Frequent Opportunity Research Articles

Reduced floating-point precision in regional climate simulations: an ensemble-based statistical verification

Abstract. The use of single precision in floating-point representation has become increasingly common in operational weather prediction. Meanwhile, climate simulations are still typically run in double precision. The reasons for this are likely manifold and range from concerns about compliance and conservation laws to the unknown effect of single precision on slow processes or simply the less frequent opportunity and higher computational costs of validation. Using an ensemble-based statistical methodology, Zeman and Schär (2022) could detect differences between double- and single-precision simulations from the regional weather and climate model COSMO. However, these differences are minimal and often only detectable during the first few hours or days of the simulation. To evaluate whether these differences are relevant for regional climate simulations, we have conducted 10-year-long ensemble simulations over the European domain of the Coordinated Regional Climate Downscaling Experiment (EURO-CORDEX) in single and double precision with 100 ensemble members. By applying the statistical testing at a grid-cell level for 47 output variables every 12 or 24 h, we only detected a marginally increased rejection rate for the single-precision climate simulations compared to the double-precision reference based on the differences in distribution for all tested variables. This increase in the rejection rate is much smaller than that arising from minor variations of the horizontal diffusion coefficient in the model. Therefore, we deem it negligible as it is masked by model uncertainty. To our knowledge, this study represents the most comprehensive analysis so far on the effects of reduced precision in a climate simulation for a realistic setting, namely with a fully fledged regional climate model in a configuration that has already been used for climate change impact and adaptation studies. The ensemble-based verification of model output at a grid-cell level and high temporal resolution is very sensitive and suitable for verifying climate models. Furthermore, the verification methodology is model-agnostic, meaning it can be applied to any model. Our findings encourage exploiting the reduction of computational costs (∼30 % for COSMO) obtained from reduced precision for regional climate simulations.

Physicians' Perspectives with the E-prescribing System in Five Teaching Hospitals.

Despite the evidence suggesting the potential of electronic prescribing (e-prescribing), this system also faces challenges that can lead to inefficiency and even failure. This study aimed to evaluate physicians' perspectives on the efficiency, effectiveness, opportunities, and challenges associated with the e-prescribing system. In 2023, a descriptive analytics cross-sectional study was carried out. Due to the finite population size, all the physicians from five studied hospitals who agreed to participate in the study were included through the census method (n = 195). Data collection was conducted using a validated questionnaire. Data were analyzed using descriptive (mean, standard deviation, and frequency) and analytical (Pearson's correlation coefficient, two-sample t-test, one-way analysis of variance (ANOVA), and linear multiple regression model) statistics. The mean scores of efficiency and effectiveness were 47.47 ± 14.46 and 36.09 ± 10.67 out of 95 and 65, respectively. Removing the illegibility of the prescriptions (n = 22) was the most frequent opportunity and internet connectivity problem (n = 37) was the most frequent challenge associated with the e-prescribing system. There was a strong positive significant correlation between efficiency and effectiveness (r = 0.850, p < 0.01). Moreover, age was found to have a significant negative correlation with efficiency (B = -7.261, p = 0.004) and effectiveness (B = - 5.784, p = 0.002). Physicians believe that e-prescribing enhances the efficiency and effectiveness of their work. There are many opportunity and challenges to the use of e-prescription. Assessing the needs of physicians, actively participating and training them in the stages of design and implementation, and conducting regular evaluations of the e-prescribing system are crucial to overcome the challenges. Our finding offers insightful information about how doctors see the e-prescribing system at teaching hospitals and provide a basis for managers and policy makers at the local and national levels to support the implementation of this system and plan for improvement of its shortcomings.

Developing Fluency In Spoken English To B2

Oral fluency is a skill that requires constant practice in an ESL classroom in order to make meaningful development. In general, when we discuss fluency, we are referring to the ease with which pupils speak, their speech rate, their pauses, and the language they can easily create in between. In an ideal scenario, the greatest method to learn to speak English effectively is to be exposed to the language on a daily basis through frequent discussion with English speakers on a range of themes. Regretfully, hardly many English language learners get the chance to practice speaking in a situation that is genuinely immersive. It is astonishing how many foreign students, who have low English proficiency despite spending years in an English-speaking nation, come home. They frequently discover that a large portion of the student body speaks their language in their town. They might not be having as many opportunities as we might think to use English outside of the classroom as a result. This just serves to emphasize how crucial it is to give students frequent opportunity to speak in class. This article focuses on how educators may provide kids these kinds of chances in the classroom to help them become more confident and fluent. When it comes to supporting students in improving their oral fluency, there are a few factors to take into account. [1:36]

