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Objective: This retrospective study was conducted to investigate whether medical students have ever bandaged patients' limbs, whether they feel confident in their ability to bandage, and whether their bandaging skills are adequate.Methods: The study included consecutive fifth-year medical students who had not been taught bandaging knowledge and skills. In total, 232 students (163 men, 69 women) participated in the study. Prior to the practical session, the students' experiences and confidence in bandaging were assessed. During the practical, an evaluator assessed the students' bandaging skills, determining the correct application of bandages and assigned a numerical score. Correlations were analyzed using the Chi-square test.Results: Of the medical students in this study, 60% had not bandaged a limb by their fifth year, and 91% lacked confidence in their bandaging ability. Only 32% of students could correctly apply a bandage with a perfect score. No significant relationships were identified between experience and bandaging skill (P = 0.64) or confidence and bandaging skill (P = 0.36).Conclusions: Bandages must be applied perfectly to prevent loosening and contamination of the wound. Nevertheless, most medical students had not bandaged a limb, lacked confidence in their bandaging abilities, and were unable to correctly apply a bandage. It is imperative that medical educators teach bandaging skills to medical students and provide ample opportunities for practice.
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Background: The traditional Japanese style of soaking in a hot bath is a lifestyle custom for many citizens, no study had ever investigated the association between bathing as a lifestyle practice and the onset of long-term depression. Through a large-scale six-year longitudinal study, we aimed to determine whether tub bathing as a lifestyle custom plays a role in preventing the onset of long-term depression. Methods: Of 11,882 individuals who responded to surveys conducted in 2010 and 2016 as part of the Japan Gerontological Evaluation Study (the JAGES) project, we analyzed 6,452 and 6,465 individuals for whom information was available regarding summer bathing frequency and winter bathing frequency, respectively; all of these individuals were independent, had a Geriatric Depression Scale (hereafter, “GDS”) score of ≤4, and did not suffer from depression. The cohort study involved dividing participants into a group of those who bathed 0-6 times a week and a group of those who bathed ≥7 times a week and determining the percentages of individuals who developed depression based on their GDS scores six years later. Multiple logistic regression analysis was performed to determine odds ratios for the association between depression onset and tub bathing. Results: For individuals who tub bathed ≥7 times a week, the odds ratios for depression onset versus individuals who bathed 0-6 times a week in summer and winter were 0.84 (95% confidence interval, 0.64-1.10) and 0.76 (95% confidence interval, 0.59-0.98), respectively. Tub bathing ≥7 times a week in winter significantly reduced the risk of depression onset. Conclusions: New-onset depression was shown to be infrequent in older adults who bathe in a tub frequently. Tub bathing was suggested to potentially contribute to the prevention of depression in the elderly.
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Background: The traditional Japanese style of soaking in a hot bath is a lifestyle custom for many citizens, no study had ever investigated the association between bathing as a lifestyle practice and the onset of long-term depression. Through a large-scale six-year longitudinal study, we aimed to determine whether tub bathing as a lifestyle custom plays a role in preventing the onset of long-term depression. Methods: Of 11,882 individuals who responded to surveys conducted in 2010 and 2016 as part of the Japan Gerontological Evaluation Study (the JAGES) project, we analyzed 6,452 and 6,465 individuals for whom information was available regarding summer bathing frequency and winter bathing frequency, respectively; all of these individuals were independent, had a Geriatric Depression Scale (hereafter, “GDS”) score of ≤4, and did not suffer from depression. The cohort study involved dividing participants into a group of those who bathed 0-6 times a week and a group of those who bathed ≥7 times a week and determining the percentages of individuals who developed depression based on their GDS scores six years later. Multiple logistic regression analysis was performed to determine odds ratios for the association between depression onset and tub bathing. Results: For individuals who tub bathed ≥7 times a week, the odds ratios for depression onset versus individuals who bathed 0-6 times a week in summer and winter were 0.84 (95% confidence interval, 0.64-1.10) and 0.76 (95% confidence interval, 0.59-0.98), respectively. Tub bathing ≥7 times a week in winter significantly reduced the risk of depression onset. Conclusions: New-onset depression was shown to be infrequent in older adults who bathe in a tub frequently. Tub bathing was suggested to potentially contribute to the prevention of depression in the elderly.
