Usual Sources Research Articles

Ведення пацієнтів із легеневою гіпертензією в умовах воєнного стану: реалії та проблеми

Any military actions on the territory of any country can significantly influence on the quality of medical care. Especially, it could reflect on patients with rare diseases requiring expensive treatment. In this article there were analyzed the work of the specialized pulmonary hypertension (PH) center during the period of Russia’s military invasion in Ukraine and presented the results of the outpatient survey due to problems with patient access to medical care and medicine provision in the period from 24-Feb-2022 to 01-Jul-2024 (war period).We selected patients with a diagnosis of PH carried out for the periods: since 01-Jan-2018 until 30-Apr-2020 (pre-war and pre-COVID-19 period) and since 22-Feb-2022 until 01-Jul-2024 (war period): n=328 and n=394 respectively. The selection was made from the electronic hospital database and the electronic registry of patients that have been conducted in the department since 2014. With the help of the Google Form system, a questionnaire was created and sent through modern devices of communication (Viber, Facebook) to fill out online to patients who are registered (applied for outpatient or inpatient care) in the department or are subscribers to the social network accounts of the Ukrainian Association of Patients with Pulmonary hypertension and/or the Lviv City Charitable Foundation «Sisters of Dalili». We got 220 responses. It was established that martial law status in the country did not significantly affect the management of patients with different forms of PH in the specialized center. The number of treated patients and performed right heart catheterization procedures increased by 20 and 22 % respectively during the «war period», compared to the «pre-war» period. 65 % of PH patients who came abroad due to the war used the help of the specialized department for direct referral to PH centers in Poland for further treatment, including surgical one. 41,7 % of respondents changed their place of residence during the war, but only 17,9 % had interruptions in taking of drugs for the PH treatment. Along with the usual sources of free medicines (humanitarian aid from charitable organizations, the government’s free medicines program), one in five patients «shared out» medicines with other patients. In 45 % of the patients who visited foreign PH centers, the therapy previously prescribed in Ukraine was changed to more effective or safer drugs that are not registered in Ukraine.

Teaching Experimental Instrumental Analytical Chemistry Are we forming professionals, training operators or illuding students (and ourselves)?

Teaching Experimental Instrumental Analytical Chemistry Are we forming professionals, training operators or illuding students (and ourselves)?

The ΛCDM-NG Cosmological Model: A Possible Resolution of the Hubble Tension

We offer a cosmological model based on conventional general relativity (no speculative physics) that may resolve the Hubble tension. A reanalysis of the foundation of the Lambda-CDM model shows that general relativity alone does not specify what fraction of the mass density acts as the source term in Friedmann’s equation and what fraction acts as the source of the gravitational potential of condensed objects. This observation opens the way to alternative cosmological models within conventional general relativity, and it proves that the ΛCDM model is not the unique solution of Einstein’s equations for the usual cosmological sources of gravitation. We emphasize that the source of the gravitation potential in the ΛCDM model is the deviation δ ρ m of the mass density away from its average value, and not the total density of condensed masses as in Newtonian theory. Though not often stated, this is a modification of Newtonian gravitation within the ΛCDM model. The ΛCDM-NG model uses the freedom to move matter between source terms to restore the source of gravitational potential to its Newtonian form. There is no Hubble tension in the ΛCDM-NG model if the gravitational potential of condensed objects (stars, galaxies, and dark matter clouds) falls in a certain range, a range that does not seem unreasonable for the actual Universe. The deceleration parameter in the ΛCDM-NG model differs from that in the ΛCDM model, suggesting a test to distinguish between the two models.

Comparison of Health Care Utilization in Different Usual Sources of Care Among Older People With Cardiovascular Disease in China: Evidence From the Study on Global Ageing and Adult Health.

