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We present deep near-infrared $K_\textrm{s}$-band imaging for 35 of the 53 sources from the high-redshift ($z \gt 2$) radio galaxy candidate sample defined in Broderick et al. (2022, PASA, 39, e061). These images were obtained using the High-Acuity Widefield K-band Imager (HAWK-I) on the Very Large Telescope. Host galaxies are detected for 27 of the sources, with $K_\textrm{s} \approx 21.6$–23.0 mag (2$^{\prime\prime}$ diameter apertures; AB). The remaining eight targets are not detected to a median $3\unicode{x03C3}$ depth of $K_\textrm{s} \approx 23.3$ mag (2$^{\prime\prime}$ diameter apertures). We examine the radio and near-infrared flux densities of the 35 sources, comparing them to the known $z \gt 3$ powerful radio galaxies with 500-MHz radio luminosities $L_{500\,\textrm{MHz}} \gt 10^{27}$ W Hz$^{-1}$. By plotting 150-MHz flux density versus $K_\textrm{s}$-band flux density, we find that, similar to the sources from the literature, these new targets have large radio to near-infrared flux density ratios, but extending the distribution to fainter flux densities. Five of the eight HAWK-I deep non-detections have a median $3\unicode{x03C3}$ lower limit of $K_\textrm{s} \gtrsim 23.8$ mag (1$.\!^{\prime\prime}$5 diameter apertures); these five targets, along with a further source from Broderick et al. (2022, PASA, 39, e061) with a deep non-detection ($K_\textrm{s} \gtrsim 23.7$ mag; $3\unicode{x03C3}$; 2$^{\prime\prime}$ diameter aperture) in the Southern H-ATLAS Regions $K_\textrm{s}$-band Survey, are considered candidates to be ultra-high-redshift ($z \gt 5$) radio galaxies. The extreme radio to near-infrared flux density ratios ($\gt 10^5$) for these six sources are comparable to TN J0924$-$2201, GLEAM J0856$+$0223 and TGSS J1530$+$1049, the three known powerful radio galaxies at $z \gt 5$. For a selection of galaxy templates with different stellar masses, we show that $z \gtrsim 4.2$ is a plausible scenario for our ultra-high-redshift candidates if the stellar mass $M_\textrm{*} \gtrsim 10^{10.5}$ M$_\odot$. In general, the 35 targets studied have properties consistent with the previously known class of infrared-faint radio sources. We also discuss the prospects for finding more UHzRG candidates from wide and deep near-infrared surveys.
To determine whether poorer performance on the Boston Naming Test (BNT) in individuals with transactive response DNA-binding protein 43 pathology (TDP-43+) is due to greater loss of word knowledge compared to retrieval-based deficits.
Methods:
Retrospective clinical-pathologic study of 282 participants with Alzheimer’s disease neuropathologic changes (ADNC) and known TDP-43 status. We evaluated item-level performance on the 60-item BNT for first and last available assessment. We fit cross-sectional negative binomial count models that assessed total number of incorrect items, number correct of responses with phonemic cue (reflecting retrieval difficulties), and number of “I don’t know” (IDK) responses (suggestive of loss of word knowledge) at both assessments. Models included TDP-43 status and adjusted for sex, age, education, years from test to death, and ADNC severity. Models that evaluated the last assessment adjusted for number of prior BNT exposures.
Results:
43% were TDP-43+. The TDP-43+ group had worse performance on BNT total score at first (p = .01) and last assessments (p = .01). At first assessment, TDP-43+ individuals had an estimated 29% (CI: 7%–56%) higher mean number of incorrect items after adjusting for covariates, and a 51% (CI: 15%–98%) higher number of IDK responses compared to TDP-43−. At last assessment, compared to TDP-43−, the TDP-43+ group on average missed 31% (CI: 6%–62%; p = .01) more items and had 33% more IDK responses (CI: 1% fewer to 78% more; p = .06).
Conclusions:
An important component of poorer performance on the BNT in participants who are TDP-43+ is having loss of word knowledge versus retrieval difficulties.
