Bathing Practices Research Articles

Association Of Bathing Habits To Pruritus and Allergic Disease

Traditionally, physicians have advised limiting bathing frequency and duration for patients with pruritis. Our patient population is primarily Afro-Caribbean immigrants, whose practice of frequent bathing to stave off heat persists after migration to the cooler climate of Brooklyn. We sought to evaluate for an association between bathing habits and pruritis in our adult allergy patients. We report preliminary data from our pilot study.

308Effect of chlorhexidine bathing and other infection control practices on the Benefits of Universal Glove and Gown (BUGG) Trial: A subgroup-analysis

308Effect of chlorhexidine bathing and other infection control practices on the Benefits of Universal Glove and Gown (BUGG) Trial: A subgroup-analysis

Impairment in water quality of Ganges River and consequential health risks on account of mass ritualistic bathing

Effect of mass ritualistic bathing was studied on the water quality of Ganges River during Maha Kumbh festival in India. Significantly higher values of biochemical oxygen demand (BOD) (14 mg/L), chemical oxygen demand (67 mg/L), total suspended solids (55 mg/L), and ammonia nitrogen (2.15 mg/L) were observed during mass ritualistic bathing. The BOD values were observed to surpass the standard BOD criteria (≤3 mg/L) of outdoor bathing. Similarly, higher number of total coliforms (792 most probable numbers [MPN]/100 mL) and fecal coliforms (482 MPN/100 mL) were observed in water samples, which show the alarming level of fecal contamination according to Indian and European (100 MPN/100 mL) standards of outdoor bathing. Furthermore, total 5,368 cases of water borne infections were observed during the epidemiological survey. In order to protect the public health and water quality of river, it is recommended to strictly regulate the bathing practices with continuous disinfection at upstream of bathing spot. Moreover, a comprehensive health-based investigation should be performed to facilitate the development of a suitable model.

Daily chlorhexidine bathing to reduce bacteraemia in critically ill children: a multicentre, cluster-randomised, crossover trial

Bacteraemia is an important cause of morbidity and mortality in critically ill children. Our objective was to assess whether daily bathing in chlorhexidine gluconate (CHG) compared with standard bathing practices would reduce bacteraemia in critically ill children.In an unmasked, cluster-randomised, two-period crossover trial, ten paediatric intensive-care units at five hospitals in the USA were randomly assigned a daily bathing routine for admitted patients older than 2 months, either standard bathing practices or using a cloth impregnated with 2% CHG, for a 6-month period. Units switched to the alternative bathing method for a second 6-month period. 6482 admissions were screened for eligibility. The primary outcome was an episode of bacteraemia. We did intention-to-treat (ITT) and per-protocol (PP) analyses. This study is registered with ClinicalTrials.gov (identifier NCT00549393).1521 admitted patients were excluded because their length of stay was less than 2 days, and 14 refused to participate. 4947 admissions were eligible for analysis. In the ITT population, a non-significant reduction in incidence of bacteraemia was noted with CHG bathing (3·52 per 1000 days, 95% CI 2·64-4·61) compared with standard practices (4·93 per 1000 days, 3·91-6·15; adjusted incidence rate ratio [aIRR] 0·71, 95% CI 0·42-1·20). In the PP population, incidence of bacteraemia was lower in patients receiving CHG bathing (3·28 per 1000 days, 2·27-4·58) compared with standard practices (4·93 per 1000 days, 3·91-6·15; aIRR 0·64, 0·42-0·98). No serious study-related adverse events were recorded, and the incidence of CHG-associated skin reactions was 1·2 per 1000 days (95% CI 0·60-2·02).Critically ill children receiving daily CHG bathing had a lower incidence of bacteraemia compared with those receiving a standard bathing routine. Furthermore, the treatment was well tolerated.Sage Products, US National Institutes of Health.

