Early newborn bathing practice and its determinants among postpartum women in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Early baby bathing has a major negative impact on the newborn's health. Even though early newborn bathing has numerous detrimental effects on neonatal health, evidence has provided little attention on the current level of practice. Furthermore, there is a dearth of data regarding the overall effects of early newborn bathing in Ethiopia, which would be helpful to program and policy designers. This meta-analysis aimed to ascertain the level of early bathing practice and its determinants among postpartum women in Ethiopia. METHODS: All articles were searched from the Web of Sciences, CINAHL (EBOSCO), Science Direct, MEDLINE, PubMed, Google Scholar, and Google websites from inception to October 10, 2023. The meta-analysis was performed using Stata version 18. The summary estimates with 95% CI were estimated using the random effect model with the Der Simonian Liard method. Heterogeneity was explored using Galbraith plot, Cochrane Q statistics, I2 statistics, and test of theta. To deal with the observed heterogeneity, subgroup analysis, sensitivity analysis, and meta-regression were done. RESULTS: This meta-analysis included a total of 2787 postpartum women. The pooled level of early newborn bathing practice among postpartum women in Ethiopia was 55% [95% CI: 38-71]. Based on subgroup analysis by region, the highest level of early newborn bathing practice was among studies conducted in the Afar region which was 73% (95% CI: 69-77). There is a significant association between maternal level of education and early newborn bathing practice among postpartum women in Ethiopia (AOR = 0.51, 95% CI: 0.24, 0.78). CONCLUSIONS: In this meta-analysis, the overall estimate illustrates that more than half of postpartum women practice early newborn bathing in Ethiopia. Maternal level of education was significantly associated with early newborn bathing practice. Thus, both the government and all the concerned stakeholders should take coordinated action to boost information dissemination and awareness creation among postpartum women thereby reducing the practice of early newborn bathing and alleviating consequences of early newborn bathing.

Endotoxin, a novel biomarker for the rapid risk assessment of faecal contamination of coastal and transitional waters.

Current methods for testing water for faecal contamination rely on the culture of faecal indicator bacteria (FIB; Escherichia coli and Enterococci) that take 24-48 h, which leads to delays in taking proactive measures and poses a risk to public health. More rapid methods are therefore required. Here, we have tested a rapid, portable assay (Bacterisk) that detects the bacterial biomarker endotoxin in 30 min to quantify the bacterial biomass present, to evaluate 159 coastal water samples and to compare the results with the traditional culture of FIB. There was a significant correlation between the Bacterisk data given in endotoxin risk (ER) units and FIB culture that could accurately distinguish between poor and sufficient or good quality bathing water using the EU bathing directive values. Receiver operating characteristic analysis was used to determine the optimal ER threshold for coastal water samples, and the area under the curve was 0.9176 with a p-value of <0.0001. The optimal threshold was 7,300 ER units with a sensitivity of 95.45% and a specificity of 83.48%. In conclusion, we have shown that the Bacterisk assay provides a rapid and easy-to-use in situ method to assess bathing water quality.

Availability of family care resources, bathing assistance and toileting assistance among older adults with functional limitations: an evidence-based study from China.