Objectives: To compare the health care utilization in different usual sources of care (USCs) among the elderly population with cardiovascular disease in China. Methods: Cross-sectional data for 3,340 participants aged ≥50years with cardiovascular disease from Global AGEing and Adult Health (2010)-China were used. Using the inverse probability of treatment weighting on the propensity score with survey weighting, combined with negative binomial regression and logistic regression models, the correlation between USCs and health care utilization was assessed. Results: Patients using primary care facilities as their USC had fewer hospital admissions (IRR = 0.507, 95% CI = 0.413, 0.623) but more unmet health needs (OR = 1.657, 95% CI = 1.108, 2.478) than those using public hospitals. Patients using public clinics as their USC had higher outpatient visits (IRR = 2.188, 95% CI = 1.630, 2.939) than the private clinics' group. Conclusion: The difference in inpatient care utilization and unmet health care needs between public hospitals and primary care facilities, and the difference in outpatient care utilization between public and private clinics were significant. Using primary care facilities as USCs, particularly public ones, appeared to increase care accessibility, but it still should be strengthened to better address patients' health care needs.

Asistensi: raising capital for innovation in health insurance, migrants and remittances

Learning outcomes After completion of this case study, students will be able to describe the funding path for start-ups, including the amounts and profiles of the usual investors or sources of funds, according to the moment in their life cycle and the characteristics of the initiative; highlight the challenges faced by start-up founders in weak entrepreneurial ecosystems and risky institutional environments; and argue in favor of or against different modes and typical instruments of venture capital (VC) investments in the early stages of new businesses, each of them different regarding dilutions, valuation potential, depth of negotiations and term sheets. Case overview/synopsis Asistensi, a technology and telemedicine start-up founded in 2020 in Venezuela by three entrepreneurs (Andrés Simón González-Silén, Luis Enrique Velásquez and Armando Baquero), raised US$3m in less than a year in a seed round in which it attracted the attention of professional VC funds such as Mountain Nazca, Alma Mundi Ventures and 468 Capital. Everything was set for launching operations in Mexico and the Dominican Republic in April 2021. However, a series of difficulties led to higher expenditure than planned, prompting the entrepreneurs to seek additional capital. The decision on the financial instrument to be associated with the potential valuation and shareholder dilution figures has been posed as a dilemma. Complexity academic level The case study focuses on understanding the start-up financing process. It can be used effectively in management- and finance-related subjects for graduate students taking introductory topics in entrepreneurship and entrepreneurial finance, as well as introductory executive education courses in entrepreneurship, entrepreneurial finance and VC. Supplementary materials Teaching notes are available for educators only. Subject code CSS3: Entrepreneurship

Peculiarities of the Operation оf Optical Communication in case of emergencies

Today, in connection with the beginning of the full-scale armed invasion of the RF on the territory of Ukraine, questions related to fire safety and stable electricity supply have arisen before our state. It. in turn, led to numerous problems in the communication system. Against this background, after damage to power supply lines and strategic objects, the search and deployment of power supplies independent of the usual supply sources became urgent. After all, under the conditions of emergency and planned power outages, only the presence of such means of power supply as fuel generators and batteries make it possible to provide work and training for a huge number of people. Thanks to the fact that people, without wasting time and wasting energy on unnecessary things and affairs, began to work on the issue that is associated with a sudden or planned power outage for known or not entirely known reasons, work for most people resumed. Autonomous power sources were fuel generators. Small shopping centers and shopping and entertainment centers have installed powerful diesel generators on their premises to power large premises. Some installed one diesel generator on each individual wing. This was done if the room was too large for one diesel generator. Small establishments, for example: cafes, restaurants, bars, pubs, hookah bars, small offices, offices, workshops, etc. installed gasoline generators if the premises were the size of a garage, a three-room apartment with an area of 92 m2 or the size of a small two-story country house with walls 8 meters long each and ceilings up to 2 meters high. Powerful diesel generators were installed in the premises, which were more than 100 m2 in area. Most generators had an automatic start feature. Some generators had an installed automatic start function, and some did not have this function, and therefore had to install this function separately. Telecommunications companies and mobile communication service companies and provider companies that sell and service cable Internet also did not waste time and effort and also installed generators on their territories. Provider companies and mobile communication service companies were the first to decide to install autonomous emergency power supplies in their territories. This was done on purpose, since the equipment that provided and monitored wireless and cable Internet services and mobile communications services was powered by network electricity, and during the absence of network electricity, the equipment obviously stopped working. Because of this, cable Internet and mobile communications were lost, which had a negative impact on some citizens of Ukraine. It had a negative impact on them, since some citizens, as mentioned above, could work or study remotely. Someone lost their job, someone lost their business due to power outages. Also in connection with this, huge accounting gaps appeared. The introduction and use of emergency power helps solve this problem.

