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Lisne buhe (Hemiptera: Sternorrhyncha: Psylloidea) sitni su kukci koje je u prirodi teško otkriti, posebno kada se nalaze u populacijama niskog intenziteta. Procjenjuje se da je u svijetu do danas opisano oko 4000 vrsta klasificiranih u sedam porodica. Samo manji broj vrsta ubraja se u važne poljoprivredne štetnike, a u posljednje vrijeme dobivaju na značaju zahvaljujući spoznaji da prenose uzročnike biljnih bolesti. Faunističko istraživanje lisnih buha u Hrvatskoj započelo je 2015. godine. Cilj ovog istraživanja bio je sastaviti popis vrsta lisnih buha prisutnih u Hrvatskoj, uz pregled pripadajućih biljaka domaćina, kao i utvrditi potencijalno prisustvo nekih do danas u Hrvatskoj nepoznatih vrsta. Odrasli primjerci lisnih buha uzorkovani su entomološkim kečerom ili metodom otresanja biljaka na bijelu podlogu te su usnim aspiratorom prikupljani u Falcon epruvete i do laboratorijske analize pohranjeni u 70% etilni alkohol. Identifikacija vrsta provedena je klasičnom makroskopskom i mikroskopskom analizom na osnovi morfoloških karakteristika odraslih stadija i genitalija mužjaka, vrlo rijetko i ženki, uz korištenje dihotomnih ključeva dostupnih u literaturi. U periodu od 2015. do 2021. godine sljedeće vrste lisnih buha iz porodice Psyllidae zabilježene su po prvi puta u Hrvatskoj: Diaphorina chobauti Puton, 1898, Arytaina genistae (Latreille, 1805), Cacopsylla brunneipennis (Edwards, 1896), Cacopsylla myrthi (Puton, 1876), Cacopsylla saliceti (Foerster, 1848), Livilla variegata (Löw, 1881), Psylla foersteri Flor, 1861 i Psylla hartigii Flor, 1861.

Thrips palmi Karny, 1925 polifagna je fitofagna vrsta tripsa zabilježena na biljnim vrstama iz više od 36 porodica, posebice iz porodica Cucurbitaceae i Solanaceae. Vektor je destruktivnih biljnih tospovirusa. Pretpostavlja se da vrsta potječe iz južne Azije. Vrsta u EU ima status karantenskog štetnog organizma i često se presreće u uvoznim izvaneuropskim pošiljkama rezanog cvijeća, plodova i povrća. Štetnik predstavlja ozbiljan fitosanitarni rizik za poljoprivrednu proizvodnju na području Mediteranskog bazena. Provođenje programa posebnog nadzora nad štetnim organizmom T. palmi započeto je u Hrvatskoj 2021. godini. Vizualnim pregledima obuhvaćeni su nasadi povrća u zaštićenim prostorima te ukrasno bilje u rasadnicima i vrtnim centrima na 34 lokaliteta u 13 županija. Odrasli primjerci tripsa prikupljeni su otresanjem biljaka na bijelu podlogu ili izravno finim kistom s biljnih organa te pohranjeni do laboratorijske analize u AGA mješavini u Eppendorf epruvetama. Ukupno je obavljeno 46 vizualnih pregleda i pritom je prikupljen 101 uzorak tripsa s 43 biljne vrste za laboratorijsku analizu. Primjerci tripsa su u prikupljenim uzorcima mikroskopski identificirani do razine vrste na osnovi morfoloških karakteristika odraslih ženki, pomoću EPPO dijagnostičkog protokola PM 7/3 (3) i relevantnih ključeva za identifikaciju.U prikupljenim uzorcima determinirano je 19 vrsta tripsa, od kojih su Chaetanaphothrips orchidii (Moulton, 1907) i Scirtothrips cf. canizoi Titchak, 1964 nove za faunu tripsa u Hrvatskoj. Niti u jednom analiziranom uzorku nije identificirana karantenska vrsta T. palmi.