BACKGROUND: An aging population has contributed to an increasing prevalence of functional limitations among older adults. Family support plays a crucial role in toileting and bathing assistance. Yet, the relationship between availability of family care resources and such actual assistance remains insufficiently explored. Our study aims to describe availability of family care resources and identify the association between availability of family care resources and toileting assistance or bathing assistance. METHODS: This study employed a cross-sectional analysis of data from the 2018 National Survey of the China Health and Retirement Longitudinal Study (CHARLS). The availability of family care resources was assessed using measurements of spouse availability, adult child availability, and living arrangement. Bathing assistance and toileting assistance were measured based on self-reported receipt of such assistance. Descriptive statistics were used to depict the overall and subgroup situation of availability of family care resources. Multivariable logistic models were employed to investigate the relationship between availability of family care resources and the receipt of toileting assistance or bathing assistance. RESULTS: Among the sample of older adults with functional limitations, 69% had a spouse, 63% had at least one adult child, and 80% resided with family members. Among those with bathing disability, 13% reported lacking bathing assistance, and among those with toileting disability, 54% reported lacking toileting assistance. Participants with 1-2 adult children had lower odds of receiving toileting assistance (OR: 0.28, 95% CI: 0.09, 0.91, p= 0.034) compared to those with three or more adult children. Spouse availability and living arrangement did not exhibit statistically significant associations with toileting assistance. Participants without a spouse had lower odds of receiving bathing assistance (OR: 0.27, 95% CI: 0.09-0.78, p= 0.016) in comparison to those with a spouse; however, adult child availability and living arrangement did not display statistically significant associations with bathing assistance. CONCLUSION: The present findings suggest a gap in family commitment when it comes to assisting older adults with functional limitations in bathing/toileting. To address this, policymakers are encouraged to prioritize the implementation of proactive mechanisms for identifying family caregivers, alongside incentives to enhance their engagement in practical caregiving activities. Furthermore, it is crucial to emphasize the prioritization of affordable and easily accessible formal toileting/bathing assistance options for older adults who lack sufficient family care resources.

Carbapenemase gene blaOXA-48 detected at six freshwater sites in Northern Ireland discharging onto identified bathing locations.

Faecal contamination of surface waters has the potential to spread not only pathogenic organisms but also antimicrobial resistant organisms. During the bathing season of 2021, weekly water samples, from six selected coastal bathing locations (n = 93) and their freshwater tributaries (n = 93), in Northern Ireland (UK), were examined for concentrations of faecal indicator bacteria Escherichia coli and intestinal enterococci. Microbial source tracking involved detection of genetic markers from the genus Bacteroides using PCR assays for the general AllBac marker, the human HF8 marker and the ruminant BacR marker for the detection of human, and ruminant sources of faecal contamination. The presence of beta-lactamase genes blaOXA-48, blaKPC, and blaNDM-1 was determined using PCR assays for the investigation of antimicrobial resistance genes that are responsible for lack of efficacy in major broad-spectrum antibiotics. The beta-lactamase gene blaOXA-48 was found in freshwater tributary samples at all six locations. blaOXA-48 was detected in 83% of samples that tested positive for the human marker and 69% of samples that tested positive for the ruminant marker over all six locations. This study suggests a risk of human exposure to antimicrobial resistant bacteria where bathing waters receive at least episodically substantial transfers from such tributaries.

Risk, Predictive, and Preventive Factors for Noninfectious Ventriculitis and External Ventricular Drain Infection.

BACKGROUND: External ventricular drain (EVD) is used for monitoring intracranial pressure or diverting cerebrospinal fluid. However, confirmation of an infection is not immediate and requires obtaining culture results, often leading to the excessive use of antibiotics. This study aimed to compare noninfectious ventriculitis and EVD infection in terms of the risk factors, predictors, prognosis, and effectiveness of care bundle interventions. METHODS: This retrospective study was conducted at a medical center with 1,006 beds in northern Taiwan between January 2018 and July 2022. Standard EVD insertion protocols and care bundles have been implemented since 2018, along with the initiation of chlorhexidine. RESULTS: In total, 742 EVD cases were identified. Noninfectious ventriculitis typically presents with fever approximately 8 days following EVD placement, whereas EVD infection typically manifests as fever after 20 days. Aneurysmal subarachnoid hemorrhage was strongly associated with the development of noninfectious ventriculitis (adjusted odds ratio [OR] 2.6, 95% confidence interval [CI] 1.5-4.4). Alcoholism (adjusted OR 3.5, 95% CI 1.1-12.3) and arteriovenous malformation (adjusted OR 13.1, 95% CI 2.9-58.2) significantly increased the risk of EVD infection. The EVD infection rate significantly decreased from 3.6% (14 of 446) to 1.0% (3 of 219) (p = 0.03) after the implementation of chlorhexidine gluconate bathing. CONCLUSIONS: Aneurysmal subarachnoid hemorrhage or fever with neuroinflammation within 2 weeks of EVD placement is indicative of a higher likelihood of noninfectious ventriculitis. Conversely, patients with arteriovenous malformation, alcoholism, or fever with neuroinflammation occurring after more than 3 weeks of EVD placement are more likely to necessitate antibiotic treatment for EVD infection. Chlorhexidine gluconate bathing decreases EVD infection.