A broadcast sub-GHz framework for unmanned aerial vehicles clock synchronization

Nowadays, set of cooperative drones are commonly used as aerial sensors, in order to monitor areas and track objects of interest (think, e.g., of border and coastal security and surveillance, crime control, disaster management, emergency first responder, forest and wildlife, traffic monitoring). The drones generate a quite large and continuous in time multimodal (audio, video and telemetry) data stream towards a ground control station with enough computing power and resources to store and process it. Hence, due to the distributed nature of this setting, further complicated by the movement and varying distance among drones, and to possible interferences and obstacles compromising communications, a common clock between the nodes is of utmost importance to make feasible a correct reconstruction of the multimodal data stream from the single datagrams, which may be received out of order or with different delays. A framework architecture, using sub-GHz broadcasting communications, is proposed to ensure time synchronization for a set of drones, allowing one to recover even in difficult situations where the usual time sources, e.g. GPS, NTP etc., are not available for all the devices. Such architecture is then implemented and tested using LoRa radios and Raspberry Pi computers. However, other sub-GHz technologies can be used in the place of LoRa, and other kinds of single-board computers can substitute the Raspberry Pis, making the proposed solution easily customizable, according to specific needs. Moreover, the proposal is low cost, since it does not require expensive hardware like, e.g., onboard Rubidium based atomic clocks. Our experiments indicate a worst case skew of about 16 ms between drones clocks, using cheap components commonly available in the market. This is sufficient to deal with audio/video footage at 30 fps. Hence, it can be viewed as a useful and easy to implement architecture helping to maintain a decent synchronization even when traditional solutions are not available.

Aeromonas sobria cellulitis with septic shock: rare but potentially lethal in chronic liver disease

Aeromonas, a common bacterial resident of freshwater is known to cause gastrointestinal illness in humans. Contaminated water and aquatic foods are the usual sources. Gastrointestinal disease is usually mild in normal individuals and responds to common antibiotics. However, extra-intestinal infections by Aeromonas species have been increasingly reported. Severe skin and soft tissue infection followed by septic shock may be seen in immunocompromised individuals. Bacteremia can also occur secondary to invasive gastroenteritis in persons with impaired immunity. Patients with decompensated chronic liver disease have been noted to be at especially high risk for fatal infection due to this pathogen. It can cause early bacteremia and rapid death without surgical debridement. We report a case of fatal Aeromonas cellulitis with septic shock in a patient with known advanced alcoholic liver disease. It started following minor skin injury and subsequent exposure to pond water. The patient presented late with septic shock and succumbed to his illness.

Metformin Prevents NDEA-Induced Memory Impairments Associated with Attenuating Beta-Amyloid, Tumor Necrosis Factor-Alpha, and Interleukin-6 Levels in the Hippocampus of Rats.

