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Natural therapy modalities such as thermal therapy and balneotherapy are commonly being practiced for the management of chronic aches and pain all over the world. Nepal has many such natural hot water springs among which few are famous for therapeutic purposes. Thousands of people with some musculoskeletal problem visit those places in the hope of getting rid of their problems. This study aimed to understand their belief in such therapies, expectations, and satisfaction after treatment along with their knowledge of the safety of hot spring water bath. Among 126 participants interviewed, 31% had inflammatory arthritis, followed by degenerative disorders in 29.4% and soft-tissue rheumatism in 12.7%. Around three-quarters believed that hot spring water has natural healing power and thus can improve their pain. Many even believed that water in natural springs is devoid of any chemicals. So, it is a safe treatment option. Regarding the expectation of cure, they had mixed opinions. Naïve participants hoped they might find a permanent cure in thermal baths. However, repeated visitors said that the effect usually lasted for a few months and they have to visit there regularly. Almost two-thirds of people thought that such natural treatment does not have any side effects. Few stated that they had faced certain problems after the treatment. The water tested from the study site showed that it contained a higher amount of chlorine and sulfate in comparison to other hot water springs in Nepal. The minerals present in water might be a cause of temporary relief of pain. Also, outbreaks of infection from common spring baths have to be considered as such cases have been reported in the past. In conclusion, the medicinal benefits of such natural hot water springs have to be studied further and awareness regarding safety should be given to the people seeking treatment., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Binit Vaidya and Shweta Nakarmi.)

Feeling good is linked to better health in Western contexts. Recent studies show, however, that the affect-health link is not consistent across cultures. We suggest two reasons for such inconsistency. The first follows from research showing that North American (vs. East Asian) cultures tend to value high arousal positive (HAP) states, for example, excited, more than low arousal positive (LAP) states, for example, calm. The second is one we propose for the first time. Positive affective experience is manifest in internal feelings but also in affective practices, such as taking a bath (a highly valued affective experience in Japan) or a fitness workout (a highly valued affective experience in the United States). We hypothesized that the HAP feelings/practices-health link would be stronger in the United States versus Japan, and the LAP feelings/practices-health link would be stronger in Japan versus the United States. Using survey samples from the United States (N = 640) and Japan (N = 382), we examined how health outcomes are shaped by positive affective feelings and practices varying in arousal. In a first set of analyses, HAP feelings predicted better physical and biological health in the United States but not in Japan. No cultural differences were consistently found for the effect of LAP feelings on health. In addition, engaging in HAP practices predicted better physical and biological health in the United States whereas engaging in LAP practices predicted better physical health in Japan but not in the United States. These findings suggest that the pathways underlying the culture-health link are culturally variable. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The onset of disability in bathing may be followed by disability in other daily activities for older adults. A bathing adaptation usually involves the removal of a bath or inaccessible shower and replacement with a level, easy access shower. The purpose is to remove the physical environmental barriers and restore older adults' ability to bathe safely and/or independently. The aim of this study was to explore the views and experiences of older adults and their carers who had received a bathing adaptation in order to examine how the adaptation had affected them and identify mechanisms of impact and outcomes from their perspectives. The study was nested within a feasibility Randomised Controlled Trial (RCT) (BATH-OUT) conducted within one local authority housing adaptations service in England. Semi-structured interviews were completed between 21 December 2016 and 19 August 2017 with 21 older adults and five carer participants of the feasibility RCT. Interview participants were purposively sampled on living arrangement and gender. Interviews were audio-recorded, transcribed verbatim and analysed in seven stages using framework analysis. Findings were presented thematically. Five themes were identified: ease of use; feeling safe; feeling clean; independence, choice and control; and confidence and quality of life. The removal of the physical barriers in the bathroom led to older adults re-mastering the activity of bathing, having an improved sense of physical functioning which gave a sense of 'freedom'. This appeared to impact a range of areas contributing to a wider sense of increased confidence consistent with constructs underpinning social care-related quality of life. We suggest that future research should examine housing adaptations from a person-environment fit approach, and that timely restoration of bathing ability is especially important as it can affect confidence and perceived competence in other areas of daily living., (© 2019 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)