Ultrasound-guided Lipiodol® hysterosalpingography: A prospective study on pregnancy and complication rates.

BACKGROUND: Fluoroscopic hysterosalpingography (HSG) with Lipiodol® is safe and has a therapeutic effect on fertility: transient in endometriosis-related infertility and sustained in unexplained infertility. Ultrasound is replacing fluoroscopy as the preferred imaging modality for HSG due to comfort and radiation safety (no ionising radiation). The safety of ultrasound-guided Lipiodol® HSG is uncertain. AIMS: Prospectively observe pregnancy and complication rates after ultrasound-guided Lipiodol® HSG. MATERIALS AND METHODS: A single-centre prospective study of women with unexplained infertility undergoing ultrasound-guided Lipiodol® uterine bathing and tubal flushing after tubal patency confirmed with ExEm® Foam HyFoSy (hysterosalpingo-foam-sonography). Pregnancy outcomes at six months and serum and urinary thyroid function at one, three and eight weeks were recorded. Pain scores were recorded during and immediately after HSG. Descriptive statistics are reported. RESULTS: Fifty-two participants were enrolled between July 2019 and April 2021, median age 33 years (range 21-45). Only 45 (87%, 45/52) completed the Lipiodol® HSG; 5/7 experienced intravasation during initial HyFoSy. Of 30 women at follow-up, 57% had biochemical (17/30, 95% CI 37%-75%), 53% clinical (16/30 95% CI 34%-72%) and 35% ongoing pregnancies (11/30, 95% CI 20%-56%). The rate of subclinical hypothyroidism (SCH) at two months was 41% (7/17). One intravasation event occurred during Lipiodol® HSG (2%, 1/45). Median pain score was 5/10 (range 0-9, interquartile range 2.5-7). No anaphylaxis, infection or oil embolism was observed. CONCLUSION: Outpatient ultrasound-guided Lipiodol® HSG was safe, with pregnancy rates comparable to previous studies of fluoroscopic guidance. Rates of intravasation and SCH were also similar, confirming the need to monitor thyroid function.

Sauna bathing, renal function and chronic kidney disease: Cross-sectional and longitudinal findings from the KIHD study.

BACKGROUND: It is uncertain if passive heat therapies are associated with adverse renal outcomes. We sought to evaluate the cross-sectional and longitudinal associations of the frequency of sauna bathing with renal function measures and chronic kidney disease (CKD). MATERIALS AND METHODS: Baseline self-reported sauna bathing habits were assessed in 2071 men aged 42-61 years with normal kidney function. Baseline estimated glomerular filtration rate (GFR) and serum levels of creatinine, potassium (K) and sodium (Na) were measured, with only 11-year measurements of K and Na 11 years in a random subset of participants due to logistical reasons. Study participants were followed up for CKD diagnosed using KDOQI guidelines, which were collected from the National Hospital Discharge Registry. The associations of frequency of sauna bathing with renal function measures were evaluated using regression analyses. Hazard ratios (HRs; 95% CIs) were estimated for CKD. RESULTS: There were no significant changes in baseline levels of estimated GFR, creatinine and Na comparing 4-7 sauna sessions/week versus 1 sauna session/week; there was a slight increase in K .05 mmoL/L (95% CI, .00, .10; p = .033). There were no significant changes in levels of serum K and Na at 11 years. After 25.7 years overall median follow-up, 188 CKD cases were recorded. Comparing 4-7 sauna sessions/week with 1 sauna session/week, there was no evidence of an association with CKD .84 (95% CI, .46-1.53; p = .56). CONCLUSIONS: Cross-sectional and longitudinal observational evidence suggests that frequent sauna bathing is not associated with impaired renal function or the future risk of CKD.

