A survey of healthcare workers on the acceptance and value of personal protective equipment for patient care.

Objective: Assess healthcare workers' (HCW) attitudes toward universal masking, and gowns and gloves used as part of transmission-based precautions.

Design: Cross-sectional survey.

Setting: Academic, tertiary care medical center in Baltimore, Maryland.

Game-based learning to improve diagnostic accuracy: a pilot randomized-controlled trial.

Objectives: Perform a pilot study of online game-based learning (GBL) using natural frequencies and feedback to teach diagnostic reasoning.

Methods: We conducted a multicenter randomized-controlled trial of computer-based training. We enrolled medical students, residents, practicing physicians and nurse practitioners.

Clinician Testing and Treatment Thresholds for Management of Urinary Tract Infection.

Greater understanding of clinical decision thresholds may improve inappropriate testing and treatment of urinary tract infection (UTI). We used a survey of clinicians to examine UTI decision thresholds. Although overestimates of UTI occurred, testing and treatment thresholds were generally rational, were lower than previously reported, and differed by type of clinician.

Impact of psychological resilience on walking capacity in older adults following hip fracture.

Background: Community-dwelling older adults experiencing hip fracture often fail to achieve adequate walking capacity following surgery and rehabilitation. Effects of psychological factors on post-fracture walking capacity are poorly understood. Accordingly, this paper investigates effects of psychological resilience on observed walking capacity measures in older adults following hip fracture, controlling for important covariates.

The Impact of Universal Glove and Gown Use on Clostridioides Difficile Acquisition: A Cluster-Randomized Trial.

Background: Clostridioides difficile is the most common cause of healthcare-associated infections in the United States. It is unknown whether universal gown and glove use in intensive care units (ICUs) decreases acquisition of C. difficile.

Exploration of Primary Care Clinician Attitudes and Cognitive Characteristics Associated With Prescribing Antibiotics for Asymptomatic Bacteriuria.

Importance: Antibiotic treatment for asymptomatic bacteriuria is not recommended in guidelines but is a major driver of inappropriate antibiotic use.

Objective: To evaluate whether clinician culture and personality traits are associated with a predisposition toward inappropriate prescribing.

Design, Setting, And Participants: This survey study involved secondary analysis of a previously completed survey.

Prediction of treatment nonadherence among older adults with chronic obstructive pulmonary disease using Medicare real-world data.

Suboptimal maintenance medication (MM) adherence remains a clinical problem among Medicare beneficiaries with chronic obstructive pulmonary disease (COPD). To inform risk-based personalized decision-making, this study sought to develop and validate prediction models of nonadherence to COPD MMs for Medicare beneficiaries. This was a retrospective cohort study of beneficiaries aged 65 years and older with COPD and inhaled MMs.

Clinician Attitudes and Beliefs Associated with More Aggressive Diagnostic Testing.

Background: Variation in clinicians' diagnostic test utilization is incompletely explained by demographics and likely relates to cognitive characteristics. We explored clinician factors associated with diagnostic test utilization.

Methods: We used a self-administered survey of attitudes, cognitive characteristics, and reported likelihood of test ordering in common scenarios; frequency of lipid and liver testing in patients on statin therapy.

Antibiotic Use and Bacterial Infection among Inpatients in the First Wave of COVID-19: a Retrospective Cohort Study of 64,691 Patients.

Hospitalized patients with SARS-CoV-2 infection (COVID-19) often receive antibiotics for suspected bacterial coinfection. We estimated the incidence of bacterial coinfection and secondary infection in COVID-19 using clinical diagnoses to determine how frequently antibiotics are administered when bacterial infection is absent. We performed a retrospective cohort study of inpatients with COVID-19 present on admission to hospitals in the Premier Healthcare Database between April and June 2020.

Prevalence and Newly Diagnosed Rates of Multimorbidity in Older Medicare Beneficiaries with COPD.