N-nitrosodiethylamine (NDEA) is a potential carcinogen known to cause liver tumors and chronic inflammation, diabetes, cognitive problems, and signs like Alzheimer's disease (AD) in animals. This compound is classified as probably carcinogenic to humans. Usual sources of exposure include food, beer, tobacco, personal care products, water, and medications. AD is characterized by cognitive decline, amyloid-β (Aβ) deposit, tau hyperphosphorylation, and cell loss. This is accompanied by neuroinflammation, which involves release of microglial cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin 1β (IL-1β), by nuclear factor kappa B (NF-κB) upregulation; each are linked to AD progression. Weak PI3K/Akt insulin-signaling inhibits IRS-1 phosphorylation, activates GSK3β and promotes tau hyperphosphorylation. Metformin, an antihyperglycemic agent, has potent anti-inflammatory efficacy. It reduces proinflammatory cytokines such as IL-6, IL-1β, and TNF-α via NF-κB inhibition. Metformin also reduces reactive oxidative species (ROS) and modulates cognitive disorders reported due to brain insulin resistance links. Our study examined how NDEA affects spatial memory in Wistar rats. We found that all NDEA doses tested impaired memory. The 80 µg/kg dose of NDEA increased levels of Aβ1-42, TNF-α, and IL-6 in the hippocampus, which correlated with memory loss. Nonetheless, treatment with 100 mg/kg of metformin attenuated the levels of pro-inflammatory cytokines and Aβ1-42, and enhanced memory. It suggests that metformin may protect against NDEA-triggered memory issues and brain inflammation.

Utilization and Staff Perspectives on an On-Demand Telemedicine Model for People with Intellectual and Developmental Disabilities Who Reside in Certified Group Residences.

Non-emergent medical problems that arise when a usual provider is unavailable can often result in emergency department or urgent care visits, which can be particularly distressing to people with intellectual and developmental disabilities (PIDD). On-demand, synchronous telemedicine may be a promising supplement when immediate care from usual sources is unavailable. Prior research demonstrated that high-quality telemedicine can be effectively delivered to PIDD. The aim of this article is to describe the utilization and staff perspectives on the implementation of the Telemedicine Triage Project (TTP), an innovative model that provides telemedicine consultations for PIDD who reside in state-certified group residences and present with an urgent but non-emergent medical concern when their usual provider is unavailable. Call frequency data for calendar years 2020 and 2021 were reviewed. The study team conducted semi-structured interviews, with 19 key informants representing organizational- and agency-level leadership and staff. The interview data were analyzed using a protocol-driven, rapid qualitative methodology. Telemedicine consultations increased from 7953 in 2020 to 15,011 calls in 2021, and call volume peaked between 10 am and 1 pm. Key informants reported high satisfaction with TTP; universal benefits and a few barriers to implementation; and strong interest in maintaining the program beyond the grant period. Over the first 2 years of its implementation, the TTP program was widely utilized and proved extremely feasible and acceptable to staff. This model is a promising and highly feasible way to provide equitable access to telemedicine for PIDD by addressing barriers to and disparities in access to health care that affect PIDD.

Prickly Pear Cladodes as an Alternative Source of Water in Small- and Medium-Scale Yellow Mealworm Rearing

New solutions are compulsorily needed to reconcile the enormous and ever-growing request for protein for human nutrition and, at the same time, reduce conventional meat production. This epochal challenge can find a valuable aid to a winning solution in insect rearing. The use of insects as feed and food, far from being a definitive solution to global food shortages, can offer new protein sources and perfectly fit circular economy precepts, yet more so when insects feed on by-products from the agri-food industry. In this scenario, Tenebrio molitor (TM) is a concrete alternative. Therefore, making its rearing more sustainable is a prime objective. In this paper, we evaluated the possibility of replacing usual plant sources of wet supplementation used in TM rearing with sustainable alternatives, including the cladodes of prickly pear (Opuntias ficus indica, OFI), to reduce the frequency of administration, thus minimizing related labor costs. The alternatives were tested for water content, dehydration, and shelf life to select the best-performing ones. On the selected matrices, we evaluated the preference of the larvae and their palatability because a matrix may be convenient and sustainable but not appreciated by consumers. The results showed that OFI cladodes have high moisture and a long shelf life and are appreciated by the larvae that prefer them to other matrices. Thus, OFI can replace the conventional wet source in TM rearing, at least in areas where this cactus grows wild and is not difficult to obtain.

Development ofa cervical cancer prevention text-messaging program forwomen living with HIV.