We describe a new low-frequency wideband radio survey of the southern sky. Observations covering 72–231 MHz and Declinations south of
$+30^\circ$
have been performed with the Murchison Widefield Array “extended” Phase II configuration over 2018–2020 and will be processed to form data products including continuum and polarisation images and mosaics, multi-frequency catalogues, transient search data, and ionospheric measurements. From a pilot field described in this work, we publish an initial data release covering 1,447
$\mathrm{deg}^2$
over
$4\,\mathrm{h}\leq \mathrm{RA}\leq 13\,\mathrm{h}$
,
$-32.7^\circ \leq \mathrm{Dec} \leq -20.7^\circ$
. We process twenty frequency bands sampling 72–231 MHz, with a resolution of 2′–45′′, and produce a wideband source-finding image across 170–231 MHz with a root mean square noise of
$1.27\pm0.15\,\mathrm{mJy\,beam}^{-1}$
. Source-finding yields 78,967 components, of which 71,320 are fitted spectrally. The catalogue has a completeness of 98% at
${{\sim}}50\,\mathrm{mJy}$
, and a reliability of 98.2% at
$5\sigma$
rising to 99.7% at
$7\sigma$
. A catalogue is available from Vizier; images are made available via the PASA datastore, AAO Data Central, and SkyView. This is the first in a series of data releases from the GLEAM-X survey.
Psychological risk factors that lead to impaired work performance, negatively impacting mental and physical health, have emerged as a concern across clinical settings. Although depression and anxiety are linked to poor physician mental health, physician burnout characterized by work related stress due to chronic exhaustion from clinical work, cynicism toward meaning of the medical profession, and feelings of inadequacy toward work related accomplishments, may be an even stronger indicator of well-being. Literature suggests that work satisfaction among physicians is rapidly deteriorating owing to high rates of burnout and poor mental health. Although the relationship between work burnout (WB) and negative affectivity has been well documented, the association with positive affect, such as trait forgiveness (TF) has been overlooked. On that note, research shows that lifetime stress severity and lower levels of forgiveness predict worse mental and physical health. Since TF has been linked strongly with healthy workplace relationships, positive occupational outcomes and general well-being, its association with WB remains to be investigated. Therefore, the aim of the present study was to explore the link between TF and WB among physicians. We hypothesized that TF would be associated with reduced levels of burnout.
Method:
A total of 62 (F=23) medical residents at a Teaching Hospital consented for the study. Residents were administered surveys on WB (Maslach Burnout Inventory), workplace bullying, personal bullying (PB), interpersonal rejection sensitivity (IRS), perceived stress scale (PSS), TF, anxiety, and depression, all of which were anonymously submitted via electronically. Hierarchical multiple regression (HMR) models were used to determine the associations between WB, work environment social factors and TF. A p-value of <0.05 was considered significant.
Results:
The mean age 33.1 ± SD 4.2 years. HMR analysis using WB as main outcome contained 6 predictors: Model 1 contained depression and anxiety, Model 2 added PB, Model 3 added IRS and PSS, Model 4 added TF. Anxiety and TF were the only significant predictors (p= >0.05) accounting for 10.4% and 17.5% of the variance in WB scores, respectively.
Conclusions:
The novel finding of the present study is that TF was associated with low levels of burnout. Additionally, WB was found to be linked to anxiety and depression which is in line with previous research. These data suggest that TF could be a potential resolution to the deleterious influence of burnout. Further exploration is needed in order to understand the psychology of forgiveness as a potential adjuvant and/or therapeutic intervention for physicians’ burnout. These results suggest that strategies including forgiveness training aimed at decreasing WB while increasing job satisfaction among physicians warrant further exploration.
Psychological risk factors that lead to impaired work performance, negatively impacting mental and physical health, have emerged as a concern across clinical settings. Although depression and anxiety are linked to poor physician mental health, physician burnout characterized by work related stress due to chronic exhaustion from clinical work, cynicism toward meaning of the medical profession, and feelings of inadequacy toward work related accomplishments, may be an even stronger indicator of well-being. Literature suggests that work satisfaction among physicians is rapidly deteriorating owing to high rates of burn out and poor mental health. Although the relationship between work burnout (WB) and negative affectivity has been well documented, the association with positive affect, such as trait forgiveness (TF) has been overlooked. On that note, research shows that lifetime stress severity and lower levels of forgiveness predict worse mental and physical health. Since TF has been linked strongly with healthy workplace relationships, positive occupational outcomes and general well-being, its association with WB remains to be investigated. Therefore, the aim of the present study was to explore the link between TF and WB among physicians. We hypothesized that TF would be associated with reduced levels of burnout.
