CLINICAL CHARACTERISTICS AND SHORT-TERM OUTCOMES OF HEMODIALYSIS PATIENTS WITH SARS-COV-2 INFECTION: THE EXPERIENCE OF A COVID NEPHROLOGY UNIT

BACKGROUND AND AIMS: SARS-CoV-2 pandemic is pressuring healthcare systems worldwide. Disease outcomes in certain subgroups of patients, such as nephropathic patients, are still scarce. Patients with chronic kidney disease (CKD) and on haemodialysis (HD) are at risk of a more severe disease course and worst outcomes. Here, we aimed to describe the characteristics and outcomes of CKD and HD patients with SARS-CoV-2 infection, admitted to the Covid Nephrology Unit in the first three pandemic waves, analysing mortality rate and risk factors for mortality in this subgroup of patients. METHOD: A Covid Nephrology Unit was organized in March 2020 to manage the high number of CKD and HD patients with SARS-CoV-2 infection. Several 'spoke' units were also set to manage HD asymptomatic patients (Hi Hotel and 'Villa Luce' Dialysis Center) or with mild symptoms ('Miulli Hospital'-Acquaviva delle Fonti and 'Fallacara Hospital'-Triggiano). Clinical and laboratory data in several timepoints were collected using electronic medical records. Primary outcome was to assess the mortality rate. Moreover, we analysed the trend of inflammatory markers in the first 7 days after hospital admission between survivors and non-survivors;finally, risk factors for mortality were analysed by logistic regression. RESULTS: From March 2020 to May 2021, a total of 221 patients were admitted to the Covid Nephrology Unit;among these, 112 patients on chronic haemodialysis, 21 with acute kidney injury (AKI), 58 with CKD, 24 kidney transplant recipients and 6 patients on peritoneal dialysis (PD). Median age was 71 years (IQR 62.5- 80), while male gender predominated (61.5%). Main comorbidities were arterial hypertension (81%), diabetes mellitus (41.8%) and cardiovascular disease (CVD, 60.6%). At admission, 13.2% of patients required non-invasive ventilatory (NIV) support (CPAP, BiPAP) and about 60% presented interstitial pneumonia at CT scan. A total of 80 patients (36.1%) died during hospital stay with a medium length of stay of 15.8 days. In the first 7 days, 29 patients presented respiratory failure requiring transfer to ICU. Conversely, 100 patients were discharged at home, while 48 patients were transferred to the spoke units (39 patients at Miulli and Fallacara Hospitals, 9 patients at Hi Hotel). Compared to survivors, patients who died were older (median age 75.5 versus 66 years, P < .001), characterized by more comorbidities (diabetes mellitus 54.5% versus 35.2%, P = .01;CVD 81.1% versus 51.4%, P < .001;chronic obstructive pulmonary disease (COPD, 41.5% versus 19%, P = .01;peripheral vasculopathy 58.4% versus 34.2%, P = .01) and more severe respiratory compromission at hospital admission (patients in NIV, 22.6% versus 8.1%, P = .005). As shown in Table 1, in the first 7 days of hospital stay, a significant increase in WBC (8.29 versus 12.6 × 106, P < .001) was described in the non-survivor group;similarly, inflammatory markers such as CRP and IL-6 did not improve in the non-survivors at day 7 (CRP 81.8 versus 85.7 mg/L, P = .62;IL-6 63.1 versus 79.4 pg/mL, P = .84), while they significantly improved in survivors (median CRP 42.5 versus 10.1 mg/L, P < .001;median IL-6 32.3 versus 13.7 pg/mL, P = .01). In a multivariate logistic regression model, age (OR 1.062, 95% CI 1.007-1.119, P = .025), history of CVD (OR 8.308, 95%CI 1.704- 40.499, P = .009) and dyspnoea at hospital admission (OR 9.465, 95%CI 1.231-72.79, P = .031) were associated with risk of mortality in this population. CONCLUSION: To our knowledge, this is the largest study analyzing characteristics and outcomes of CKD and hemodialysis patients to date. A wide heterogeneity of severity of disease has been documented in our cohort;we documented a higher mortality rate in this cohort of patients compared to general population. The presence of several comorbidities, a more severe disease at hospital admission and the persistence of elevated inflammatory markers during hospital stay are risk factors for mortality. (Table Presented).

