Background Community Paramedics (CPs) require access to timely blood analysis in the field to guide treatment and transport decisions. Point of care testing (POCT), as opposed to laboratory analysis, may offer a solution, but limited research exists on CP POCT. The purpose of this study was to compare the validity of two devices (Abbott i-STAT® and Alere epoc®) by CPs in the community. Methods In a CP programme responding to 6000 annual patient care events, a split sample validation of POCT against traditional laboratory analysis for seven analytes (sodium, potassium, chloride, creatinine, hemoglobin, hematocrit, and glucose) was conducted on a consecutive sample of patients. The difference of proportion of discrepant results between POCT and laboratory was compared using a two sample proportion test. Usability was analysed by survey of CP experience, a linear mixed effects model of Systems Usability Scale (SUS) adjusted for CP clinical and POCT experience, an expert heuristic evaluation of devices, a review of device-logged errors, and coded observations of POCT use during quality control testing. Results Of 1649 episodes of care screened for enrollment, 174 required a blood draw, with 108 episodes (62.1%) enrolled from 73 participants. Participants had a mean age of 58.7 years (SD16.3); 49% were female. In 4 of 646 (0.6%) comparisons, POCT reported a critical value but the laboratory did not; with no statistically significant ( p = 0.323) difference between i-STAT® (0.9%;95%CI:0.0,1.9%) compared with epoc® (0.3%;95%CI:0.0,0.9%). There were no instances of the laboratory reporting a critical value when POCT did not. In 88 of 1046 (8.4%) comparisons the a priori defined acceptable difference between POCT and the laboratory was exceeded; occurring more often in epoc® (10.7%;95%CI:8.1,13.3%) compared with i-STAT® (6.1%;95%CI:4.1,8.2%)( p = 0.007). Eighteen of 19 CP surveys were returned, with 11/18 (61.1%) preferring i-STAT® over epoc®. The i-STAT® had a higher mean SUS score (higher usability) compared with epoc® (84.0/100 vs. 59.6/100; p = 0.011). There were no statistically significant differences in device logged errors between i-STAT® and epoc® ( p = 0.063). Conclusions CP programmes can expect clinically valid results from POCT. Device usability assessments should be considered with any local implementation as the two POCT systems have different strengths. Electronic supplementary material The online version of this article (10.1186/s12873-019-0243-4) contains supplementary material, which is available to authorized users.

Nutrient fat—food fats and oils, as well as fat from meat, milk, and other fat containing foods—in the U.S. food supply has increased ca. one‐fourth over the past 60 years or so on a per person/day basis. Ca. two‐fifths of the fat currently comes from fats and oils, including butter; over a third comes from meat (including fat pork cuts), poultry, and fish; and ca. one‐eight comes from dairy products. This large increase in nutrient fat is due mainly to the use of more vegetable fats—margarine, shortening, and salad and cooking oils. The per capita amount provided by animal fats actually has decreased, because the large decreases in consumption of butter and lard are only partly offset by increases in fat associated with greater consumption of meats. Despite the decrease in consumption of animal fats, they continue to provide ca. one‐fourth of the total calories. Although the proportion of calories from vegetable fats has increased, animal products still account for the largest share of the calories provided by fat. Shifts in sources of fat and the increased amount of fat have changed the fatty acid content of the food supply.

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The Accreditation Board for Engineering and Technology (ABET) and the Engineer of 2020, an engineering education initiative, have recommended that engineering students be provided with opportunities to participate in real‐world projects to supply them with the skills they will need in the workplace. Service learning is a pedagogical approach where students apply skills they learn in a classroom to a real‐world problem identified by a community organization. In 2009, a service learning project was introduced in an undergraduate Ergonomics Industrial Engineering course composed of engineering and nonengineering students at Montana State University (MSU). Its integration and development in the existing course required creating a detailed project description and finding a partner organization. Students worked with clients or staff at the partner organization to develop ergonomic solutions for workplace health and safety issues and manufacturing productivity. At the end‐of‐semester presentations, the community partners, instructor, and other students assessed each solution's effectiveness. These assessments found that students, compared to the partner's feedback, undervalued their prototypes with regard to how they improved worker and process efficiency, and they overvalued their solution's creativity, cost, and implementation feasibility. In addition, the service learning course's technical and professional skills ranked above the average ABET course outcomes of MSU's Industrial Engineering fall courses. This demonstrates how the service learning project and the intended goals from ABET and Engineer 2020 come together—service learning exposes students to real‐world situations that better prepare and inform them of the skills that will be needed after graduation.

Massage Therapists (MT) are almost exclusively self-employed and lose income if they are unable to perform massage treatments. This study investigated MT workplace pain via survey and assessed musculoskeletal disorder (MSD) risk by video recording MT massage treatments then calculating the Strain Index (SI) scores. First, randomly contacted MTs (16 respondents of 100 cold calls) completed an online survey about their work practices. Despite 87% of MTs reporting self care regimes, 83% reported workrelated pain in the wrist or thumb over their careers with 57% experiencing pain in the last 30 days. SI scores were calculated for a 60 minute, naturalistic massage performed by seven licensed MTs (six female and one male reflecting the MT population sex proportions). There was suggestive evidence that the average and maximum hands-on day mean peak right hand SI scores (M = 5.6 and 7.7, SD = 4.30 and 5.73, and p = 0.08 and 0.04, respectively) were greater than an SI of 3.0 (moderate risk for MSD). There was no evidence of MSD risk for the left hand (M = 3.2 and 4.3, SD = 2.93 and 3.91, and p = 0.42 and 0.20, respectively). MTs may be at moderate risk of incurring work-related upper extremity disorders.