Method
A total of 62 (F=23) medical residents at a Teaching Hospital consented for the study. Residents were administered surveys on WB (Maslach BurnoutInventory), workplace bullying, personal bullying (PB), interpersonal rejection sensitivity (IRS), perceived stress scale (PSS), TF, anxiety, and depression, all of which were anonymously submitted via electronically. Hierarchical multiple regression (HMR) models were used to determine the associations between WB, work environment social factors and TF. A p-value of <0.05 was considered significant.
Results
The mean age 33.1±SD 4.2 years. HMR analysis using WB as main outcome contained 6 predictors: Model 1 contained depression and anxiety, Model 2 added PB, Model 3 added IRS and PSS, Model 4 added TF. Anxiety and TF were the only significant predictors (p= >0.05) accounting for 10.4% and 17.5% of the variance in WB scores, respectively.
Conclusions
The novel finding of the present study is that TF was associated with low levels of burnout. Additionally, WB was found to be linked to anxiety and depression which is in line with previous research. These data suggest that TF could be a potential resolution to the deleterious influence of burnout. Further exploration is needed in order to understand the psychology of forgiveness as a potential adjuvant and/or therapeutic intervention for physicians’ burnout. These results suggest that strategies including forgiveness training aimed at decreasing WB while increasing job satisfaction among physicians warrant further exploration.
Neutron scattering studies have indicated that the non-coordinated water at smectite surfaces has a similar mobility to that of bulk water, but that the water coordinated to the cations is immobile on the time scale of the neutron measurements. Thus hydrophylic polymers can readily displace the non-coordinated water and bind to the silicate surface, and to the exchangeable cations through a water-bridge mechanism. Poly(ethylene oxide) molecules with molecular weights up to 4000 appear to be bound to Na-montmorillonite in flattened conformations at the clay surface. Poly(vinyl alcohol) is extensively bound by Na-montmorillonite and by Na-Laponite (a synthetic hectorite-like clay); as binding progresses fewer molecule segments can contact the surface and so at the higher levels of adsorption extensive loops of polymer extend away from the silicate surface. Some polyanions provide good protection for smectites against flocculation with salt. The abilities of such polymers to protect the clays is dependent both on the extents of the charges and on the solution conformations which these polymers can assume.
The commissioning and operation of apparatus for neutron diffraction at simultaneous high temperatures and pressures is reported. The basic design is based on the Paris-Edinburgh cell using opposed anvils, with internal heating. Temperature is measured using neutron radiography. The apparatus has been shown in both on-line and off-line tests to operate to a pressure of 7 GPa and temperature of 1700°C. The apparatus has been used in a neutron diffraction study of the crystal structure of deuterated brucite, and results for 520°C and 5.15 GPa are presented. The diffraction data that can be obtained from the apparatus are of comparable quality to previous high-pressure studies at ambient temperatures, and are clearly good enough for Rietveld refinement analysis to give structural data of reasonable quality.
The octahedral-framework mineral bernalite, Fe(OH)3, provides a rare opportunity to examine directly the effects of a vacant A site upon the physical properties of perovskite-like structures. Here, we report the effect upon compressibility. Bernalite has been reported previously as having space group Immm (Birch et al., 1993), but numerous reflections violating I-centering were observed in the present study. A case is presented for bernalite having orthorhombic space group Pmmn. Lattice parameters were refined using the Le Bail method for a metrically tetragonal cell and their variation with pressure at room temperature was determined from 17 measurements at pressures from 10–4 to 9.3 GPa using synchrotron X-ray powder diffraction. No discontinuities in the compression curves of lattice parameters were observed. Fitting to a second-order Birch-Murnaghan equation-of-state (KT0' = 4) gives V0 = 438.51±0.06 Å3 and KT0 = 78.2±0.4 GPa. Second-order fits of (a/a0)3 and (c/c0)3 give elastic moduli KT0a = 82.0(6) GPa and KT0c = 71.6(4) GPa: the shorter cation–cation distance is the more compressible. These values are very close to those of stottite, FeGe(OH)6, which has tilt system a+a+c–. The difference in the elastic moduli KT0a and KT0c of bernalite and their close similarity to the stottite values support the revised Pmmn structure (tilt system a+b+c–) for bernalite proposed here. The compressional anisotropy observed in bernalite may reflect its highly anisotropic and directional H-bonding topology.
