neuropathic pain, mood stabilization, etc. Queries to the database are anonymous, the key information that is recorded is the country of origin.Results: During 51 months of follow-up, a total of 94, 695 queries from 98 countries were recorded by website users to check DDIs between eiAEs and DAAs.The most frequently requested DAAs were glecaprevir/pibrentasvir (GP; 23.3%) and sofosbuvir/velpatasvir (22.3%).Among the eiAEs, carbamazepine was the most frequently requested eiAE (37.9%) followed by phenytoin (19.9%) and oxcarbazepine (18.7%).Until recently, all of these combinations were contraindicated (red flag).On an individual level, the most frequently requested DDI between an eiAE and a DAA was carbamazepine & GP (n = 7, 773 queries).Conclusion: During our observation period, we received an average number of 1, 857 requests per month for a potential DDI between an eiAE and a DAA, demonstrating a huge demand globally for advice on concomitant use of these drugs.Our recommendations have recently been updated to reflect recent real-life data.Given the high number of DDI requests involving an eiAE and DAAs, we believe physicians should be informed that treatment options have now been improved, and HCV treatment should no longer be deferred when an eiAE is on board.

Abstract Background Canada is currently on target to reach the 2030 WHO goal of hepatitis C virus (HCV) elimination. Continued high rates of treatment initiation are required to meet this goal. People who use drugs (PWUD), account for the majority of new HCV cases in BC and continue to have many barriers to accessing DAA therapies, despite demonstrated high SVR rates in clinical trials. Improved elimination efforts including innovative outreach testing and treatment with this population are essential. Novel models have proven successful to engage PWUD in HCV therapy with a simplified, task-shifted cascade of care. Peer-based testing and support models have been piloted in other communities and may help connect to marginalized populations. People with lived and living experience of HCV treatment and drug use (peers) are seen as trusted sources of knowledge. Peers can vouch for the efficacy, minimal side effects and ease of HCV treatment that now exist in the current DAA era. Purpose The Peer HCV Point of Care (POC) testing project developed within our long standing nurse-led HCV treatment program seeks to determine whether an outreach peer model of HCV POC testing can be successful in Victoria, BC. The peer program focuses on finding populations who use drugs without regular access to primary care still living with HCV. This task shifting approach is the next phase of local micro-elimination efforts and has not been attempted previously. Method Six peers have been trained to provide HCV POC antibody and dried blood spot RNA tests. Our goals are to pilot the program, learn from our experiences, specifically from the direct input of peers to develop effective and supportive testing and treatment strategies. Peers have worked with nursing and research staff in two-hour blocks and are paid $26 per hour for these shifts. They provide testing at local supportive housing, shelters, social service sites and special events. Each client tested is offered a $10 incentive. Our peers are able to offer both POC antibody testing and, for those who have been exposed to HCV (currently infected, treated or cleared), RNA testing by dried blood spot. Serology by nursing from our mobile outreach van is collected as needed. Result(s) Within the first 4 months of the project peers and staff tested 304 people: 251 people with HCV POC antibody tests (227 negative and 24 positive results), 41 people with HCV dried blood spot RNA tests and 28 with nurse RNA serology. To date 12 people tested RNA+ (11 with previously unknown HCV have active RNA that require treatment), 7 people have been started on treatment. Conclusion(s) This innovative and novel approach to HCV therapy in PWUD was able to successfully use a peer-based approach to find people with limited connection to primary health care to test and treat HCV. We still have much to learn from the valuable knowledge, established relationships and novel perspectives of peers in our efforts to reduce barriers and reach PWUD and others who remain untreated. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest T. Barnett Grant / Research support from: AbbVie, Gilead, Merck, M. Selfridge Grant / Research support from: Kirby Institute, AbbVie, Gilead, Merck, ViiV, A. Drost Grant / Research support from: Abbvie, Gilead, Merck, K. Guarasci Grant / Research support from: Gliead, Abbvie, Merck , K. Lundgren Grant / Research support from: Abbvie, Gilead, Merck , C. Fraser Grant / Research support from: Abbvie, Gilead, Merck, Kirby Institute, ViiV, F. Boothman : None Declared