Few studies have quantified the multimorbidity burden in older adults with chronic obstructive pulmonary disease (COPD) using large and generalizable data. Such evidence is essential to inform evidence-based research, clinical care, and resource allocation. This retrospective cohort study used a nationally representative sample of Medicare beneficiaries aged 65 years or older with COPD and 1:1 matched (on age, sex, and race) non-COPD beneficiaries to: (1) quantify the prevalence of multimorbidity at COPD onset and one-year later; (2) quantify the rates [per 100 person-years (PY)] of newly diagnosed multimorbidity during in the year prior to and in the year following COPD onset; and (3) compare multimorbidity prevalence in beneficiaries with and without COPD.

Clinician Conceptualization of the Benefits of Treatments for Individual Patients.

Importance: Knowing the expected effect of treatment on an individual patient is essential for patient care.

Objective: To explore clinicians' conceptualizations of the chance that treatments will decrease the risk of disease outcomes.

Design, Setting, And Participants: This survey study of attending and resident physicians, nurse practitioners, and physician assistants was conducted in outpatient clinical settings in 8 US states from June 2018 to November 2019.

Accuracy of Practitioner Estimates of Probability of Diagnosis Before and After Testing.

Importance: Accurate diagnosis is essential to proper patient care.

Objective: To explore practitioner understanding of diagnostic reasoning.

Design, Setting, And Participants: In this survey study, 723 practitioners at outpatient clinics in 8 US states were asked to estimate the probability of disease for 4 scenarios common in primary care (pneumonia, cardiac ischemia, breast cancer screening, and urinary tract infection) and the association of positive and negative test results with disease probability from June 1, 2018, to November 26, 2019.

Comorbidity and severity-of-illness risk adjustment for hospital-onset infection using data from the electronic medical record.

Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment.

Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018.

Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index.

Acquisition of Antibiotic-Resistant Gram-negative Bacteria in the Benefits of Universal Glove and Gown (BUGG) Cluster Randomized Trial.

Background: The Benefits of Universal Glove and Gown (BUGG) cluster randomized trial found varying effects on methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus and no increase in adverse events. The aim of this study was to assess whether the intervention decreases the acquisition of antibiotic-resistant gram-negative bacteria.

Methods: This was a secondary analysis of a randomized trial in 20 hospital intensive care units.

Dental care expenditures and retirement.

Objectives: To examine the relationship of dental care coverage, retirement, and out-of-pocket (OOP) dental expenditures in an aging population, using data from the Health and Retirement Study (HRS).

Methods: We estimate OOP dental expenditures among individuals who have dental utilization as a function of dental care coverage status, retirement, and individual and household characteristics. We also estimate a multivariate model controlling for potentially confounding variables.

Dental care coverage transitions.

Objective: To examine dental insurance transition dynamics in the context of changing employment and retirement status.

Study Design: Data from the Health and Retirement Study (HRS) were analyzed for individuals 51 years and older between the 2004 and 2006 waves of the HRS.

Methods: The primary focus of the analysis is the relationship between retirement and transitions in dental care coverage.

Dental care utilization and retirement.

Objective: The authors examine the relationship of dental care coverage, retirement, and utilization in an aging population using data from the Health and Retirement Study (HRS).

Methods: The authors estimate dental care use as a function of dental care coverage status, retirement, and individual and household characteristics. They also estimate a multivariate model controlling for potentially confounding variables.

Dental care coverage and retirement.

Objectives: To examine the convergence of an aging population and a decreased availability of dental care coverage using data from the Health and Retirement Study (HRS).

Methods: We calculate national estimates of the number and characteristics of those persons age 51 years and above covered by dental insurance by labor force, retirement status, and source of coverage. We also estimate a multivariate model controlling for potentially confounding variables.

Health of community-dwelling adults with mobility limitations in the United States: incidence of secondary health conditions. Part II.

Objective: To compare incident health conditions that occurred over a 2-year period in nationally representative groups of adults with mobility, nonmobility, and no limitations.

Design: Data were collected prospectively from a probability subsample of households that represent the civilian, noninstitutionalized U.S.

Health of community-dwelling adults with mobility limitations in the United States: prevalent health conditions. Part I.

Objective: To characterize the extent and types of prevalent health conditions among nationally representative groups of adults with mobility, nonmobility, and no limitations.

Design: Data were collected during 5 rounds of household interviews from a probability subsample of households that represent the civilian, noninstitutionalized U.S.