Water-based passive body heating (PBH WB ) as a warm shower or bath before bedtime is often recommended as a simple means of improving sleep. We searched PubMed, CINAHL, Cochran, Medline, PsycInfo, and Web of Science databases and extracted pertinent information from publications meeting predefined inclusion and exclusion criteria to explore the effects of PBH WB on sleep onset latency (SOL), wake after sleep onset, total sleep time, sleep efficiency (SE), slow wave sleep, and subjective sleep quality. The search yielded 5322 candidate articles of which 17 satisfied inclusion criteria after removing duplicates, with 13 providing comparable quantitative data for meta-analyses. PBH WB of 40-42.5 °C was associated with both improved self-rated sleep quality and SE, and when scheduled 1-2 h before bedtime for little as 10 min significant shortening of SOL. These findings are consistent with the mechanism of PBH WB effects being the extent of core body temperature decline achieved by increased blood perfusion to the palms and soles that augments the distal-to-proximal skin temperature gradient to enhance body heat dissipation. Nonetheless, additional investigation is required because the findings regarding PBH WB are limited by the relative scarcity of reported research, especially its optimal timing and duration plus exact mechanisms of effects., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Bed bath in daily nursing care is crucial for cleaning and moisturizing patients' skin. The purpose of this study was to compare the effectiveness of cleaning and level of comfort of towel and disposable baths. The 2 methods were evaluated based on measurements of the transition of resident skin bacteria, stratum corneum water content, transepidermal water loss, and perceived relaxation levels., Methods: Twenty-six healthy women aged 65-90 years participated in this study and received disposable and towel baths. We measured 4 indicators before and after bathing. The participants' relaxation levels were measured by the Japanese adult version of the Profile of Mood States Second Edition short form., Results: Both disposable and towel baths significantly decreased resident skin bacteria. Disposable bath also significantly reduced Staphylococcus aureus and effectively maintained the water content of the stratum corneum. Furthermore, disposable bath was as effective as towel bath at contributing to participants' relaxation levels., Conclusions: This study suggested that using a disposable bath for daily cleaning of patients' skin is more comfortable and effective than using a towel bath., (Copyright © 2018. Published by Elsevier Inc.)

Background: Many studies investigating daily chlorhexidine gluconate (CHG) bathing as an infection control intervention to decrease health care-associated infections have focused on reduction of infection and colonization; few studies have assessed CHG bathing compliance, work system factors, facilitators, and barriers to implementation., Methods: This is a combination retrospective/prospective pilot study conducted at a large academic teaching hospital that implemented daily CHG bathing across all inpatient units. CHG compliance and patient refusal were calculated on the basis of documentation in the electronic medical record. We used the health belief model to guide semistructured interviews with patients about knowledge and barriers related to CHG bathing., Results: Of the 31 patients interviewed, 74% reported using CHG soap during their stay. Average compliance documented in the electronic medical record was 78% with a range of 57%-91% among all hospital units. Sixteen percent of patients declined CHG bathing, and refusal ranged from 3%-29% among all units. Major themes about CHG bathing from patient interviews include low perceived susceptibility to infection, high degree of trust in medical professionals, low knowledge of benefits of CHG, and low perceived self-efficacy in preventing HAIs., Conclusions: Educating patients about CHG bathing appears to be a critical factor in decreasing patient refusal of CHG bathing., (Published by Elsevier Inc.)

Bathing is a routine care procedure that exposes preterm infants to prolonged handling, which could cause stress and potentially disrupt infants' biobehavioral responses. The aim of this double-blind randomized crossover trial was to compare the preterm infant's body temperature, heart rate (HR), peripheral capillary oxygen saturation (SpO2), salivary cortisol levels, and sleep-wake states during and after swaddled and conventional tub baths. Forty-three infants born at 32 to 36 weeks postmenstrual age, weighing 2225 g or less, were enrolled in the study. Infants were videotaped before and after each type of baths. The time interval between baths ranged from 24 to 72 hours to allow a washout period. Physiological, hormonal, and behavioral responses were collected at baseline and during recovery from baths. No significant differences in the mean body temperature, HR, SpO2, salivary cortisol levels, and sleep-wake states between the bath types were observed in the baseline or recovery responses during the first 20 minutes after bath. Regardless of bath type, salivary cortisol levels showed a nonstatistical significant increase.

