Frequency Of Bathing Research Articles

Longitudinal associations of sauna bathing with inflammation and oxidative stress: the KIHD prospective cohort study

Purpose: We sought to determine cross-sectional and longitudinal associations of frequency of sauna bathing with high sensitivity C-reactive protein (hsCRP), fibrinogen, leucocyte count and gamma-glutamyltransferase (GGT).Design: Baseline sauna bathing habits were assessed in 2269 men aged 42–61 years. Concentrations of hsCRP, fibrinogen, leucocyte count, and GGT were determined at baseline and 11 years later. The associations of sauna bathing frequency with baseline and 11-year hsCRP, fibrinogen, leucocyte count, and GGT levels were examined using robust multivariate regression analyses.Results: In baseline analysis, 4–7 sauna sessions/week (compared with 1 sauna session/week) was associated with −0.84 mg/l (95% CI, −1.55, −0.14; p = .019) lower hsCRP; −0.07 g/l (95% CI, −0.15, 0.02; p = .112) lower fibrinogen; and −0.28 × 109/l (95% CI, −0.51, −0.06; p = .015) lower leucocyte count, after multivariable adjustment. In longitudinal analysis, the corresponding estimates were −1.66 mg/l (95% CI, −3.13, −0.19; p = .027); −0.16 g/l (95% CI, −0.31, −0.02; p = .031); and −0.49 × 109/l (95% CI, −0.85, −0.14; p = .007) respectively. Sauna bathing frequency was not associated with GGT at baseline and 11 years.Conclusion: Observational evidence supports the hypothesis that reduction in inflammation may be one of the pathways linking frequent sauna bathing with decreased risk of acute and chronic disease conditions.KEY MESSAGESCross-sectional evidence or short-term studies suggest Finnish sauna bathing may exert its beneficial health effects via reduction in inflammation and oxidative stress; however, the long-term effects of sauna bathing on these outcomes are uncertain.In this population-based prospective cohort study, frequent sauna sessions significantly decreased levels of inflammatory markers at baseline and 11-year follow-up; but had no effect on oxidative stress.The health benefits of sauna bathing may in part be mediated via reduced systemic inflammation.

Habitual hot water bathing protects cardiovascular function in middle-aged to elderly Japanese subjects

Favorable effects of sauna bathing on cardiovascular disease have been demonstrated. Hot water bathing is an alternative, and could also have similar effects. Information pertaining to hot water bathing frequency and water temperature was obtained from 873 subjects. Carotid mean and max intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) were measured as indices of atherosclerosis. Central haemodynamics were evaluated using radial pulse waveform analyses. Plasma levels of B-type natriuretic peptide (BNP) were measured as an index for cardiac loading. The mean duration of a single hot bath was 12.4 ± 9.9 min. Subject bathing in hot water ≥5 times per week had significantly lower baPWV, central pulse pressure (PP), and BNP after correcting for possible confounding parameters. Stepwise regression analyses revealed that hot water temperature was negatively associated with baPWV, while bathing frequency was negatively related to central PP and BNP. A longitudinal follow-up in 164 subjects showed that hot water bathing ≥5 times per week was associated with significantly lower increase in BNP over time, while the temperature of the water tended to be related to lower increases in carotid max IMT and baPWV. Hot water bathing showed a favorable effect on atherosclerotic and central haemodynamic parameters.