Coaches’ experience of the importance, development and integration of decision-making and visual exploratory behaviour in an elite football academy setting

ABSTRACT Effective visual exploratory activity (VEA) and decision-making are integral to being an elite football player. Despite this, there is a lack of understanding regarding how these skills are coached and developed in a youth academy setting. Twelve male, football club youth academy coaches were interviewed to develop an understanding of their approach to coaching VEA and decision-making. Using a reflexive thematic analysis, the findings highlight that in order to maximise the impact of developing VEA and decision-making, coaches and players need to work together to create a shared understanding and common language using a combination of questions, phrases and video analysis. Integrating VEA and decision-making successfully in developmental sessions were viewed as most effective in opposed, chaotic training, which provides frequent opportunity for players to utilise problem solving skills (cf. develop conditional knowledge). Developing and delivering “chaotic” sessions was impacted by coach experience and development of the coach–player relationship.

Providing Experience for Undergraduate Nursing Students to Care for Older Adults: A Qualitative Study

Care of the older adult can be complex and frequently influenced by ageism. Nursing students do not have the frequent opportunity to provide care for older adults. The purpose of this pilot study was to expose sophomore nursing students to older adults earlier and more often in the undergraduate curriculum by providing a unique clinical experience at St. Thomas of Villanova Monastery, a residential facility for retired Augustinian priests. This study examines the experience of students’ participation in this clinical experience. Qualitative content analysis of 12 student logs was conducted. Themes that emerged included: age-related changes, environmental considerations, psychosocial needs and changes, and consideration of gerontology as a career choice and existing bias. Students gained a valuable understanding of the unique age-related changes that older adults are experiencing. Early experiences are vital in the curriculum and provide enhanced engagement in gerontology.

Diagnóstico multidimensional y morbilidad de las cooperativas de producción en México: un estudio descriptivo y explicativo de las áreas de oportunidad de las cooperativas de la región de la costa de Oaxaca

En este trabajo se describen las diez principales deficiencias o áreas de oportunidad que afectan el desarrollo de treinta cooperativas de producción de la Región de la Costa de Oaxaca en México, abarcando las dimensiones normativa-institucional, social, económica, administrativa, técnica y política a partir de considerar que los fenómenos de la realidad son multidimensionales. Asimismo, a partir del análisis de la literatura teórica reciente en el área de las Ciencias Sociales y Económico Administrativas, se identifican seis causas estratégicas externas de fondo de los problemas encontrados: 1) Excesiva precariedad económica de los socios cooperativistas; 2) Política educativa alienada, sin programas académicos para la economía social y el emprendimiento; 3) Deficiente arreglo normativo-institucional; 4) Deficientes y limitadas políticas públicas de apoyo a la economía social; 5) Desarrollo de una cultura individualista y oportunista en el supra-sistema, y 6) Educación formal escasa y no pertinente a las necesidades de la región.&#x0D; Recibido: 12 mayo 2020Aceptado: 17 septiembre 2020

Observation of Hand Hygiene Practices in Home Health Care

ObjectiveTo describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits. DesignObservational study of nurse hand hygiene practices. Settingand Participants: Licensed practical/vocational and registered nurses were observed in the homes of patients being served by a large nonprofit HHC agency. MethodsTwo researchers observed 400 home care visits conducted by 50 nurses. The World Health Organization's “5 Moments for Hand Hygiene” validated observation tool was used to record opportunities and actual practices of hand hygiene, with 3 additional opportunities specific to the HHC setting. Patient assessment data available in the agency electronic health record and a nurse demographic questionnaire were also collected to describe patients and nurse participants. ResultsA total of 2014 opportunities were observed. On arrival in the home was the most frequent opportunity (n = 384), the least frequent was after touching a patient's surroundings (n = 43). The average hand hygiene adherence rate was 45.6% after adjusting for clustering at the nurse level. Adherence was highest after contact with body fluid (65.1%) and lowest after touching a patient (29.5%). The number of hand hygiene opportunities was higher when patients being served were at increased risk of an infection-related emergency department visit or hospitalization and when the home environment was observed to be “dirty.” No nurse or patient demographic characteristics were associated with the rate of nurse hand hygiene adherence. Conclusions and ImplicationsHand hygiene adherence in HHC is suboptimal, with rates mirroring those reported in hospital and outpatient settings. The connection between poor hand hygiene and infection transmission has been well studied, and it has received widespread attention with the outbreak of SARS-CoV-2. Agencies can use results found in this study to better inform quality improvement initiatives.