Radom se tematizira čovjekova socijalna narav koju razne društveno-političke zajednice tumače na sebi svojstvene načine. Ukazuje se na značaj međuljudskih odnosa u pojedinčevom individualno-psihološkom razvoju i formiranju karaktera. Problematizira se liberalno-kapitalističko tumačenje čovjeka i društva. Radom se zagovara razumijevanje jedinke kao zajedničarskog stvorenja. No, unatoč podržavanju predodžbe subjekta kao bića kolektiviteta, upućuje se na nužnost njegovog prepoznavanja kao jedinstvenog, autonomnog individuuma. Iako se naglašava neprikladnost pristupa koji čovjeka interpretira kao društveno otuđeno, samodostatno, dominantno samome sebi usmjereno stvorenje, naglašava se kako on, iako zajednici usmjeren, nikada u njoj ne smije biti negiran i manipulativno zloupotrebljen. Podržavanje individualnosti kolektivno usmjerenog pojedinca zahtijeva odgojni poticaj. Stoga će radom biti analizirana međunarodno značajna slikovnica Marcusa Pfistera, Riba duginih boja.

Background Small intestinal bacterial overgrowth (SIBO) is defined as an excessive growth and/or changed composition of bacteria in the small bowel. Obese patients are at increased risk of SIBO and related complications. The purpose of this study is to evaluate the incidence of SIBO after bariatric bypass procedures, connection between SIBO, symptoms, comorbidities, and liver pathology. Methods Patients underwent a hydrogen breath test with glucose substrate (25 g/200 ml of water). The demographic, anthropometric data, comorbidities, and symptoms were analysed with a questionnaire. In 45 patients, the NAFLD Activity Score was evaluated in liver biopsies. Results Glucose breath test was positive in 24/56 (43%) of patients and was associated with higher frequency of defecation (p = 0.022), lactose intolerance (p = 0.047), scleroderma (p = 0.042), irritable bowel syndrome (p = 0.018), and diabetes (p = 0.002). Mean NAFLD Activity Score in SIBO patients (n = 18) was 3.33 and 3.00 in non-SIBO patients (n = 27). In SIBO-positive cohort of patients, a statistically important trend in difference between NAS and difference to range value anti-Xa 4 h after subtherapeutic dose application was calculated. Conclusions The incidence of SIBO after bariatric surgery bypass procedures is alarmingly high (43%). The results of our study conclude that diagnosis cannot be set based on specific symptom and SIBO is related to reduced response to the application of LMWH. Mandatory SIBO screening and appropriate treatment would affect the clinical outcome of the underlying disease, improve it significantly, and prevent the development of its complications. Graphical abstract

The archeology of the Puna, a high elevation desert in South America, gives us a long-term perspective on the role of wild plants in people’s diets during the Holocene. We explore the impact of aridification on the use of edible wild plants among desert people through the study of macrobotanical remains. Our goal is to examine the variation in plant dependency and risk management strategies used over time, in particular during the drought of the Middle Holocene (ca. 8700–4500 BP). The macrobotanical record suggests the use of risk-averse strategies in order to cope with unpredictable resource productivity. Hunter-gatherers relied on carbohydrate rich resources from the vega wetlands and tolar shrublands, such as roots and tubers, as well as low-ranked seeds, stems, leaves, and fruits. They also obtained non-local edible plants by strengthening ties and forming safety nets with groups living in different ecozones that were not subject to the same resource fluctuation. Social interaction with areas lying beyond the ecological boundaries of the Puna has a longstanding tradition in this area beginning in the Early Holocene, and was likely a means of providing food security to populations whose subsistence depended mainly on camelid hunting, and eventually camelid pastoralism. A notable increase in that interaction began during the Late-Holocene, which was a period of lesser aridity, with the introduction of corn and quinoa.

Background Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Method A working group of experienced general, acute care, and bariatric surgeons was created to carry out a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and to answer the PICO questions formulated after the Operative management in bariatric acute abdomen survey. The literature search was limited to late/long-term complications following laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Conclusions The acute abdomen after bariatric surgery is a common cause of admission in emergency departments. Knowledge of the most common late/long-term complications (> 4 weeks after surgical procedure) following sleeve gastrectomy and Roux-en-Y gastric bypass and their anatomy leads to a focused management in the emergency setting with good outcomes and decreased morbidity and mortality rates. A close collaboration between emergency surgeons, radiologists, endoscopists, and anesthesiologists is mandatory in the management of this group of patients in the emergency setting.

