BACKGROUND: Older adults in Japan have the highest drowning mortality rate globally due to frequent bathing practices. Low outdoor temperatures have been linked to bath-related deaths; however, previous studies employed limited statistical models and focused on a single prefecture. Given Japan's aging population, preventing bath-related deaths is a public health priority. This study aimed to analyze the association between outdoor temperature and bath-related drowning deaths across Japan from 1995 to 2020 (n = 110,938), examining regional variations and identifying contributing prefectural characteristics. METHODS: Daily counts of bath-related drowning deaths per prefecture were matched with daily mean temperature data from the Japan Meteorological Agency. Prefecture-level demographic and environmental data were obtained from Japan's Official Statistics. We applied a generalized additive mixed model to examine the association between daily mean temperature and bath-related drowning death risk. Meta-regression was used to identify prefecture-level modifiers. RESULTS: Bath-related drowning death risk peaked at a daily mean temperature of 1.8 °C (relative risk [RR] 9.7, 95% confidence interval [CI]: 9.5-9.9), compared with the lowest risk at 30.3 °C. The association was stronger at mid-range temperatures, particularly among males and individuals aged ≥65 years. Among prefectures, Kagoshima-the southernmost prefecture on Japan's main islands-had the highest maximum RR at 19.6 (95% CI: 16.2-23.6), while Hokkaido-the northernmost prefecture-had the lowest at 3.8 (95% CI: 3.4-4.3). Prefecture-level factors that strengthened this relationship included a lower prevalence of double-pane windows as a proxy of housing insulation and higher annual mean temperatures with ratio of RR change per one standard deviation increase of 0.76 (95% CI: 0.69-0.83) and 1.27 (95% CI: 1.18-1.37), respectively. CONCLUSIONS Warmer prefectures in southern regions exhibited greater maximum-to-minimum risk ratios compared to cooler northern prefectures. This paradoxical finding underscores the importance of region-specific interventions to reduce bath-related deaths.
Japan/epidemiology* ; Humans ; Drowning/epidemiology* ; Male ; Aged ; Female ; Baths/statistics & numerical data* ; Middle Aged ; Temperature ; Aged, 80 and over ; Adult ; Young Adult ; Risk Factors ; Adolescent

BACKGROUND: Previous studies have shown that old age and cold temperatures are risk factors for bathing-related accidents (BRAs) in Japan. The differences between outdoor and indoor temperatures are believed to depend on the housing type (detached houses or apartment buildings). This study aimed to investigate the associations between age, temperature, and BRAs according to housing type in Japan. METHODS: We included cases in which patients were transported by ambulance from domestic bathrooms between April 2016 and March 2022 in Nagoya city. Age-specific BRA incidence rates measured by 5-year age groups, temperature-specific age-adjusted standardized incidence rates (SIRs) for BRA calculated by temperature quintile groups, and the BRA risk regarding temperature based on a time-stratified case-crossover (CCO) design were compared between detached houses and apartment buildings. RESULTS: We observed 4,848 ambulance dispatches owing to BRAs (3,083 in detached houses and 1,765 in apartment buildings; SIR for detached houses compared to apartment buildings: 1.37; 95% confidence interval [CI]: 1.33-1.43). The ratio of detached houses to apartment buildings in the age-specific BRA incidence was almost the same in middle-aged people, but it significantly increased from the age of 70 years onward (incidence rate ratio for the 70-74-years age group: 1.74; 95% CI: 1.43-2.11). Temperature-specific SIR for detached houses compared to apartment buildings was not significantly different in the hottest temperature quintile but increased significantly in the other colder temperature quintiles (SIR in coldest quintile: 1.56; 95% CI: 1.47-1.66). BRA risk based on CCO design increased significantly with a decrease in temperature in detached houses (risk ratio [RR] for 3 °C: 1.25; 95% CI: 1.05-1.47), but not in apartment buildings (RR for 3 °C: 1.07; 95% CI: 0.86-1.34). CONCLUSIONS Detached houses had higher BRA incidence rates than apartments. Older age and lower temperatures, which are risk factors for BRAs, were more prevalent in detached houses than in apartment buildings. Thus, public health measures that focus on detached houses are necessary for preventing BRAs in Japan.
Humans ; Japan/epidemiology* ; Aged ; Middle Aged ; Housing/statistics & numerical data* ; Baths/adverse effects* ; Ambulances/statistics & numerical data* ; Male ; Adult ; Female ; Temperature ; Incidence ; Aged, 80 and over ; Young Adult ; Age Factors ; Adolescent ; Child, Preschool ; Infant ; Child ; Risk Factors ; Infant, Newborn ; Accidents, Home/statistics & numerical data*

OBJECTIVETo investigate incidence of HIV infection and identify associated risk factors among men who have sex with men (MSM) in common bathing pools in Tianjin.

METHODSA prospective cohort study was conducted among the MSM recruited in a common bathing pool in Tianjin from 2011 to 2013. A total of 733 MSM were surveyed to obtain the information about their sociodemographic characteristics, HIV-related knowledge awareness and sexual behaviors, and subsequent follow-up surveys were carried out every four months. Cox regression analysis was conducted to identify the risk factors for HIV infection.

