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Objectives To assess the effectiveness of thermostatic mixing valves (TMVs) in reducing bath hot tap water temperature, assess acceptability of TMVs to families and impact on bath time safety practices. Design Pragmatic parallel arm randomised controlled trial. Setting A social housing organisation in Glasgow, Scotland, UK. Participants 124 families with at least one child under 5 years. Intervention A TMV fitted by a qualified plumber and educational leaflets before and at the time of TMV fitting. Main outcome measures Bath hot tap water temperature at 3-month and 12-month post-intervention or randomisation, acceptability, problems with TMVs and bath time safety practices. Results Intervention arm families had a significantly lower bath hot water temperature at 3-month and 12-month follow-up than families in the control arm (3 months: intervention arm median 45.0°C, control arm median 56.0°C, difference between medians, −11.0, 95% CI −14.3 to −7.7); 12 months: intervention arm median 46.0°C, control arm median 55.0°C, difference between medians −9.0, 95% CI −11.8 to −6.2) They were significantly more likely to be happy or very happy with their bath hot water temperature (RR 1.43, 95% CI 1.05 to 1.93), significantly less likely to report the temperature as being too hot (RR 0.33, 95% CI 0.16 to 0.68) and significantly less likely to report checking the temperature of every bath (RR 0.84, 95% CI 0.73 to 0.97). Seven (15%) intervention arm families reported problems with their TMV. Conclusions TMVs and accompanying educational leaflets are effective at reducing bath hot tap water temperatures in the short and longer term and are acceptable to families. Housing providers should consider fitting TMVs in their properties and legislators should consider mandating their use in refurbishments as well as in new builds.

Background A bidet has been proposed as a replacement for the sitz bath. Like a sitz bath, it brings water into contact with the perineum. However, the high force of water from commercially used electronic bidets may harm the anus. We developed a new electronic bidet and evaluated its effects on anal resting pressure compared with a warm sitz bath. Methods Forty volunteers used the electronic bidet and sitz bath on separate days. The electronic bidet was newly designed with warm (38 °C) water and very low force (10 mN) with a fountain type of flow. Anal resting pressure at the high-pressure zone was measured before (control) and after the electronic bidet and sitz bath. Pressure changes after bidet or sitz bath were expressed as percentages compared with control. Water temperatures and rectal temperatures were also recorded. Results The anal resting pressures before the electronic bidet and sitz bath were 90.2 ± 24.6 and 88.1 ± 16.8 mmHg, respectively. At 3 min after the electronic bidet and sitz bath, the anal resting pressures were 71.3 ± 23.4 and 69.6 ± 19.8 mmHg, respectively. The pressure changes compared with the control were 78.2 ± 12.9 and 78.1 ± 12.5 %, respectively, which were not significantly different. The maximal increase and minimal decrease were not significantly different. The rectal temperature was not elevated, and the water temperature decreased significantly with the sitz bath ( p  < 0.001). Conclusions Our new electronic bidet may reduce the anal resting pressure much like a warm sitz bath does.

AimsTo assess the cost-effectiveness of installing thermostatic mixer valves (TMVs) in reducing risks of bath water scalds and estimate the costs of avoiding bath water scalds.MethodsThe evaluation was undertaken from the perspective of the UK public sector, and conducted in conjunction with a randomised control trial of TMVs installed in social housing in Glasgow. Installation costs were borne by the social housing organisation, while support materials were provided by the UK NHS. Effectiveness was represented by the number of families with at-risk bath water temperatures pre- and post-installation, and the number of bath scalds avoided as a result of installation. Differences in the number of families with at-risk temperatures between groups were derived from the RCT. Cost-effectiveness was assessed and a series of one-way sensitivity analyses were conducted.ResultsUnit costs associated with installation were calculated to be £13.68, while costs associated with treating bath water scalds ranged from £25 226 to £71 902. The cost of an avoided bath water scald ranged from net savings to public purse of £1887 to £75 520 and at baseline produced a net saving of £3 229 008; that is, £1.41 saved for every £1 spent.ConclusionIt is very likely that installing TMVs as standard in social housing in new buildings and major refurbishments accompanied by educational information represents value for money.Trial registration numberISRCTN:21179067.

