Predicting performance in a doctor of physical therapy gross anatomy course based on an exploratory factor analysis of the anatomical self-efficacy instrument.

Measuring self-efficacy can be a valuable means for instructors to predict student performance. However, it is crucial to measure self-efficacy within specific contexts to effectively gauge students' perceptions of their capabilities. This study evaluated the factors comprising the Anatomical Self-Efficacy Instrument (ASEI) and determined whether these factors could predict performance in gross anatomy. Three cohorts of Doctor Physical Therapy (DPT) students completed the ASEI at the start of gross anatomy. An exploratory factor analysis (EFA) analyzed the ASEI's dimensionality, and Cronbach's alpha evaluated the internal consistency of the extracted factors. Linear regression was used to determine whether ASEI's total or subdomain scores predicted final anatomy course performance scores. In total, 142 of 287 (49.5%) DPT students completed the ASEI. EFA revealed three distinct factors, including "cognitive," "psychomotor," and "clinical anatomy self-efficacy", and explained 44.9%, 13.7%, and 5.2% of the total variance, respectively. Only cognitive self-efficacy predicted final gross anatomy course performance (ß = 0.34; R2 = 0.071; F(3,138) = 3.51; p < 0.05). Overall, the ASEI's 3-factor solution implies its multidimensionality, a finding that could inform the development of more comprehensive self-efficacy measures. Notably, "cognitive self-efficacy" was the only subdomain that predicted DPT student performance in anatomy, suggesting its potential as a tool for identifying students in need of additional learning support. The ASEI's practical usability should be further explored through additional psychometric testing.

Quantitative microbial risk assessment (QMRA) tool for modelling pathogen infection risk to wastewater treatment plant workers.

Wastewater treatment plants (WWTPs) provide vital services to the public by removing contaminants from wastewater prior to environmental discharge or reuse for beneficial purposes. WWTP workers occupationally exposed to wastewater can be at risk of respiratory or gastrointestinal diseases. The study objectives were to: (1) quantify pathogens and pathogen indicators in wastewater aerosols near different WWTP processes/unit operations, (2) develop a QMRA model for multi-pathogen and multi-exposure pathway risks, and (3) create a web-based application to perform and communicate risk calculations for wastewater workers. Case studies for seven different WWTP job tasks were performed investigating infection risk across nine different enteric and respiratory pathogens. It was observed that the ingestion risk among job tasks was highest for "walking the WWTP," which involved exposure from splashing, bioaerosols, and hand-to-mouth contact from touching contaminated surfaces. There was also a notable difference in exposure risk during peak (5:00am-9:00am) and non-peak hours (9:00am- 5:00am), with risks during the peak flow hours of the early morning assumed to be 5 times greater than non-peak hours. N95 respirator usage reduced median respiratory risks by 77 %. The developed tool performs multiple QMRA calculations to estimate WWTP workers' infection risks from accidental ingestion or inhalation of wastewater from multiple pathogens and exposure scenarios, which can inform risk management strategies to protect occupational health. However, more data are needed to reduce uncertainty in model estimates, including comparative data for pathogen concentrations in wastewater during peak and non-peak hours. QMRA tools will increase accessibility of risk models for utilization in decision-making.

Removal, Kill, and Transfer of Bacteria from Hands by Antibacterial or Nonantibacterial Soaps After Handling Raw Poultry.

Hand hygiene is broadly recognized as a critical intervention in reducing the spread of disease-causing pathogens in both professional and personal uses. In this study, the impact of antibacterial (AB) or nonantibacterial soaps on the removal and postwash transfer of E. coli following the handling of raw poultry was assessed. Baseline bacterial contamination ranged between 107 and 109 CFU per hand. Hands were washed for 30 s in 40°C ± 2°C tap water using 2 mL of AB soap (0.5% and 1.0% Chloroxylenol, 0.5% Benzalkonium Chloride, or 4.0% Chlorhexidine Gluconate), non-AB soap (cosmetic/plain soap), or water. Postwash, water, and non-AB soap had a mean 3.63 and 3.65 Log10 reduction of E. coli on hands. AB treatments had a mean 4.19-4.35 Log10 reduction. Rinse water had mean bacterial counts of 8.62 and 8.88 Log10 CFU/mL for non-AB soap and water and 5.37-6.90 Log10 CFU/mL for AB treatments. Bacterial transfer was assessed by following the test subject's handling of a sterile polymer knife handle for 30 s postwash. E. coli transfer ranged from 263 to 903 CFU/handle for AB soaps and 1572 or 1709 CFU/handle for water and non-AB soap. Differences between AB and non-AB treatments were statistically significant (p < 0.0001) for hands and rinse water. Differences in transfer from hands to knife handle were not statistically significant (p = 0.139). Combined, these data highlight significant differences in the performance of AB soaps relative to non-AB soaps in a food handling environment-specific usage example and provide an unexplored assessment of the bactericidal vs. removal effects of AB vs. non-AB soaps on bacteria removed from the hands. These data reinforce the importance of hand hygiene, provide new details on the differences between AB vs. non-AB soaps, and highlight potential differences to inform food handling environment operators and public health personnel on how these products may impact food safety.