Early emollient bathing is associated with subsequent atopic dermatitis in an unselected birth cohort study.

BACKGROUND: Skin barrier dysfunction is a key component of the pathogenesis of atopic dermatitis (AD). Recent research on barrier optimization to prevent AD has shown mixed results. The aim of this study was to assess the relationship between emollient bathing at 2 months and the trajectory of AD in the first 2 years of life in a large unselected observational birth cohort study. METHODS: The Babies After SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints Birth Cohort study enrolled 2183 infants. Variables extracted from the database related to early skincare, skin barrier function, parental history of atopy, and AD outcomes. Statistical analysis was performed to adjust for potential confounding variables. RESULTS: One thousand five hundred five children had data on AD status available at 6, 12, and 24 months. Prevalence of AD was 18.6% at 6 months, 15.2% at 12 months, and 16.5% at 24 months. Adjusted for potential confounding variables, the odds of AD at any point were higher among infants who had emollient baths at 2 months (OR (95% CI): 2.41 (1.56 to 3.72), p < .001). Following multivariable analysis, the odds of AD were higher among infants who had both emollient baths and frequent emollient application at 2 months, compared with infants who had neither (OR (95% CI) at 6 months 1.74 (1.18-2.58), p = .038), (OR (95% CI) at 12 months 2.59 (1.69-3.94), p < .001), (OR (95% CI) at 24 months 1.87 (1.21-2.90), p = .009). CONCLUSION: Early emollient bathing was associated with greater development of AD by 2 years of age in this population-based birth cohort study.

Guidelines of care for the management of atopic dermatitis in adults with topical therapies.

BACKGROUND: New evidence has emerged since the 2014 guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These guidelines update the 2014 recommendations for management of AD with topical therapies. OBJECTIVE: To provide evidence-based recommendations related to management of AD in adults using topical treatments. METHODS: A multidisciplinary workgroup conducted a systematic review and applied the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach for assessing the certainty of evidence and formulating and grading recommendations. RESULTS: The workgroup developed 12 recommendations on the management of AD in adults with topical therapies, including nonprescription agents and prescription topical corticosteroids (TCS), calcineurin inhibitors (TCIs), Janus kinase (JAK) inhibitors, phosphodiesterase-4 inhibitors (PDE-4), antimicrobials, and antihistamines. LIMITATIONS: The pragmatic decision to limit the literature review to English-language randomized trials may have excluded data published in other languages and relevant long-term follow-up data. CONCLUSIONS: Strong recommendations are made for the use of moisturizers, TCIs, TCS, and topical PDE-4 and JAK inhibitors. Conditional recommendations are made for the use of bathing and wet wrap therapy and against the use of topical antimicrobials, antiseptics, and antihistamines.

Executive summary: American Academy of Dermatology guidelines of care for the management of atopic dermatitis in adults with topical therapies.

These guidelines update the 2014 recommendations for management of atopic dermatitis in adults with topical therapies. A multidisciplinary workgroup employed best practices for guideline development, including a systematic review of the evidence and application of the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of the evidence and formulating and grading recommendations. The evidence on atopic dermatitis treatment supported strong recommendations for the use of nonprescription moisturizers, topical calcineurin inhibitors, topical corticosteroids, and topical PDE-4 and JAK inhibitors. Conditional recommendations are made for the use of bathing and wet wrap therapy and against the use of topical antimicrobials, antiseptics, and antihistamines.

Drowning rates among children and adolescents (aged 7-17) in Israel during the years 2008-2018.