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The primary objective of this study was to collect evidence that individuals who use hot spring facilities and public baths have a low risk of being infected with COVID-19. The secondary objective was to comprehensively summarize the research issues that remain to be explored in the field of balneology considering results of previous research. Literature databases used were CINHAL, Cochrane Library (Clinical Answer, Cochrane Protocol, Cochrane Review, Editorials, Special Collections, Trials), Ichushi Web (in Japanese), MEDLINE, and Web of Science Core Collection. For each database, we selected results from the time it was opened through July 26, 2021. When intervention studies and experimental were searched, the following modified PICOS was used the following: P (Participant: no restrictions on the presence or absence of illness), I (Intervention: normal breathing or intentional sneezing, coughing, conversation), C (Comparison: no restrictions), O (Outcome: markers that simulate the flow of indoor air, the dynamics of droplets, and droplets in bathrooms and dressing rooms), and S (Study design: including intervention studies and experiments without a control group). For observational studies, PECOS included: P (participants: unlimited with or without disease), E (Exposure: public bathing facility), C (comparison: unrestricted), and S (study design: cross-sectional study, cohort study, and case-control study). For the primary objective, no studies met the eligibility criteria, and at the time of this study there was no evidence that the use of hot spring facilities or public baths presented a low risk of being infected with COVID-19. Regarding the secondary objective, there were 15 relevant studies. In the context of a society that is strongly influenced by COVID-19, our literature review identified four research issues: “A. Use of hot spring facilities and public baths has a low risk of COVID-19 infection”, “B. The quality of hot springs and the room temperature and water temperature of public baths make SARS-CoV-2 inactivate/attenuate”, “C. Hot spring facilities, public baths, bathing habits at home lead to prevention of COVID-19 and alleviation of symptoms”, “D. Bathing for survivors of COVID-19 is effective for various rehabilitation of patients”. Suitable research approaches for each issue would be required in order to grasp each evidence.
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The primary objective of this study was to collect evidence that individuals who use hot spring facilities and public baths have a low risk of being infected with COVID-19. The secondary objective was to comprehensively summarize the research issues that remain to be explored in the field of balneology considering results of previous research. Literature databases used were CINHAL, Cochrane Library (Clinical Answer, Cochrane Protocol, Cochrane Review, Editorials, Special Collections, Trials), Ichushi Web (in Japanese), MEDLINE, and Web of Science Core Collection. For each database, we selected results from the time it was opened through July 26, 2021. When intervention studies and experimental were searched, the following modified PICOS was used the following: P (Participant: no restrictions on the presence or absence of illness), I (Intervention: normal breathing or intentional sneezing, coughing, conversation), C (Comparison: no restrictions), O (Outcome: markers that simulate the flow of indoor air, the dynamics of droplets, and droplets in bathrooms and dressing rooms), and S (Study design: including intervention studies and experiments without a control group). For observational studies, PECOS included: P (participants: unlimited with or without disease), E (Exposure: public bathing facility), C (comparison: unrestricted), and S (study design: cross-sectional study, cohort study, and case-control study). For the primary objective, no studies met the eligibility criteria, and at the time of this study there was no evidence that the use of hot spring facilities or public baths presented a low risk of being infected with COVID-19. Regarding the secondary objective, there were 15 relevant studies. In the context of a society that is strongly influenced by COVID-19, our literature review identified four research issues: “A. Use of hot spring facilities and public baths has a low risk of COVID-19 infection”, “B. The quality of hot springs and the room temperature and water temperature of public baths make SARS-CoV-2 inactivate/attenuate”, “C. Hot spring facilities, public baths, bathing habits at home lead to prevention of COVID-19 and alleviation of symptoms”, “D. Bathing for survivors of COVID-19 is effective for various rehabilitation of patients”. Suitable research approaches for each issue would be required in order to grasp each evidence.
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Pregnancy has been removed from the list of contraindications for hot spring bathing. Therefore, The Japanese Society of Balneology, Climatology and Physical Medicine has considered that it is necessary to conduct a joint research on the safety of hot spring bathing for pregnant women, publish the results extensively, and enlighten the public about this matter. Considering that only a small number of reports have been published in Japan about the safety of hot spring bathing for pregnant women, the Society has decided to study this subject. Expectant and nursing mothers living in hot spring towns, such as Beppu and Ibusuki City, have responded to questions about the period between the early stages of pregnancy and delivery via a self-administered questionnaire; The questions included: 1) age when the pregnancy ended, 2) number of previous deliveries, 3) details of hot spring bathing habits (whether they bathed in hot springs on a daily basis, how often they bathed during the different [early, middle, and late] stages of pregnancy, and whether they used hot spring baths attached to their homes or hot spring facilities away from their homes), and 4) whether they had pregnancy complications such as miscarriages (excluding those occurring in the early stages of pregnancy), premature delivery, threatened premature delivery, or toxemia of pregnancy/pregnancy-induced hypertension (edema, hypertension). Total 1,721 responses were collected (86% reply rate). The mean participant age was 30.8 years. Importantly, there were 643 (37.6%) primigravid and 1,078 (62.4%) parous women. Age and gravidity were not associated with pregnancy complications. In the early and middle stages of pregnancy, there were no significant differences in the incidence of pregnancy complications between individuals who bathed ≥ once per week [hot spring bath (+)] group and those who bathed < once per week [hot spring bath (−)] group. In the late stages of pregnancy, the number of pregnancy complications were fewer in the hot spring bath (+) group (20.3%) than that in the hot spring bath (−) group (25.9%) (p = 0.028). In addition, there were no significant differences in the pregnancy complications between hot spring bathing (+) and hot spring bath (−) groups in the early and middle stages of pregnancy even if we focused on the homecoming pregnant women. Whereas, in the late stages of pregnancy, the number of pregnancy complications were fewer in the hot spring bath (+) group (13.0%) compared with the hot spring bath (−) group (24.5%) (p = 0.028) in the homecoming pregnant women. This study has confirmed that daily hot spring bathing during pregnancy does not increase the incidence of pregnancy complications. Furthermore, it can be stated that the removal of “pregnancy” from the contraindications of hot spring bathing was appropriate.