Comparisons of customer behavior in Markovian queues with vacation policies and geometric abandonments

This paper mainly studies customers’ equilibrium balking behavior in Markovian queues with single vacation and geometric abandonments. Whenever the system becomes empty, the server begins a vacation. If it is still empty when the vacation ends, the server stays idle and waits for new arrivals. During a vacation, abandonment opportunities occur according to a Poisson process, and at an abandonment epoch, customers decide sequentially whether they renege and leave the system or not. We consider four information levels: the fully/almost observable cases and the almost/fully unobservable cases, and get the customers’ equilibrium balking strategies, respectively. Then we also get their optimal balking strategies for the almost observable and the almost/fully unobservable cases, and make comparisons of customer strategies and social welfare for the almost observable and the almost/fully unobservable queues with single vacation and multiple vacations. Because of abandonment, we find that the customers’ equilibrium threshold in a vacation may exceed the one in a busy period in the fully observable queues. However, it has little effect on their equilibrium threshold in the almost observable queues, although frequent abandonment opportunity arrival inhibits their optimal threshold. Interestingly, for the almost unobservable queues, customers who arrive in a busy period are not affected by reneging that happened in the previous vacation when they make decisions of joining or balking, whereas the social planner expects that the customers can take it into consideration for social optimization. In the fully unobservable queues, because of no information, possible reneging surely influences customers’ equilibrium and optimal balking behavior. For the almost observable and the almost/fully unobservable queues, the optimal social welfare is greater in the queues with single vacation than that in the queues with multiple vacations.

Transplantation Opportunities of Hepatitis C Virus–Seropositive Patients on the Kidney Waiting List

ObjectiveBesides severe organ shortage, hepatitis C virus (HCV) infection is an important obstacle for kidney transplantation because of long waiting times on deceased kidney donor waiting lists. We aimed to evaluate calling number of candidates according to HCV serology. MethodA total of 404 adults on the deceased donor waiting list invited for cadaveric transplantation was evaluated. Demographic data, waiting time, calling number for transplantation, and viral serology were obtained during the 6-year period. ResultsMean waiting duration and calling number of all patients were 42.7 ± 34 months and 1.56 ± 4.37 times, respectively. Twenty-six candidates had chronic HCV infection and 12 of 26 were HCV RNA–positive. Mean waiting duration and calling number in anti-HCV–positive candidates were significantly higher compared with anti-HCV–negative candidates (85.3 ± 38.8 vs 39.8 ± 31.6 months, and 10.8 ± 10.3 vs 0.92 ± 2.6 times, respectively; P < .001). Mean waiting duration and total calling number in HCV-RNA–positive candidates were significantly higher than in HCV-RNA–negative ones (107.5 ± 7.5 vs 66.2 ± 44.8 months; P = .018; 15 ± 9.7 vs 7.3 ± 9.8 times, respectively; P = .026). ConclusionsChronic HCV infection is an important issue leading to longer waiting time on the list. Our observation showed that waiting durations of anti-HCV–positive candidates were longer than that of negative patients, although they had more frequent opportunity for transplantation.

Mother to Child Transmission of HIV after Option B+ in Low Income Environment

Background: In Cameroon, the prevalence of HIV in pregnant women was 7.8% in 2012, and they were 8500 HIV positive newborns in 2013. Option B+ is the first highly active antiretroviral therapy (HAART) preventive protocol. The objective was to evaluate the rate of HIV transmission on children born from mothers who were on Option B+ during pregnancy, in three university teaching hospitals of the University of Yaounde I. Methods: It was a retrospective, cross-sectional study over a period of four years (2013-2017). We included HIV positive mothers not on previous antiretroviral treatment and who received a single tablet daily of combined tenofovir (300 mg) + Lamivudine (300 mg) + Efavirenz (600 mg) started at any time during pregnancy. Newborn received nevirapine syrup according to WHO option B+ protocol. Results: 179 women were included. The average age was 33.5 ± 2.92 years, all ages were represented. Blood donation was the most frequent HIV positive screening opportunity, voluntary testing rate was 29% (29/179), and adherence rate was 98.9%. Few male partners were involved (58/179). Premature deliveries and low birth weight were rare (5/179; 10/179)), the indication of mode of delivery was strictly obstetrical, newborn feeding choice didn’t affect the transmission outcome, and the mother to child transmission rate was 2.2% (4/179). Conclusion: Option B+ could achieve the lowest mother to child transmission ever in Cameroon and should be generalized in high endemicity low resources settings.

