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Background: The ability to perform drug calculations accurately is imperative to patient safety. Research into paramedics’ drug calculation abilities was first published in 2000 and for nurses’ abilities the research dates back to the late 1930s. Yet, there have been no studies investigating an undergraduate paramedic student’s ability to perform drug or basic mathematical calculations. The objective of this study was to review the literature and determine the ability of undergraduate and qualified paramedics to perform drug calculations.Methods: A search of the prehospital-related electronic databases was undertaken using the Ovid and EMBASE systems available through the Monash University Library. Databases searched included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, JSTOR, EMBASE and Google Scholar, from their beginning until the end of August 2009. We reviewed references from articles retrieved.Results: The electronic database search located 1,154 articles for review. Six additional articles were identified from reference lists of retrieved articles. Of these, 59 were considered relevant. After reviewing the 59 articles only three met the inclusion criteria. All articles noted some level of mathematical deficiencies amongst their subjects.Conclusions: This study identified only three articles. Results from these limited studies indicate a significant lack of mathematical proficiency amongst the paramedics sampled. A need exists to identify if undergraduate paramedic students are capable of performing the required drug calculations in a non-clinical setting.[WestJEM. 2009;10:240-243.]

This paper discusses potential barriers to electric vehicle purchase in fleets and how these could be overcome by policymakers, fleets, and organizations with fleets. Fleets may face unique challenges to electrification and require different support than is provided to private consumers due to their variety of vehicle uses and applications. The paper is divided into discussions on purchase issues and those on operational issues. Purchase issues include ensuring plug-in electric vehicles (PEVs) are available across different vehicle types, creating educational campaigns for both decision-makers and fleet vehicle drivers, and tailoring incentives to the fleet context. Operational issues include factors such as creating post-purchase incentives, implementing low-emission zones and congestion charges, and facilitating utility support for fleet vehicle charging installations.

Each year, a growing international collection of researchers meets at the NIH to share and discuss developments in the microbiome HIV story. This past year has seen continued progress toward a detailed understanding of host-microbe interactions both within and outside the field of HIV. Commensal microbes are being linked to an ever-growing list of maladies and physiologic states, including major depressive disorder, chronic kidney disease, and Parkinson disease. PubMed citations for "microbiome" are growing at an exponential rate with over 11,000 in 2018. Various microbial taxa have been associated with HIV infection, and some of these taxa associated with HIV infection have also been associated with systemic markers of inflammation in HIV infected individuals. Causality remains unclear however as environmental and behavioral factors may drive HIV risk, inflammation, and gut enterotype. Much of the work currently being done addresses potential mechanisms by which gut microbes influence immune and inflammatory pathways. No portion of the microbiome landscape has grown as rapidly as study of the interplay between gut microbes and response to cancer immunotherapy. As Dr. Wargo discussed in her keynote address, this area has opened the door to better understanding on how commensal microbes interact with the human immune system.

Background: The use of casual staff within the university undergraduate educational setting is a widespread phenomenon worldwide. However a lack of understanding exists regarding experiences of recruitment, support, professional development and other perceived professional needs in this area. Although previous studies of the experience of sessional educators have been reported in the literature, this is the first to describe experiences within the paramedic discipline. Objectives: To explore the experiences of sessional educators in an undergraduate program within the paramedic department of a university in Melbourne, Australia. Methods: A qualitative methodology was used that involved 10 semi-structured interviews with a purposive sample of sessional paramedic educators. Data collected from the interviews were thematically analysed to identify major issues from interview transcripts. The study was conducted in the paramedic department of a major university located in an outer metropolitan area of Melbourne, Australia. Results: Interview analysis identified five key themes of the sessional paramedic educator experience--informal processes, program inconsistencies, preparation for teaching, connection and support, and, educator benefits. Conclusion: This study fills a gap in the literature by describing the experiences of paramedic sessional educators, which was previously unreported. Many of the experiences expressed were commonly reported in the literature from other disciplines. Although the experiences was generally described as positive, the study identified a need for targeted support of these individuals, including formalisation of employment procedures, encouraging the open and timely transmission of information, as well as provisions for performance feedback and professional development.

By informing timely targeted treatments, rapid whole-genome sequencing can improve the outcomes of seriously ill children with genetic diseases, particularly infants in neonatal and pediatric intensive care units (ICUs). The need for highly qualified professionals to decipher results, however, precludes widespread implementation. We describe a platform for population-scale, provisional diagnosis of genetic diseases with automated phenotyping and interpretation. Genome sequencing was expedited by bead-based genome library preparation directly from blood samples and sequencing of paired 100-nt reads in 15.5 hours. Clinical natural language processing (CNLP) automatically extracted childrens deep phenomes from electronic health records with 80% precision and 93% recall. In 101 children with 105 genetic diseases, a mean of 4.3 CNLP-extracted phenotypic features matched the expected phenotypic features of those diseases, compared with a match of 0.9 phenotypic features used in manual interpretation. We automated provisional diagnosis by combining the ranking of the similarity of a patients CNLP phenome with respect to the expected phenotypic features of all genetic diseases, together with the ranking of the pathogenicity of all of the patients genomic variants. Automated, retrospective diagnoses concurred well with expert manual interpretation (97% recall and 99% precision in 95 children with 97 genetic diseases). Prospectively, our platform correctly diagnosed three of seven seriously ill ICU infants (100% precision and recall) with a mean time saving of 22:19 hours. In each case, the diagnosis affected treatment. Genome sequencing with automated phenotyping and interpretation in a median of 20:10 hours may increase adoption in ICUs and, thereby, timely implementation of precise treatments.

Key Takeaways1. Plug-in hybrid electric vehicles (PHEVs) have an important role in the electrifi cation of passenger transportation. Long-range PHEVs not only are a transitional technology. They also are an enabling technology that can encourage more consumers to adopt electric vehicles.2. The electric range of PHEVs has a signifi cant impact on electric vehicle miles traveled. PHEVs with electric range of at least 60km (37 miles (EPA Range)) have a similar ability to electrify travel as short-range battery electric vehicles (BEVs).3. Assuming the goal of policymakers is to increase electric vehicle miles traveled, policy support should correspond directly to electric driving range of both PHEVs and BEVs. Short-range PHEVs should receive less policy support; long-range PHEVs and BEVs should receive more policy support.4. Consumer research in several countries shows that mainstream consumers tend to be more attracted to PHEVs than to BEVs, however many consumers are unaware of how a PHEV diff ers from a BEV. Consumers and car dealerships need to be educated about PHEVs, their benefi ts, and the importance of charging the vehicles.

Our microbial cotravelers have increasingly apparent roles in both maintaining health and causing disease in several organ systems. Investigators gather annually at the National Institutes of Health to present new discoveries regarding the role of the microbiome in human health and a special focus on persons living with HIV. Here, we summarize the discussions from the third annual Virology Education workshop on the microbiome in HIV, which took place in October of 2017.