Secondary blast injuries may result from high-velocity projectile fragments which ultimately increase medical costs, reduce active work time, and decrease quality of life. The role of skin penetration requires more investigation in energy absorption and surface mechanics for implementation in computational ballistic models. High-speed ballistic penetration studies have not considered penetrating and non-penetrating biomechanical properties of the skin, including radial wave displacement, resultant surface wave speed, or projectile material influence. A helium-pressurized launcher was used to accelerate 3/8″ (9.525 mm) diameter spherical projectiles toward seventeen whole porcine legs from seven pigs (39.53 ± 7.28 kg) at projectile velocities below and above V

Objectives: The transmission of impact loading from the seat-to-pelvis-to-lumbar spine in a seated occupant in automotive and military events is a mechanism for fractures to these body regions. While postmortem human subject (PMHS) studies have replicated fractures to the pelvis or lumbar spine using isolated/component models, the role of the time factor that manifests as a loading rate issue on injuries has not been fully investigated in literature. The objective of this study was to explore the hypothesis that short duration pulses fracture the pelvis while longer pulses fracture the spine, and intermediate pulses involve both components. Methods: Unembalmed PMHS thoracolumbar spine-pelvis specimens were fixed at the superior end, and a six-axis load cell was attached. The specimens were mounted on a vertical accelerator, and noninjury and injury tests were conducted by applying short, medium, or long pulses with 5, 15, or 35 ms durations, respectively. Peak axial, shear and resultant forces were obtained. Injuries were documented using posttest x-ray and computed tomography images and scaled using the AIS (2015). Results: The mean age, stature, weight, body mass index, and BMD of twelve specimens were 64.8 ± 11.4 years, 1.8 ± 0.01 m, 83 ± 13 kg, 26.7 ± 5.0 kg/m2, and 114.5 ± 21.3 mg/cc, respectively. For the short, long, and medium duration pulses, the mean resultant forces were 5.6 ± 0.9 kN, 5.9 ± 0.94 kN, and 5.4 ± 1.8 kN, and time durations were 4.8 ± 0.5 ms, 16.3 ± 7.3 ms, and 34.5 ± 7.5 ms, respectively. For the short pulse, pelvis injuries were more severe in 3 out 4 specimens, for the medium pulse, they were distributed between the pelvis and spine, and for the long pulse, spine injuries were more severe in 3 out of 4 specimens. Conclusions: While acknowledging the limitations of the sample size, the results of this study support the hypothesis of the time variable in the tradeoff between pelvis and spine injuries with pulse duration. The tradeoff pattern is attributed to mass recruitment: short pulse biases injuries to pelvis while limiting spinal injuries, and the opposite is true for the longer pulse, thus supporting the hypothesis. It is important to account for the time variable in injury analysis.

The objective of this paper is to employ machine learning (ML) and deep learning (DL) techniques to obtain, from input data (storm features) available in or derived from the HURDAT2 database, models capable of simulating important hurricane properties (e.g., landfall location and wind speed) consistent with historical records. In pursuit of this objective, a trajectory model providing the storm center in terms of longitude and latitude and intensity models providing the central pressure and maximum 1-min wind speed at 10-m elevation were created. The trajectory and intensity models are coupled and must be advanced together, 6 h at a time, as the features that serve as inputs to the models at any given step depend on predictions at the previous time steps. Once a synthetic storm database is generated, properties of interest, such as the frequencies of large wind speeds, may be extracted from any part of the simulation domain. The coupling of the trajectory and intensity models obviates the need for an intensity decay model inland of the coastline. Prediction results are compared with historical data, and the efficacy of the storm simulation models is evaluated at four sites: New Orleans, Louisiana; Miami, Florida; Cape Hatteras, North Carolina; and Boston, Massachusetts.

In addition to good accommodation and sports infrastructure, Slovenia has an extremely developed system of training, testing, and rehabilitation of athletes. Slovenian athletes have always topped in various sports providing excellent training and friendly partnerships for athletes and sports teams coming to the preparations. These characteristics provide an opportunity for developing off-peak tourist products, focusing on sports and sports recreation. However, sports recreation marketing faces challenges like the division into sports-oriented and sports-related vacations. Accordingly, the main goal of this paper is to discern the link between sports and tourism, marketing strategies and tools, and identify the potential variables that could encourage Slovenian organizations in enhancing successful engagement of sports tourism in the following years. Therefore, to discuss the possibilities for sporting organizations to cooperate with the tourism industry, an in-depth discussion based on the case studies of Slovenian companies from two different destinations is conducted.