Adding nitrate to or increasing the concentration of lipid in the diet are established strategies for reducing enteric methane (CH4) emissions, but their effectiveness when used in combination has been largely unexplored. This study investigated the effect of dietary nitrate and increased lipid included alone or together on CH4 emissions and performance traits of finishing beef cattle. The experiment was a 2×4 factorial design comprising two breeds (cross-bred Aberdeen Angus (AAx) and cross-bred Limousin (LIMx) steers) and four dietary treatments (each based on 550 g forage : 450 g concentrate/kg dry matter (DM)). The four dietary treatments were assigned according to a 2×2 factorial design where the control treatment contained rapeseed meal as the main protein source, which was replaced either with nitrate (21.5 g nitrate/kg DM); maize distillers dark grains (MDDG, which increased diet ether extract from 24 to 37 g/kg DM) or both nitrate and MDDG. Steers (n=20/dietary treatment) were allocated to each of the four treatments in equal numbers of each breed with feed offered ad libitum. After 28 days adaptation to dietary treatments, individual animal intake, performance and feed efficiency were recorded for 56 days. Thereafter, CH4 emissions were measured over 13 weeks (six steers/week). Increasing dietary lipid did not adversely affect animal performance and showed no interactions with dietary nitrate. In contrast, addition of nitrate to diets resulted in poorer live-weight gain (P<0.01) and increased feed conversion ratio (P<0.05) compared with diets not containing nitrate. Daily CH4 output was lower (P<0.001) on nitrate-containing diets but increasing dietary lipid resulted in only a non-significant reduction in CH4. There were no interactions associated with CH4 emissions between dietary nitrate and lipid. Cross-bred Aberdeen Angus steers achieved greater live-weight gains (P<0.01), but had greater DM intakes (P<0.001), greater fat depth (P<0.01) and poorer residual feed intakes (P<0.01) than LIMx steers. Cross-bred Aberdeen Angus steers had higher daily CH4 outputs (P<0.001) but emitted less CH4 per kilogram DM intake than LIMx steers (P<0.05). In conclusion, inclusion of nitrate reduced CH4 emissions in growing beef cattle although the efficacy of nitrate was less than in previous work. When increased dietary lipid and nitrate inclusion were combined there was no evidence of an interaction between treatments and therefore combining different nutritional treatments to mitigate CH4 emissions could be a useful means of achieving reductions in CH4 while minimising any adverse effects.
Four starch-encapsulated formulations of EPTC (S-ethyl dipropylthiocarbamate) and of butylate (S-ethyl diisobutylthiocarbamate) were prepared and evaluated by comparison with their respective emulsifiable concentrate formulations for their slow-release capabilities and efficacies. Chemical and biological evaluation indicated that difference in controlled-release could be achieved by the selection of the starch xanthate and oxidant used in the formualtion process. EPTC and butylate released slower when formulated as starch-encapsulated granules than when formulated as emulsifiable concentrates under soil conditions that favored rapid release. The initial release was adequate for weed control and slow enough for desired residual activity. Repeated seeding and harvesting the treated soils and bioassays of treated soils generally produced release rate anticipated from short term dry and wet chemical tests.
Accurate models of X-ray absorption and re-emission in partly stripped ions are necessary to calculate the structure of stars, the performance of hohlraums for inertial confinement fusion and many other systems in high-energy-density plasma physics. Despite theoretical progress, a persistent discrepancy exists with recent experiments at the Sandia Z facility studying iron in conditions characteristic of the solar radiative–convective transition region. The increased iron opacity measured at Z could help resolve a longstanding issue with the standard solar model, but requires a radical departure for opacity theory. To replicate the Z measurements, an opacity experiment has been designed for the National Facility (NIF). The design uses established techniques scaled to NIF. A laser-heated hohlraum will produce X-ray-heated uniform iron plasmas in local thermodynamic equilibrium (LTE) at temperatures ${\geqslant}150$ eV and electron densities ${\geqslant}7\times 10^{21}~\text{cm}^{-3}$. The iron will be probed using continuum X-rays emitted in a ${\sim}200$ ps, ${\sim}200~\unicode[STIX]{x03BC}\text{m}$ diameter source from a 2 mm diameter polystyrene (CH) capsule implosion. In this design, $2/3$ of the NIF beams deliver 500 kJ to the ${\sim}6$ mm diameter hohlraum, and the remaining $1/3$ directly drive the CH capsule with 200 kJ. Calculations indicate this capsule backlighter should outshine the iron sample, delivering a point-projection transmission opacity measurement to a time-integrated X-ray spectrometer viewing down the hohlraum axis. Preliminary experiments to develop the backlighter and hohlraum are underway, informing simulated measurements to guide the final design.