Objective: Though bathing (hydrotherapy) is widely used during labor to decrease anxiety and pain and to promote relaxation, the influence of cultural beliefs about bathing by parturients is virtually unknown. This pilot study explored pregnant women's experiences of bathing, bathing in labor, and cultural beliefs about bathing., Design: An exploratory, descriptive design., Setting: Low risk obstetrical clinics., Participants: Healthy Hispanic, Black, White, American-Indian and Asian women (N = 41) at >37 weeks gestation., Methods: During a routine prenatal visit women responded to a brief openended questionnaire on the use of bathing. Data was captured using a modified ethnographic method involving observation and note taking with thematic analysis and quantification of percent response rates., Findings: Forty-six percent (N = 41) of women used bathing for purposes other than hygiene but only 4.9% (N = 41) of these women bathed during a previous labor. The women described bathing as relaxing, easing, calming, and efficacious for relief of menstrual cramps and labor contractions. Ten percent of women reported cultural beliefs about bathing., Conclusions: Women who bathe, report relief of anxiety, menstrual and labor pain and promotion of mental and physical relaxation. The findings do not support the view that bathing is associated with identifiable cultural beliefs; rather, they suggest that bathing is a self-care measure used by women. This practice is likely transmitted from generation to generation by female elders through the oral tradition. Assumptions that race or ethnicity precludes the use of bathing may be faulty. Cautionary instructions should be given to pregnant women who are <37 completed weeks of gestation, to avoid bathing for relief of cramping or contractions and to seek immediate health care evaluation. Study of culturally intact groups may uncover additional themes related to bathing in labor and as a self-care measure for dysmenorrhea., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: To investigate the relationship between perceived exertion while bathing/dressing/grooming and associations with social-recreational activities outside the home for individuals with mobility impairment (MI)., Design: A 2-study approach was used to examine data from the American Time Use Survey (ATUS) and primary data from the Health and Home Survey (HHS). The relationship between bathing/dressing/grooming and engagement in social-recreational activities was explored, as well as the role that exertion in the bathroom may play in participation in these activities., Setting: General community setting., Participants: For the ATUS survey, participants (n=6002) included individuals who reported an MI. For the HHS, 2 mail-based recruitment methods were used to recruit a sample of individuals with MI (n=170) across 3 geographically diverse U.S. communities., Interventions: Not applicable., Main Outcome Measures: Participation in social and recreational activities., Results: People with MI (relative to those without MI) were less likely to report spending any time bathing/dressing/grooming on a given day, but spent more time when they did. People with MI reported higher exertion while bathing/dressing/grooming than people without. People with MI were less likely to leave the house or engage in social-recreational activities on days where they did not engage in bathing activities. People who reported greater exertion in the bathroom engaged in fewer social-recreational activities., Conclusions: Exertion in the bathroom may present a barrier to participation, indicating a relationship between exertion in the bathroom and social-recreational participation. Research that examines the impact of home modifications on exertion and participation is needed., (Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Background: There is little published research that has examined practitioners' views and experiences of pain relieving measures commonly used during labour and birth, particularly for non-pharmacological measures such as water immersion. Furthermore, there is minimal published research examining the process of policy and guideline development, that is, the translation of published research to usable practice guidance., Aims: The aims of phase three of a larger study were to explore midwives knowledge, experiences and support for the option of water immersion for labour and birth in practice and their involvement, if any, in development of policy and guidelines pertaining to the option., Methods: Phase three of a three phased mixed methods study included a web based survey of 234 Australian midwives who had facilitated and/or been involved in the development of policies and/or guidelines relating to the practice of water immersion., Findings: Midwives who participated in this study were supportive of both water immersion for labour and birth reiterating documented benefits of reduced pain, maternal relaxation and a positive birth experience. The most significant concerns were maternal collapse, the difficulty of estimating blood loss and postpartum haemorrhage whilst barriers included lack of accredited staff, lifting equipment and negative attitudes. Midwives indicated that policy/guideline documents limited their ability to facilitate water immersion and did not always to support women's informed choice., Conclusion: Midwives who participated in this study supported the practice of water immersion reiterating the benefits documented in the literature and minimal risk to the woman and baby., Ethical Considerations: The Human Research Ethics Committee of the University of South Australia approved the research., (Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

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.

The present study investigated changes in autonomic nervous system activity and emotions after a short (2 h) forest bathing program in the Xitou Nature Education Area (XNEA), Taiwan. One hundred and twenty-eight (60.0 ± 7.44 years) middle-aged and elderly participants were recruited. Physiological responses, pulse rate, systolic and diastolic blood pressure, heart rate variability (HRV), and psychological indices were measured before and after the program. We observed that pulse rate, systolic and diastolic blood pressure were significantly lower after the program, which indicated physiological benefits from stress recovery. The Profile of Mood States negative mood subscale scores of "tension-anxiety", "anger-hostility", "fatigue-inertia", "depression-dejection", and "confusion-bewilderment" were significantly lower, whereas the positive mood subscale score of "vigor-activity" was higher. Furthermore, participants exhibited significantly lower anxiety levels according to the State-Trait Anxiety Inventory. However, changes in sympathetic and parasympathetic nerve activity were nonsignificant. Our study determined that the short forest bathing program is a promising therapeutic method for enhancing heart rate and blood pressure functions as well as an effective psychological relaxation strategy for middle-aged and elderly individuals.