Potential transmission opportunity of CTX-M-producing Escherichia coli on a large-scale chicken farm in Vietnam.

Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli have disseminated worldwide. This study investigated blaCTX-M-positive E. coli on a large-scale Vietnamese chicken farm and analysed whether there was any difference in prevalence and molecular characteristics of blaCTX-M-positive E. coli between the farm and the Vietnamese community. Faecal samples were collected from 24 human individuals and 38 chickens from the large-scale chicken farm as well as 51 humans and 36 chickens from the community. All samples were collected between June 2013 and June 2014 in Bavi Province in the Red River Delta region of Vietnam. Molecular characterisation of CTX-M-producing E. coli and genetic relatedness among the isolates were evaluated by conventional typing methods. Antimicrobial susceptibility of the isolates was evaluated by the disk diffusion method. The prevalence of blaCTX-M-positive E. coli was 83.3%, 71.1%, 54.9% and 13.9% in farm workers, farm chickens, community individuals and community backyard chickens, respectively. On average, blaCTX-M-positive E. coli isolates from farm chickens were resistant to 8.3 different antibiotics. The average number of detected aminoglycoside-modifying enzyme genes (3.4 genes) and the detection rate of the plasmid-mediated colistin resistance gene mcr-1 (33.3%) were higher in blaCTX-M-positive E. coli isolated from farm chickens compared with other sampling groups. In addition, two types of indistinguishable pulsed-field gel electrophoresis (PFGE) patterns were observed in six blaCTX-M-65-positive E. coli and three blaCTX-M-55-positive E. coli from farm chickens. These results suggest a more frequent transmission opportunity of blaCTX-M-positive E. coli on the large-scale Vietnamese chicken farm.

음주 여부에 따른 원주지역 남자대학생의 건강상태와 식습관 조사

This study was performed to investigate the health status and food habits of male college students in Wonju according to drinking behavior. A total of 204 (drinking group: 133, non-drinking group: 71) male college students were recruited and a questionnaire-based survey was conducted. General characteristics, drinking-related factors, health status, and food habits were investigated. Data were analyzed by SPSS program (ver 21.0). The type of residence (P<0.05) and obesity rate (P<0.05) were significantly different by drinking status. Frequency of drinking was 65.2%, and 39.9% of subjects started drinking upon entering college. The motivation to start drinking was 'from necessity'. Reason for drinking was 'Social relations'. The most frequent drinking opportunity in college was 'membership training'. The favorite kind of drink was beer. Health status factor scores for 'concerns about health (P<0.05)', and 'smoking (P<0.05)' were significantly higher in drinking group than those in non-drinking group. Food habits score (drinking group: 50.9 vs non-drinking group: 52.4, P<0.01) was significantly lower in the drinking group. Scores for 'I have breakfast regularly (P<0.05)', 'Do not eat the junk food often (P<0.05)', and 'Do not eat out often (P<0.05)' were significantly lower in the drinking group. 'Drink milk every day' was significantly higher in the drinking group.

A Clinical Residency in Sausage Making

Gaining the perspective of users is an essential goal of anyone performing human factors work in product design. Within medical product design teams, engineers have the frequent opportunity to interact with medical professionals. This embarrassment of riches in access to the user experience presents unique benefits and challenges to developing a usable product interface. This panel will provide insight into situations and perspectives of when human factors engineers work with medical device users (healthcare providers such as doctors, nurses, pharmacists, biomedical engineers) who were also part of the product development teams. The scope will include: what interactions are involved to work effectively on a project team; what was expected compared to what actually happened; effectively providing recommendations for designing usable products; what user experience / use testing methodologies were learned and performed by someone outside of human factors; and best practices for team interactions.

A survey of the views of US veterinary teaching faculty to owned cat housing practices.