Determinants of Schistosoma mansoni in Sanja health center, north West Ethiopia

BackgroundIn developing countries, Schistosoma mansoni is one of the chronic but neglected tropical diseases. In sub-Saharan Africa, the disease affects over 250 million people with nearly 800 million are at risk. In Ethiopia, Schistosoma mansoni is one of the most prevalent parasitic diseases. The aim of this study was to determine the prevalence and identify the determinant factors of Schistosoma mansoni, in terms of some socio-demographic variables and risk factors.MethodsA cross-sectional parasitological survey was conducted at Sanja health center, northwest Ethiopia from June 1 to June 30, 2015. A total of 228 study participants were included in the study. The participants were selected using systematic random sampling technique. Stool specimens were collected and examined using Kato-Katz methods. Structural questionnaires were used to collect data on socio-demographic variables and risk factors by face to face interviews. The major risk factors and demographic determinants of the infection status of Schistosoma mansoni were identified by using descriptive and ordinal logistic regression techniques.ResultsThe overall prevalence of Schistosoma mansoni was 16.67% (95%CI: 11.83–21.51%). Covariates such as no habit of swimming in rivers has lower risk (AOR = 0.022: 95%CI: 0.011–0.764), no frequency of swimming in rivers (AOR = 0.022: 95%CI: 0.0024–0.207), and 1 to 2 frequency of swimming (OR = 0.302: 95%CI: 0.097–0.941), washing clothes in rivers (AOR = 0.194: 95%CI: 0.046–0.0.811) and bathing in the river (AOR = 0.09: 95%CI: 0.010–0.815) were the most important determinant factors (P-value < 0.5) of Schistosoma mansoni in Sanja health center.ConclusionIn this study, the prevalence of Schistosoma mansoni was found to be high. Swimming habits, frequency of swimming, washing clothes, and bathing in rivers were found to be significant predictors of Schistosoma mansoni. Provisions of a safe water supply in the area and health education about the transmission of the Schistosoma mansoni infection are required.

Different ethnic background is associated with distinct clinical profiles in the spondyloarthritides in the North and South of Brazil.

The objective of this study was to analyze the clinical profile of the spondyloarthritides (SpA) in distinct Brazilian regions. A common protocol of investigation was prospectively applied to 202 SpA patients, including 138 patients from the South and 64 patients from the North. All the patients were classified as axial or peripheral SpA. Clinical and demographic variables and disease indexes were analyzed. Bonferroni correction was used to adjust the level of significance of each test; results with p value < 0.003 were considered statistically relevant. White ethnicity was associated with positive HLA-B27, while non-Whites presented higher frequency of peripheral arthritis, although not statistically significant. When comparing non-White patients from the North with those from the South, the Southerners presented significantly higher scores of Ankylosing Spondylitis Disease Activity Score using C-reactive protein (p = 0.001) and Health Assessment Questionnaire (p = 0.001). Although not statistically significant, Northern non-White patients were more frequently males, while Southerners had higher frequency of anterior uveitis and higher Bath Ankylosing Spondylitis Disease Activity Index and Ankylosing Spondylitis Quality of Life. Brazilian SpA patients present distinct patterns of disease according to the geographic region, especially regarding the non-White populations.

高齢者の入浴・洗浄回数と皮膚の状態に関する調査・研究

入浴・洗浄は清潔さを保つための重要な生活習慣であるが，高齢者では過度の入浴・洗浄は皮膚の乾燥を招く恐れがある。高齢者の適切な入浴・洗浄条件を検討する目的で 105 病棟の入浴状況をアンケート調査した。その結果，週 2 回の入浴が最多(55％)であった。ついで，入院中の 41名の患者について，右下腿は週 2 回洗浄，左下腿は週 7 回洗浄の2群に分けて皮膚状態が変化するかを検討した。週 7 回洗浄群では皮膚水分量，伸側の皮膚水分蒸散量，皮膚 pH が有意に上昇したが，視診による皮膚状態の違いは見出せなかった。

A unified stochastic formulation of dissipative quantum dynamics. II. Beyond linear response of spin baths.

We use the "generalized hierarchical equation of motion" proposed in Paper I [C.-Y. Hsieh and J. Cao, J. Chem. Phys. 148, 014103 (2018)] to study decoherence in a system coupled to a spin bath. The present methodology allows a systematic incorporation of higher-order anharmonic effects of the bath in dynamical calculations. We investigate the leading order corrections to the linear response approximations for spin bath models. Two kinds of spin-based environments are considered: (1) a bath of spins discretized from a continuous spectral density and (2) a bath of localized nuclear or electron spins. The main difference resides with how the bath frequency and the system-bath coupling parameters are distributed in an environment. When discretized from a continuous spectral density, the system-bath coupling typically scales as ∼1/NB where NB is the number of bath spins. This scaling suppresses the non-Gaussian characteristics of the spin bath and justifies the linear response approximations in the thermodynamic limit. For the nuclear/electron spin bath models, system-bath couplings are directly deduced from spin-spin interactions and do not necessarily obey the 1/NB scaling. It is not always possible to justify the linear response approximations in this case. Furthermore, if the spin-spin Hamiltonian is highly symmetrical, there exist additional constraints that generate highly non-Markovian and persistent dynamics that is beyond the linear response treatments.