Cervical cancer screening and human papillomavirus (HPV) vaccination are critical for those immunocompromised due to human immunodeficiency virus (HIV). Health education programs, including text messaging, can effectively improve knowledge of cervical cancer and recommended screening. This paper describes the data-driven development of a 4-week text-messaging intervention to improve HPV and cervical cancer knowledge among women living with HIV (WLH). This study reports data from surveys (n = 81; January 2020 to September 2021) and focus group discussions (FGDs, n = 39; April-June 2020) conducted among WLH in the DC area. While most WLH revealed that their usual sources of health information were through in-person group sessions, they pointed out that these were impractical options due to the coronavirus 2019 pandemic. They noted that a text-messaging intervention was feasible and acceptable. FGD participants' responses structured around the Protection Motivation Theory constructs informed the text-messaging library, covering topics such as (I) understanding of cervical cancer and HPV, (II) cervical cancer prevention and (III) HPV self-sampling. The utilization of low-cost and easily accessible health education interventions, such as mobile-based text messaging, can effectively increase knowledge and awareness of cervical cancer in populations that have been historically difficult to access and during times when health services are disrupted such as during a global pandemic or public health emergency.

DP01 Survey on the management of dysplastic naevus

Abstract Although dysplastic naevus (DN) is a frequent diagnosis, there is significant controversy on its definition and gradation and its relationship to melanoma risk. Therefore, there is no consensus over optimal management, and surveys from Australia, Canada and the USA have shown variation in clinical practice. Dysplastic naevus with involved histological margins has not been shown to progress to melanoma. To assess UK management of DN depending on the grade of atypia and reported excision margin, we circulated a questionnaire via email to dermatologists in Scotland, north Wales, Liverpool and Manchester. Seventy-two responded, of whom 46 (64%) were consultants. The cohort was generally highly experienced, with 10 (14%) responders with 1–5 years’ dermatology experience, 15 (21%) with 6–10 years, 27 (37%) with 11–20 years and 20 (28%) with > 20 years’ experience. Management of DN varied greatly. For mild DN excised with < 1-mm margin, 59 (82%) agreed that no further management was required. Opinions were divided when margins were involved in mild DN, with 14 (19%) agreeing that no further management was required, 42 (58%) choosing to re-excise and six (8%) to re-excising only any residual pigmentation. Most dermatologists reassured patients with moderately DN with margins < 1 mm (49, 68%); 18 (25%) preferred to re-excise. For moderate DN with involved margins, six respondents (8%) felt that no further management was necessary and 54 (75%) would re-excise. For severe DN with margins > 1 mm, 16 (22%) would still re-excise and six (8%) would agree management in the multidisciplinary team meeting (MDT). For severe DN with margins < 1 mm, 41 (57%) would re-excise and seven (10%) would agree management in the MDT. Lastly, for severe DN with involved margins, 62 (86%) would re-excise and seven (10%) would agree management in the MDT. This study has shown comparable results with those from Australia and the USA, whereby most dermatologists would re-excise moderate and severe DN with involved margins. Significant numbers indicated that they would re-excise in the case of close histological margins: this is unnecessary, and more standardized management may reduce expenditure. Limitations of the study include the usual potential sources of bias in a questionnaire survey; it should be noted that reported behaviour may differ from actual practice. However, this is the first UK study on this common clinical scenario. The move to report DN as low- or high-grade may help to reduce variation, but our survey suggests that some patients are currently undergoing unnecessary procedures.

Cutting-edge medicine: A case of hypertension managed at the barbershop

We present a case of 43-year-old African American man, MS, who was diagnosed with hypertension at his barbershop after getting his blood pressure taken by a pharmacist team during his haircut. He was started on blood pressure medications and made several lifestyle modifications. He continued to get his blood pressure checked weekly during haircuts for the next six months and was able to lower his blood pressure to heathy levels. MS was then able to manage his blood pressure solely through lifestyle changes. We further discuss the significance of “barbershop medicine” and its role in combating the racial disparities in usual sources of care, as well as other non-traditional sources of health care particularly for the hypertension management.

Patterns of Health Care Access and Use in an Urban American Indian and Alaska Native Population.