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<b>Background and objectives:</b> Bathing services are available under long-term care insurance for the elderly. However, care workers have difficulty assessing safety for bathing in the absence of concrete criteria and guidelines. Currently, the pre-bathing health condition of care receivers is assessed mainly by blood pressure and body temperature measurements. This study aimed to identify the relationship of pre-bathing health condition assessed by blood pressure and body temperature measurements with illness and incidents related to bathing care.<br><b>Methods:</b> <br>1. Design: A case-control study (prospective registry study). <br>2. Subjects: All registered service providers of long-term care (2,330 in total) offering at-home bathing support. <br>3. Methods: Cases were defined as community-dwelling residents who had a bathing care-related illness or incident. As controls, two care receivers for each service provider were randomly extracted from the collected data. The study period was 1 year, from June 2012 to May 2013. A simple comparative analysis between the two groups was conducted for age, sex, degree of independence in daily life of disabled elderly individuals (degree to which they were bedbound), degree of long-term care needed, modified Rankin Scale score, level of alertness, degree of independence in daily life of patients with dementia, blood pressure before bathing, and body temperature before bathing. Univariate and multivariate logistic regression analyses were performed, with illness and all incidents or illness and incidents excluding elevated body temperature and elevated or reduced blood pressure as objective variables, and other factors as explanatory variables. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. <br><b>Results:</b> A total of 596 cases and 1,511 controls were analyzed. Simple comparative analysis revealed more care receivers had elevated body temperature before bathing in the case group than in the control group. Multivariate analysis with illness and incidents excluding elevated body temperature and blood pressure changes as objective variables showed significant relationships when systolic blood pressure was 160-179 mmHg (OR, 3.63; 95%CI, 1.39-9.50), diastolic blood pressure was 100-109 mmHg (OR, 14.71; 95%CI, 1.31-165.77), body temperature was 37.5-37.9°C(OR, 16.47; 95%CI, 3.30-82.40), and body temperature was ≥38.0°C (OR, 6.57; 95%CI, 1.40-30.81) before bathing. <br><b>Conclusion:</b> High blood pressure (≥160/100 mmHg) and elevated body temperature (≥37.5°C) before bathing are possible risk factors of bathing-care-related illness and incidents.
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<b>Background and objectives:</b> Bathing services are available under long-term care insurance for the elderly. However, care workers have difficulty assessing safety for bathing in the absence of concrete criteria and guidelines. Currently, the pre-bathing health condition of care receivers is assessed mainly by blood pressure and body temperature measurements. This study aimed to identify the relationship of pre-bathing health condition assessed by blood pressure and body temperature measurements with illness and incidents related to bathing care.<BR><b>Methods: </b><BR>1. Design: A case-control study (prospective registry study). <BR>2. Subjects: All registered service providers of long-term care (2,330 in total) offering at-home bathing support. <BR>3. Methods: Cases were defined as community-dwelling residents who had a bathing care-related illness or incident. As controls, two care receivers for each service provider were randomly extracted from the collected data. The study period was 1 year, from June 2012 to May 2013. A simple comparative analysis between the two groups was conducted for age, sex, degree of independence in daily life of disabled elderly individuals (degree to which they were bedbound), degree of long-term care needed, modified Rankin Scale score, level of alertness, degree of independence in daily life of patients with dementia, blood pressure before bathing, and body temperature before bathing. Univariate and multivariate logistic regression analyses were performed, with illness and all incidents or illness and incidents excluding elevated body temperature and elevated or reduced blood pressure as objective variables, and other factors as explanatory variables. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.<BR><b>Results:</b> A total of 596 cases and 1,511 controls were analyzed. Simple comparative analysis revealed more care receivers had elevated body temperature before bathing in the case group than in the control group. Multivariate analysis with illness and incidents excluding elevated body temperature and blood pressure changes as objective variables showed significant relationships when systolic blood pressure was 160-179 mmHg (OR, 3.63; 95%CI, 1.39-9.50), diastolic blood pressure was 100-109 mmHg (OR, 14.71; 95%CI, 1.31-165.77), body temperature was 37.5-37.9°C(OR, 16.47; 95%CI, 3.30-82.40), and body temperature was ≥38.0°C (OR, 6.57; 95%CI, 1.40-30.81) before bathing. <BR><b>Conclusion:</b> High blood pressure (≥160/100 mmHg) and elevated body temperature (≥37.5°C) before bathing are possible risk factors of bathing-care-related illness and incidents.