Sauna Bathing and Risk of Psychotic Disorders: A Prospective Cohort Study

Objective: Sauna bathing has been suggested to promote mental well-being and relaxation, but the evidence is uncertain with respect to mental disorders. We aimed to assess the association of frequency of sauna bathing with risk of psychosis in the Kuopio Ischemic Heart Disease prospective population-based study. Subjects and Methods: Baseline sauna bathing habits were assessed in 2,138 men aged 42–61 years who had no history of psychotic disorders. Participants were classified into three groups based on the frequency of sauna bathing (once, 2–3, and 4–7 times per week). Results: During a median follow-up of 24.9 years, 203 psychotic disorders were recorded. A total of 537, 1,417, and 184 participants reported having a sauna bath once a week, 2–3 times, and 4–7 times per week, respectively. In Cox regression analysis adjusted for age, compared to men who had 1 sauna session per week, the hazard ratio (95% confidence intervals) of psychosis for 4–7 sauna sessions per week was 0.23 (0.09–0.58). In a multivariable model adjusted for several risk factors and other potential confounders, the corresponding hazard ratio was 0.21 (0.08–0.52). The association was similar after further adjustment for total energy intake, socioeconomic status, physical activity, and C-reactive protein (0.22 [0.09–0.54]) and was unchanged on additional adjustment for duration of a sauna session and temperature of the sauna bath (0.23 [0.09–0.57]). Conclusion: Our study suggests a strong inverse and independent association between frequent sauna bathing and the future risk of psychotic disorders in a general male population.

Effects of bathing interval on skin condition and axillary bacterial colonization in preterm infants

AimThe objective of this study was to evaluate the effects of preterm infant bathing periods on skin condition and axillary skin colonization. BackgroundReducing the frequency of bathing in preterm infants is beneficial in reducing the risk of hypothermia and exposure to stress from frequent nursing contacts. MethodsThe subjects of this study were observed at The V hospital at the C University in South Korea between December 2012 and August 2013. A total of 32 preterm infants were included and were randomly assigned to two different bathing intervals; every four days (n=16) and the other every two days (n=16) bathing groups. A neonatal skin conditions were assessed on a daily basis, whereas, axillary skin colonization was measured every eight days before bathing. Data was analyzed via the SPSS program with a non-inferiority test, t-test, chi-square test, Fisher's exact test, and paired t-test. ResultsMean differences of skin condition between the four-day bathing and two-day bathing groups were 0.065 and the 97.5% one-sided confidence limit was 0.196 (less than the non-inferiority margin, 0.3). There were no statistically significant differences in skin condition and axillary skin colonization between the two groups (p>0.05). ConclusionThe interval of bathing for preterm infants can be changed from every two days to every four days without increasing the incidence of skin condition problems or axillary skin colonization. Less-frequent bathing may decrease the chance of physiological instability caused by the caring process, while providing them with a better environment for growth and development.

Assessing the potential and benefits of domestic solar water heating system based on field survey

Domestic solar water heating system (DSWHS) without auxiliary energy is widely used in loess hilly region of China. However, there is a lack of studies on DSWHS in this region. This article assessed the potential and benefits of DSWHS on the basis of field survey. Results indicate that a DSWHS with evacuated tube collectors (ETC DSWHS), with a collecting area of 2.09 m2 and an average thermal efficiency of 40%, can supply heat of 3661.7 MJ during its valid period of 263 d. A household with an average of 4.9 people consumes annually 11,043.5 kg of hot water supplied by DSWHS. A total of 1238.7 MJ of energy is needed to heat so much water. The actual thermal efficiency of DSWHS is only 13.53%. Clearly, there is a great potential to improve the energy efficiency of DSWHS. DSWHS has low economic benefit because of its low actual thermal efficiency. However, it has enormous environmental benefits and significant social impacts. The 1238.7‐MJ energy provided by it is equal to that provided by 211.6‐kg raw coal, which can emit 454.99‐kg CO2, 3193.79‐g SO2 during use. Rural residents are recommended to use more hot water supplied by DSWHS through increasing the frequency of bathing and cloth washing. The government should further promote DSWHS utilization by driving costs down. © 2017 American Institute of Chemical Engineers Environ Prog, 37: 1781–1791, 2018

Frequent sauna bathing may reduce the risk of pneumonia in middle-aged Caucasian men: The KIHD prospective cohort study.

