Decision-maker and staff perceptions of the pharmacist's role in transitions of care programs.

OBJECTIVES: To identify perceptions of decision-makers and staff at a local hospital about the pharmacist's role in transitions of care (TOC) programs. SETTING: Independent community pharmacy located inside a local community hospital. PRACTICE DESCRIPTION: Pharmacy personnel offer a bedside delivery service to hospital patients and have professional relationships with administration. PRACTICE INNOVATION: Pharmacy personnel intend to expand the bedside delivery service to a comprehensive TOC program. Researchers believed it would be important to gather the perceptions of pharmacist's role in TOC programs from nonpharmacist clinicians and administration to successfully develop the program. EVALUATION: This project would identify perceptions to help develop a TOC program. METHODS: A 22-question survey was developed after consulting with key staff and informed by literature regarding TOC and pharmacists' roles in patient care services. Collected demographic information included primary department, number of years worked at the institution, and involvement in TOC. After an 8-week survey distribution period, descriptive statistics were performed on the data collected. RESULTS: A total of 13 decision-makers and staff responded to the survey with a response rate of 87%. Eleven of 12 respondents (92%) thought that pharmacists should be involved in TOC and can be the communication link between patients and other health care providers to ensure continuity of care. All of the participants thought that pharmacists should provide medication reconciliation and patient and caregiver education through TOC services. The participants were less likely to think that pharmacists should offer follow-up care after discharge. CONCLUSION: Participants agreed that pharmacists should be involved in TOC services but had varied perceptions on the pharmacist's specific role. Decision-maker and staff perceptions identified in this study will be used to develop the pharmacist's role in a TOC program at the institution.

EBIT Observation of Ar Dielectronic Recombination Lines near the Unknown Faint X-Ray Feature Found in the Stacked Spectrum of Galaxy Clusters.

Motivated by possible atomic origins of the unidentified emission line detected at 3.55-3.57 keV in a stacked spectrum of galaxy clusters, an electron beam ion trap (EBIT) was used to investigate the resonant dielectronic recombination (DR) process in highly charged argon ions as a possible contributor to the emission feature. The He-like Ar DR-induced transition 1s22l-1s2l3l' was suggested to produce a 3.62 keV photon near the unidentified line at 3.57 keV and was the starting point of our investigation. The collisional-radiative model NOMAD was used to create synthetic spectra for comparison with both our EBIT measurements and with spectra produced with the AtomDB database/Astrophysical Plasma Emission Code (APEC) used in the Bulbul et al. work. Excellent agreement was found between the NOMAD and EBIT spectra, providing a high level of confidence in the atomic data used. Comparison of the NOMAD and APEC spectra revealed a number of missing features in the AtomDB database near the unidentified line. At an electron temperature of T e = 1.72 keV, the inclusion of the missing lines in AtomDB increases the total flux in the 3.5-3.66 keV energy band by a factor of 2. While important, this extra emission is not enough to explain the unidentified line found in the galaxy cluster spectra.

Hitomi X-ray studies of Giant Radio Pulses from the Crab pulsar.

To search for giant X-ray pulses correlated with the giant radio pulses (GRPs) from the Crab pulsar, we performed a simultaneous observation of the Crab pulsar with the X-ray satellite Hitomi in the 2 - 300 keV band and the Kashima NICT radio observatory in the 1.4 - 1.7 GHz band with a net exposure of about 2 ks on 25 March 2016, just before the loss of the Hitomi mission. The timing performance of the Hitomi instruments was confirmed to meet the timing requirement and about 1,000 and 100 GRPs were simultaneously observed at the main and inter-pulse phases, respectively, and we found no apparent correlation between the giant radio pulses and the X-ray emission in either the main or inter-pulse phases. All variations are within the 2 sigma fluctuations of the X-ray fluxes at the pulse peaks, and the 3 sigma upper limits of variations of main- or inter-pulse GRPs are 22% or 80% of the peak flux in a 0.20 phase width, respectively, in the 2 - 300 keV band. The values become 25% or 110% for main or inter-pulse GRPs, respectively, when the phase width is restricted into the 0.03 phase. Among the upper limits from the Hitomi satellite, those in the 4.5-10 keV and the 70-300 keV are obtained for the first time, and those in other bands are consistent with previous reports. Numerically, the upper limits of main- and inter-pulse GRPs in the 0.20 phase width are about (2.4 and 9.3) ×10-11 erg cm-2, respectively. No significant variability in pulse profiles implies that the GRPs originated from a local place within the magnetosphere and the number of photon-emitting particles temporally increases. However, the results do not statistically rule out variations correlated with the GRPs, because the possible X-ray enhancement may appear due to a > 0.02% brightening of the pulse-peak flux under such conditions.