Researchers performed foot baths and massages for residual schizophrenia patients to gauge the effects on psychiatric symptoms. Subjects were six residual schizophrenia patients hospitalized in a psychiatric hospital. Three times a week for 4weeks, they received an 8-minute effleurage massage to their legs after a 10-minute foot bath. The effect of physiological relaxation was identified by a significant decline in heart rate in all cases. The results of the Positive and Negative Symptom Scale are as follows: a mean score of 29.0 was measured before treatment, which lowered to 21.5 after treatment, indicating that foot care improved their negative symptoms (p<0.05).The results of the Quality of Life Scale before the foot care intervention, were 10.5 and increased to 34.0 after the intervention, indicating improvement in their quality of life (p<0.05). The results of the two measurements indicate that foot baths and massages were effective in improving psychiatric symptoms., (Copyright © 2016 Elsevier Inc. All rights reserved.)

When in Istanbul, I visited a hamam, a traditional Turkish bath. I'm familiar with other bathing rituals--steam room, sauna, Jacuzzi--but suspected being washed by someone in front of others was not very British.

Introduction: Skin physiology of neonates and preterm infants and evidence-based skin care are not well explored for health care providers., Aim: The aim of our present study was to investigate the skin care methods of the tertiary Neonatal Intensive Care Units in Hungary., Method: A standardized questionnaire was distributed among the 22 tertiary Neonatal Intensive Care Units with questions regarding skin care methods, bathing, emollition, skin disinfection, umbilical cord care, treatment of diaper dermatitis, and use of adhesive tapes., Results: The skin care methods of the centres were similar in several aspects, but there were significant differences between the applied skin care and disinfectant products., Conclusions: The results of this survey facilitate the establishment of a standardized skin care protocol for tertiary Neonatal Intensive Care Units with the cooperation of dermatologists, neonatologists and pharmacists.

Objectives: To evaluate the effectiveness of the Bathing Without a Battle intervention in reducing physical and verbal aggressive behaviors for nursing home residents with dementia., Design: A randomized crossover diffusion study, with one group receiving the intervention after one round of baseline observations and a delayed intervention group receiving the intervention after two rounds of baseline observations., Setting: Six nursing home facilities in the state of New York., Participants: Nursing home residents with dementia (N = 240)., Intervention: The Bathing Without a Battle educational program, designed for direct-care staff members responsible for bathing residents diagnosed with dementia and implemented through a train-the-trainer model., Measurements: Rates of verbal and physical aggressive and agitated behaviors were measured using the Care Recipient Behavior Assessment; secondary measures of effect included bath duration, bath modality, and antipsychotic medication use., Results: In spite of implementation obstacles (consent delays and change in leadership at one facility), a significant change was observed in how residents were bathed that translated into a significant reduction in the rate of aggressive and agitated behaviors, particularly verbal, during residents' baths. The use of in-bed baths increased 17%, and average bath duration decreased significantly (average 1.5 minutes less) in the postintervention period, particularly for in-bed baths. Verbal behaviors declined 17.8% (P = .008), combined verbal and physical behaviors declined 18.6% (P = .004), and antipsychotic use declined 30% (P = .002) after the intervention., Conclusion: The Bathing Without a Battle educational program, delivered through a train-the-trainer format, is an effective means of improving the bathing experience of residents with dementia in nursing homes. This research supports broadly adopting this intervention, especially for nursing homes serving many residents with dementia., (© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.)

Objectives: Showering before entering a swimming pool is highly recommended to reduce the risk of biological and chemical contamination. This study evaluated the behaviour of indoor swimming pool users; analysed the variables associated with lack of showering; and assessed awareness of the importance of showering., Study Design: Cross-sectional study., Methods: A self-administered questionnaire was used to collect data about users of swimming pools located in five different Italian cities. The association between specific variables and the lack of showering was assessed. P < 0.05 was considered to indicate statistical significance., Results: In total, 4356 questionnaires were analysed. Sixty-five percent of interviewees always showered before entering the pool. The main reason given for pre-swim showering was 'to wash oneself' (50.5%); or 'to get used to the temperature of the water' (44.3%); and 5.2% answered 'for both reasons'. Risk factors significantly associated with lack of showering were: female sex (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.2-1.59), age 14-17 years (OR 5.09, 95% CI 3.40-7.64); not reading the swimming pool rules (OR 1.24, 95% CI 1.10-1.41); living in Central Italy (OR 3.3, 95% CI 2.65-4.1) or Southern Italy (OR 1.35, 95% CI 1.18-1.55); and previous/current attendance of a swimming course (OR 1.7, 95% CI 1.48-1.97)., Conclusions: The results revealed low compliance with the rule of showering before entering a swimming pool, and little awareness of the preventive role of showering in the hygienic management of swimming pools. There is a need for targeted educational interventions to inform swimming pool users of the reasons for the importance of showering before entering a pool., (Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Aim and Objective: 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., Background: 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., Design: A qualitative descriptive study employing the critical incident technique (CIT) was used., Method: Eight PSWs were interviewed and 24 incidents were collected and analyzed using thematic content analysis., Results: 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., Conclusions: 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., Implications for Practice: This study has clear implications for knowledge translation., (© 2011 Blackwell Publishing Ltd.)