Emerging evidence suggests sauna bathing to be linked with numerous health benefits. Having frequent sauna baths has been found to be associated with reduced risk of acute and chronic disease conditions. Sauna bathing may reduce the risk of respiratory diseases; however, the evidence is uncertain. We aimed to assess the association of frequency of sauna bathing with risk of pneumonia. Baseline sauna bathing habits were assessed by administration of questionnaires in a prospective cohort of 2210 men aged 42-61 years. During a median follow-up of 25.6 years, 375 hospital diagnosed cases of pneumonia were recorded. In age-adjusted analyses, the hazard ratios (HRs) 95% confidence intervals (CIs) of pneumonia were 0.67 (0.53-0.83) and 0.53 (0.34-0.84) for participants who had 2-3 and ≥4 sauna sessions per week respectively compared with participants who had≤1 sauna session per week. After further adjustment for several major risk factors, the HRs were 0.69 (0.55-0.86) and 0.56 (0.35-0.88) respectively. The associations remained on additional adjustment for total energy intake, socioeconomic status, physical activity, and C-reactive protein, 0.72 (0.57-0.90) and 0.63 (0.39-1.00) respectively. Frequent sauna baths is associated with reduced pneumonia risk in a middle-aged male Caucasian population.

Joint associations of sauna bathing and cardiorespiratory fitness on cardiovascular and all-cause mortality risk: a long-term prospective cohort study

Purpose: We aimed to evaluate the joint impact of cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) on the risk of cardiovascular and all-cause mortality.Design: CRF measured by respiratory gas analyses and sauna exposure were assessed at baseline in a prospective study of 2277 men. CRF was categorized as low and high (median cut-offs) and FSB as low and high (≤2 and 3–7 sessions/week, respectively).Results: During a median follow-up of 26.1 years, 520 cardiovascular and 1124 all-cause deaths occurred. Comparing high versus low CRF, the multivariate-adjusted hazard ratios (HRs) 95% CIs for cardiovascular and all-cause mortality were 0.51 (0.41–0.63) and 0.65 (0.57–0.75), respectively. Comparing high versus low FSB, the corresponding HRs were 0.74 (0.59–0.94) and 0.84 (0.72–0.97), respectively. Compared to low CRF & low FSB, the HRs of CVD mortality for high CRF & high FSB; high CRF & low FSB; and low CRF & high FSB were 0.42 (0.28–0.62), 0.50 (0.39–0.63) and 0.72 (0.54–0.97), respectively. For all-cause mortality, the corresponding HRs were 0.60 (0.48–0.76), 0.63 (0.54–0.74) and 0.78 (0.64–0.96), respectively.Conclusions: A combination of high CRF and frequent sauna bathing confers stronger long-term protection on mortality outcomes compared with high CRF or high FSB alone.KEY MESSAGESCardiorespiratory fitness (CRF) and frequency of sauna bathing are independently associated with reduced mortality risk; a combination of good CRF and frequent sauna bathing may confer additional survival benefits.In a population-based prospective cohort study, a combination of high CRF levels and frequent sauna bathing (3–7 sessions per week) was associated with a substantial risk reduction in fatal cardiovascular and all-cause mortality events compared with good CRF or frequent sauna bathing alone.A combination of good fitness levels produced by aerobic exercises and frequent sauna bathing may have added health benefits and confer more protection on the risk of mortality.

