Objective Transition may be associated with poor health outcomes, but limited data exist regarding inflammatory bowel disease (IBD). Acquisition of self-management skills is felt to be important to this process. IBD specific checklists of such skills have been developed to aid in transition, but none has been well studied or validated. This study aimed to describe self-assessment of ability to perform tasks on one of these checklists and to explore the relationship to patient age and disease duration. Methods 10–21yr old patients with IBD were recruited. An iPad survey queried the patients for self-assessment of ability to perform specific self-management tasks. Task categories included: basic knowledge of IBD, doctor visits, medications and other treatments, and disease management. Associations with age and disease duration were tested with Spearman rank correlation. Results 67 patients (31 male) with Crohn's disease (n=40), ulcerative colitis (n=25), and indeterminate colitis (n=2) participated. Mean patient age was 15.8 ±2.5yr with median disease duration of 5yr (2mo-14yr). The proportion of patients who self-reported ability to complete a task without help increased with age for most tasks including: telling others my diagnosis (ρ=0.43, p=0.003), telling medical staff I do not like or am having trouble following a treatment (ρ=0.37, p=0.003), and naming my medications (ρ=0.28, p=0.02). No task significantly improved with disease duration. Conclusions Self-assessment of ability to perform some key tasks of transition appears to improve with age, but not with disease duration. Importantly, communication with the medical team did not improve with age, despite being of critical importance to functioning within an adult care model.

Increasing bowel wall restricted diffusion (lower ADC values) is associated with multiple MRI findings that are traditionally associated with active inflammation in pediatric small bowel Crohn disease.

Wide variation exists in the practice of infliximab administration in pediatric IBD. The effect of these variations on outcomes is unknown.

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213 Background: In March 2020, the coronavirus disease (COVID-19) spread across New York City. All non-emergent medical care was delayed, and healthcare resources were redirected to COVID-19 patients. Physicians managing prostate cancer faced unprecedented decisions to balance risks of the pandemic against risks of cancer progression. Here we review management of localized prostate cancer at an Urban Cancer Center in New York City during the height of the pandemic. Methods: We examined men with newly diagnosed, localized prostate cancer seen in initial consultation by Urology or Radiation Oncology between January 1 and June 30, 2020 (COVID-19 cohort). We reviewed cancer management, as well as the impact of the pandemic on treatment choice and patterns of care. Chi square and t-test analyses were performed to compare the COVID-19 cohort to a similar cohort managed before the pandemic from July 1, 2019 to December 31, 2019 (pre-COVID-19 cohort). Results: We identified 75 men in the COVID-19 cohort. NCCN risk profile: 20% low risk, 53.4% intermediate, and 26.7% high. During the height of the pandemic, there was 7 week pause in both new radiation therapy (RT) and radical prostatectomy. 11 patients continued previous RT, 1 of which developed a symptomatic covid infection and required a 2 week pause in treatment. During the operating room restart, 11 patients underwent radical prostatectomy including 8 with unfavorable-intermediate or high-risk disease. No surgical patients acquired COVID-19. Compared to the pre-COVID-19 cohort, the COVID-19 cohort had longer time from initial visit to treatment (92.1 days vs 71.0 days, p = 0.045) and a larger percentage of patients who were seen but did not return for management (25.3% vs 14%, p = 0.044). Conclusions: Our cancer center had a coordinated, 7-week cessation in primary RT and surgery for prostate cancer during the height of the COVID-19 pandemic. There were no severe COVID-19 infections among patients finishing RT, or the first cohort of men having surgery during the restart of treatments, suggesting that localized prostate cancer treatments can be safely delivered in the event of a second wave. We identified a substantial number of men who were seen, but did not return for management, highlighting a cohort who need to be reintegrated into the healthcare system. [Table: see text]

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INTRODUCTION AND OBJECTIVE: Underrepresented minorities (URM) within urology remain significantly low compared to other medical fields. Investigation into differences between urology residency applications by racial and ethnic groups may illuminate sources of bias in the current recruitment and selection process that contribute to continued underrepresentation.METHODS: A total of 342 personal statements submitted to the University of North Carolina urology program in the 2016-17 cycle were evaluated with Linguistic Inquiry and Word Count (LIWC), a validated text analysis program. Independent sample T-tests and multivariate regression controlling for STEP1 score and gender were used to compare match rates, residency application variables and statement linguistic characteristics by reported race/ethnicity. RESULTS: Of evaluated applicants, 181 identified as White non-Hispanic, 86 as Asian and 75 as an URM. When evaluating application differences by race/ethnicity, Asian and URM applicants had more research projects compared to White applicants (11.7 and 12.9 vs. 8.8, p[0.01). STEP 1 scores for URMs were slightly lower when compared to White applicants (244.6 vs. 238.5, p[0.01). When evaluating personal statement linguistics, all applicants wrote with the same degree of analytical thinking. Asian applicants wrote with decreased authenticity (p[0.03) and emotional tone (p[0.04) while URM applicants wrote with increased clout (p[0.04). Asian applicants used longer words and more formal sentence structure. Applicants also differed in their use of pronouns: Asian applicants used 'we/us/our' more often (p<0.01), URM applicants used 'you' significantly more often (p[0.02) and White applicants used 'I' more often (p[0.01). There was no significant difference in personal statement characteristics between matched and unmatched applicants.CONCLUSIONS: Improving diversity in the workforce requires awareness of biases that may exist in the application process. In urology applications, subtle differences in word usage and writing style exist by racial/ethnic groups, which could influence perceptions of applicants, matching, and downstream training interactions. Appreciating these differences may help residency programs recruit and support trainees from diverse backgrounds.