OBJECTIVE: Drowning is one of the leading causes of death among children and youth worldwide. This study aims to examine differences in the rates of drowning (fatal and non-fatal drowning) among children and youth in Israel stratified by age, sex, sector, place of drowning, and the drowning outcome. In addition, we compared the results of studies reported in other countries in specific age groups based on statistics of about 100,000 drowning cases. METHOD: A statistical analysis of 474 drownings between 2008 and 2018 was conducted. All cases refer to youngsters aged 7-17 in the State of Israel. Statistical analysis was performed on data obtained from the Beterem - Safe Kids Israel organization and from the Israel Central Bureau of Statistics. Disparities between groups within the examined population were analyzed based on gender, sector (Jewish versus non-Jewish), and drowning site. RESULTS: Of the 474 drownings that occurred during 2008-2018, 38.4% ended in death. 79% of the cases occurred in pools. The Arab minority sector (21.1% of the general population) accounted for 25.1% of all drownings, males accounted for 70.5% of the drowning cases, and the age group with the most drownings (48.5%) was that of 15-17 years. The Jewish population was involved in more than 75% of drownings in places designated for bathing and in more than 83% of all disaster scenarios, whereas the Arab minority was involved in more than 61% of drownings in places not designated for bathing. CONCLUSIONS: The results are comparable to those of other studies worldwide. Boys drown twice as much as girls, mainly in the age group of 15-17. This may be explained by overconfidence in boys and a tendency to overestimate their actual swimming abilities. Most drownings occur in pools. Drowning among the Jewish population occurs mainly in designated bathing sites. PRACTICAL APPLICATIONS: The findings can and, in fact, must be used to inform and educate the younger generation as to the potential dangers involving bathing in designated bathing sites.

Frequency of newborn bathing in the first 9 weeks of life and related factors: An observational study in a community-based sample from Meta-LARC.

PURPOSE: Environmental factors such as bathing may play a role in atopic dermatitis (AD) development. This analysis utilized data from the Community Assessment of Skin Care, Allergies, and Eczema (CASCADE) Trial (NCT03409367), a randomized controlled trial of emollient therapy for AD prevention in the general population, to estimate bathing frequency and associated factors within the first 9 weeks of life. METHODS: Data were collected from 909 parent/newborn dyads recruited from 25 pediatric and family medicine clinics from the Meta-network Learning and Research Center (Meta-LARC) practice-based research network (PBRN) consortium in Oregon, North Carolina, Colorado, and Wisconsin for the CASCADE trial. Ordinal logistic regression was used to conduct a cross-sectional analysis of the association between bathing frequency (measured in baths per week) and demographic, medical, and lifestyle information about the infant, their family, and their household. Variables were selected using a backwards-stepwise method and estimates from the reduced model are reported in the text. RESULTS: Moisturizer use (OR = 2.03, 95% CI: 1.54-2.68), Hispanic or Latino ethnicity (OR = 1.97, 95% CI: 1.42-2.72), a parental education level lower than a 4-year college degree (OR = 2.48, 95% CI: 1.70-3.62), living in North Carolina or Wisconsin (compared to Oregon; OR = 2.12 and 1.47, 95% CI: 1.53-2.93 and 1.04-2.08, respectively), and increasing child age (in days; OR = 1.02, 95% CI: 1.01-1.02) were significantly associated with more frequent bathing, while pet ownership (OR = 0.67, 95% CI: 0.52-0.87) was significantly associated with less frequent bathing. CONCLUSIONS: We found significant ethnic, geographic, and socioeconomic variation in bathing frequency before 9 weeks of age that may be of relevance to AD prevention studies.

Maternal and child factors associated with late neonatal bathing practices in Nigeria: evidence from a national survey.