To safeguard the quality of life of people suffering from Alzheimer's by the creation of an individual care plan, by identifying pleasurable activities or fond memories of the individual, thereby restoring a sense of present well being. The therapeutic bath, an action which might be considered somewhat straightforward, in fact enables the measurement of the capability of an elderly person to respond to stimulation by medical staff.

Background: Shower assessments are complex and challenging tasks undertaken by many occupational therapists with little known about how they are conducted and how new graduates learn to carry these out. There are no published guidelines and limited opportunity for students to practise shower assessments during their training bringing into question how new graduates learn to do this assessment and judge their effectiveness., Aim: To investigate the experience of new graduate occupational therapists undertaking their first shower assessments in South Australia., Method: Six graduate occupational therapists participated in a phenomenological study. Data were gathered through semi-structured interviews and analysed according to Giorgi's descriptive phenomenological method., Findings: New graduates found the shower assessment process cognitively and emotionally demanding. Without prior experience, new graduates lacked confidence to perform the practical aspects of conducting a shower assessment. The sense of responsibility for getting it right and ensuring client safety was at times overwhelming. Social norms around nudity, age and gender impacted on the graduate's interaction with clients in the shower environment. However, graduates with previous care attendant work were better able to manage the social and practical challenges inherent in shower assessments., Conclusion: The findings of this study suggest that additional experiential, 'hands on', learning is needed in university curriculum for new graduates to develop practical clinical skills, particularly as practice placements have become more diverse. Similarly there is a need for organisations to provide orientation activities and mentoring for new graduates as they transition from student to therapist., (© 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.)

Background: Cannabis is the most commonly used illicit substance worldwide. Cannabinoids or cannabinoid receptor agonists are often used to treat nausea, vomiting, and anorexia. However, in recent years, several medical journals have published reports of patients with nausea and vomiting thought to be induced by chronic cannabis use., Objective: The authors seek to inform readers about Cannabinoid Hyperemesis Syndrome (CHS)., Method: The authors describe four patients with chronic cannabis abuse, episodic, intractable nausea and vomiting, and compulsive hot water bathing. Previous cases of CHS are reviewed, pathophysiology is hypothesized, and difficulties with making the diagnosis are discussed., Conclusion: CHS should be strongly considered in the differential diagnosis of patients with intractable vomiting and/or compulsive hot water bathing., (Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.)

