The aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed.

The Indiana Area Health Education Centers (AHEC) Scholars program is a two-year leadership program designed to supplement health professions student's academic training and enhance practice readiness around six core topic areas including practice transformation. The study was a retrospective cohort study assessing learners' report level of self-efficacy on a set of six competencies around practice transformation and quality improvement. A total of 68 students graduating in the first cohort responded to the competency questions. AHEC scholars reported a significantly increase in self-efficacy on the competencies "identify issues emerging healthcare delivery such as accountable care organizations, medical homes, and health insurance exchanges", "understand how to practice effectively within the organization and culture of the interprofessional team, practice setting, and local healthcare system", and "use an electronic health record to retrieve relevant information and to document care". We found that learners reported a significant increase in self-efficacy related to implementing practiced transformation.