From October 20 to 27, 1984, an assembly of the Association of Yugoslav Volunteers of the Spanish Republican Army was held in Sarajevo from which an open letter was sent to the Central Committee of the League of Communists of Yugoslavia. This paper (re)constructs a chronology of events, following the thoughts and activities of Konstantin Koča Popović, which he wrote in his diary (from August 1984 to February 1985) during the preparations for the Sarajevo meeting, as well as his reactions to the talks held by representatives of the CC LCY and members of the Board of the Association. Today, the diary notes of Koča Popović are kept in the Family Fund – Legacy of Koča Popović and Lepa Perović in the Historical Archive of Belgrade.

Vrijednosti koje zajednica ljudi hvali, pohvalni ciljevi kojima se individualno teži, karakterne osobine koje se dostojanstvenom čovjeku pripisuju i opći ideali kulturnog okruženja shvatljivi su samo unutar društvenog konteksta iz kojeg proizlaze. Iz tog se razloga ovim radom uvodno naznačuju osnovne karakteristike liberalnog svjetonazora i njemu pripadnog kapitalističkog ekonomskog uređenja. Unutar društvenog konstrukta tako određenih ideološko-gospodarskih obilježja promatra se tumačenje specifičnih društvenih vrijednosti poput slobode, jednakosti i, osobito, solidarnosti. Proces društvenoga odgoja i obrazovanja, između ostaloga, raspolaže zadaćom upućivanja odrastajuće populacije na arhetip moralnoga pojedinca i vrijednosna očekivanja zajednice spram individue. Važan medij kojim se dijete rane i predškolske dobi upućuje na etičke stavove društva jest slikovnica. Konkretna interpretacija liberalno shvaćene solidarnosti koja se predlaže vrtićkom djetetu u ovome će radu biti naznačena kroz osvrt na nagrađivanu britansku slikovnicu Najotmjeniji div u gradu (2003) autorice Julije Donaldson, koja djetetu nudi svojstven odgovor na pitanje što znači dati?

The colour of the egg yolk is one of the most important sensory characteristics among consumers and is often perceived as a health and quality component of the product. Carotenoids found in hen diet are the main components contributing to the yolk pigmentation, and therefore, nutrition is a major factor influencing the yolk quality and colour. The ratio of yellow and red carotenoid pigments is of great importance in achieving the desired yolk colour. The difficulties associated with the optimum carotenoid concentration in the diet arise from the considerable variation in amounts in feeds and bioavailability from the sources used, synthetic or phytochemical. In addition, the carotenoid content in phytochemical sources is not always constant, and it is necessary to consider their interaction with other components in the diet, as well as denaturation during processing or loss during prolonged storage. Laying hens are unable to synthesise carotenoids de novo and depend on their supply through the diet. For this reason, pigmentation can decrease due to reduced diet intake, which a number of factors can influence. The housing system affects yolk pigmentation due to differences in applied nutritional management. In addition, reduced diet intake, carotenoid utilisation for health defence and reduced absorption occurs in response to stress conditions and various diseases. The objective of this review was to summarise the recent findings in available literature data on nutritional and non-nutritional factors affecting egg yolk pigmentation.

Bariatric surgery is a highly effective treatment option for morbid obesity. Short- and long-term effects of bariatric surgery are not limited to weight loss but include resolution of type 2 diabetes, arterial hypertension, improvement of cardiovascular health, and overall mortality. The long life expectancy of patients undergoing bariatric procedures means many of these patients will succumb to other diseases. Altered GI anatomy after bariatric procedures could prove an obstacle in treatment. We present our management of one such occurrence. The patient, who had 5 years previously undergone a Roux-en-Y gastric bypass, presented after a massive subarachnoid hemorrhage which resulted in spastic tetraplegia. He was unable to consume food and was at risk of malnutrition. A decision was made to laparoscopically create a percutaneous gastrostomy (PEG) into the excluded stomach, allowing for the use of standard feeding formula and avoiding the need for parenteral nutrition and prolonged hospitalization due to metabolic complications. The growing number of patients following bariatric procedures directs the need for novelty treatment options suited to the altered anatomy and physiology of the patient post-bariatric surgery. Prompt evaluation of long-term complications after cardiovascular events in patients operated with bariatric surgical technics reduced nutritional complications, rated hospital stay, and improved quality of life. In those patients who, due to the localization of the brain defect, are expected to be unable to feed independently due to the consequences of the latter and have either long-term or lifelong feeding through feeding tubes, it is necessary to establish an enteral feeding pathway through which the patient can receive a standard nutritional formula. This prevents the patient from developing metabolic complications and related complications. At the same time, we enable inpatient accommodation without the risk of dietary complications associated with bariatric surgery.