According to the American Pet Products Association, in the USA there are an estimated 86.4 million owned cats, and approximately 40% of these are allowed to roam outdoors. Little has been written about the contribution of owned cats to problems attributed to feral cats, including wildlife predation, spread of zoonotic diseases and overpopulation. A recent study found that 64% of cats have visited the veterinarian within the past year, suggesting frequent opportunity for veterinarians to communicate risks and benefits of indoor vs outdoor living. We conducted the following survey to evaluate current views about this role of veterinarians, by surveying veterinary school faculty (n = 158). Our objectives were to assess (i) the degree to which veterinary teaching faculty believe that the issue of clients maintaining owned cats indoors vs outdoors is appropriate for discussion with students within the veterinary school curriculum; (ii) the degree of agreement and understanding there is among the faculty as to the reasons that clients maintain cats either inside or outside the home; and (iii) the degree to which veterinary faculty believe owned cats that are allowed to go outdoors contribute to various identified problems. The results indicated that many participants believed that the discussion of maintaining cats indoors is relevant to the profession, that it belongs in the veterinary school curriculum, that they understand client motivations, that they feel that more practicing veterinarians should discuss cat housing practices with clients and that cat overpopulation continues to be a significant concern for owned cats being outdoors. Additional ways to help maintain the health and wellbeing of cats that are primarily housed indoors is briefly discussed, including through such means as environmental enrichment or by providing cats access to safe areas while outdoors.

Cœur, artères et femmes, un circuit de soins dédié aux femmes à risque cardiovasculaire

Cardiovascular (CV) diseases are the primary cause of death of women. Since they kill 10 times more than breast cancer, preventive measures should be implemented. According to U.S. recommendations, a woman is either at “CV risk” or at “optimal health status” if she has no risk factors and a perfectly healthy lifestyle. Some risk factors are more deleterious to women (smoking, diabetes, stress, depression, atrial fibrillation); or specific to women (preeclampsia, gestational diabetes, contraception, menopause, headaches). The lifestyle plays a key role for them. The blood pressure measurement is the most frequent opportunity to detect women at risk. CV tests should be performed to all symptomatic women and for those over the age of 45 who want to start practicing sport. The cardiologist can play a key role to improve women's CV health by integrating their hormonal risks. Women can also be a powerful medium of prevention by adopting a healthy lifestyle. From those recommendations concerning women's CV health, there is a great opportunity to initiate a health path for women at high cardiovascular risk. The objectives of the specific path “heart, arteries and women” of University hospital of Lille will be to improve professional practice, awareness of women, educate public authorities and within a few years reduce the epidemic of CVD of French women.

IEEE 802.11 무선 랜에서의 토큰링 기반의 매체 접속 제어 프로토콜

본 논문에서는 인프라스트럭처 네트워크에서 토큰링 기법을 활용하여 지연시간 절감과 성능향상을 달성하고자 한다. AP(Access Point)는 노드의 A-ID (Association-ID)를 ACK 프레임에 담아 순차적으로 전송함으로써 토큰 패싱 효과를 준다. 이는 매체접속에 필요한 시간을 최대한 단축시키고, 그에 따라 전송률 또한 향상시킨다. 또한, AP는 큐 테이블을 생성 및 관리 하여 AP에 의해 결합된 노드 중에서 큐 정보가 가장 큰 노드에게 더 많은 매체 접속 기회를 제공한다. 이는 노드들의 큐의 포화 정도에 따라 균등하게 매체 접속 기회를 제공한다. In this paper, proposed method achieves delay reduction and throughput improvement by utilizing token-ring method in infrastructure network. Access Point gives token passing effect by successively transmitting ACK frame including a node's Association ID. Not only can this method considerably reduce time for medium access, but also improve throughput. Furthermore, AP offers more frequent medium access opportunity to node having highest data queue among nodes associated by AP. these method can evenly offer medium access opportunity according to Queue's volumes.