Summary A 27‐year‐old Arabian pony gelding presented for evaluation of weight loss, intermittent sheath oedema, persistent neutropenia and thrombocytopenia, and acute left hindlimb swelling and gait abnormality. Clinical findings included swelling, heat and sensitivity localised over the left greater trochanter, mild to moderate ventral and sheath oedema, a left hindlimb post‐legged gait, and off‐loading of weight from the left hindlimb at rest. Initially, neutropenia and thrombocytopenia were confirmed on bloodwork, but neutrophilia and thrombocytopenia persisted as the case progressed. Diagnostic imaging (radiography and percutaneous ultrasonography) of the left hindquarters revealed an aggressive, mixed proliferative and lytic bony lesion of the proximal left femur as well as associated muscle fibre disruption and a soft tissue mass. A percutaneous core biopsy of the lesion led to the diagnosis of osteoblastic osteosarcoma on histopathology. Pain and inflammation associated with the lesion was medically managed in the hospital with mild improvement. Additionally, palliative radiation was performed under general anaesthesia. Unfortunately, before a response to palliative radiation could be assessed, the patient was subjected to euthanasia due to development of acute neurological signs.

Introduction: In the emergency department (ED), high-acuity presentations encountered at low frequencies are associated with reduced staff comfort. Previous studies have shown that simulation can improve provider confidence with practical skills and management of presentations in various fields of medicine. The present study examined the effect of in situ simulation on interprofessional provider comfort with the identification and management of high-acuity low-frequency events in the ED. It further assessed the feasibility of implementing weekly simulation as an interprofessional education initiative in a high-volume ED. Methods: This was a retrospective pre-test post-test quasi-experimental design. Weekly in situ simulation events were facilitated by an interdisciplinary team in a high-volume ED in Hamilton, Ontario that sees an average of 185 patients per day. To date, 34 simulation events were held between January 18, 2019 and November 22, 2019, and included neonatal, paediatric and obstetric emergencies, and adult codes. There was an average of 20 patients presenting to the ED during these events. Events included a debrief, and typically lasted 60 minutes in total. Participants included individuals from various disciplines working on shift at the time of the event. Questionnaires were administered via email following the event, in which participants were asked to rank their comfort with emergency codes before and after the simulation using two 5-point Likert scales. The data from 39 questionnaires was analyzed. T-tests were used to analyze differences in self-reported comfort scores. Results: Questionnaire responders included nurses (41%), respiratory therapists (26%), resident physicians (10%), paramedics (3%), attending physicians (3%), students of various disciplines (10%) and other (7%). 38% of participants reported increases in comfort following simulation when compared to prior. Using the 5-point scale, the average reported score for comfort pre-simulation was 3.59 (95% CI 3.30–3.88), and the average post-simulation score was 3.97 (95% CI 3.76–4.19, p = 0.03). Conclusion: Our results demonstrate that weekly interprofessional in situ simulation is feasible in a high-volume ED, and significantly improves self-reported provider comfort with the identification and management of high-acuity, low-frequency events. This warrants the implementation of this simulation design to improve staff confidence and has implications for its potential role in improving team dynamics and patient safety.

HCV-related liver disease in people who inject drugs (PWIDs) carries a heavy personal, healthcare and societal burden. Current HCV treatment uptake in PWIDs is low and related to barriers at the individual, provider and healthcare system levels. Collect data related to demographic, medical and behavioral variables in HCV-infected PWIDs already engaged in care in Canada to help define treatment barriers. This multicenter observational study used retrospective chart review to collect data on patients receiving care from 12 Canadian centers. Patients with chronic HCV infection (HCV RNA+) and a history of injection drug use (in the previous 12 months) were included; HIV co-infection was excluded. Data were collected from October 2015 to February 2016. Of 423 participants: 74% were male, 65% Caucasian, 12% Aboriginal, with a median age of 42 years. All clinical sites provided multidisciplinary care and 11/12 had harm reduction programs. 33% of patients injected daily and 20% recently shared needles. Most frequent HCV genotypes were 1a (47%) and 3 (29%). When the fibrosis score was known (65% cases), 55% had F0-F1 and 14% had F4. The majority of patients were not yet being treated for HCV (83%). Of the 71 patients who received treatment, 37% (26/71) received IFN-free regimens. In the multivariate analysis, increasing age (OR = 1.10, 95% CI [1.03, 1.08]), not using a needle exchange program (OR = 6.95, 95% CI [1.73, 27.97]), moderate alcohol consumption (males ≤ 15 or females ≤ 10 drinks per week) vs. other (OR = 3.70, 95% CI [2.05,6.69]) and a recent fibrosis assessment with F4 vs. F0-F3 (OR = 4.91, 95% CI [2.18,11.09]) were associated with a higher likelihood of receiving treatment. A large number of HCV-infected PWIDs are engaged in care in Canada. Treatment rates are still low and patients are being prioritized for treatment. Barriers to treatment identified in this analysis will help to design targeted interventions for this group. Merck Canada Inc.