Background: In this prospective longitudinal study, we investigated the relation between sleeping arrangements and infant cortisol reactivity to stressors in the first two post-natal months. Co-sleeping, as compared to solitary sleeping, is hypothesized to provide more parental external stress regulation by night, thus reducing general stress sensitivity. We therefore expected lower cortisol reactivity to stress in infants who co-slept more regularly., Methods: Participants were 163 mothers and infants from uncomplicated, singleton pregnancies. Mothers completed daily diaries on sleeping arrangements in the first 7 weeks of life. Co-sleeping was defined as sleeping in the parents' bedroom (i.e. own or parents' bed). Cortisol reactivity was measured twice: to a mild physical stressor (bathing session) at 5 weeks of age and to a mild pain stressor (vaccination) at 2 months of age., Results: Infants with a solitary sleeping arrangement in their first month of life showed a heightened cortisol response to the bathing session at 5 weeks compared to infants that co-slept regularly. This effect was not explained by breastfeeding practices, maternal caregiving behavior, or infants' night waking and sleep duration. No effects were found of co-sleeping on the cortisol response to the vaccination at 2 months., Conclusions: The results suggest that solitary sleeping in the first month of life is associated with heightened sensitivity of the HPA-axis to a mild stressor, possibly due to less nocturnal parental availability as external stress regulator. Whether this effect continues in later life, remains to be investigated., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Classic and contemporary research on person perception has demonstrated the paramount importance of interpersonal warmth. Recent research on embodied cognition has shown that feelings of social warmth or coldness can be induced by experiences of physical warmth or coldness, and vice versa. Here we show that people tend to self-regulate their feelings of social warmth through applications of physical warmth, apparently without explicit awareness of doing so. In Study 1, higher scores on a measure of chronic loneliness (social coldness) were associated with an increased tendency to take warm baths or showers. In Study 2, a physical coldness manipulation significantly increased feelings of loneliness. In Study 3, needs for social affiliation and for emotion regulation, triggered by recall of a past rejection experience, were subsequently eliminated by an interpolated physical warmth experience. Study 4 provided evidence that people are not explicitly aware of the relationship between physical and social warmth (coldness), as they do not consider a target person who often bathes to be any lonelier than one who does not, with all else being equal. Together, these findings suggest that physical and social warmth are to some extent substitutable in daily life and that this substitution reflects an unconscious self-regulatory mechanism., (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Persistent genital arousal disorder is not well known or adequately understood by physicians. The disorder is characterized by a persistent and highly unwanted state of genital arousal and orgasm-like feelings. Ghusl is an ablution in Islamic culture, which is an obligatory ritual wherein the body is washed thoroughly after exposure to religious contaminants such as sexual intercourse, menstruation, and childbirth. Muslim women suffering from the disorder may bathe frequently because of their religious beliefs. The authors summarize the case histories of 3 patients with persistent genital arousal disorder who were initially misdiagnosed with obsessive-compulsive disorder. All 3 patients presented with complaints of unwanted, persistent orgasms or orgasm-like arousals, and as a result, they performed ghusl several times a day. At previous interviews, the genital arousal was diagnosed as a sexual and somatic obsession, and repeatedly performing ghusl was considered a cleansing compulsion. Physicians' lack of awareness or knowledge of persistent genital arousal disorder, combined with the unwillingness of patients to discuss sexual problems, can lead to a focus on the repetitive bathing, and thus, a misdiagnosis of the problem as obsessive-compulsive disorder. These cases are presented to highlight the possible pitfalls in the diagnosis of persistent genital arousal disorder cases in Islamic countries where ghusl is common.

We observed that neonates who cried during bathing on day 2 still cried on days 3 and 4. The correlation coefficient, for example, between day 2 and day 3 was r=0.410, p<0.001, n=100. Neonates may already have a distinct temperament (withdrawal and adaptability) as early as day 2 after birth., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Objective: Benefits attributed to waterbirth (WB) include a shorter second stage of labour and reduction of perineal trauma. The aim of this study is to assess the incidence of perineal trauma and pelvic floor function following WB compared to land birth (LB)., Study Design: We conducted a retrospective analysis on the incidence of perineal trauma following a spontaneous WB (n=160) or a LB (n=623). Data were collected using the hospital's healthcare database, which codes information on pregnancy outcomes and related variables. ICIQ-VS for vaginal symptoms, and the ICIQ-KH Long Form (KHQ) were used to assess pelvic floor function a year after delivery., Results: Length of 2nd stage was significantly shorter in the WB group. Although this did not translate into less perineal trauma, the incidence of 3rd degree tears appeared to be doubled in the WB group. 77 (38.5%) women from the WB group and 54 (22%) from the LB group answered the postal questionnaires. A significant number of women reported vaginal and urinary symptoms, however the difference between both groups was not statistically significant., Conclusion: Waterbirth results in a shorter 2nd stage of labour. This does not lead to less overall perineal trauma or better pelvic floor performance postpartum. Physical limitations in protecting the perineum during the expulsion phase may be associated with an increase in the incidence of 3rd degree tears in the WB population., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

In her essays on Wieland, written around 1980, Elizabeth Boa went against contemporary fashion both by praising a neglected writer and by vindicating the role of pleasure in the reception of literature. She noted how Wieland varies a literary topos – a man watching a woman bathing naked – by letting women watch men bathing naked. This topos most often occurs in the pastoral, a popular eighteenth-century genre. Various examples are examined to show that they suggest equality rather than male dominance in relations between the sexes: men watching women bathing in James Thomson and Gottfried Keller; an example involving cross-dressing in Kleist; and finally women watching men bathing naked in Swift, Voltaire and Wieland's Idris und Zenide.

