ID specialist may be important to effective antibiotic stewardship

Aplicación de un modelo de productividad en el sector de la comercialización de madera tratada en la ciudad de Ambato. Empresa de estudio: Súper Tableros

El trabajo de investigación realizado en este trabajo de titulación se lo ha realizado en la empresa SUPERTABLEROS, ubicada en la ciudad de Ambato. El objetivo de este análisis fue la de determinar qué modelo de productividad es el que mejor se aplica y se adapta a las características en el sector de madera tratada, para ello se estudiaron ocho modelos de los cuales se escogió uno para su implementación debido a que es el que mejor cumplía con los factores que la empresa desea analizar. Se escogió el modelo estructural de Kurosawa. Para llegar a esta conclusión se empezó por hacer el levantamiento del proceso productivo y posteriormente medir los tiempos de cada una de las actividades dentro de dicho proceso. Se procedió a recopilar dentro de la empresa todos los datos necesarios para el cálculo de cada uno de los ocho modelos de productividad. El modelo estructural de Kurosawa es bastante minucioso, sin embargo es muy práctico ya que mide los tiempos y movimientos de los trabajadores dentro del proceso productivo considerando el tiempo efectivamente trabajado. Además de medir la eficiencia global de la empresa. Dentro del análisis interno realizado se pudo observar que la empresa cuenta con una posición consolidada en el mercado, tiene indicadores favorables de rentabilidad y existen ciertas barreras de entrada para potenciales competidores como una considerable inversión inicial de capital, conseguir buenos proveedores internacionales y crear canales de distribución eficientes. Esto hace que SUPERTABLEROS esté en una posición óptima para la implementación de un modelo productivo que le permita manejarse de una manera más eficaz y eficiente en el corto, mediano y largo plazo

Antibiotic Stewardship Implementation and Antibiotic Use at Hospitals With and Without On-site Infectious Disease Specialists.

BackgroundMany US hospitals lack infectious disease (ID) specialists, which may hinder antibiotic stewardship efforts. We sought to compare patient-level antibiotic exposure at Veterans Health Administration (VHA) hospitals with and without an on-site ID specialist, defined as an ID physician and/or ID pharmacist.MethodsThis retrospective VHA cohort included all acute-care patient admissions during 2016. A mandatory survey was used to identify hospitals' antibiotic stewardship processes and their access to an on-site ID specialist. Antibiotic use was quantified as days of therapy per days present and categorized based on National Healthcare Safety Network definitions. A negative binomial regression model with risk adjustment was used to determine the association between presence of an on-site ID specialist and antibiotic use at the level of patient admissions.ResultsEighteen of 122 (14.8%) hospitals lacked an on-site ID specialist; there were 525 451 (95.8%) admissions at ID hospitals and 23 007 (4.2%) at non-ID sites. In the adjusted analysis, presence of an ID specialist was associated with lower total inpatient antibacterial use (odds ratio, 0.92; 95% confidence interval, .85-.99). Presence of an ID specialist was also associated with lower use of broad-spectrum antibacterials (0.61; .54-.70) and higher narrow-spectrum β-lactam use (1.43; 1.22-1.67). Total antibacterial exposure (inpatient plus postdischarge) was lower among patients at ID versus non-ID sites (0.92; .86-.99).ConclusionsPatients at hospitals with an ID specialist received antibiotics in a way more consistent with stewardship principles. The presence of an ID specialist may be important to effective antibiotic stewardship

Seasonal and Temperature-Associated Increases in Gram-Negative Bacterial Bloodstream Infections among Hospitalized Patients

BACKGROUND: Knowledge of seasonal trends in hospital-associated infection incidence may improve surveillance and help guide the design and evaluation of infection prevention interventions. We estimated seasonal variation in the frequencies of inpatient bloodstream infections (BSIs) caused by common bacterial pathogens and examined associations of monthly BSI frequencies with ambient outdoor temperature, precipitation, and humidity levels. METHODS: A database containing blood cultures from 132 U.S. hospitals collected between January 1999 and September 2006 was assembled. The database included monthly counts of inpatient blood cultures positive for several clinically important Gram-negative bacteria (Acinetobacter spp, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa) and Gram-positive bacteria (Enterococcus spp and Staphylococcus aureus). Monthly mean temperature, total precipitation, and mean relative humidity in the postal ZIP codes of participating hospitals were obtained from national meteorological databases. RESULTS: A total of 211,697 inpatient BSIs were reported during 9,423 hospital-months. Adjusting for long-term trends, BSIs caused by each gram-negative organism examined were more frequent in summer months compared with winter months, with increases ranging from 12.2% for E. coli (95% CI 9.2-15.4) to 51.8% for Acinetobacter (95% CI 41.1-63.2). Summer season was associated with 8.7% fewer Enterococcus BSIs (95% CI 11.0-5.8) and no significant change in S. aureus BSI frequency relative to winter. Independent of season, monthly humidity, monthly precipitation, and long-term trends, each 5.6°C (10°F) rise in mean monthly temperature corresponded to increases in gram-negative bacterial BSI frequencies ranging between 3.5% for E. coli (95% CI 2.1-4.9) to 10.8% for Acinetobacter (95% CI 6.9-14.7). The same rise in mean monthly temperature corresponded to an increase of 2.2% in S. aureus BSI frequency (95% CI 1.3-3.2) but no significant change in Enterococcus BSI frequency. CONCLUSIONS: Summer season and higher mean monthly outdoor temperature are associated with substantially increased frequency of BSIs, particularly among clinically important gram-negative bacteria

Advancing Epidemiological Science Through Computational Modeling: A Review with Novel Examples

Computational models have been successfully applied to a wide variety of research areas including infectious disease epidemiology. Especially for questions that are difficult to examine in other ways, computational models have been used to extend the range of epidemiological issues that can be addressed, advance theoretical understanding of disease processes and help identify specific intervention strategies. We explore each of these contributions to epidemiology research through discussion and examples. We also describe in detail models for raccoon rabies and methicillin-resis-tant Staphylococcus aureus, drawn from our own research, to further illustrate the role of computation in epidemiological modeling