Background: Incarcerated individuals who experience pregnancy or childbirth in correctional facilities face unique considerations for obstetric care and consequently are at greater risk of adverse maternal and fetal outcomes.Objectives: To characterise patient experiences regarding pregnancy and childbirth during incarceration via qualitative synthesis.

Background Different sedation practices are utilized in pediatric and adult endoscopy settings. While pediatric endoscopies are performed under deep sedation, adult endoscopies are often performed under conscious sedation. Purpose This study sought to explore the experiences of patients with pediatric-onset IBD that have undergone transfer to adult care and to identify gaps in endoscopy sedation practices that may inform a larger and more comprehensive evaluation of this topic. Method A pilot study was performed at Women's College Hospital involving patients aged 18 to 25 years old with a diagnosis of pediatric-onset IBD that received endoscopies in both the pediatric and adult setting. Patients were recruited between June 1 and October 1, 2022. A 36-item questionnaire was distributed assessing sedation methods used in pediatric and adult settings, anxiety, pain, satisfaction during endoscopy and perceptions of transition of care preparation as it pertained to endoscopy. This study was reviewed by institutional authorities at WCH and was deemed not to require REB approval. Result(s) Twelve patients participated in the pilot survey study (7 Ulcerative colitis, 5 Crohn’s disease) with a mean age of 22. Of those, 100% were female and 66% did not have any comorbid conditions. The mean age of diagnosis was 12.8 years, with respondents spending an average of 67.3 months in pediatric care prior to transition. In pediatric care, the mean number of endoscopies received was 2.3 with a majority performed under deep sedation (83%). Respondents reported being very satisfied with their sedation experience (58%) and experiencing no pain (67%), however mild to severe anxiety was reported (58%). In adult care, mean endoscopies received was 2.1, with conscious sedation (50%) performed more often than deep (42%) or no sedation (8%). More respondents reported satisfaction with deep sedation (100%) than conscious sedation (67%). During conscious sedation, respondents experienced more pain (50% vs. 20%), moderate discomfort (33% vs. 0%), and were more anxious (83% vs. 60%) than in deep sedation. Factors that contributed to anxiety included fear of endoscopy and insufficient sedation. Of those who received deep sedation in the adult setting, 60% reported that the sedation method utilized impacted their future willingness for endoscopy. Lack of communication regarding sedation method, poor experiences with conscious sedation, and the desire to choose the sedation method appropriate for them were areas for improvement. Conclusion(s) This pilot study demonstrated that IBD patients transferred to adult care receive varying endoscopy sedation methods and experience differential levels of satisfaction favouring deep sedation. This is an important signal that requires larger study. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

Background Effective strategies at educating high risk IBD patients about COVID-19 and the benefits of vaccination is critical. Purpose The primary objective of this study was to assess the impact of early adulthood (18-25 years) on COVID-19 vaccination compliance. Secondary objectives were to assess the impact of early adulthood on vaccine hesitancy and reasons for non-compliance. Method A retrospective chart review was performed on all eligible IBD patients. Inclusion criteria: patients followed at Women’s College Hospital, age 18 years and older, diagnosis of Crohn’s disease (CD), Ulcerative Colitis (UC) or Indeterminant Colitis (IC). Data was collected between January 01 and August 31, 2022. Demographic data, level of immunosuppression and COVID-19 vaccine status were collected. All participants identified as not fully vaccinated (defined as less than 3 COVID-19 vaccines) were enrolled into the second phase of the study in which a modified Oxford COVID-19 Vaccine Hesitancy Scale was administered, and reasons for vaccine hesitancy discussed and addressed using a prepared educational template. Chi-square test evaluated the impact of age on vaccination status. Adjusted logistic regression was also performed. Fisher exact test evaluated the impact of age on willingness to accept vaccination counseling. Generalized linear regression model evaluated the impact of this on vaccine hesitancy. Result(s) 287 patients were included in the study of which 254 (89%) were immunosuppressed, 197 (69%) were female. 144 (50%) had CD, 136 (47%) had UC and 7 (2.4%) had IC. There were significantly more young adults who were under/unvaccinated 22/82 (27%) compared to older adults 22/205 (11%), p=0.0006 . Gender, IBD phenotype, immunosuppression status did not significantly affect vaccination status. The only variable found to significantly affect vaccination status on adjusted logistic regression was age, >25 years associated with OR 3.25 (95% CI 1.63-6.50) for full vaccination. 32/39 study subjects who were un/under-vaccinated agreed to counseling (82% of the early adults and 82% of older adults). Gender, IBD phenotype, immunesuppression status and age had no impact on uptake. Linear regression modeling found no significant impact on vaccine hesitancy by age, gender, IBD phenotype or immunesuppression. The main reasons described by patients for hesitancy included safety concerns and potential side effects (43%), perceived low risk (27%), prior COVID-19 infection (17%), lack of knowledge of current public health guidance (13%). Conclusion(s) Early adult IBD patients were found to be significantly less compliant with obtaining COVID-19 vaccines. This hesitancy mainly stems from concerns regarding vaccine safety and efficacy and perceived low risk. More targeted education strategies are required to increase awareness and ensure vaccine compliance. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

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