Goals/background: The cannabis hyperemesis syndrome, which is associated with chronic cannabis use, was recently reported in seven case reports and one clinical series of ten patients from Australia. We further characterize this syndrome with eight well-documented cases in the United States and report results of cannabis discontinuation and cannabis rechallenge., Study Methods: Patients were identified by the three investigators in gastroenterology clinic or inpatient wards at William Beaumont Hospital from January to August 2009 based on chronic cannabis use; otherwise unexplained refractory, recurrent vomiting; and compulsive bathing. Charts were retrospectively analyzed with follow-up data obtained from subsequent physician visits and patient interviews., Results: The eight patients on average were 32.4 ± 4.1 years old. Five were male. The mean interval between the onset of cannabis use and development of recurrent vomiting was 19.0 ± 3.7 years. Patients had a mean of 7.1 ± 4.3 emergency room visits, 5.0 ± 2.7 clinic visits, and 3.1 ± 1.9 admissions for this syndrome. All patients had visited at least one other hospital in addition to Beaumont Hospital. All patients had vomiting (mean vomiting episodes every 3.0 ± 1.7 h), compulsive bathing (mean = 5.0 ± 2.0 baths or showers/day; mean total bathing time = 5.0 ± 5.1 h/day), and abdominal pain. Seven patients took hot baths or showers, and seven patients experienced polydipsia. Four out of five patients who discontinued cannabis use recovered from the syndrome, while the other three patients who continued cannabis use, despite recommendations for cessation, continued to have this syndrome. Among those four who recovered, one patient had recurrence of vomiting and compulsive bathing with cannabis resumption., Conclusions: Cannabis hyperemesis is characterized by otherwise unexplained recurrent nausea and vomiting, compulsive bathing, abdominal pain, and polydipsia associated with chronic cannabis use. This syndrome can occur in the United States as well as in Australia. Cannabis cessation may result in complete symptomatic recovery.

According to our previous research, the use of glory holes in public venues such as saunas and bathhouses is very popular. The popularity of glory holes is due in part to the anonymous sex that these architectural elements allow. This post-structuralist theoretical reflection seeks to understand the specific nature of anonymous public sex among bathhouse patrons, focusing on the links between desire-architecture-place-sexual practices. Drawing on interviews with glory hole users gathered during an ethnographic research project in bathhouses, this essay goes beyond traditional public health discourse to offer an original perspective on anonymous public sex. Utilizing the philosophy of Deleuze and Guattari's concepts of assemblages and machines, we re-theorize glory hole sex--what we call 'faceless sex'--and rethink the ways that desire is imbricated with our understanding of architecture, place, and public. Finally, we reflect upon the particular ethical challenges that are posed by these particular sexual practices, and ask whether a post-structuralist ethic might be possible.

Background: Health behaviour models have been mainly used to explain indicators and the development of hygiene behaviours. However, health behaviour models do not explain and predict general and oral hygiene behaviours., Aim: To develop and test a theoretical model of the factors influencing oral and general hygiene behaviours in male and female adolescents in Mashhad, Iran., Design: A representative stratified random sample of 1132 6th grade Iranian students in Mashhad, with an average age of 12.4 (SD = 0.8) years, answered a 37-item questionnaire. The questionnaire had items on socio-demographic characteristics, education achievement and future aspiration, Sense of Coherence, toothbrushing frequency, frequency of showering and changing underwear, and peer social networks. Confirmatory structural equation modelling was used to test the validity of the model in the whole sample and among two sexes separately., Results: All measurement models fitted the data. Significant correlations among latent variables were observed. Fit indices indicated good representation of the data in the whole sample. Goodness-of-fit statistics were significant among the two sexes., Conclusions: The proposed theoretical model of the factors influencing general and oral hygiene behaviours in adolescents was valid. Further studies should further investigate the properties of this model in different populations.

This study compared the levels of anxiety presented by patients with acute myocardial infarction in bed and shower baths and the influence of antecedent variables: age, gender, medications, previous hospitalization and/or bed bath, patients' preference regarding the professional's gender, risk factors and anxiety-traits. This crossover study was conducted between February and August 2007 in coronary units. The sample was composed of 71 patients with acute myocardial infarction. The State-Trait Anxiety Inventory (STAI) was applied before the baths (bed and shower baths), immediately after the baths and twenty minutes after the second evaluation. Results revealed that patients were more anxious in the bed bath than in the shower in the three assessments (p <0.0001) and the only variable that interfered with state-anxiety was high blood pressure.

Objectives: To understand the bathing experiences, attitudes, and preferences of older persons in order to inform the development of effective patient-centered interventions., Design: Qualitative study using the Grounded Theory framework., Setting: In-depth, semistructured interviews were conducted in participants' homes., Participants: Twenty-three community-living persons aged 78 and older identified from the Precipitating Events Project (PEP)., Measurements: Open-ended questions about bathing habits, personal meaning and purpose of bathing, difficulties and concerns about bathing, preferences for independent bathing, and attitudes toward different types of bathing assistance., Results: Three themes emerged: the importance and personal significance of bathing to older persons; variability in attitudes, preferences, and sources of bathing assistance; and older persons' anticipation of and responses to bathing disability., Conclusion: The bathing experiences described by study participants underscore the personal significance of bathing and the need to account for attitudes and preferences when designing bathing interventions. Quantitative disability assessments may not capture the bathing modifications made by older persons in anticipation of disability and may result in missed opportunities for early intervention. Findings from this study can be used to inform the development of targeted, patient-centered interventions that can subsequently be tested in clinical trials.