The ideal moisturizer: a survey of parental expectations and practice in childhood-onset eczema

Aim: We evaluated the moisturizing and bathing practices and preferences of patients with childhood-onset eczema. Methods: The attitudes and practice of patients with eczema managed at a pediatric dermatology clinic were evaluated, using children with non-eczematous skin diseases as controls. Disease severity of eczema in the preceding 12 months was evaluated by the Nottingham Eczema Severity Score (NESS). Skin hydration (SH) and transepidermal water loss (TEWL) were assessed. Results: Majority of patients took shower instead of bath and spent 12–13 min in shower. Most eczema patients applied emollients after shower/bath. Air-conditioning use was frequent, and patients with eczema maintained a lower ambient temperature than non-eczema patients (p = 0.001). Most eczema patients reported regular emollient usage (1.8 times/day for mild vs 2.8 times/day for moderate-to-severe eczema, p = 0.001), and acceptability of the current product was good to fair. Parents reported that the current emollients were most often recommended by doctors. Majority of parents/patients with mild eczema thought an ideal emollient needs only to be used twice a day whereas moderate-to-severe patients preferred more frequent usage (p = 0.001), and most of them preferred a non-fragrant, non-herbal white cream. Agreements concerning ideal emollient usage were only “moderate-to-fair” (kappa values <0.61), implying what parents/patients practiced was not the same as what they preferred. Conclusion: This study helps better understand the emolliation practices and preferences of eczema patients. Doctors remain the most important source of recommendation. Majority think an ideal moisturizer is a non-fragrant, non-herbal, white or transparent cream which needs only to be used two to three times per day. Compliance may be enhanced if the recommended moisturizer conforms to the parents/patients preference.

Cultural uses of non-timber forest products among the Sts'ailes, British Columbia, Canada

We have identified cultural uses of non-timber forest products (NTFPs) in the Sts'ailes, a group within the central Coast Salish First Nation in British Columbia, Canada. The non-timber forest products are culturally important and often accessible to local people. We undertook a community-based participatory case study of the cultural uses of non-timber forest products within the Sts'ailes traditional territory. We used semi-structured interviews, ethnography, and secondary documents (e.g. maps and supporting documents) to provide in-depth understanding of the NTFP uses. Sts'ailes people use NTFPs by (1) gathering plants for food and medicine, (2) making materials from the plants, (3) making spiritual regalia and paints for winter ceremonials, and (4) brushing with cedar branches as spiritual practices. Forest environments and NTFPs provide secured environment for spiritual bathing and other spiritual practices and cedar branches are essential to use for purification. Because of these uses, Canadian governments need to consult and accommodate the Sts'ailes people when undertaking forestry operations. In addition, Sts'ailes use of the land demonstrates their continued possession of it.

Extreme preconditioning: Cold adaptation through sea swimming as a means to improving surgical outcomes

The practice of sea bathing for its health benefits was popularised by Richard Russell in Regency Brighton during the 18th Century. Although the cures he claimed it could effect seem a little far-fetched today, as with many historical remedies, there is much to be gained from revisiting such theories in the light of modern medical research. In this paper I will draw parallels between the surgical stress response and the response to cold exposure and hypothesise how a programme of sea bathing may be used to enhance postoperative recovery and reduce preoperative complications.

Bathing residents with dementia in long‐term care: critical incidents described by personal support workers

The aim of this study was to describe and gain insight into the critical incidents depicted by personal support workers (PSWs) in long-term care (LTC) related to bathing residents who have dementia. Residents with dementia in LTC often display responsive/protective behaviours during bathing. Consequently, bathing is a source of stress for PSWs who provide most of the personal care for LTC residents in Ontario, Canada. A qualitative descriptive study employing the critical incident technique (CIT) was used. Eight PSWs were interviewed and 24 incidents were collected and analyzed using thematic content analysis. Findings revealed that PSWs experience the following during bathing: managing responsive/protective behaviours, working with limited resources, and dealing with communication difficulties. Participants used various strategies to respond to these challenges; however, they reported limited strategies to manage the most challenging behaviours. Many of the bathing strategies described by the PSWs in this study are found in the literature about best bathing practices in dementia care. However, it is evident that further work is needed to support PSWs to manage the most difficult physical responsive/protective behaviours that occur during bathing. This study has clear implications for knowledge translation.