Outdoor movement education in primary school during COVID-19 pandemic in the synthetic perceptions of primary school university training student

The problem is the new scenario for the school in the SARS-COVID-19 pandemic era, especially in physical education (PE) because of the extreme difficulty to practice body and physical activity by distance for students 5-11 age. The aim is to detect the opinions of master's degree courses in primary education students to have the complex aspects of contents and objectives of PE in outdoor mode. Through a qualitative survey carried out by submitting specific questionnaires by the Google Modules platform at the random sample of primary education master student population of Salerno and Basilicata in the southern part of Italy. Questionnaire is made by 28 questions related to: demographic data (1-5), practice of indoor and outdoor physical activity (614), physical education in school during pandemic (15-18), the future practice or possibility of practicing outdoor lessons (19-23), on the psychological impact due to social distancing / closure of gyms (24-26) and on the perception of the importance of physical and motor activity during COVID-19 (27-28). The data showed how active are students, where they practice, how the pandemic and the smart configuration of life affected their lifestyles, what are their perceptions and perspectives about outdoor movement education. Thus, it needs different university training about the teaching methods of PE, the need to provide training actions also on the teaching of outdoor movement education, by providing these knowledges during teachers' training, it is possible that they can increase children chances of moving and of a global development of their skills.

Primary school physical education in outdoor during COVID-19 pandemic: The perceptions of teachers

In Italy since February 2020 and still currently, schools of all levels throughout the National territory have carried out their activities alternating distance teaching with face-to-face one, with the relative adaptations due to the online and face-to-face mode in compliance with the health safety protocols. Teachers had to make substantial changes to their teaching/learning design and, to deal with this issue, the permanent training activities in service are fundamental. Physical education is one of the teaching subjects that most needs to be adapted in design and outdoor movement education seems to be a good practice to be developed to offer new ideas for teaching/learning planning. The aim is to detect the opinions of primary school teachers in order to offer effective contents of the permanent training about physical education during pandemic and to promote teaching methods of physical education in primary school moreover on outdoor education. The results show how active are teachers, where they practice, how the pandemic and the smart configuration of life affected their lifestyles, what are their perceptions and perspectives about outdoor physical education and its importance for the achievement of children movement development goal. The collected data revealed an high recognition of the contribution that physical education offers to the achievement of skills development goals but at the same time emerge specific training needs in teaching methods of physical education.

Inclusion in physical and sport education for special movement needs

European Union countries promote an approach to social cohesion based on equity of rights. One of these fundamental rights is access to optimal health: physical activity is a key element in promoting and maintaining individual health and well-being. It is therefore necessary to guarantee full access to the right to health for all, also through a correct approach qualitative-quantitative to physical activities and sports, with particular attention to "special" populations (children, elderly, people with disabilities and more generally people who are vulnerable) which are more exposed to risk factors for health and well-being. The research activity aims to promote inclusion through physical and sports education programs able to respond to the needs for movement by "special" populations, needs that require specific and further adaptations according to the contingencies determined by the COVID-19 pandemic. The purpose is also to describe and compare the behaviours implemented and the opinions expressed, as well as the system of norms, values, beliefs to which the subjects belonging to the selected sample of participants (disabled people that practice sport activities) in the survey activity in order to define physical and sports education programs adapted to the special needs for movement.