Background To examine unintentional drowning mortality by age and body of water across 60 countries, to provide a starting point for further in-depth investigations within individual countries. Methods The latest available three years of mortality data for each country were extracted from WHO Health Statistics and Information Services (updated at 13 November 2013). We calculated mortality rate of unintentional drowning by age group for each country. For countries using International Classification of Disease 10 (ICD-10) detailed 3 or 4 Character List, we further examined the body of water involved. Results A huge variation in age-standardised mortality rate (deaths per 100 000 population) was noted, from 0.12 in Turkey to 9.19 in Guyana. Of the ten countries with the highest age-standardised mortality rate, six (Belarus, Lithuania, Latvia, Russia, Ukraine and Moldova) were in Eastern Europe and two (Kazakhstan and Kyrgyzstan) were in Central Asia. Some countries (Japan, Finland and Greece) had a relatively low rank in mortality rate among children aged 0–4 years, but had a high rank in mortality rate among older adults. On the contrary, South Africa and Colombia had a relatively high rank among children aged 0–4 years, but had a relatively low rank in mortality rate among older adults. With regard to body of water involved, the proportion involving a bathtub was extremely high in Japan (65%) followed by Canada (11%) and the USA (11%). Of the 13 634 drowning deaths involving bathtubs in Japan between 2009 and 2011, 12 038 (88%) were older adults aged 65 years or above. The percentage involving a swimming pool was high in the USA (18%), Australia (13%), and New Zealand (7%). The proportion involving natural water was high in Finland (93%), Panama (87%), and Lithuania (85%). Conclusions After considering the completeness of reporting and quality of classifying drowning deaths across countries, we conclude that drowning is a high-priority public health problem in Eastern Europe, Central Asia, Japan (older adults involving bathtubs), and the USA (involving swimming pools).

Although environmental chambers have traditionally been used to study passive dehydration and recovery in the context of sports nutrition, portable infrared saunas may provide a more accessible and cost-effective alternative. This study aimed to assess the efficacy and test-retest reliability of achieving target body mass (BM) losses using a portable infrared sauna. Fifteen healthy adults (11 males: 22.46 ± 2.70 years, 175.48 ± 6.54 cm, 76.35 ± 9.78 kg; 4 females: 21.00 ± 2.58 years, 163.10 ± 2.79 cm, 54.78 ± 4.25 kg) completed two identical dehydration trials separated by at least 72 hours. After a standardized warm-up, participants alternated for up to 20 minutes of sauna exposure (~66 °C) with 5 minutes of rest (~23 °C) until reaching 2.8% ± 0.3% (males) or 2.4% ± 0.3% (females) BM loss. The dependent variables were total sauna time, maximum core temperature (MCT), average sauna temperature when entering, average sauna temperature when exiting, absolute BM loss, relative BM loss, absolute BM loss per 60 minutes, and relative BM loss per 60 minutes. Reliability was evaluated using a two-way fixed intraclass correlation coefficient (ICC) and coefficients of variation (CVs; acceptable <15%). The point estimate ICCs ranged from 0.710 to 0.969, with CVs < 5%. There were significant intertrial differences for MCT (Trial 1 > Trial 2,  < 0.05), whereas all other variables demonstrated no significant differences. These findings indicate that a portable infrared sauna protocol yields reliable dehydration outcomes (CV < 5%; ICC > 0.75) and achieves > 2% BM loss in under 180 minutes, supporting its use when environmental chambers are unavailable.

A randomized controlled trial evaluated the impact of different methods of water agitation on clinical and microbiological outcomes in 31 nursing home residents. Four conditions were tested: a) whirlpool tub, jets on, using standard soap products; b) ultrasound tub, ultrasound on, using the standard soap products; c) ultrasound tub, ultrasound on, using specialized soap and skin conditioner; and d) either tub (randomized), water circulation off, using standard soap products (the control condition). Outcomes of interest included skin microbial flora, water microbial flora, skin condition, time spent bathing, and staff satisfaction. Resident skin condition and skin microbial flora did not differ between the four treatments. The tubs also did not differ in terms of bacterial colonization; however, there was a non-statistically significant trend for the highest counts to occur in whirlpool tubs after being idle overnight. The ultrasound and whirlpool tubs were preferred by staff over the control treatment (still water) in terms of sound and overall suitability. In addition, staff reported that the ultrasound tub using enhanced skin cleansers made bathing residents easier and faster than the same tub using standard cleansers.