Infant skin-cleansing product versus water: A pilot randomized, assessor-blinded controlled trial

BackgroundThe vulnerability of newborn babies' skin creates the potential for a number of skin problems. Despite this, there remains a dearth of good quality evidence to inform practice. Published studies comparing water with a skin-cleansing product have not provided adequate data to inform an adequately powered trial. Nor have they distinguished between babies with and without a predisposition to atopic eczema. We conducted a pilot study as a prequel to designing an optimum trial to investigate whether bathing with a specific cleansing product is superior to bathing with water alone. The aims were to produce baseline data which would inform decisions for the main trial design (i.e. population, primary outcome, sample size calculation) and to optimize the robustness of trial processes within the study setting.Methods100 healthy, full term neonates aged <24 hours were randomly assigned to bathing with water and cotton wool (W) or with a cleaning product (CP). A minimum of bathing 3 times per week was advocated. Groups were stratified according to family history of atopic eczema. Transepidermal water loss (TEWL), stratum corneum hydration and skin surface pH were measured within 24 hours of birth and at 4 and 8 weeks post birth. Measurements were taken on the thigh, forearm and abdomen. Women also completed questionnaires and diaries to record bathing practices and medical treatments.ResultsForty nine babies were randomized to cleansing product, 51 to water. The 95% confidence intervals (CI) for the average TEWL measurement at each time point were: whole sample at baseline: 10.8 g/m2/h to 11.7 g/m2/h; CP group 4 weeks: 10.9 g/m2/h to 13.3 g/m2/h; 8 weeks: 11.4 g/m2/h to 12.9 g/m2/h; W group 4 weeks:10.9 g/m2/h to 12.2 g/m2/h; 8 weeks: 11.4 g/m2/h to 12.9 g/m2/h.ConclusionThis pilot study provided valuable baseline data and important information on trial processes. The decision to proceed with a superiority trial, for example, was inconsistent with our data; therefore a non-inferiority trial is recommended.Trial registrationISRCTN72285670

Effectiveness of Routine Patient Bathing to Decrease the Burden of Spores on the Skin of Patients withClostridium difficileInfection

For 74 patients with Clostridium difficile infection, the quality and frequency of bathing was often limited because of such factors as the presence of devices, decreased mobility, and pain. Routine bathing practices had limited efficacy in decreasing the burden of spores on skin; however, showers were more effective than bed baths.

Schistosomiasis in infants and preschool-aged children: Infection in a single Schistosoma haematobium and a mixed S. haematobium– S. mansoni foci of Niger

The burden of schistosomiasis in infants and preschool-aged children and their mothers is poorly known. We carried out a cross-sectional epidemiological survey in two villages in Niger: Falmado is endemic for Schistosoma haematobium only, whereas a mixed S. haematobium– S. mansoni focus has been reported from Diambala. The survey examined 282 children (149 girls, 133 boys, average age: 2.6 years) and 224 mothers (average age: 30.1 years). For S. haematobium diagnosis, two urine samples obtained on consecutive days were subjected to the standard urine filtration method. Additionally, macro- and microhaematuria were determined. The diagnosis of S. mansoni was based on a single stool sample with duplicate Kato-Katz thick smears. In Diambala, a standardised, pre-tested questionnaire was administered to mothers, which recorded demographic data, treatment history with anthelminthic drugs, household sanitation and water supply, and bathing practices for their children. Prevalence of egg-patent S. haematobium infections among young children and their mothers was respectively 50.5% and 55.6%, in Falmado, and 60.5% and 72.2% in Diambala. The prevalence of S. mansoni infection in Diambala was 43.8% among children and 52.1% in mothers. Mixed egg-patent infections of S. haematobium and S. mansoni were revealed in 28.6% of the children and 37.3% of the mothers. Questionnaire data showed that 69.8% of the children were accompanied by their mothers to schistosomiasis transmission sites before they were 1 year of age, and that three-quarter of the mothers used water directly drawn from the irrigation canals to wash their children. To conclude, a substantive proportion of children below the age of 5 years had egg-patent schistosomiasis, inclusive of co-infection with S. haematobium and S. mansoni. In the context of schistosomiasis control, more attention should be paid on preschool-aged children and women of childbearing age, so that they can benefit from preventive chemotherapy, which in turn might increase effective coverage of those infected.

Skin care for preterm and term neonates

Neonatal skin experiences a progressive adaptation to the extrauterine environment during which special care is needed. The immaturity of the epidermal barrier in the neonatal period may cause dry skin, vulnerability to trauma, rapid onset of microbial colonization and percutaneous drug toxicity. This article reviews the practical implications for hygiene, bathing practices, skin integrity, emollient use, infection control and exposure to percutaneous toxic agents in preterm and term infants.