Implementation of a pharmacist resident medication reconciliation program

Purpose: The objectives of this study were to describe opportunities and barriers to establishing a medication reconciliation program operated by a college-based pharmacist resident at a tertiary hospital. Methods: A pharmacist resident rotating on the telemetry floor piloted the medication reconciliation program by providing services 2–3 days per week for 4 weeks for a total of 10 days. The resident participated on medical rounds with the cardiology consult service. All patients were offered the reconciliation program. A list of patients admitted was obtained from the institution’s list of admissions; discharge counselling services were initiated by the pharmacy resident, medical team or nursing. The number and type of interventions rendered as well as challenges to the implementation are described. Results: Fifty-six admission histories and 40 discharge counselling sessions were provided. The most frequent opportunity was related to interventions; 56 interventions were made. The most common interventions were improper documentation of allergies or medications (N = 26, 46.4%) and not starting a previous medication (N = 20, 35.7%). Non-cardiac medications accounted for 67.9% of interventions. The barriers included that the pharmacy resident provided part-time coverage; therefore, not all patients were educated and fewer interventions were made. Another barrier was related to health literacy. Over 80% of patients did not have a medication list and did not kn Purpose: The objectives of this study were to describe opportunities and barriers to establishing a medication reconciliation program operated by a college-based pharmacist resident at a tertiary hospital. Methods: A pharmacist resident rotating on the telemetry floor piloted the medication reconciliation program by providing services 2–3 days per week for 4 weeks for a total of 10 days. The resident participated on medical rounds with the cardiology consult service. All patients were offered the reconciliation program. A list of patients admitted was obtained from the institution’s list of admissions; discharge counselling services were initiated by the pharmacy resident, medical team or nursing. The number and type of interventions rendered as well as challenges to the implementation are described. Results: Fifty-six admission histories and 40 discharge counselling sessions were provided. The most frequent opportunity was related to interventions; 56 interventions were made. The most common interventions were improper documentation of allergies or medications (N = 26, 46.4%) and not starting a previous medication (N = 20, 35.7%). Non-cardiac medications accounted for 67.9% of interventions. The barriers included that the pharmacy resident provided part-time coverage; therefore, not all patients were educated and fewer interventions were made. Another barrier was related to health literacy. Over 80% of patients did not have a medication list and did not know the names of their medications. Conclusions: Pharmacist residents have many opportunities to impact patient care by conducting these services. The demand for such services may increase as pharmacist-provided medication reconciliation has been given increased national attention and since there is a push for increased pharmacist residency training. Given the limited resources, collaborations between college- and hospital-based pharmacy personnel are essential to optimize the services. ow the names of their medications. Conclusions: Pharmacist residents have many opportunities to impact patient care by conducting these services. The demand for such services may increase as pharmacist-provided medication reconciliation has been given increased national attention and since there is a push for increased pharmacist residency training. Given the limited resources, collaborations between college- and hospital-based pharmacy personnel are essential to optimize the services.

Metaphor Awareness and Skills: Learning A Few Good Metaphors

This paper discusses in general how metaphors are basic to human thought, and in particular the paper documents metaphors occurring with high frequency in mediation and negotiation dialog. The author argues that if a mediator were skilled with just these few metaphor domains, he or she would find frequent opportunity to apply that skill to better facilitate the mediation process. A three-level curriculum is outlined for mediators to become metaphor-aware.

Are trainees trained to use Kielland forceps and do they maintain their skills?

The Kielland forcep is an instrument which should be used only by a well-trained operator who has frequent opportunity to maintain his or her skills. A trainee was defined as a junior doctor who possessed the MRCOG part I or above. The Survey of Training (2002) questionnaires were sent to all College Tutors to be distributed to 1857 eligible trainees. As part of the survey trainees were asked the following. (1) Have you been trained to perform rotational forceps (Kiellands)? (2) How many did you perform in the last 12 months? The total number of respondents equalled 930 (50.1%). Two hundred and ninety-nine (31.2%) trainees were senior house officers (SHOs), 538 (57.8%) were specialist registrars (SpRs). The remaining 93 were a mix of lecturers and research fellows. Thirty-seven (12.4%) SHOs had been trained to perform Kiellands, of whom 12 (32.4%) had performed none and 13 (35.1%) had performed only 1–3 in the last 12 months; 175 (32.5%) SpRs had been trained to perform Kiellands, of whom 61 (34.9%) had performed none and 62 (35.4%) had performed only 1–3 in the last 12 months.

Contact voltage measured in residences: implications to the association between magnetic fields and childhood leukemia.

We measured magnetic fields and two sources of contact current in 36 homes in Pittsfield, MA. The first source, V(P-W), is the voltage due to current in the grounding wire, which extends from the service panel neutral to the water service line. This voltage can cause contact current to flow upon simultaneous contact with a metallic part of the water system, such as the faucet, and the frame of an appliance, which is connected to the panel neutral through the equipment-grounding conductor. The second is V(W-E), the voltage between the water pipe and earth, attributable to ground currents in the water system and magnetic induction from nearby power lines. In homes with conductive water systems and drains, V(W-E) can produce a voltage between the faucet and drain, which may produce contact current into an individual contacting the faucet while immersed in a bathtub. V(P-W) was not strongly correlated to the magnetic field (both log transformed) (r = 0.28; P < 0.1). On the other hand, V(W-E) was correlated to the residential magnetic field (both log transformed) (r = 0.54; P < 0.001), with the highest voltages occurring in homes near high voltage transmission lines, most likely due to magnetic induction on the grounding system. This correlation, combined with both frequent exposure opportunity for bathing children and substantial dose to bone marrow resulting from contact, lead us to suggest that contact current due to V(W-E) could explain the association between high residential magnetic fields and childhood leukemia.