Hospitalized influenza patients are often treated with antibiotics empirically while awaiting final diagnosis. The goal of this study was to describe the inappropriate continuation of antibiotics for influenza respiratory tract infections (RTIs).
DESIGN
We retrospectively studied adults admitted to our institution over 2 respiratory flu seasons with positive influenza RTIs. Inappropriate antibiotic duration (IAD) was defined as antibiotic use for >24 hours after a positive influenza test in patients presenting with <72 hours of RTI symptoms and with no other indications of bacterial infection.
RESULTS
During the study period, 322 patients included in this study were admitted for influenza RTI. Respiratory cultures were ordered for 50 of these patients (15.5%) and 71 patients (22%) had a positive chest x-ray, but antibiotics were prescribed to 211 patients (65.5%) on admission. Antibiotics were inappropriately continued in 73 patients (34.5%). Patients receiving IAD had a longer length of stay (LOS) (median, 6 days; range, 4–9 days) compared with those whose antibiotics were discontinued appropriately (median, 5 days; range, 3–8 days) and those who were not treated with antibiotics (median, 4 days; range, 3–6 days; P<.001). However, mortality was similar among these 3 groups: 3 patients (4.1%) from the IAD cohort died; 6 patients (4.3%) from the group with an appropriate antibiotic duration died; and 2 patients [1.8%] from the group given no antibiotics died (P=.510). The 30-day readmission rates were similar as well: 9 patients (12.3%) from the IAD group were readmitted within 30 days; 21 patients (15.2%) from the group with appropriate antibiotic duration were readmitted; and 11 patients (9.9%) from the group given no antibiotics were readmitted (P=.455). Total hospital costs were greater in patients treated with IAD ($10,645; range, $6,485–$18,035) compared with the group treated with appropriate antibiotic duration ($7,479; range, $4,866–$12,922) and the group given no antibiotics $5,961 (range, $4,711–$9,575). Thus, the hospital experienced a median loss in net hospital revenue of $2,076 per IAD patient compared with a patient for which antibiotic duration was appropriate.
CONCLUSION
The majority of patients with influenza RTI received antibiotics on admission, and 34.5% were inappropriately continued on antibiotics without evidence of bacterial infection, which led to increased LOS, loss of net revenue, and no improvement in outcome. Thus, stewardship initiatives aimed at this population are warranted.
Adding nitrate to the diet or increasing the concentration of dietary lipid are effective strategies for reducing enteric methane emissions. This study investigated their effect on health and performance of finishing beef cattle. The experiment was a two×two×three factorial design comprising two breeds (CHX, crossbred Charolais; LU, Luing); two basal diets consisting of (g/kg dry matter (DM), forage to concentrate ratios) 520 : 480 (Mixed) or 84 : 916 (Concentrate); and three treatments: (i) control with rapeseed meal as the main protein source replaced with either (ii) calcium nitrate (18 g nitrate/kg diet DM) or (iii) rapeseed cake (RSC, increasing acid hydrolysed ether extract from 25 to 48 g/kg diet DM). Steers (n=84) were allocated to each of the six basal diet×treatments in equal numbers of each breed with feed offered ad libitum. Blood methaemoglobin (MetHb) concentrations (marker for nitrate poisoning) were monitored throughout the study in steers receiving nitrate. After dietary adaptation over 28 days, individual animal intake, performance and feed efficiency were recorded for a test period of 56 days. Blood MetHb concentrations were low and similar up to 14 g nitrate/kg diet DM but increased when nitrate increased to 18 g nitrate/kg diet DM (P<0.001). An interaction between basal diet and day (P<0.001) indicated that MetHb% was consistently greater in Concentrate – than Mixed-fed steers at 18 g nitrate/kg diet DM. Maximum individual MetHb% was 15.4% (of total Hb), which is lower than considered clinically significant (30%). MetHb concentrations for individual steers remained consistent across time. Concentrate-fed steers were more efficient (lower residual feed intake (RFI) values) than Mixed-fed steers (P<0.01), with lower dry matter intake (DMI) (kg/day) (P<0.001) and similar average daily gain (ADG). CHX steers were more efficient (lower RFI; P<0.01) than LU steers with greater ADG (P<0.01), lower DMI (/kg BW; P<0.01) and lower fat depth (P<0.001). ADG, BW or DMI did not differ across dietary treatments (P>0.05). Neither basal diet nor treatment affected carcass quality (P>0.05), but CHX steers achieved a greater killing out proportion (P<0.001) than LU steers. Thus, adding nitrate to the diet or increasing the level of dietary lipid through the use of cold-pressed RSC, did not adversely affect health or performance of finishing beef steers when used within the diets studied.