U radu se tematizira slika suvremenog djeteta rane i predškolske dobi u kontekstu aktualne pedagoške paradigme. Suvremeno društvo, zainteresirano da znanjem unaprijedi svoj gospodarski sustav, upućuje specifičan interes odgoju i obrazovanju pojedinaca. Suvremeni pedagoški koncept društva znanja zasniva se na teoriji učenja – konstruktivizmu. U skladu s time, dijete je dominantno shvaćeno kao ono koje uči uspostavljajući pritom partnerske odnose s odraslima. Djetetu se upućuje specifična odgovornost za vlastitu razvojnu dobrobit, ono se adultizira. Suvremen pristup djetetu, koji se zasniva na sociološkom konceptu njegovih prava, zanemaruje stajališta psihološkog diskursa kojim se razmatraju njegove razvojne potrebe, što se posljedično reflektira na karakter suvremenog odgojnog odnosa i dovodi do krize odgoja. Ovim se radom razmatra specifičan utjecaj suvremenih pedagoških polazišta, poput primjerice onog o ravnopravnom partnerstvu djeteta i odgojitelja, djetetu kao autonomnom subjektu ili prostoru kao trećem odgojitelju, na pojedine aspekte razvoja adultizirano shvaćenog djeteta rane i predškolske dobi. Upućuje se na važnost pojmovnog redefiniranja, umjesto odbacivanja, koncepta odgoja kao središnjeg predmeta pedagogijske znanosti.

The paper deals with an image of a modern child of early and preschool age in the context of current pedagogical paradigm. Modern society, interested in improving its economic system through knowledge, has a specific interest in the upbringing and education of individuals. The modern pedagogical concept of knowledge society is based on the theory of learning – constructivism. Accordingly, a child is predominantly understood as the one who learns while establishing partnerships with adults. A child is given a specific responsibility for his own developmental well-being, he is adultized. The modern approach to the child, which is based on the sociological concept of his rights, neglects the views of psychological discourse which considers his developmental needs, which consequently reflects on the character of the modern educational relationship and leads to a crisis of upbringing. This paper discusses the specific impact of modern pedagogical starting points, such as the one on equal partnership between child and educator, child as an autonomous subject or space as the third educator, on certain aspects of development of adultized early and preschool children. The paper points out the importance of conceptual redefining, instead of rejecting, the concept of upbringing as a central subject of pedagogical science.

A new alternative synthetic route to the transition-metal free π-conjugated polyHIPEs is reported, which combines the Schiff-base condensation reaction and an emulsion-templating technology.

We conducted a nationwide longitudinal observational study to estimate the incidence of syphilis in a cohort of male persons living with HIV (PLWH) in Croatia in the pre-COVID-19 and COVID-19 years. Data were reviewed and extracted from the clinical database. We analyzed 1187 PLWH (> 18 years) in care in Croatia from 2018 to 2021 and used Poisson regression to calculate rates. We observed a 91.4% increase in incidence between 2019 and 2020; the overall rate was 6.0/100 person-years, and the annual rate ranged from 3.3/100 person-years in 2018 to 9.3/100 person-years in 2021. We found higher rates in men who have sex with men, PLWH with a baseline history of syphilis, PLWH with a more recent HIV diagnosis, and a lower rate in those who had clinical AIDS. The rate of syphilis serological testing was 3.5% lower in 2020 compared to 2019. Recurrent syphilis was more likely asymptomatic compared to the first episodes. In conclusion, during the COVID-19 epidemic years there was a huge increase in syphilis. Results highlight the need for enhanced and novel prevention interventions.