BACKGROUND: Twohundred and seventy out of every thousand live births died in Nigeria in 2019. These deaths were attributable to infections, complications of preterm birth, and intrapartum-related conditions. The World Health Organization recommends withholding bathing of neonates until 24 h after birth or until their vital signs become stable to prevent hypothermia. Despite the link between neonatal bathing and thermal control, the subject is understudied in Nigeria. This study aimed at investigating the factors associated with late neonatal bathing practices in Nigeria. METHODS: The study adopted a cross-sectional design and extracted data from the women's file of the 2018 Nigerian Demographic and Health Survey. The unit of analysis was limited to 12,972 women who had complete data for the study. We applied chi-square test of independence to ascertain the association between the outcome variable and explanatory variables. At 95% confidence interval, two logistic regression models were built with Model I consisting of only maternal factors whilst Model II contained both maternal and child factors, and results were presented in adjusted odds ratio. RESULTS: Descriptively, 12% (CI = 0.122-0.134) of the women bathed their neonates after 24 h of delivery. Inferentially, women with secondary/higher education [AOR = 1.30, CI = 1.05-1.61], the rich [AOR = 1.24, CI = 1.03-1.50], those with access to mass media [AOR = 131, CI = 1.15-1.50], women that professed other religions [AOR = 9.28, CI = 4.24-17.56], those who delivered in a health facility [AOR = 1.93, CI = 1.66-2.25], whose child was small in size at birth [AOR = 1.46, CI = 1.21-1.77] and delivered by caesarean section [AOR = 2.50, CI = 1.97-3.18] had higher odds of bathing their neonates 24 h after birth. CONCLUSIONS: The proportion of women who practised late neonatal bathing was generally low. To improve the practice of late neonatal bathing, much-concerted effort should be directed to women's education and approaches to increasing receptivity of late neonatal bathing among pregnant women through the media. The Nigerian Ministry of Health should incorporate routine counselling on the risks of bathing newborns prematurely into antenatal and postnatal care services.

Association between Radon Hot Spring Bathing and Health Conditions: A Cross-Sectional Study in Misasa, Japan.

No epidemiological studies have examined the health effects of daily bathing in radon hot springs. In this cross-sectional study, we investigated the associations between radon hot spring bathing and health conditions. The target population was 5,250 adults ≥ 20 years old in the town of Misasa, Japan. We collected information about the participants' bathing habits and alleviation of a variety of disease symptoms, and their self-rated health (SRH). Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated. In both the adjusted and unadjusted models of hypertension, significant associations between the > 1×/week hot spring bathing and the alleviation of hypertension symptoms were observed compared to the group whose hot spring bathing was <1×/week: adjusted model, OR 5.40 (95%CI: 1.98-14.74); unadjusted model, 3.67 (1.50-8.99) and for gastroenteritis: adjusted model, 9.18 (1.15-72.96); unadjusted model, 7.62 (1.59-36.49). Compared to the no-bathing group, higher SRH was significantly associated with both bathing < 1×/week: unadjusted model, 2.27 (1.53-3.37) and > 1×/week: adjusted model, 1.91 (1.15-3.19). These findings suggest that bathing in radon hot springs is associated with higher SRH and the alleviation of hypertension and gastroenteritis.

Active recovery vs hot- or cold-water immersion for repeated sprint ability after a strenuous exercise training session in elite skaters.

This study compared the acute effects of three recovery methods: active recovery (AR), hot- and cold-water immersion (HWI and CWI, respectively), used between two training sessions in elite athletes. Twelve national-team skaters (7 males, 5 females) completed three trials according to a randomized cross-over study. Fifteen minutes after an exhaustive ice-skating training session, participants underwent 20 min of HWI (41.1 ± 0.5°C), 15 min of CWI (12.1 ± 0.7°C) or 15 min of active recovery (AR). After 1 h 30 min of the first exercise, they performed a repeated-sprint cycling session. Average power output was slightly but significantly higher for AR (767 ± 179 W) and HWI (766 ± 170 W) compared to CWI (738 ± 156 W) (p = 0.026, d = 0.18). No statistical difference was observed between the conditions for both lactatemia and rating of perceived exertion. Furthermore, no significant effect of recovery was observed on the fatigue index calculated from the repeated sprint cycling exercises (p > 0.05). Finally, a positive correlation was found between the average muscle temperature measured during the recoveries and the maximal power output obtained during cycling exercises. In conclusion, the use of CWI in between high-intensity training sessions could slightly impair the performance outcomes compared to AR and HWI. However, studies with larger samples are needed to confirm these results, especially in less trained athletes.

Experimental study on dynamic thermal responses and comfortable evaluations under bathing conditions.

