Exploring multi-stakeholder perceptions of practice-related facilitators to optimising the quality of integration of regulated pharmacy technicians in community pharmacy in Ontario: A qualitative study

OBJECTIVES: The objective of this study was to investigate multi-stakeholder perceptions of practice-related facilitators to optimising the quality of Regulated Pharmacy Technician (RPT) integration into the community workforce in Ontario. Facilitators to incorporating technicians into the workflow and supporting their optimal scope of practice were explored. METHODS: A qualitative exploratory study comprising a series of one-to-one interviews using a piloted, semi-structured interview guide was conducted with four community pharmacy stakeholder groups; pharmacists, RPTs, pharmacy assistants and pharmacy owners. Interviews were conducted until saturation of themes. Verbatim transcripts were coded inductively using the software, NVivo v12 (QSR International) and general inductive analysis identified key findings. KEY FINDINGS: Twenty-seven interviews were conducted consisting of seven pharmacists, seven RPTs, eight assistants and five pharmacy owners working within community pharmacy and/or academia or hospital. All participants from every stakeholder group acknowledged that the promise of regulation of pharmacy technicians was unfulfilled in practice. Three major themes of practical significance were derived: (i) A viable business plan that incorporates RPT remuneration and ensures sustainability is a facilitator to fuller integration of RPTs, (ii) Planning the pharmacy workflow to support RPTs’ and pharmacists’ evolving scopes is a facilitator to RPT integration and (iii) Schedule planning to incorporate RPTs and appropriate staffing ratios in relation to prescription volume and pharmacy services allows for optimal utilisation of RPT skills and facilitates their integration. CONCLUSIONS: Achieving integration of RPTs into the business of a community pharmacy has educational, workplace and regulatory implications, requiring the effective engagement of all stakeholders in pharmacy

The cool wake around 4C 34.16 as seen by XMM-Newton

We present XMM-Newton observations of the wake-radiogalaxy system 4C34.16, which shows a cool and dense wake trailing behind 4C34.16's host galaxy. A comparison with numerical simulations is enlightening, as they demonstrate that the wake is produced mainly by ram pressure stripping during the galactic motion though the surrounding cluster. The mass of the wake is a substantial fraction of the mass of an elliptical galaxy's X-ray halo. This observational fact supports a wake formation scenario similar to the one demonstrated numerically by Acreman et al (2003): the host galaxy of 4C34.16 has fallen into its cluster, and is currently crossing its central regions. A substantial fraction of its X-ray halo has been stripped by ram pressure, and remains behind to form the galaxy wake.Comment: 9 pages, 6 figures, accepted for publication in MNRA

Radio loud AGN and the L_X - \sigma relation of galaxy groups and clusters

We use the ROSAT All-Sky Survey to study the X-ray properties of a sample of 625 groups and clusters of galaxies selected from the Sloan Digital Sky Survey. We stack clusters with similar velocity dispersions and investigate whether their average X-ray luminosities and surface brightness profiles vary with the radio activity level of their central galaxies. We find that at a given value of $\sigma$, clusters with a central radio AGN have more concentrated X-ray surface brightness profiles, larger central galaxy masses, and higher X-ray luminosities than clusters with radio-quiet central galaxies. The enhancement in X-ray luminosity is more than a factor of two, is detected with better than 6$\sigma$ significance, and cannot be explained by X-ray emission from the radio AGN itself. This difference is largely due to a subpopulation of radio-quiet, high velocity dispersion clusters with low mass central galaxies. These clusters are underluminous at X-ray wavelengths when compared to otherwise similar clusters where the central galaxy is radio-loud, more massive, or both.Comment: Section 5.2 is updated, more discussion on the dependence of L_X - \sigma relation on the stellar mass of BCG

Systematic study of X-ray Cavities in the brightest galaxy of the Draco Constellation NGC 6338

We present results based on the systematic analysis of currently available Chandra archive data on the brightest galaxy in the Draco constellation NGC 6338, in order to investigate the properties of the X-ray cavities. In the central ~6 kpc, at least a two and possibly three, X-ray cavities are evident. All these cavities are roughly of ellipsoidal shapes and show a decrement in the surface brightness of several tens of percent. In addition to these cavities, a set of X-ray bright filaments are also noticed which are spatially coincident with the H{\alpha} filaments over an extent of 15 kpc. The H{\alpha} emission line filaments are perpendicular to the X- ray cavities. Spectroscopic analysis of the hot gas in the filaments and cavities reveal that the X-ray filaments are cooler than the gas contained in the cavities. The emission line ratios and the extended, asymmetric nature of the H{\alpha} emission line filaments seen in this system require a harder ionizing source than that produced by star formation and/or young, massive stars. Radio emission maps derived from the analysis of 1.4 GHz VLA FIRST survey data failed to show any association of these X-ray cavities with radio jets, however, the cavities are filled by radio emission. The total power of the cavities is 17\times 1042 erg s-1 and the ratio of the radio luminosity to cavity power is ~ 10-4, implying that most of the jet power is mechanical.Comment: The paper contains 12 figures and 3 tables, Accepted 2011 December 7 for publication in MNRA

Fragmentation in the future of work:A horizon scan examining the impact of the changing nature of work on workers experiencing vulnerability