Aims We aimed to identify determinants of variation in central line use between neonatal units in England. Methods We obtained data from the National Neonatal Research Database at Imperial College London for 112 neonatal intensive care and high dependency care units in England for the period 2010 to 2015, as part of the PREVAIL Generalisability Study (ISRCTN: 81931394). The data contained daily care records, including the presence of central lines, and birth details. We defined central line days as days when a peripherally inserted cutaneous long line, surgical central venous catheter, umbilical venous catheter or umbilical arterial catheter was present. We used multi-level Poisson regression to model line days per admission, adjusting for gestation, birthweight, age at admission, surgery and days on respiratory support. Results Of 62 948 admissions with gestation Conclusion Nearly all variation in line days between units was explained by differences in baby case-mix. We suggest when using line days as a denominator for comparing rates of bloodstream infection between neonatal units, case mix should be taken into account.

Background and Aims As for all child-health professionals, knowledge of safeguarding/child protection (SCP) is a key role of PICU nurses. A trust-wide audit showed deficiencies in knowledge of SCP processes in our PICU-lead centre, despite standard training. We describe the institution of a bespoke training package to address this. Methods After a 2008 audit showed 65% compliance with SCP documentation, an internal lead nurse for SCP was appointed (CF) and lead a Transformation project entailing a series of bespoke SCP Study Days training ALL staff to Level-3 Child Protection, (recommended NHS London), on-going bi-annual updates, regular SCP information sharing and mandatory SCP induction for new starters. Repeat audits in 2010 and 2012 are reported, together with further qualitative questions (2012). Results 30/90 PICU nurses completed each questionnaire. Repeat SCP audit showed increased compliance with SCP processes 65% (2008), 90% (2010) and 94% (2012) with 100% aware of correct SCP documentation. All staff now feel supported caring for a child with SCP concerns, and able to suggest areas for improving practice. Consultant Intensivist & lead social worker were not always identified as people who must be notified. Conclusions We report increased SCP awareness on our PICU after a lead-nurse transformation project, with nurses now confident managing CP cases, and feeling SCP is well-managed. However, further improvement could be made in nurses interaction with the Hospital Social Care Team and further staff-support when caring for children with SCP concerns would be appreciated - especially when nurses inform parents of SCP referral.

Technology has led to tremendous advancements in our society but has also brought more danger to victims of stalking and given more tools for stalkers to use. New technology has made it more difficult for prosecutors and judges to hold stalkers accountable for their crimes, and without an understanding of how technology is misused by stalkers to track and monitor their victims, many victims don't get the justice they deserve. This article addresses the tremendous impact of technology on stalking, especially within the context of intimate partner stalking.

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

Banana (Musa spp.) production in Mozambique is largely confined to the Cavendish variety that is eaten as a dessert. On the other hand, banana is a staple food crop in many countries in sub-Saharan Africa. The introduction of a range of high yielding and disease resistant cooking and dessert varieties in Mozambique could play a potential role in ensuring food security and raising incomes of millions of small scale farmers. In the framework of a USAID-funded project on dissemination and evaluation of improved banana varieties, plantlets of new Musa hybrids were distributed to small-scale farmers. In addition, several demonstration plots and an on-station trial at the Agrarian Research Institute of Mozambique (IIAM), Umbeluzi research farm were established. The objectives of this study were (i) to evaluate the general performance of the hybrids in the different locations and analyse data collected from one of the sites, and (ii) to assess farmer acceptability of the hybrids in one of the agro-ecologies in Mozambique. The FHIA (Fundacion Hondurena de Investigacion Agricola) hybrids performed relatively well in the more moist agro-ecologies and where irrigation was available, but not in the drier areas in the south of Maputo. Although ‘FHIA 17’ was the most vigorous, this variety took the longest time to produce a bunch. The hybrid, ‘SH 3640’ produced the largest bunch but this was not significantly different from that of ‘Grand Naine’ the local check used in the trials. The hybrid ‘SH3460’ and ‘Grand Naine’ emerged as the best cultivars in terms of post-harvest quality and acceptability. Less than 50% of the participants indicated their preference for ‘FHIA17’, ‘FHIA21’ or ‘FHIA23’. Feedback from farmers involved in the on-farm activities indicated that those from the central and southern parts of the country preferred dessert types, while those from the north preferred both dessert and cooking types.