Isotopic effects in vibrational relaxation dynamics of H on a Si(100) surface

In a recent paper [U. Lorenz and P. Saalfrank, Chem. Phys. 482, 69 (2017)], we proposed a robust scheme to set up a system-bath model Hamiltonian, describing the coupling of adsorbate vibrations (system) to surface phonons (bath), from first principles. The method is based on an embedded cluster approach, using orthogonal coordinates for system and bath modes, and an anharmonic phononic expansion of the system-bath interaction up to second order. In this contribution, we use this model Hamiltonian to calculate vibrational relaxation rates of H-Si and D-Si bending modes, coupled to a fully H(D)-covered Si(100)-(2×1) surface, at zero temperature. The D-Si bending mode has an anharmonic frequency lying inside the bath frequency spectrum, whereas the H-Si bending mode frequency is outside the bath Debye band. Therefore, in the present calculations, we only take into account one-phonon system-bath couplings for the D-Si system and both one- and two-phonon interaction terms in the case of H-Si. The computation of vibrational lifetimes is performed with two different approaches, namely, Fermi's golden rule, and a generalized Bixon-Jortner model built in a restricted vibrational space of the adsorbate-surface zeroth-order Hamiltonian. For D-Si, the Bixon-Jortner Hamiltonian can be solved by exact diagonalization, serving as a benchmark, whereas for H-Si, an iterative scheme based on the recursive residue generation method is applied, with excellent convergence properties. We found that the lifetimes obtained with perturbation theory, albeit having almost the same order of magnitude-a few hundred fs for D-Si and a couple of ps for H-Si-, are strongly dependent on the discretized numerical representation of the bath spectral density. On the other hand, the Bixon-Jortner model is free of such numerical deficiencies, therefore providing better estimates of vibrational relaxation rates, at a very low computational cost. The results obtained with this model clearly show a net exponential decay of the time-dependent survival probability for the H-Si initial vibrational state, allowing an easy extraction of the bending mode "lifetime." This is in contrast with the D-Si system, whose survival probability exhibits a non-monotonic decay, making it difficult to define such a lifetime. This different behavior of the vibrational decay is rationalized in terms of the power spectrum of the adsorbate-surface system. In the case of D-Si, it consists of several, non-uniformly distributed peaks around the bending mode frequency, whereas the H-Si spectrum exhibits a single Lorentzian lineshape, whose width corresponds to the calculated lifetime. The present work gives some insight into mechanisms of vibration-phonon coupling at surfaces. It also serves as a benchmark for multidimensional system-bath quantum dynamics, for comparison with approximate schemes such as reduced, open-system density matrix theory (where the bath is traced out and a Liouville-von Neumann equation is solved) or approximate wavefunction methods to solve the combined system-bath Schrödinger equation.

Daily Chlorhexidine Bathing in General Hospital Units – Results of the ABATE Infection Trial (Active BAThing to Eliminate Infection)

Daily Chlorhexidine Bathing in General Hospital Units – Results of the ABATE Infection Trial (Active BAThing to Eliminate Infection)

Prevalence of Bacterial Vaginosis and Associated Risk Factors among Women Complaining of Genital Tract Infection.

Background Bacterial vaginosis is a global concern due to the increased risk of acquisition of sexually transmitted infections. Objectives To determine the prevalence of bacterial vaginosis and bacteria causing aerobic vaginitis. Methods A cross-sectional study was conducted among 210 patients between September 2015 and July 2016 at St. Paul's Hospital. Gram-stained vaginal swabs were examined microscopically and graded as per Nugent's procedure. Bacteria causing aerobic vaginitis were characterized, and their antimicrobial susceptibility pattern was determined. Results The overall prevalence of bacterial vaginosis was 48.6%. Bacterial vaginosis was significantly associated with number of pants used per day (p = 0.001) and frequency of vaginal bathing (p = 0.045). Of 151 bacterial isolates, 69.5% were Gram-negative and 30.5% were Gram-positive bacteria. The overall drug resistance level of Gram-positive bacteria was high against penicillin, tetracycline, and erythromycin. Cefoxitin and tobramycin were the most active drugs against Gram-positive bacteria. The overall drug resistance level of Gram-negative bacteria was high against tetracycline, ampicillin, and amoxicillin. Amikacin and tobramycin were the most active drugs against Gram-negative bacteria. Conclusions The prevalence of bacterial vaginosis was high and was affected by individual hygiene. Routine culture of vaginal samples should be performed on patients with vaginitis and the drug susceptibility pattern of each isolate should be determined.