Introduction: The future of work is characterized by changes that could disrupt all aspects of the nature and availability of work. Our study aims to understand how the future of work could result in conditions, which contribute to vulnerability for different groups of workers. Methods: A horizon scan was conducted to systematically identify and synthesize diverse sources of evidence, including academic and gray literature and resources shared over social media. Evidence was synthesized, and trend categories were developed through iterative discussions among the research team. Results: Nine trend categories were uncovered, which included the digital transformation of the economy, artificial intelligence (AI)/machine learning-enhanced automation, AI-enabled human resource management systems, skill requirements for the future of work; globalization 4.0, climate change and the green economy, Gen Zs and the work environment; populism and the future of work, and external shocks to accelerate the changing nature of work. The scan highlighted that some groups of workers may be more likely to experience conditions that contribute to vulnerability, including greater exposure to job displacement or wage depression. The future of work could also create opportunities for labor market engagement. Conclusion: The future of work represents an emerging public health concern. Exclusion from the future of work has the potential to widen existing social and health inequities. Thus, tailored supports that are resilient to changes in the nature and availability of work are required for workers facing vulnerability

Rejuvenated radio galaxies J0041+3224 and J1835+6204 : how long can the quiescent phase of nuclear activity last?

We present radio observations of two well-known doubledouble radio galaxies, J0041+3224 and J1835+6204, at frequencies ranging from 150 to 8460 MHz, using both the Giant Metrewave Radio Telescope and the Very Large Array. These observations, over a large radio frequency range, enable us to determine the spectra of the inner and outer lobes. Our detailed spectral ageing analysis of their inner and outer lobes demonstrates that the outer doubles of doubledouble radio galaxies are created by the previous cycle of activity, while the inner doubles are due to the present cycle of activity. The (core subtracted) spectra of the inner doubles of both sources are power laws over a large frequency range. We found that the duration of the quiescent phase of J0041+3224 is between 4 and 28 per cent of the active phase of the previous activity. The outer north-western lobe of J1835+6204 has a compact hotspot and the regions of both the outer hotspots have close to power-law (rather than curved) spectra, which indicates that the outer lobes are still fed by jet material ejected in the previous episode just before the central engine stopped powering the jet. We estimate that the duration of the quiescent phase of J1835+6204 is ?5 per cent of the duration of the active phase of the previous activity. Therefore, we conclude that the duration of the quiescent phase can be as short as a few per cent of the active phase in radio galaxies of this type.Peer reviewe

Disclosure, Privacy and Workplace Accommodation of Episodic Disabilities: Organizational Perspectives on Disability Communication-Support Processes to Sustain Employment

© 2020, The Author(s). Purpose Employers increasingly are asked to accommodate workers living with physical and mental health conditions that cause episodic disability, where periods of wellness are punctuated by intermittent and often unpredictable activity limitations (e.g., depression, anxiety, arthritis, colitis). Episodic disabilities may be challenging for workplaces which must comply with legislation protecting the privacy of health information while believing they would benefit from personal health details to meet a worker’s accommodation needs. This research aimed to understand organizational perspectives on disability communication-support processes. Methods Twenty-seven participants from diverse employment sectors and who had responsibilities for supporting workers living with episodic disabilities (e.g., supervisors, disability managers, union representatives, occupational health representatives, labour lawyers) were interviewed. Five participants also had lived experience of a physical or mental health episodic disability. Participants were recruited through organizational associations, community networks and advertising. Semi-structured interviews and qualitative content analysis framed data collection and analyses, and mapped communication-support processes. Results Seven themes underpinned communication-support process: (1) similarities and differences among physical and mental health episodic disabilities; (2) cultures of workplace support, including contrasting medical and biopsychosocial perspectives; (3) misgivings about others and their role in communication-support processes; (4) that subjective perceptions matter; (5) the inherent complexity of the response process; (6) challenges arising when a worker denies a disability; and (7) casting disability as a performance problem. Conclusions This study identifies a conceptual framework and areas where workplace disability support processes could be enhanced to improve inclusion and the sustainability of employment among workers living with episodic disabilities

AGN Feedback in Galaxy Groups: the Delicate Touch of Self-Regulated Outflows

AGN heating, through massive subrelativistic outflows, might be the key to solve the long-lasting `cooling flow problem' in cosmological systems. In a previous paper, we showed that cold accretion feedback and, to a lesser degree, Bondi self-regulated models are in fact able to quench cooling rates for several Gyr, at the same time preserving the mainc ool core features, like observed density and temperature profiles. Is it true also for lighter systems, such as galaxy groups? The answer is globally yes, although with remarkable differences. Adopting a modified version of the AMR code FLASH 3.2, we found that successful 3D simulations with cold and Bondi models are almost convergent in the galaxy group environment, with mechanical efficiencies in the range 5.e-4 - 1.e-3 and 5.e-2 - 1.e-1, respectively. The evolutionary storyline of galaxy groups is dominated by a quasi-continuous gentle injection with sub-Eddington outflows (with mechanical power and velocity around 1.e44 erg/s and 1.e4 km/s). The cold and hybrid accretion models present, in addition, very short quiescence periods, followed by moderate outbursts (10 times the previous phase), which generate a series of 10-20 kpc size cavities with high density contrast, temperatures similar to the ambient medium and cold rims. After shock heating, a phase of turbulence promotes gas mixing and diffusion of metals, which peak along jet-axis (up to 40 kpc) during active phases. At this stage the tunnel, produced by the enduring outflow (hard to detect in the mock SBx maps), is easily fragmented, producing tiny buoyant bubbles, typically a few kpc in size. In contrast to galaxy clusters, the AGN self-regulated feedback has to be persistent, with a `delicate touch', rather than rare and explosive strokes. This evolutionary difference dictates in the end that galaxy groups are not scaled-down versions of clusters.Comment: Accepted by MNRAS; 22 pages, 7 figure