This study investigated the dynamic thermal responses and comfortable boundaries under different bathing conditions through a series of human subject experiments. Eleven subjects' subjective questionnaires and physiological parameters were collected. During the 40-min 40 °C bath, subjects' whole-body thermal sensation, sweating sensation, and fatigue relieving vote increased from 0 (neutral) to 2.6 (near 'hot' sensation), 3.5 (near 'very sweaty' sensation), and 1.6 (near 'relieved' vote), respectively. Thermal comfort vote firstly increased to 1.5 (near 'comfortable' sensation) in the first 10 min, then decreased to -0.5 (between 'neutral and slightly uncomfortable' sensation), and eventually remained around 1.1 ('slightly comfortable' sensation) after the bath. After the 40-min bath, the skin temperature and core temperature rose by 2.0 °C and 0.9 °C respectively. The mean heart rate increased by 45% and blood pressure decreased in most subjects. The percentage of ß brain wave (representing concentration emotion) decreased while that of δ brain wave (representing relaxing emotion) increased, indicating that the bathed subjects tended to be more relaxed and sleeping emotionally. Based on these observations, we inferred that bathing thermal comfort can be influenced by multiple factors simultaneously but effective evaluation tools quantifying bathing thermal comfort are yet to be produced. Compared with showering, bathing usually induces more intensive thermal stress to the body, causing similar changing patterns but stronger amplitudes in subjective and physiological responses. These results can provide references for more comfortable and healthier bathroom environment design and relevant environmental conditioning products.

How are they really doing? Animal welfare on organic laying hen farms in terms of health and behaviour.

1. The present study describes the current welfare situation on commercial organic laying hen farms in Sweden in terms of indoor environment, bird health and behaviour.2. Organic laying hen farms (n = 11) in Sweden were visited for one day each. The farm visits were performed at the end of lay and involved farmer interviews, indoor environment assessments, behavioural observations and tests and clinical examinations in one flock per farm.3. In 95% of all human avoidance distance test trials performed, the hens distanced themselves from the observer before the test was completed. Median number of birds per flock approaching during a novel object test (n = 4 trials per flock) was 2 (0-9). These results may indicate a high level of fear of humans and general fearfulness among the hens.4. Plumage damage was especially prevalent and most severe on the breast and belly, tail and wings, with median prevalence of moderate-severe damage of 96% (84-100), 96% (72-100) and 98% (94-100), respectively. Median prevalence of keel bone deviations was 67% (32-84) with 3% fractures (0-8). Median prevalence of breast skin lesions was 57% (10-74). There was a significant positive association between breast skin lesions and keel bone deviations (P = 0.02) and foot pad hyperkeratosis (P < 0.001). Median prevalence of severe hyperkeratosis was 33% (8-96), with prevalence being significantly lower where litter depth was thicker (P = 0.003). More dust bathing events were observed in flocks where litter depth was thicker (P = 0.007).5. The present study contributes with updated knowledge of laying hen welfare on organic farms in Sweden. The results confirm the findings of previous on-farm studies, demonstrating that important issues, including keel bone damage and severe feather pecking, remain in need of attention to ensure the welfare of laying hens in future commercial egg production.

The effects of dyes and bleaches on the sorption and desorption of trace elements in human hair.

Trace element concentrations and isotope ratios of hair reflect the blood levels at the time of hair formation, but can be affected by external factors such as dyeing, bleaching, and bathing. To investigate the effect of dyeing, bleaching, and bathing on hair, hair was immersed in tap water, and changes in trace element concentrations and the Sr isotope ratio were observed over time. During soaking, alkaline earth metals (Ca, Mg, and Sr) from tap water were gradually absorbed into the hair over time. After about one day, the adsorption capacity of hair reached a maximum and the reverse reaction started to occur. In contrast, alkaline metals (Na and K) behaved in reverse. In dyed and bleached hair, Na was significantly desorbed from the hair and gradually migrated to the water over time. The adsorption and desorption of trace elements were minimal in untreated original hair, but much higher in dyed and bleached hair. Thus, dyeing and bleaching appear to damage the hair surface structure and greatly promote the exchange of trace elements. The rapid exchange of trace elements, including Sr, between hair and tap water observed in this study indicates that hair samples can be easily contaminated during bathing.