Studies of health care access and use among historically resilient populations, while common, often field a limited sample size and rarely ask the groups most impacted by health inequities to weigh in. This is especially so for research and programs that focus on the American Indian and Alaska Native (AIAN) population. The present study addresses this gap by examining data from a cross-sectional survey of AIANs in Los Angeles County. To better interpret project findings and generate culturally relevant contexts, qualitative feedback was gathered at a community forum held in Spring 2018. Because recruitment of AIANs has historically been challenging, purposive sampling was employed to strategically identify a larger eligible pool. Among those who were eligible, 94% completed the survey (n = 496). AIANs who were enrolled in a tribe were 32% more likely to use the Indian Health Service (IHS), compared with those who were not enrolled (95% CI: 20.4%, 43.2%; p < .0001). In multivariable modeling, the strongest factors influencing IHS access and use were: tribal enrollment, preference for culturally-specific health care, proximity of the services to home or work, having Medicaid, and having less than a high school education. Feedback from the community forum indicated cost and trust (of a provider) were important considerations for most AIANs. Study findings reveal heterogeneous patterns of health care access and use in this population, suggesting a need to further improve the continuity, stability, and the image of AIANs' usual sources of care (e.g., IHS, community clinics).

Diabetes Care Barriers, Use, and Health Outcomes in Younger Adults With Type 1 and Type 2 Diabetes

Treatment challenges exist for younger adults with type 1 (T1D) and type 2 diabetes (T2D). Health care coverage, access to, and use of diabetes care are not well delineated in these high-risk populations. To compare patterns of health care coverage, access to, and use of diabetes care and determine their associations with glycemia among younger adults with T1D and with T2D. This cohort study analyzed data from a survey that was jointly developed by 2 large, national cohort studies: the SEARCH for Diabetes in Youth (SEARCH) study, an observational study of individuals with youth-onset T1D or T2D, and the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study, a randomized clinical trial (2004-2011) followed by an observational study (2012-2020). The interviewer-directed survey was administered during in-person study visits in both studies between 2017 and 2019. Data analyses were performed between May 2021 and October 2022. Survey questions addressed health care coverage, usual sources of diabetes care, and frequency of care use. Glycated hemoglobin (HbA1c) levels were assayed in a central laboratory. Patterns of health care factors and HbA1c levels were compared by diabetes type. The analysis included 1371 participants (mean [range] age, 25 [18-36] years; 824 females [60.1%]), of whom 661 had T1D and 250 had T2D from the SEARCH study and 460 had T2D from the TODAY study. Participants had a mean (SD) diabetes duration of 11.8 (2.8) years. More participants with T1D than T2D in both the SEARCH and TODAY studies reported health care coverage (94.7%, 81.6%, and 86.7%), access to diabetes care (94.7%, 78.1%, and 73.4%), and use of diabetes care (88.1%, 80.5%, and 73.6%). Not having health care coverage was associated with significantly higher mean (SE) HbA1c levels in participants with T1D in the SEARCH study (no coverage, 10.8% [0.5%]; public, 9.4% [0.2%]; private, 8.7% [0.1%]; P < .001) and participants with T2D from the TODAY study (no coverage, 9.9% [0.3%]; public, 8.7% [0.2%]; private, 8.7% [0.2%]; P = .004). Medicaid expansion vs without expansion was associated with more health care coverage (participants with T1D: 95.8% vs 90.2%; participants with T2D in SEARCH: 86.1% vs 73.9%; participants with T2D in TODAY: 93.6% vs 74.2%) and lower HbA1c levels (participants with T1D: 9.2% vs 9.7%; participants with T2D in SEARCH: 8.4% vs 9.3%; participants with T2D in TODAY: 8.7% vs 9.3%). The T1D group incurred higher median (IQR) monthly out-of-pocket expenses than the T2D group ($74.50 [$10.00-$309.00] vs $10.00 [$0-$74.50]). Results of this study suggested that lack of health care coverage and of an established source of diabetes care were associated with significantly higher HbA1c levels for participants with T1D, but inconsistent results were found for participants with T2D. Increased access to diabetes care (eg, through Medicaid expansion) may be associated with improved health outcomes, but additional strategies are needed, particularly for individuals with T2D.