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Background and objectives: Bathing services are available under long-term care insurance for the elderly. However, care workers have difficulty assessing safety for bathing in the absence of concrete criteria and guidelines. Currently, the pre-bathing health condition of care receivers is assessed mainly by blood pressure and body temperature measurements. This study aimed to identify the relationship of pre-bathing health condition assessed by blood pressure and body temperature measurements with illness and incidents related to bathing care. Methods: 1. Design: A case-control study (prospective registry study). 2. Subjects: All registered service providers of long-term care (2,330 in total) offering at-home bathing support. 3. Methods: Cases were defined as community-dwelling residents who had a bathing care-related illness or incident. As controls, two care receivers for each service provider were randomly extracted from the collected data. The study period was 1 year, from June 2012 to May 2013. A simple comparative analysis between the two groups was conducted for age, sex, degree of independence in daily life of disabled elderly individuals (degree to which they were bedbound), degree of long-term care needed, modified Rankin Scale score, level of alertness, degree of independence in daily life of patients with dementia, blood pressure before bathing, and body temperature before bathing. Univariate and multivariate logistic regression analyses were performed, with illness and all incidents or illness and incidents excluding elevated body temperature and elevated or reduced blood pressure as objective variables, and other factors as explanatory variables. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results: A total of 596 cases and 1,511 controls were analyzed. Simple comparative analysis revealed more care receivers had elevated body temperature before bathing in the case group than in the control group. Multivariate analysis with illness and incidents excluding elevated body temperature and blood pressure changes as objective variables showed significant relationships when systolic blood pressure was 160-179 mmHg (OR, 3.63; 95%CI, 1.39-9.50), diastolic blood pressure was 100-109 mmHg (OR, 14.71; 95%CI, 1.31-165.77), body temperature was 37.5-37.9°C(OR, 16.47; 95%CI, 3.30-82.40), and body temperature was ≥38.0°C (OR, 6.57; 95%CI, 1.40-30.81) before bathing. Conclusion: High blood pressure (≥160/100 mmHg) and elevated body temperature (≥37.5°C) before bathing are possible risk factors of bathing-care-related illness and incidents.
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<b>Background</b>: A 30-60 min rest after exercising is generally recommended before taking a bath. Although this was considered an appropriate bathing method, effects of pre-bath rest on recovery from exercise fatigue remain unclear. Here, we aimed to examine the effects on fatigue recovery of pre-bath rest after a workload, with the focus on changes in lactic acid levels. <BR><b>Methods and Results</b>: Ten healthy adult men increased their blood lactic acid levels through a treadmill workload performed in accordance with the Bruce method, then took either a 60-min post-workload rest followed by a 10-min full-immersion 38°C bath (Experiment A) or a 10-min full-immersion 38°C bath followed by a 60-min rest (Experiment B). Body temperature, blood pressure, pulse rate, and blood lactic acid level were measured at three time points: before workload (Test 1), after workload (Test 2), and after bathing/resting (Test 3). Decreases and percent decreases in blood lactic acid levels were calculated by comparing Test 3 results with Test 2 results. These calculated values and the measured values in three tests were compared between Experiment A and Experiment B using paired-t test. There were no significant differences in maximum systolic blood pressure, maximum diastolic blood pressure, maximum workload attained, and maximum pulse rate measurements between Experiment A and Experiment B. Differences in systolic blood pressure and diastolic blood pressure measurements in Tests 1, 2, and 3 were not significant. The pulse rates measured at the final measurement (Test 3) were significantly higher in Experiment A than in Experiment B (90.4 ± 18.2 bpm vs 79.6 ± 11.6 bpm, p = 0.04). No significant differences were observed in other measurement timings. The body temperature measurements at the final measurement were slightly higher in Experiment A than in Experiment B (36.4 ± 0.4 vs 36.1 ± 0.3°C, p = 0.05). No significant differences were observed in other measurements. Blood lactic acid levels before workload (Test 1) were significantly higher in Experiment A (6.6 ± 4.7mmol/L) than in Experiment B (2.0 ± 1.4 mmol/L, p = 0.02), but those at other measurement points (Test 2 and Test 3) were similar. Neither decreases nor percentage decreases in blood lactic acid levels differed between Experiment A and Experiment B.<BR><b>Conclusions</b>: Resting before a post-exercise bath did not change the decreases or percent decreases in blood lactic acid levels after bathing at 38°C, suggesting negligible effects of pre-bath resting on recovery from exercise fatigue.