Potential Use of ChatGPT in Responding to Patient Questions and Creating Patient Resources.

ChatGPT (OpenAI) is an artificial intelligence-based free natural language processing model that generates complex responses to user-generated prompts. The advent of this tool comes at a time when physician burnout is at an all-time high, which is attributed at least in part to time spent outside of the patient encounter within the electronic medical record (documenting the encounter, responding to patient messages, etc). Although ChatGPT is not specifically designed to provide medical information, it can generate preliminary responses to patients' questions about their medical conditions and can precipitately create educational patient resources, which do inevitably require rigorous editing and fact-checking on the part of the health care provider to ensure accuracy. In this way, this assistive technology has the potential to not only enhance a physician's efficiency and work-life balance but also enrich the patient-physician relationship and ultimately improve patient outcomes.

Transmission of Viruses from Restroom Use: A Quantitative Microbial Risk Assessment.

Restroom use has been implicated in a number of viral outbreaks. In this study, we apply quantitative microbial risk assessment to quantify the risk of viral transmission by contaminated restroom fomites. We estimate risk from high-touch fomite surfaces (entrance/exit door, toilet seat) for three viruses of interest (SARS-CoV-2, adenovirus, norovirus) through eight exposure scenarios involving differing user behaviors, and the use of hand sanitizer following each scenario. We assessed the impacts of several sequences of fomite contacts in the restroom, reflecting the variability of human behavior, on infection risks for these viruses. Touching of the toilet seat was assumed to model adjustment of the seat (open vs. closed), a common touch point in single-user restrooms (home, small business, hospital). A Monte Carlo simulation was conducted for each exposure scenario (10,000 simulations each). Norovirus resulted in the highest probability of infection for all exposure scenarios with fomite surfaces. Post-restroom automatic-dispensing hand sanitizer use reduced the probability of infection for each virus by up to 99.75%. Handwashing within the restroom, an important risk-reduction intervention, was not found to be as effective as use of a non-touch hand sanitizer dispenser for reducing risk to near or below 1/1,000,000, a commonly used risk threshold for comparison.

Comparing the quality of ChatGPT- and physician-generated responses to patients' dermatology questions in the electronic medical record.

BACKGROUND: ChatGPT is a free artificial intelligence (AI)-based natural language processing tool that generates complex responses to inputs from users. OBJECTIVES: To determine whether ChatGPT is able to generate high-quality responses to patient-submitted questions in the patient portal. METHODS: Patient-submitted questions and the corresponding responses from their dermatology physician were extracted from the electronic medical record for analysis. The questions were input into ChatGPT (version 3.5) and the outputs extracted for analysis, with manual removal of verbiage pertaining to ChatGPT's inability to provide medical advice. Ten blinded reviewers (seven physicians and three nonphysicians) rated and selected their preference in terms of 'overall quality', 'readability', 'accuracy', 'thoroughness' and 'level of empathy' of the physician- and ChatGPT-generated responses. RESULTS: Thirty-one messages and responses were analysed. Physician-generated responses were vastly preferred over the ChatGPT -responses by the physician and nonphysician reviewers and received significantly higher ratings for 'readability' and 'level of empathy'. CONCLUSIONS: The results of this study suggest that physician-generated responses to patients' portal messages are still preferred over ChatGPT, but generative AI tools may be helpful in generating the first drafts of responses and providing information on education resources for patients.

The Need for Responsive Workforce Development During the Pandemic and Beyond: A Case Study of the Regional Public Health Training Centers.

CONTEXT: The COVID-19 pandemic underscored the importance of a strong public health infrastructure for protecting and supporting the health of communities. This includes ensuring an adaptive workforce capable of leading through rapidly changing circumstances, communicating effectively, and applying systems thinking to leverage cross-sector partnerships that help promote health equity. The 10 Regional Public Health Training Centers (PHTCs) advance the capacity of the current and future public health workforce through skill development and technical assistance in these and other strategic areas. PROGRAM: This study examines activities through which the Regional PHTCs and their partners supported the public health workforce during the pandemic. Representatives of the 10 Regional PHTCs completed a survey in the spring of 2022. The survey included (1) pulling trends in training usage from 2018-2021 annual performance reports and (2) questions assessing the type, content, and reach of training needs assessments, training and technical assistance, student placements, and PHTC Network collaborative activities that occurred from January 1, 2020, to December 31, 2021. Respondents also reflected on trends in use, challenges, lessons learned, stories of impact, and future PHTC practice. EVALUATION: During the pandemic, the Regional PHTCs engaged in numerous efforts to assess needs, provide training and technical assistance to the practice community, facilitate projects that built student competency to support public health agency efforts, and collaborate as the PHTC Network on national-level initiatives. Across these activities, the Regional PHTCs adjusted their approaches and learned from each other in order to meet regional needs. DISCUSSION: The Regional PHTCs provided student and professional development in foundational public health knowledge and skills within their regions and nationally while being flexible and responsive to the changing needs of the field during the pandemic. Our study highlights opportunities for collaboration and adaptive approaches to public health workforce development in a postpandemic environment.