Sauna bathing is inversely associated with dementia and Alzheimer's disease in middle-aged Finnish men.

there are no previous studies linking repeated heat exposure of sauna and the risk of memory diseases. We aimed to investigate whether frequency of sauna bathing is associated with risk of dementia and Alzheimer's disease. prospective population-based study. the frequency of sauna bathing was assessed at baseline in the Kuopio Ischaemic Heart Disease population-based prospective cohort study of 2,315 apparently healthy men aged 42-60 years at baseline, with baseline examinations conducted between 1984 and 1989. Hazard ratios (HRs) with 95% confidence intervals (CIs) for dementia and Alzheimer's disease were ascertained using Cox-regression modelling with adjustment for potential confounders. during a median follow-up of 20.7 (interquartile range 18.1-22.6) years, a total of 204 and 123 diagnosed cases of dementia and Alzheimer's disease were respectively recorded. In analysis adjusted for age, alcohol consumption, body mass index, systolic blood pressure, smoking status, Type 2 diabetes, previous myocardial infarction, resting heart rate and serum low-density lipoprotein cholesterol, compared with men with only 1 sauna bathing session per week, the HR for dementia was 0.78 (95% CI: 0.57-1.06) for 2-3 sauna bathing sessions per week and 0.34 (95% CI: 0.16-0.71) for 4-7 sauna bathing sessions per week. The corresponding HRs for Alzheimer's disease were 0.80 (95% CI: 0.53-1.20) and 0.35 (95% CI: 0.14-0.90). in this male population, moderate to high frequency of sauna bathing was associated with lowered risks of dementia and Alzheimer's disease. Further studies are warranted to establish the potential mechanisms linking sauna bathing and memory diseases.

Bathing and Associated Treatments in Atopic Dermatitis.

Atopic dermatitis is one of the most common complaints presenting to dermatologists, and patients typically inquire as to appropriate bathing recommendations. Although many dermatologists, allergists, and primary-care practitioners provide explicit bathing instructions, recommendations regarding frequency of bathing, duration of bathing, and timing related to emollient and medication application relative to bathing vary widely. Conflicting and vague guidelines stem from knowledge related to the disparate effects of water on skin, as well as a dearth of studies, especially randomized controlled trials, evaluating the effects of water and bathing on the skin of patients with atopic dermatitis. We critically review the literature related to bathing and associated atopic dermatitis treatments, such as wet wraps, bleach baths, bath additives, and balneotherapy. We aim to provide readers with a comprehensive understanding of the impact of water and related therapies on atopic dermatitis as well as recommendations based upon the published data.

A Study on User Satisfaction of Village Bathhouses in Rural Areas - Focusing on Pilot Project of Common Facilities for Rural Seniors -

The purpose of this study is to evaluate user satisfaction with village bathhouses, selected from a two-year pilot project of common facilities for seniors in rural areas from 2014 to 2015. A survey was conducted using a questionnaire to evaluate user satisfaction, and 96 questionnaires were collected from 10 village bathhouses. User satisfaction was evaluated in five categories with a five-point scale: location and spatial composition; emotions and intimacy; safety; hygiene and equipment; and maintenance and management. The results are as follows. First, scores on hygiene and equipment stood at four points or higher, indicating higher user satisfaction. However, scores on the other four categories were below four points. But when overall user satisfaction was evaluated on a five-point scale, the average score stood at 4.13out of five points and 89.5 out of 100 points. These findings suggest that users were generally satisfied with the bathhouses. Second, a comparison of bathing patterns from before and after bathhouse construction in villages revealed that 42.7% of residents had previously gone to neighboring villages to bathe. Local bathhouse construction led to an increase in overall bathing frequency, exerting a beneficial effect on hygiene. Third, general user satisfaction correlated more closely with items related to location and spatial composition than items of other categories, indicating that the architectural elements of the bathhouses have a major impact. Finally, access to a bathhouse at all times showed strong correlation with satisfaction levels, suggesting a need for the establishment of more bathhouses throughout rural areas.

Does bathing frequency matter in pediatric atopic dermatitis?

Does bathing frequency matter in pediatric atopic dermatitis?