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Background: A 30-60 min rest after exercising is generally recommended before taking a bath. Although this was considered an appropriate bathing method, effects of pre-bath rest on recovery from exercise fatigue remain unclear. Here, we aimed to examine the effects on fatigue recovery of pre-bath rest after a workload, with the focus on changes in lactic acid levels. Methods and Results: Ten healthy adult men increased their blood lactic acid levels through a treadmill workload performed in accordance with the Bruce method, then took either a 60-min post-workload rest followed by a 10-min full-immersion 38°C bath (Experiment A) or a 10-min full-immersion 38°C bath followed by a 60-min rest (Experiment B). Body temperature, blood pressure, pulse rate, and blood lactic acid level were measured at three time points: before workload (Test 1), after workload (Test 2), and after bathing/resting (Test 3). Decreases and percent decreases in blood lactic acid levels were calculated by comparing Test 3 results with Test 2 results. These calculated values and the measured values in three tests were compared between Experiment A and Experiment B using paired-t test. There were no significant differences in maximum systolic blood pressure, maximum diastolic blood pressure, maximum workload attained, and maximum pulse rate measurements between Experiment A and Experiment B. Differences in systolic blood pressure and diastolic blood pressure measurements in Tests 1, 2, and 3 were not significant. The pulse rates measured at the final measurement (Test 3) were significantly higher in Experiment A than in Experiment B (90.4 ± 18.2 bpm vs 79.6 ± 11.6 bpm, p = 0.04). No significant differences were observed in other measurement timings. The body temperature measurements at the final measurement were slightly higher in Experiment A than in Experiment B (36.4 ± 0.4 vs 36.1 ± 0.3°C, p = 0.05). No significant differences were observed in other measurements. Blood lactic acid levels before workload (Test 1) were significantly higher in Experiment A (6.6 ± 4.7mmol/L) than in Experiment B (2.0 ± 1.4 mmol/L, p = 0.02), but those at other measurement points (Test 2 and Test 3) were similar. Neither decreases nor percentage decreases in blood lactic acid levels differed between Experiment A and Experiment B. Conclusions: Resting before a post-exercise bath did not change the decreases or percent decreases in blood lactic acid levels after bathing at 38°C, suggesting negligible effects of pre-bath resting on recovery from exercise fatigue.
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<b>Background:</b> Japan has an extremely large number of hot spring facilities, with more than 27,000 natural spring sources across the country. Despite the high usage of hot springs for leisure in Japan, almost no studies have investigated the general public’s utilization of hot springs at non-medical facilities as a form of alternative medicine. The aim of this study was therefore to elucidate the current status, including frequency and purpose, of hot spring utilization as an alternative medicine.<BR><b>Methods:</b> In January 2011, we conducted an online self-administered questionnaire survey on balneotherapy utilization of 10,400 ordinary citizens (men and women, 5,200 each) aged 20 to 69 years who were registered as consumer reviewers with an Internet survey company.<BR><b>Results:</b> Among 10,400 Internet consumer reviewers, 3,227 responded to the survey (response rate, 31.0%), of whom 3,212 provided unambiguous survey responses and were subsequently included in this study. The results revealed that 177 subjects (5.5%; 85 men, 5.3%; 92 women, 5.7%) had utilized balneotherapy (in the form of bathing, drinking, and/or inhalation) at a non-medical facility in the previous month. Among participants who had consulted a physician in the previous month, 51 (9.1%) had utilized balneotherapy, compared to 41 (3.9%) among those who had not, revealing significantly higher utilization of balneotherapy among those who had consulted a physician (p<0.001). Only 7 men (8.2%) and 1 woman (1.1%) consulted a physician prior to balneotherapy, and 8 men (9.4%) and 2 women (2.2%) received a physician referral.<BR><b>Conclusions:</b> This online survey of balneotherapy utilization among the general public in Japan revealed that among those in the study population with recent experience of balneotherapy, few had consulted or obtained a referral from a physician prior to utilization.