The vexing error of excess variance in the sizing of single particles degrades accuracy in applications ranging from quality control of nanoparticle products to hazard assessment of nanoplastic byproducts. The particular importance of lipid nanoparticles for vaccine and medicine delivery motivates this comment on a publication$^{\textrm{1}}$ in ACS Nano. In ref 1, the benchmark measurements of a nanoparticle standard manifest large errors of the size distribution that contradict the claim of validation. Such errors can bias the correlation of fluorescence intensity as an optical proxy for the molecular loading of lipid nanoparticles and give misleading insights from power-law models of intensity$-$size data. Looking forward, measurement error models have the potential to address this widespread issue., Comment: Peer reviewed and pending acceptance by ACS Nano

The leaves of Mitragyna speciosa (kratom), a plant native to Southeast Asia, are increasingly used as a pain reliever and for attenuation of opioid withdrawal symptoms. Using the tools of natural products chemistry, chemical synthesis, and pharmacology, we provide a detailed in vitro and in vivo pharmacological characterization of the alkaloids in kratom. We report that metabolism of kratom’s major alkaloid, mitragynine, in mice leads to formation of (a) a potent mu opioid receptor agonist antinociceptive agent, 7-hydroxymitragynine, through a CYP3A-mediated pathway, which exhibits reinforcing properties, inhibition of gastrointestinal (GI) transit and reduced hyperlocomotion, (b) a multifunctional mu agonist/delta-kappa antagonist, mitragynine pseudoindoxyl, through a CYP3A-mediated skeletal rearrangement, displaying reduced hyperlocomotion, inhibition of GI transit and reinforcing properties, and (c) a potentially toxic metabolite, 3-dehydromitragynine, through a non-CYP oxidation pathway. Our results indicate that the oxidative metabolism of the mitragynine template beyond 7-hydroxymitragynine may have implications in its overall pharmacology in vivo.

Objective This study's objective was to examine a crash severity characteristic and the relationship as an indicator of abdominal injury causation. Methods Data were analyzed from 23 CIREN case vehicles involved in a frontal type collision, had an AIS 2+ abdominal injury, and contained an electronic data recorder (EDR) download. Data was downloaded from the NHTSA and IIHS crash test databases for comparison. Data was run through a MATLAB algorithm calculating the maximum velocity-time profile slope. This data was compared to the available crash tests. Results The CIREN vehicle EDR velocity-time slopes ranged from 233 m/s2 to 434 m/s2 for crashes with a delta-v range of 42 km/h to 77 km/h. NHTSA NCAP comparable data was available for all cases, and the slopes ranged from 263 m/s2 to 405 m/s2 calculated from the collected accelerometer. Three comparable tests were available from the IIHS database and the calculated slopes ranged from 252 m/s2 to 298 m/s2. Four test vehicles had EDR data, two each from NHTSA and IIHS and slopes ranged from 245 m/s2 to 281 m/s2. The crash test EDRs slope calculations were lower than the accelerometer data. Nine of the 12 case vehicles had slope values lower than the comparable NCAP accelerometer velocity-time slopes. Conclusions Vehicle velocity-time profile can be beneficial to examine the characteristics of crash severity and potential injury. This small sample of field crashes did not indicate a clear relationship of abdominal injury related to crash severity measured by the EDR delta-v slope. EDR results can be considered when determining crash severity, but the limitations need to be understood.

The COVID-19 pandemic required a shift away from the evidence-based practices known to infection prevention professionals' (IPP). Relaying these guidelines to beleaguered front line staff contributed to the experience of moral distress and burnout among IPPs.A mixed methods design was used to explore the experiences of IPPs during the COVID-19 pandemic. An electronic survey was sent to a convenience sample from the Wisconsin APIC membership. A subset of this sample completed additional semi-structured interviews.A total of 61 IPPs responded to the survey, 18 agreed to interviews with 11 completions. Most respondents identified as female (n=58, 95.0%) and White (n=55, 90.1%). More than half of the respondents (n=39, 63.9 %) reported they experienced moral distress (MD). Themes from one-on-one interviews included: Feeling depleted, challenges to IPP role, validation of IPP expertise, value of peer support.We found that IPPs endured significant distress and exhaustion during the COVID-19 pandemic regardless of their practice setting. The long-term effects on the IPP profession must be examined. IPPs are susceptible to high levels of stress and anxiety similar to other frontline healthcare workers. IPPs deserve recognition for their service during the pandemic and should have access to resources that can support their well-being.