Scoping systematic review of treatments for eczema

BackgroundEczema is a very common chronic inflammatory skin condition.ObjectivesTo update the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) systematic review of treatments for atopic eczema, published in 2000, and to inform health-care professionals, commissioners and patients about key treatment developments and research gaps.Data sourcesElectronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Skin Group Specialised Register, Latin American and Caribbean Health Sciences Literature (LILACS), Allied and Complementary Medicine Database (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from the end of 2000 to 31 August 2013. Retrieved articles were used to identify further randomised controlled trials (RCTs).Review methodsStudies were filtered according to inclusion criteria and agreed by consensus in cases of uncertainty. Abstracts were excluded and non-English-language papers were screened by international colleagues and data were extracted. Only RCTs of treatments for eczema were included, as other forms of evidence are associated with higher risks of bias. Inclusion criteria for studies included availability of data relevant to the therapeutic management of eczema; mention of randomisation; comparison of two or more treatments; and prospective data collection. Participants of all ages were included. Eczema diagnosis was determined by a clinician or according to published diagnostic criteria. The risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool. We used a standardised approach to summarising the data and the assessment of risk of bias and we made a clear distinction between what the studies found and our own interpretation of study findings.ResultsOf 7198 references screened, 287 new trials were identified spanning 92 treatments. Trial reporting was generally poor (randomisation method: 2% high, 36% low, 62% unclear risk of bias; allocation concealment: 3% high, 15% low, 82% unclear risk of bias; blinding of the intervention: 15% high, 28% low, 57% unclear risk of bias). Only 22 (8%) trials were considered to be at low risk of bias for all three criteria. There was reasonable evidence of benefit for the topical medications tacrolimus, pimecrolimus and various corticosteroids (with tacrolimus superior to pimecrolimus and corticosteroids) for both treatment and flare prevention; oral ciclosporin; oral azathioprine; narrow band ultraviolet B (UVB) light; Atopiclair™ and education. There was reasonable evidence to suggest no clinically useful benefit for twice-daily compared with once-daily topical corticosteroids; corticosteroids containing antibiotics for non-infected eczema; probiotics; evening primrose and borage oil; ion-exchange water softeners; protease inhibitor SRD441 (Serentis Ltd); furfuryl palmitate in emollient; cipamfylline cream; andMycobacterium vaccaevaccine. Additional research evidence is needed for emollients, bath additives, antibacterials, specialist clothing and complementary and alternative therapies. There was no RCT evidence for topical corticosteroid dilution, impregnated bandages, soap avoidance, bathing frequency or allergy testing.LimitationsThe large scope of the review coupled with the heterogeneity of outcomes precluded formal meta-analyses. Our conclusions are still limited by a profusion of small, poorly reported studies.ConclusionsAlthough the evidence base of RCTs has increased considerably since the last NIHR HTA systematic review, the field is still severely hampered by poor design and reporting problems including failure to register trials and declare primary outcomes, small sample size, short follow-up duration and poor reporting of risk of bias. Key areas for further research identified by the review include the optimum use of emollients, bathing frequency, wash products, allergy testing and antiseptic treatments. Perhaps the greatest benefit identified is the use of twice weekly anti-inflammatory treatment to maintain disease remission. More studies need to be conducted in a primary care setting where most people with eczema are seen in the UK. Future studies need to use the same core set of outcomes that capture patient symptoms, clinical signs, quality of life and the chronic nature of the disease.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

Pediculosis capitis among primary and middle school children in Asadabad, Iran: An epidemiological study

ObjectiveTo investigate the prevalence of head lice in primary and middle school children in Asadabad, Iran. MethodsThis study is an analytical descriptive cross-sectional one conducted among primary and middle school children in Asadabad during the academic year of 2013–2014. Data were collected at baseline via questionnaire, checklist and head examination. ResultsA total of 600 students were examined (412 girls and 188 boys), and 14 students showed pediculosis. And the total prevalence rate was 2.3% (3.2% girls and 0.5% boys). The infestation was equal in public and private schools. The rate of pediculosis was higher in students of primary schools (4.0%) than those in middle schools (0.7%). The age of the students ranged from 6 to 14 years. The total number of infected group was 14 with mean age of 8.93 ± 2.43 years, and it was 586 with mean age of 10.98 ± 2.82 years for the uninfected group who were enrolled in the study (P < 0.01). This study showed significant differences between students with curly hair (5.5%) and those with straight hair (1.9%) when compared in terms of head lice infestation (P < 0.05). The relations of pediculosis and other socioeconomic factors such as sharing common comb and a room with other people, frequency of bathing, and parents' profession and education were analyzed, and Chi-square test did not show a statistically significant relationship between head lice contamination and the abovementioned socioeconomic factors (P > 0.05). ConclusionsIt is necessary to find the risk factors of the infection in order to understand how to control or decrease infection in students, considering the important role of health education in reduction of head lice infections.