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Among lots of lifestyle factors thought to be related to the Japanese health status, bathing in hot water, utilizing onsen (hot spring) facilities, and drinking green tea are very special among the Japanese. In our previous study, we investigated the frequency of bathing, the utilization of onsen facilities, and the consumption of green tea among the Japanese and found that these activities improved subjective health to a similar degree as balanced diet, exercise, no tobacco use, and quality sleep. In the present study, to ascertain healthy activities that should be encouraged throughout the year, we included survey items about seasonal variations in taking baths, taking showers, and utilizing onsen facilities, as well as investigated the difference between consumption of brewed green tea and of canned and bottled green tea. A cross-sectional questionnaire survey was conducted of 6,000 residents in Shizuoka prefecture aged ≥20 years in 2012. Using unconditional logistic models, odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for several factors that were considered to affect self-rated health (SRH; subjective health, sufficient sleep and rest, and subjective happiness). This time, in a more detailed investigation of bathing habits, onsen utilization, and green tea consumption, we found that daily bathing all year round (subjective health: OR=1.27, 95%CI 1.05-1.52; p=0.012, sufficient sleep and rest: OR=1.41, 95%CI 1.13-1.77; p=0.003, subjective happiness: OR=1.35, 95%CI=1.15-1.58; p0.021), and daily consumption of at least 500 mL of brewed green tea (subjective health: OR=1.24, 95%CI 1.01-1.53; p=0.039) are health-improving habits that should be proactively encouraged in daily living. We believe that the inclusion of a formal recommendation for daily green tea consumption and daily bathing and the establishment of reference values for these habits in the Health Promotion Policy will foster health and longevity in Japanese citizens.
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<b>Objectives:</b> Ceramic bathing is a kind of sauna on which visitors lie and enjoy hot stimulus. Our aim in this study was to examine whether an intensive exposure of ceramic bathing improves physical and psychological functions or not.<BR><b>Methods:</b> The study design is a non-randomized single-arm before-after trial. The 38 subjects (6 males and 32 females) were enrolled in Yachiyo city, Chiba, Japan and bathing 8 times in 2 months from November 2009 to May 2010. Physiological, physical and psychological functions were examined when participants were bathing first and last time. We measured systolic blood pressure, diastolic blood pressure, pulse rate and body mass index (BMI) as physiological functions and SF-8, Profile of Mood States (POMS), and Cornell Medical Index (CMI) questionnaire score for examining subjective changes of physical and psychological functions. The results were compared by paired t test.<BR><b>Results:</b> Physiological functions were not changed considerably by intensive bathing, excepting a slight decline of diastolic blood pressure. Concerning subjective physical functions, we observed statistically-significant improvement in 11 items: eyes/ears, cardiovascular, digestive, skin, nervous, physical component summary, general health, role physical, bodily pain, vitality, and physical functioning. Regarding subjective psychological functions, 9 items were significantly improved: sensitivity, anger, psychological component summary, role emotional, mental health, tension-anxiety, anger-hostility, fatigue, and confusion. We observed certain but not-significant improvements in 6 items of subjective physical functions (respiratory, musculo-skeletal, genito-urinary, fatigability, frequency of illness, and social functioning) and 5 items of subjective psychological functions (depression in CMI and POMS, maladaptation, anxiety, and tension). There observed little change in only 1 item in subjective psychological function (vigor in POMS). There were no items showing significant deterioration after intensive bathing.<BR><b>Conclusion:</b> An intensive exposure of ceramic bathing might be effective in improving physical and psychological functions without changing physiological status.
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<b>Objecti</b><b>ves:</b> To assess the quality of study reports on spa therapy based on randomized controlled trials by the spa therapy and balneotherapy checklist (SPAC), and to show the relationship between SPAC score and the characteristics of publication.<BR><b>Methods:</b> We searched the following databases from 1990 up to September 30, 2013: MEDLINE via PubMed, CINAHL, Web of Science, Ichushi Web, Global Health Library, the Western Pacific Region Index Medicus, Psyc INFO, and the Cochrane Database of Systematic Reviews. We used the SPAC to assess the quality of reports on spa therapy and balneotherapy trials (SPAC) that was developed using the Delphi consensus method.<BR><b>Results: </b>Fifty-one studies met all inclusion criteria. Forty studies (78%) were about “Diseases of the musculoskeletal system and connective”. The total SPAC score (full-mark; 19pts) was 10.8±2.3pts (mean±SD). The items for which a description was lacking (very poor; ＜50%) in many studies were as follows: “locations of spa facility where the data were collected”; “pH”; “scale of bathtub”; “presence of other facility and exposure than bathing (sauna, steam bath, etc.)”; “qualification and experience of care provider”; “Instructions about daily life” and “adherence”. We clarified that there was no relationship between the publish period, languages, and the impact factor (IF) for the SPAC score.<BR><b>Conclusion:</b> In order to prevent flawed description, SPAC could provide indispensable information for researchers who are going to design a research protocol according to each disease.