Gram-negative bloodstream infections in hematopoietic stem cell transplant patients: The roles of needleless device use, bathing practices, and catheter care

Between August 1 and October 30, 1998 (outbreak period), an increased incidence of central venous catheter (CVC)-associated gram-negative bacterial bloodstream infection (GN-BSI) was detected in hematopoietic stem cell transplantation (HSCT) candidates and recipients in an outpatient HSCT unit. The objectives of the present study were to determine strategies for controlling the outbreak and identify risk factors for GN-BSI. Two case-control studies, an assessment of infection control practices, microbiologic studies, and water quality analysis were conducted. A case was defined as any outpatient with a CVC and a primary GN-BSI during the outbreak period. All of the 31 case patients identified had needleless intravenous (IV) access devices. Independent risk factors for CVC-associated GN-BSI were self-administered IV infusion (odds ratio [OR] = 6.2; P = .02), lower frequency of needleless device changes (OR = 15.2; P = .03), and more frequent baths (OR = 1.4; P = .05). Interventions included increased frequency of needleless device change, recommending showers rather than baths, and use of CVC protection during showering/bathing. After these interventions, the CVC-associated GN-BSI rate declined to below the preoutbreak period rate (2.1/1000 vs 0.3/1000 CVC-days; P < .01). This study demonstrated an increased risk of CVC-associated GN-BSIs related to self-IV infusion, bathing habits, and frequency of needleless device change. Infection control practices associated with the use of needleless devices may expose susceptible patients to increased risk for BSI.

THE ARCHITECTURE OF PUBLIC BATHS OF TUNISIA: A TYPOLOGICAL ANALYSIS

The Punic, Roman, Byzantine and Islamic civilizations contributed with their architectural knowledge to the development of different public baths design. Based on previous historical work on the collective baths in the Mediterranean basin, and in particular Tunisia, this study aims to explore and analyse the hammāms (Islamic public baths) of Tunisia. This study uses a semantic and representative approach to help defi ne the components of the historic public bath, and to reveal its integration modes in the urban fabric of the medina, and eventually represent the functional diagrams of bathing practices. It clarifies how the functioning mode of the bath is in direct relation with the evolution of the society (its lifestyle, its culture and its own paradigms) and classifi es these building types according to a semantic division of the architectural places. Hence and in order to analyze the hammām spaces, a matrix of incidence. An analytical tool which quantifies the relations existing between the spaces of the same building has been used. As a result of this analysis, three typologies of Tunisian hammāms have been identified.

Many Facilities Are Embracing Culture Change

Many Facilities Are Embracing Culture Change

Neonatal home care practices in rural Egypt during the first week of life

To provide information about home care practices for newborns in rural Egypt, in order to improve neonatal home care through preventive measures and prompt recognition of danger signs. Survey of newborn home care practices during the first week of life in 217 households in three rural Egyptian Governorates. Many practices met common neonatal care standards, particularly prompt initial breastfeeding, feeding of colostrum and continued breastfeeding, and most bathing practices. However, several practices could be modified to improve neonatal care and survival. Supplemental substances were given to 44% of newborns as pre-lacteal feeds, and to more than half during the first week. Nearly half (43%) of mothers reported that they did not wash their hands before neonatal care, and only 7% washed hands after diaper changes. Thermal control was not practiced, although mothers perceived 22% of newborns to be hypothermic. The practices we observed, which are critical for newborn survival, could be improved with minor modifications. We provide a framework for communicating behaviour change and setting research priorities for improving neonatal health.

Bathing Practices and Emollient Use among Psoriasis Patients

The following submission is a brief report of a recently conducted survey on the bathing practices of people with psoriasis. The scope of the survey was to discover what practices psoriasis patients have adopted in caring for their skin as compared to controls. An Institutional Review Board (IRB)-approved survey was conducted in conjunction with the National Psoriasis Foundation National Conference, which took place Aug. 5–7, 2005, in Boston, Mass. Subjects reported their frequency of bathing, the amount of pain they experienced when bathing and showering, and whether or not they applied moisturizer on a daily basis. Psoriasis subjects were also asked to rate the severity of their psoriasis. Significant differences were found in people reporting pain with showering in the psoriasis group as compared with controls, and psoriasis respondents preferred cooler water temperatures when bathing. Both of these findings correlated with disease severity. Further, psoriasis subjects were found to use moisturizers more frequently and avoid the use of harsher products such as exfoliators when compared to controls. The findings of this survey suggest that the bathing practices of psoriasis patients are affected by their skin condition. In addition, daily pain associated with showering may negatively impact a patient's quality of life. The results of this research suggest that increased efforts should be made to evaluate pain severity and other affected aspects of caring for skin in this patient population.