Review on the management of water quality for bio-mineral swimming pools in Western Europe.

In this review, we depict the state of the art concerning the water quality management of bio-mineral bathing pools, and compare these to traditional swimming pools. Bio-mineral pools use a combination of mechanic filtration, bio-filtration, and UV-treatment to disinfect the water. Studies in test tanks have shown that bio-filtration is effective in maintaining the water quality with regard to the treatment of organic pollution. Concerning biological risks, the bio-mineral pool relies on UV-treatment to degrade bacteria. Unlike chemical disinfectant treatments, UV disinfection does not lose its effectiveness in the event of high traffic in the pool. However, as only the water taken up by the filtration system is disinfected, it is essential that all the water in the pool is filtered. If the pool has a dead zone, its water is not disinfected and there is a risk of localized pathogen development. As the development of bio-mineral pools spreads in Europe, legislation gradually follows. The health parameters measured differ slightly from one country to another, but there are constants: the measurement of Escherichia coli, Enterococci, and Pseudomonas aeruginosa. In terms of biological swimming pools, regulatory homogeneity across Europe does not exist. From these comparisons, Austrian legislation segmenting water quality into 4 categories ranging from "excellent" to "poor" represents legislation that combines health and safety with indications of possible malfunctions. Next, a study of three real sites of bio-mineral pools is presented. It appears that whatever the type of pool, bio-mineral filtration makes it possible to achieve performances comparable to those encountered in chlorinated swimming pools concerning the risks associated with fecal contamination and external pollution. On the other hand, when frequentation is high, as is the case in small pools used for aquafitness, monitoring the risks of inter-bather contamination, as illustrated by the presence of Staphylococcus aureus, reveals a recurring problem. Knowing that this parameter is not evaluated in bathing waters in the natural environment and that numerous studies show that Staphyloccocus aureus are always detected, even on beaches, we propose the definition of three thresholds: i.e., 0 CFU/100 mL (threshold value in Wallonia) for water of excellent quality, less than 20 CFU/100 mL (threshold value in France) for water of very good quality, less than 50 CFU/100 mL (contribution of bathers by simple immersion) for good quality water, and more than 50 CFU/100 mL for poor quality water. This document could therefore be converted into a manual for operators on the use and management of bio-mineral baths.

Assessment on the pollution level and risk of microplastics on bathing beaches: a case study of Liandao, China.

Microplastic pollution on bathing beaches threatens the health of human beings and coastal organisms. There is a lack of assessment on the level of microplastic pollution and the health risk associated with plastics. As one of the earliest open bathing beaches in China, Liandao is well known as the two high-quality beaches. However, little is known about the extent of microplastic pollution on these bathing beaches. Based on the analysis of microplastic pollution abundance, distribution, shape, size, color, and composition at the Liandao bathing beaches, this study puts forward a novel approach to comprehensively evaluate the microplastic pollution level and risk level by using the Nemerow pollution index (NPI) and polymer hazard index (PHI). The results show that the average abundance of microplastics on the Liandao bathing beaches is 135.42 ± 49.58 items/kg; the main shapes are fibers, fragments, and granules. Most of the microplastics are transparent, brown, and black, accounting for 71.54%, and they have an average particle size of 0.63 ± 0.43 mm. The main components are PE, PP, PS, PET, and nylon, of which nylon appears in the highest proportion (54.77%). The microplastic NPI and PHI values are 0.38 and 74.81, respectively, indicating that the pollution level and health risk index of microplastics on the Liandao bathing beaches are both low. With the increase in population and per capita consumption, plastic waste generated on land will continue to increase. Finally, this study puts forward some suggestions regarding microplastic monitoring, plastic waste management, and environmental attitudes and behavior.