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<b>Purpose: </b>Our previous study compared the characteristics of middle-aged persons who regularly take hot bathtub baths with those who do not and found taking hot bathtub baths helped to have good sleep and increase self-rated health. However, few studies have focused on this habit among young people. This study therefore compared the characteristics of young persons who regularly take hot bathtub baths with those who do not and clarify the potential effects of habitual bathtub bathing on their health. <BR><b>Methods: </b> In this cross-sectional study, a self-reported questionnaire on bathtub bathing habits and general health and lifestyle was distributed to 483 university students between May and June 2013. Respondents were divided into two groups: those who took 3 or more bathtub baths per week (high-frequency group) and those who took 2 or fewer bathtub baths per week (low-frequency group). Differences between the groups were determined for sex, age, living with or apart from one’s family, quality of sleep, sense of fatigue, and self-rated health. Prior to conducting the study, the study protocol was approved by the Institutional Review Board of Daito Bunka University.<BR><b>Results: </b>We obtained 394 responses (response rate: 81.6%) and analyzed 376 valid responses. Those who answered the question on bathtub bathing habits were divided into a high-frequency group (176 persons, 47%) and a low-frequency group (200 persons, 53%). The high-frequency group (52% men, 43% women, 5% sex was unknown) had a slightly greater proportion of men than in the low-frequency group (p=0.07). The two bathing frequency groups did not significantly differ by age group(p=0.43), and the age distribution in the high-frequency group age was 51% among 18 year olds, 45% among 19 year olds, 39% among 20 year olds, 48% among 21 year olds, and 61% among 22 year olds and older. Significantly more of the high-frequency group lived with their family (70% versus 23% living alone) than the low-frequency group (p<0.001). In terms of quality of sleep, 62% of the high-frequency group and 60% of the low-frequency group reported having good sleep (p=0.72). For sense of fatigue, 27% of the high-frequency group and 23% of the low-frequency group reported they did not experience fatigue (p=0.36), and for self-rated health, 81% of the high frequency group and 76% of the low-frequency group reported they were healthy (p=0.30). While there were no significant differences between the two groups, the findings suggest that those in the high-frequency group experienced good health. Results of logistic regression analysis adjusted for living with or apart from family showed the following odds ratios (95% confidence intervals) in the high-frequency group: good quality of sleep 1.02 (0.63-1.66), no fatigue 1.37 (0.76-2.46), and self-rated health 1.61 (0.90-2.89).<BR><b>Conclusion: </b>Among university students in this study, men and persons living with their families were highly likely to take hot bathtub baths regularly. While there were no significant differences between the high and low frequency bathers, taking hot bathtub baths may marginally help to reduce fatigue and increase self-rated health. <BR>Competing interests: The authors declare no conflicts of interest.
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<b>Introduction:</b> The health-related QOL is important for an index to prescribe health condition, but there is little analysis that what kind of bathing method the person whom this index has good performs. In this study, health-related QOL and habitual bathing was intended to clarify relationship, correlation. <BR><b>Methods: </b>The participants were 198 employees of a quasi-drug manufacturing company and their family members who could and cooperated in the present study. The study was conducted as a self-report survey from October 1-30, 2010, with questionnaires being distributed to and collected from subjects before and after this period.Participants were asked about their sex, age, bathing number of times in week, frequency of bath additive use in week, temperature of bathing, bathing duration, and water level when in the bath, health, and sleep quality. Health-Related Quality of Life was assessed using the Short-Form Health Survey (SF-36v2) , and self-rated health andquality of sleep were assessed using a Visual Analog Scale (VAS).<BR><b>Results:</b> When I divided it at the average age concerning a bathing method and the age, there was much frequency of bathing per week in late debut as an entertainer 45 years old or older, and under 45 years old had a short bathing time, and water level when in the bath was shallow. The shallow tendency that water level when in the bath was observed in that level in female. Relationship SF-36v2 and bathing method, it was suggested that a Social functioning significantly (p<0.01) increases so that temperature of bathing was low, a Role physical significantly (p<0.05) increases so that there was much bathing number of times in week, a General health significantly (p<0.05) increases so that there was much frequency of use of bath additives per week. Each of subjective self-rated health, quality of sleep by VAS, it was good in conjunction with frequency of use of bath additives per week.<BR><b>Discussion:</b> This study applied to an authorized company employee, and there was a limit that the external validity was weak, but was related to General health, social functioning, Role physical and bathing method. The influence of bathing habits such as full-bath bathing and the use of bath additives on a person’s physical and psychological state as found by our study can be regarded as a way of maintaining health among those in the prime of life. Because our study uses a cross-sectional design, interpretation had a limit, and it was thought that a prospective study would be necessary in future.