Large collections of well-preserved specimens of the ammonite Baculites inornatus Meek (1862) from two lower to middle Campanian localities on the Pacific coast of North America are analyzed quantitatively to examine both variability and evolutionary change of species-level distinguishing characters. To this end, we present a new method of describing the morphology of the biostratigraphically important Upper Cretaceous zonal index fossil Baculites, using five independent shell characters that can be measured quantitatively. We then use this method to test hypotheses of phyletic evolutionary change in B. inornatus specimens collected from Sucia Island, Washington, USA, and Punta San Jose, Baja California, Mexico.
The greatest observed character change is in mature shell size: baculitids from the older of the two outcrops (Sucia islands) show a smaller mean diameter at maturity compared to those of the younger of the two outcrops (Punta San Jose). Other than this phyletic size increase, no other directional changes were observed from specimens collected at sub-meter precision from the 90 m-thick measured stratigraphic section of the Rosario Formation located at Punta San Jose. Importantly, neither the younger nor older baculitid assemblages show a size distribution of mature specimens that can be attributed to sexual dimorphism. We observed fluctuating proportions of individuals with ribs and/or keels through this section; since both characters have been used in previous taxonomic studies to define, or differentiate between, other Baculites species, our results indicate that no single character is sufficient to discriminate species within this lineage, and that there is far more variation of these characters than has previously been accepted. Our methodology can also be used to assess morphologic variation and taxonomic assignments of Baculites species in other biogeographic provinces, as well as to evaluate ecological influences on population variation and to test hypotheses of lineage evolution.
Introduction: Hospital pharmacists currently play a limited role in the management of nicotine withdrawal and smoking-cessation. They have multiple tasks and limited time; a strong evidence base is required to determine importance of including smoking-cessation interventions into their routine practice.
Aims: The aims of this study were to evaluate the effectiveness of a hospital pharmacist initiated smoking-cessation intervention (SCI) in increasing the utilisation of Nicotine Replacement Therapy (NRT) in hospitalised smokers, and in increasing quit rates post-discharge.
Methods: This study was conducted in a tertiary referral hospital using a pragmatic randomised control design. After screening, 100 inpatient smokers were enrolled and randomised by the research pharmacist (RP) to either the intervention or usual care arm (n = 50 for both arms). Smoking-cessation advice was available to all smokers during their hospital stay under the smoking management policy, which represented usual care. However, this approach is often unstructured and provided on an ad-hoc basis. Those in the intervention arm received brief SCI from the RP, who also facilitated NRT prescribing if required. Prescribing rates of NRT in the hospital and on discharge in both the groups were compared. Participants were contacted by phone three-months after enrolment to assess their seven-day point prevalence of abstinence (PPA) from smoking and use of NRT post-discharge.
Results: A significantly higher proportion of participants in the intervention arm used NRT in the hospital (82% vs. 24%, Χ2 = 33.8, p < 0.001) and at discharge (68% vs. 12%, Χ2 = 32.7, p < 0.0001) and significantly more participants who received SCI from the RP continued to use NRT after discharge (OR 3.1, CI 1.2 to 8.2). A similar number of participants in both the groups claimed seven-day PPA after three-months (18% usual-care vs. 15% intervention-arm, OR 0.8, CI 0.24 to 2.67).
Conclusions: Hospital pharmacist led brief SCI can enhance the utilisation of NRT in hospital and after discharge; there was no clear effect on cessation rates at three months. There is a need to explore feasible options for a coordinated, multidisciplinary approach to smoking-cessation in hospital and across the continuum, which may have a greater impact on long term smoking-cessation rates.