This study investigated the experience and perceptions of Georgia certified nurse-midwives about waterbirth and their level of support for establishing waterbirth in their work setting. A survey was distributed to a convenience sample of 119 certified nurse-midwives from the American College of Nurse Midwives, Georgia chapter; 45% of those surveyed responded. The majority of midwives had some exposure to waterbirth through self-education or through clinical practice. More than half supported the incorporation of waterbirth in their workplace setting. Maternal relaxation and reduced use of analgesia were perceived as the greatest benefit of waterbirth. Of 11 items related to disadvantages of waterbirth, certified nurse-midwives were moderately to severely concerned about none. The most concerning factors, with a mean of 2.4 to 2.5 on a scale of 1 (no worry) to 5 (severe worry), were maintenance of water temperature, physical stress on the midwife, and inability to see the perineum. Midwives' support for waterbirth focused mostly on the perceived benefits to the mother with little worry about the risks., (Copyright 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.)

This uncontrolled intervention study explored the effects of stone spa use on the psychological states of women. Sixty-eight female volunteers (mean age 37.5 years (standard deviation 14.8)) recruited at a women-only stone spa facility participated in the study. They completed the short-form Profile of Moods States (POMS) and the State-Trait Anxiety Inventory (STAI) before and after stone spa use in order to determine changes in mood and anxiety states. Six factors relating to mood were measured using the POMS: Tension-Anxiety, Depression-Dejection, Anger-Hostility, Vigor, Fatigue, and Confusion. The two anxiety concepts of state anxiety and trait anxiety were also measured. The scores for Tension-Anxiety and Anger-Hostility and both anxiety measures were improved statistically after stone spa use. Stone spa use shows considerable promise for improving mood and reducing anxiety. Since this study was a descriptive, prospective and uncontrolled intervention study, further investigation of these promising findings is warranted.

Objective: to evaluate the effect of an immersion bath on pain magnitude during the first stage of labour., Design: a randomised controlled trial comparing the pain scores of bathing and non-bathing nulliparous women during birth was employed., Setting: the study was conducted at the Normal Birth Center of Amparo Maternal, São Paulo, Brazil., Participants: 108 birthing women, with 54 women randomly assigned to each group., Interventions: when the birthing women presented at 6-7 cm of cervical dilation, they were placed in an immersion bath for 60 mins., Outcome Measures: pain scores, using a behavioural pain scale and a numeric scale, were recorded at two evaluation time points: at 6-7 cm of cervical dilation and 1h after the first pain score evaluation., Findings: at the first evaluation, on the behavioural scale, the means were 2.1 for both groups (p=0.914; 95% confidence intervals (CI) 1.9-2.3 for the control group and 2.0-2.2 for the experimental group). On the numeric scale, the means were 8.7 and 8.5 for the control and experimental groups, respectively (p=0.235; 95% CI 8.2-9.2 for the control group and 8.1-8.9 for the experimental group). At the second evaluation, the pain score means for both scales were statistically higher in the control group than in the experimental group. On the behavioural scale, the scores were 2.4 vs. 1.9, respectively, for the control and experimental groups (p<0.001; 95% CI 2.2-2.6 for the control group and 1.7-2.1 for the experimental group). On the numeric scale, the scores were 9.3 vs. 8.5, respectively, for the control and experimental groups (p<0.05; 95% CI 8.9-9.7 for the control group and 8.1-8.9 for the experimental group)., Conclusions: mean labour pain scores in the control group were significantly higher than those in the experimental group. The present findings suggest that use of an immersion bath is a suitable alternative form of pain relief for women during labour.

Background: Aquagenic pruritus (AP) occurs during or after contact of the skin with water such as occurs in bathing., Methods: This study aims to describe the prevalence of aquagenic pruritus in a young adult population and describe the circumstances of bathing.A Population-based cross sectional study involving administration of Questionnaires to young adult Nigerians on the occurrence of pruritus associated with bathing., Results: The prevalence of bathing pruritus among respondents in this study was 23.8%. The commonest type of water respondents itch to was rain water (23%) followed by cold water (19%). 8.33% of respondents feels like avoiding bathing because of these., Conclusion: Bathing pruritus is a common finding among young adult Nigerians in the general population.