Body, movement, and outdoor education in pre-school during the covid-19 pandemic: Perceptions of teachers

The Italian preschool has a peculiar teaching structure that is based on five fields of experience and teachers must guarantee experiential teaching based on the body and movement. So physical activities and sensorimotor experiences should be particularly encouraged as they represent the main way of approaching the fenomena in this stage of development. This study aims to detect the opinions of pre-school teachers in order to calibrate the contents and objectives of the permanent training, through a qualitative survey carried out by submitting to preschool teachers specific questionnaires through the Google Modules platform. The questionnaire is composed by 28 questions related to: demographic data (1-5), practice of indoor and outdoor physical activity (6-14), safety during the practice of motor activity (15-18), the future practice or possibility of practicing outdoor lessons (19-23), on the psychological impact due to social distancing / closure of gyms (24-26) and on the perception of the importance of physical and motor activity during covid-19 (27-28). The data collected on the perception of teachers with regard to the body and movement field of experience and the adaptations for outdoor motor practice reveal specific training needs in the context of the teaching methods of physical education and the need to provide training actions also outdoor activities, in particular it emerges that with proper permanent training on children’s movement and learning during outdoor free play and including more natural features in the design of outdoor play areas, it could encourage teachers to do more outdoor movement education improving children’s body and movement awareness. © JPES.

Body, movement, and outdoor education in pre-school during covid-19: Perceptions of future teachers during university training

Teachers play an important role in influencing childrens’ physical activity levels, so it is crucial design the training course for teachers matching the different knowledges essential to be able to teach. Physical activity-related training and resources provided to pre-school teachers appears to be very important: if future teachers training includes adequate focus on physical activity they will be better disposed to improve children moving. This study aims to detect the opinions of students attending single-cycle master's degree courses in Primary Education in order to calibrate the contents and objectives of the Teaching methods of Physical Education class, through a qualitative survey carried out by submitting specific questionnaires through the Google Modules platform. The questionnaire has been submitted to students of Primary Education and it was composed by 28 questions related to: demographic data (1-5), practice of indoor and outdoor physical activity (6-14), safety during the practice of motor activity (15-18), the future practice or possibility of practicing outdoor lessons (19-23), on the psychological impact due to social distancing / closure of gyms (24-26 ) and on the perception of the importance of physical and motor activity during covid-19 (27-28). The data collected on the perception of students with regard to the body and movement field of experience and the adaptations for outdoor practice reveal specific training needs in the context of the teaching methods of physical education and the need to provide training actions also on outdoor movement education. University curricula represent an excellent opportunity to provide future teachers with enriched teaching methods of PE training and support, such as physical activity guidelines indoor and outdoor. © 2021, Editura Universitatii din Pitesti. All rights reserved.

How has the practice of physical activity changed during the covid-19 quarantine? a preliminary survey

Research purpose. The present study aims to examine the changes in physical activity levels during the lockdown due to COVID-19 in Italy. In particular, it aims to assess whether people have continued to exercise at home, how much the home environment has influenced the desire to train and what people think about Smart-fitness and sport in general. Materials and methods. A sample of 268 people from the province of Salerno participated in the study, with an average age of 26 years. To achieve the tasks set, the study relied on the following methods: Analysis of scientific literature, formulation and administration of a questionnaire and data analysis through methods of mathematical statistics. A structured questionnaire was prepared, disseminated through social networks. To analyze the data, the Social Sciences Statistical Package (SPSS) and descriptive statistics were used to calculate the demographic variables. The factor analysis was also calculated to verify the characteristics of the sport considered important by the participants. Results. The results obtained made it possible to understand the main type of physical activity carried out during the quarantine (aerobic activity 35 %, functional training 27 %, anaerobic activity 19 %), the time dedicated to each session (52.8 % practice for 1 hour) and the weekly frequency of the same (42.9 % practice physical activity continuously more than times a week). It was also understood the reasons that prompted the interviewees to train, the way they planned their session and the equipment used. Finally, it was shown that the majority of the sample (64.17%) knew smart fitness considering it an interesting activity, and the influence attributed to the home environment by a scale of values from 1 to 5. Furthermore, the factor analysis shows us the most relevant aspects wich respondents attributed to sport. More frequently, respondents place greater importance on being loyal and correct, on the contrary, lower values are attributed to the importance of earning money, and not to disappoint others. Conclusions. The study found that COVID-19 did not stop athletes, who quickly adapted to the new situation. The home environment has proved to be very influential on the desire to train, despite this, they hope to return to the gym as soon as possible. © 2020 OVS LLC. All rights reserved.