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<b>Purpose:</b> Tsukioka Onsen is the prominent hot spring which contains the largest amounts of sulfur in Japan. The purpose of this study is to clarify the benefits of bathing in Tsukioka Onsen by comparison between the bathing in Tsukioka hot spring and with natural water.<BR><b>Methods:</b> Subjects were 20 females aged from 30 to 60 y.o. On 21th of November, we applied them to bathe in Tsukioka hot spring for 10 minutes (42 celcius) and to bathe in natural water for 10 minutes (42 celcius) using cross-over methods. The interval of the two way bathing was 2 hours. We conducted a questionnaire survey using visual analog scale in which participants answered their subjective health and the sensory evaluation of skin with hot water. Statistical analysis was performed using paired t-test. This research was approved by ethical committee of the Japan health & research institute.<BR><b>Results: </b>Warming effect of full body, blood circulation, stiff shoulder and back pain were all improved after bathing either with hot spring and natural water. The effects were particularly stronger with hot spring than natural water. Recovery from fatigue, sense of relaxation, sense of refresh, most feeling of skin, refreshing touch of skin were improved only after bathing with hot spring.<BR> Regarding to sensory evaluation of skin, smooth feeling and moist feeling of skin were significantly notified predominantly with hot spring not with natural water.<BR><b>Conclusion:</b> This study showed that bathing in Tsukioka Onsen may cause thermal, cleaning, and moisture effects more than the one with natural water. We think that the alkalinity and the rich containing of chloride in hot water in Tukioka Onsen may contribute to these effects. We also suggested that one reason for these effects is that the large amounts of containing sulfur in Tukioka hot spring penetrated through skin may cause particular dilation of blood vessels in addition to the thermal effect of hot water.
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<b>Objectives:</b> To reveal a relationship between bathing and sleep quality making for healthy aging.<BR><b>Materials and Methods:</b> A population based self-administered mail survey was conducted for randomly selected or all independent people without long-term care needs aged 65 and over in 31 municipalities of Japan in 2010. This data is a part of the Japan Gerontological Evaluation Study (JAGES) project. Frequency of bathing using bathtub in summer and winter was asked. Logistic regression analyses were applied to estimate univariate and multivariate odds ratios of bad sleep quality by regular bathing (7 times or more per week for average of summer and winter) adjusting sex, age, equivalized household income, self-rated health, depression, working status, and region. <BR><b>Results:</b> Response rate of the mail survey was 66.3%. The number of people who made a valid answer for bathing was 18,090. Among them, 53.0% did bathing 7 times a week, 44.6% did less than 7 times, and 2.4% did more than 7 times. Odds ratios by regular bathing were shown on the tables. Most of them indicated significantly low risk for sleeping problems.<BR><b>Conclusion: </b>Regular bathing would be helpful to better sleep quality. After the survey, we are now following up the participants for incidence of long-term care needs and death.
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Background: Japan has an extremely large number of hot spring facilities, with more than 27,000 natural spring sources across the country. Despite the high usage of hot springs for leisure in Japan, almost no studies have investigated the general public’s utilization of hot springs at non-medical facilities as a form of alternative medicine. The aim of this study was therefore to elucidate the current status, including frequency and purpose, of hot spring utilization as an alternative medicine. Methods: In January 2011, we conducted an online self-administered questionnaire survey on balneotherapy utilization of 10,400 ordinary citizens (men and women, 5,200 each) aged 20 to 69 years who were registered as consumer reviewers with an Internet survey company. Results: Among 10,400 Internet consumer reviewers, 3,227 responded to the survey (response rate, 31.0%), of whom 3,212 provided unambiguous survey responses and were subsequently included in this study. The results revealed that 177 subjects (5.5%; 85 men, 5.3%; 92 women, 5.7%) had utilized balneotherapy (in the form of bathing, drinking, and/or inhalation) at a non-medical facility in the previous month. Among participants who had consulted a physician in the previous month, 51 (9.1%) had utilized balneotherapy, compared to 41 (3.9%) among those who had not, revealing significantly higher utilization of balneotherapy among those who had consulted a physician (p<0.001). Only 7 men (8.2%) and 1 woman (1.1%) consulted a physician prior to balneotherapy, and 8 men (9.4%) and 2 women (2.2%) received a physician referral. Conclusions: This online survey of balneotherapy utilization among the general public in Japan revealed that among those in the study population with recent experience of balneotherapy, few had consulted or obtained a referral from a physician prior to utilization.