Biomarkers of Pesticide Exposure: Adult and Adolescent Farmworker Comparisons

SM1-PD-10 Agricultural workers may be exposed to pesticide spray, drift, and residues on plants; however, little evidence is available on acceptable levels of pesticide exposure in this population. It has been suggested that developmental factors (physical, cognitive, and psychologic) may place youth workers at increased risk for occupational illness and injury, including the potential for pesticide exposure. We conducted an investigation of 133 hispanic farmworkers and 56 appropriate controls and assessed whether short-term biomarkers of exposure to pesticides (including insecticides and fungicides) differed in adolescents employed in agriculture compared with adult farmworkers, controlling for type of agricultural work, hours worked, and reported hygiene practices. All agricultural workers were employed in crop harvesting and were recruited from agricultural temporary housing and from evening and school year ESL programs. The mean age of the adult workers was 29 years with a mean of 9.3 years of agricultural work and average age of the adolescent workers was 15.3 years with an mean of 3.0 years of agricultural work. Surveys were administered on work histories and work practices and included questions on type of work activity, pesticide application, type of crop(s), work hours per week, use of protective clothing, bathing, and laundry practices. A spot urine sample was collected for the measurement of pesticide urinary biomarkers. Urinary samples were analyzed for alkylphosphate metabolites from organophosphates and for the metabolite of Captan (tetrahydrophthalimide; THPI), a fungicide frequently used on berry crops. All pesticide metabolite levels were adjusted for urinary creatinine concentration. Levels of THPI were were shifted significantly higher in the total agricultural when compared with controls. We found that median levels of the major OP metabolite (DMTP) among teen farmworkers was slightly higher compared with adult workers, although not statistically higher (3.2 ng/mL vs. 1.1 ng/mL). A similar, but nonsignificant trend was observed for THPI (0.073 μg/mL vs. 0.025 μg/mL). Our previous studies have found that adolescent farmworkers are less knowledgeable about pesticide safety, but protective practices did not differ significantly from those of adults. These results indicate that exposure levels among these 2 populations do not differ; and while these results are reassuring, they cannot be generalized to all crops in which adolescents work. Future analyses will examine differences in markers of potential health effects in adolescent farmworkers compared with adults with comparable levels of pesticide exposure.

The Azerbaijani scrub: a simple method to harvest large amounts of stratum corneum

The study of skin barrier constituents may require collection of much stratum corneum. Existing methods are inadequate and/or difficult. A simple and safe method to harvest stratum corneum from glabrous human skin derives from the bathing practices of people in Azerbaijan. The method requires water immersion of the subject for 30 min immediately followed by vigorous scrubbing of skin with a moist rough crepe mitten. This scrubbing method causes the separation of large amounts of stratum corneum which is easily harvested. The method facilitates study of stratum corneum components, including intercellular lipids.

Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh: a qualitative study

Understanding of local knowledge and practices relating to the newborn period, as locally defined, is needed in the development of interventions to reduce neonatal mortality. We describe the organisation of the neonatal period in Sylhet District, Bangladesh, the perceived threats to the well-being of neonates, and the ways in which families seek to protect them. We did 39 in-depth, unstructured, qualitative interviews with mothers, fathers, and grandmothers of neonates, and traditional birth attendants. Data on neonatal knowledge and practices were also obtained from a household survey of 6050 women who had recently given birth. Interviewees defined the neonatal period as the first 40 days of life (chollish din). Confinement of the mother and baby is most strongly observed before the noai ceremony on day 7 or 9, and involves restriction of movement outside the home, sleeping where the birth took place rather than in the mother's bedroom, and sleeping on a mat on the floor. Newborns are seen as vulnerable to cold air, cold food or drinks (either directly or indirectly through the mother), and to malevolent spirits or evil eye. Bathing, skin care, confinement, and dietary practices all aim to reduce exposure to cold, but some of these practices might increase the risk of hypothermia. Although fatalism and cultural acceptance of high mortality have been cited as reasons for high levels of neonatal mortality, Sylheti families seek to protect newborns in several ways. These actions reflect a set of assumptions about the newborn period that differ from those of neonatal health specialists, and have implications for the design of interventions for neonatal care.