The aim of these guidelines is to encourage dermatologists to use bath psoralen plus ultraviolet A (PUVA), bathing suit PUVA and soak PUVA in the treatment of psoriasis vulgaris and other conditions. Evidence was collected using searches of the PubMed, MEDLINE and COCHRANE databases using the keywords \"bath PUVA,\" \"soak PUVA,\" \"bathing suit PUVA\" and \"turban PUVA.\" Only publications in English were reviewed. One hundred and thirty-eight studies were evaluated, 57 of which fulfilled the criteria for inclusion. Both bath PUVA and bathing suit PUVA are very effective and safe treatments for generalized stable plaque psoriasis (strength of recommendation, A). Soak PUVA is very effective in the treatment of both palmoplantar psoriasis and chronic palmoplantar eczema (strength of recommendation, A).

ABSTRACT Objective: to produce a reflective essay on what has been produced in relation to bath as a procedure related to nursing care and diagnosis for dependent patients undergoing mediate and immediate rehabilitation processes after a traumatic event. Method: discursive, reflective study supported by classical content analysis consisting of the following stages: a) reading of the texts in their most comprehensive form; b) emphasizing the relevant elements produced about bathing; c) reflection on texts and what is produced about bathing. Results: the texts point out to three categories for nursing practice and reflection: Meaning to patients on the purposes of bathing; Representation for nurses in the work process; Representation for nurses in the management of care and nursing care planning. Conclusion: the reflection points out understandings on bathing as a care focused on the autonomy of nursing rehabilitation patients, requiring further investigations. RESUMEN Objetivo: Analizar en la perspectiva de un ensayo reflexivo sobre lo que está siendo producido acerca del baño, como procedimiento de atención y diagnóstico de enfermería para pacientes dependientes, en proceso de rehabilitación mediato e inmediato, posterior a evento traumático. Método: Discursivo, reflexivo, respaldado por análisis de contenido clásico, incluyendo las etapas: a) lectura integral de los textos; b) énfasis en elementos relevantes producidos sobre el baño; c) reflexión sobre los textos y sobre la producción sobre el baño. Resultados: Los textos determinaron tres categorías para reflexión y práctica de enfermería: Significado para el paciente de la práctica de enfermería; Representación para enfermeros en el proceso de trabajo; representación para enfermeros en la gestión del cuidado y planificación de atención de enfermería. Conclusión: La reflexión refiere una comprensión del baño como cuidado enfocado en la autonomía del paciente de enfermería de rehabilitación, y carece de investigaciones futuras. RESUMO Objetivo: versar na perspectiva de um ensaio reflexivo do que vem sendo produzido sobre o banho, como um procedimento do cuidado e do diagnóstico de enfermagem para clientes dependentes, em processo de reabilitação mediata e imediata, após evento traumático. Método: discursivo reflexivo, apoiado pelo método de análise de conteúdo clássica, constituída pelas seguintes etapas: a) leitura dos textos em sua forma mais abrangente; b) destaque para os elementos relevantes produzidos sobre o banho; c) reflexão sobre os textos e o que é produzido sobre o banho. Resultados: os textos apontam três categorias para reflexão e prática de enfermagem: Significado para o cliente nos propósitos desta; representação para enfermeiros no processo de trabalho; representação para estes na gestão do cuidado e planejamento da assistência de enfermagem. Conclusão: a reflexão aponta entendimentos do banho como cuidado focado na autonomia dos clientes da enfermagem de reabilitação e carece de futuras investigações.

Objective: To determine if Algo, a clinical algorithm to select bathing equipment for ‘straightforward’ cases, guides home health aides in selecting the appropriate bath seat. Design: Criterion validity study. Setting: Community home care. Subjects: Eight home health aides used Algo with community-dwelling older adults having a straightforward problem. Main measures: Their bath-seat recommendations were compared with those proposed by an occupational therapist (OT), which were considered as the gold standard. In order to determine a clinically acceptable threshold of agreement between the recommendations, a subgroup of community-dwelling elderly people was assessed a third time by another OT. Results: Half of the clients (74/143) for whom bathroom assessments were requested qualified as potentially straightforward cases after triage and were visited at home by a home health aide using Algo. In 84% of cases (95% confidence interval (CI) = [75, 93]), the non-OTs using Algo identified a seat that would enable these older adults to bathe according to their preferences, abilities and environment, as confirmed by the gold standard OT. Moreover, this appropriateness rate did not statistically differ from that obtained when comparing another OT to the gold standard. Conclusion: Algo guides non-OTs toward a bath seat that meets the needs of community-dwelling older adults in the majority of cases.