Accentuate the positive, eliminate the negative, latch on to the affirmative

As I begin my third and final year as chair of the American Chemical Society Women Chemists Committee (WCC), I want to share some thoughts about navigating the past and future. The COVID-19 pandemic created challenges and opportunities during my term. Vaccines and variants became part of our everyday vocabulary. The term zooming morphed to refer to virtual meetings instead of describing traffic on the highway. For many, working from home and hybrid work became the new reality. Masked people entered stores, not as thieves, but to search for mostly unavailable products. The usual sources of solace became muddled by uncertainty. Wanting to leave you with an uplifting message, I pondered the words of Harold Arlen and Johnny Mercer in their hit jazz tune “Accentuate the Positive.” Released after World War II and sung by generations of entertainers, the song has lyrics that provide encouragement: You’ve got to accentuate the

The Account of Perseus in Orosius: Sources and Precedents

Abstract Orosius includes a note on the hero Perseus that neglects the usually prominent features of his myth, saying little more than that Perseus led an expedition into Asia and, once victorious, named the people he conquered there Persians after himself. He is the earliest of the surviving Latin authors to say either of these things about Perseus. And he is apparently the first author to combine these pieces of information – until, that is, John Malalas, who says much the same things about Perseus not once, but twice. This paper will survey Orosius’ usual sources for possible influences, trace the development of the notions that Perseus invaded Asia and that the Persians were named for him, and explore the possibility that Orosius and Malalas might have shared a source on Perseus and the history of Assyria.

“Abusers are Using COVID to Enhance Abuse”: Domestic Abuse Helpline Workers’ Perspectives on the Impact of COVID-19 Restrictions on those Living with Domestic Abuse

Background: Mobility restrictions enforced by the UK Government in March 2020 as a response to COVID-19 resulted in those vulnerable to domestic abuse being confined in isolation with their abusers, deprived of safe spaces and many of their usual sources of support. Domestic abuse helplines therefore became an increasingly vital avenue for victim support, seeing a substantial increase in service demand during lockdown periods. Purpose: This project examined the nature and frequency of calls received by domestic abuse helplines since the first COVID-19 lockdown period. Design and Sample: Through semi-structured interviews with 11 domestic abuse helpline workers across UK services dedicated to a diverse range of populations. Results: Key themes identified through thematic analysis were: (1) Abusers weaponising government guidelines to justify and intensify abuse, and restrictions acting as both a barrier and facilitator to leaving an abusive relationship; (2) A loss of previously accessed support, with users uncertain about what help was available and issues around engaging with new forms of support; and (3) Isolation from social support networks, with callers reporting a loss of respite, lack of emotional and practical support, removal of third-party abuse monitoring opportunities, and subsequent mental health implications. Conclusions: These findings will act as a crucial guide for policy decision-making regarding support needs emerging from the pandemic and beyond, highlighting the importance of multi-agency partnerships and clear referral pathways to share the increasing financial burden of domestic abuse amongst services. The longer-term integration of more diverse options for remote support to reduce the risk of detection will be paramount as we emerge from the pandemic, but these should serve to offer a wider range of support routes for abuse victims rather than a replacement for face-to-face provision.

INCIDENCE AND DETERMINANTS OF BULLYING IN PRIVATE DENTAL COLLEGES OF LAHORE

This study aimed to identify the incidence of bullying among dental students in Lahore and to find out the usual sources and forms of bullying. In three different private dental colleges of Lahore, a cross sectional survey of undergraduate dental students was conducted. Data was collected by using a standardized, pre-validated Negative Acts Questionnaire (NAQ-R) to identify tormenting of dental students for past 12 months from 150 students. One-Way ANOVA was applied to explore the difference of bullying prevalence among 3 colleges. Overall, 137 (91.3%) dental students reported bullying of various types, confronted over the past 12 months. Most commonly noticed bullying source in this study was trainee fellows. 94 (68.6%) of participants never lodged a complaint about bullying. Higher Percentage of Participants reported of being bullied in dental college which needs serious attention as well as action to control this situation.