RESULTSA total of 59 HIV infection cases were found in the 2.5-years follow-up survey. The cumulative follow-up time was 7384.9 person-months. The incidence rate of HIV infection was 9.59/100 person-year. The multivariate Cox regression analysis showed that young age, low score of HIV/AIDS knowledge awareness (HR=1.82, 95%CI:1.03-2.66), having two and more sexual partners during past 6 months (HR=1.74, 95%CI: 1.26-2.58) and syphilis (HR=2.36, 95%CI:1.31-3.27) were significantly associated with HIV infection in this MSM cohort.

CONCLUSIONSLow score of HIV/AIDS knowledge awareness, young age, having two and more sexual partners during past 6 months and syphilis were the risk factors for HIV infection in MSM in common bathing pools. It is necessary to strengthen the HIV surveillance and intervention in this population.

Baths ; China ; epidemiology ; HIV Infections ; epidemiology ; Homosexuality, Male ; statistics & numerical data ; Humans ; Incidence ; Male ; Prospective Studies ; Risk Factors ; Surveys and Questionnaires

BACKGROUND: Serotonin is found in the blood of the umbilical cord at birth in concentrations sufficiently high to affect vascular tone. Serotonin has been suggested to be involved in the pathogenesis of preeclampsia. Magnesium sulfate (MgSO4) is used to treat convulsions and hypertension in patients with preeclamptic toxemia. Bupivacaine is used in the epidural anesthesia for a cesarean section. The effects of magnesium and bupivacaine on serotonin-induced vasocontraction in a human umbilical artery was investigated. METHODS: Experiments were performed on 52 human umbilical arteries. The rings were suspended in an organ bath to record isometric mechanical activity. The concentration-contraction responses to bupivacaine, magnesium and serotonin were measured respectively. Vessels were pretreated with bupivacaine (10(-5) M) or magnesium (2 mM or 6 mM), and then serotonin (10(-9) M - 10(-6) M) was added cumulatively. Data analysis was assessed by an unpaired t test, one-way ANOVA and a Kruskal-Wallis test. RESULTS: Bupivacaine induced a contraction of umbilical arterial rings, and showed a maximal contraction (51.8 +/- 6.1%) at a concentration of 43nM. Magnesium induced relaxation of the umbilical artery in a concentration dependent manner. Pretreatment with bupivacaine (10(-5) M) potentiated significantly the concentration response to serotonin (P < 0.05). Pretreatment with MgSO4 (2 mM or 6 mM) significantly suppressed the contractile response to serotonin (P < 0.05). CONCLUSIONS: Bupivacaine, magnesium and serotonin are vasoactive on human umbilical arteries. Magnesium exerts a strong relaxant effect on serotonin induced vasocontraction in the human umbilical artery. Potentiation of serotonin induced vasoconstriction by bupivacaine may play a significant role in the reduction of umbilicoplacental blood flow.
Anesthesia, Epidural ; Baths ; Bupivacaine* ; Cesarean Section ; Female ; Humans* ; Hypertension ; Magnesium Sulfate ; Magnesium* ; Parturition ; Pre-Eclampsia ; Pregnancy ; Relaxation ; Seizures ; Serotonin ; Statistics as Topic ; Toxemia ; Umbilical Arteries* ; Umbilical Cord ; Vasoconstriction

The purpose of this descriptive study was to identify the homecare needs of patients with cancer and to provide a basis of interventions. One hundred and two patients at one general hospital in Gyeongnam responded to a questionnaire developed on the basis of care needs perceived by nurse caring for hospitalized patients with cancer. The questionnaire was a Likert type 5 point scale with 56 items on five need categories ; 1) informational 2) physical care 3) emotional care 4) socioeconomic care and 5) special care needs. Internal consistency of this questionnaire was Cronbach's alpha=.9101 for total items. The data was collected from March 1st to May 31th, 1998, by tow graduate nurses. In the data analysis, mean & standard deviation were calculated to identify the degree of care need of each item, and the t-test & ANOVA were done to determine the effects of patients' demographic background on their care needs. The findings are summarized as follows ; 1) The mean score of total of need items was 3.048. Of the four need categories the highest score was informational at 3.4, followed by emotional care, 3.063, physical care, 2.623, and socioeconomic care, 2.599. 2) In the informational and category there were four subcategories with 19 items. Medication and pain control had the highest score, 3.755 ; second was diet and exercise, 3.613 ; third was disease and treatment process, 3.337 ; and last was personal hygiene and infection prevention at 2.687. 3) In the physical care need category there was nine items, IV infusion for nutrition and management of treatment complication was above 3.2 points and the remaining items were in the 2.847-2.070 score ranges. 4) In the emotional care need category there were seven items. The highest need was in support for relationships with health personnel, 3.673. The need for support of religions beliefs and support fir having a religion were low at about 2 points. 5) In the socioeconomic care need category there were six items. Support for medical insurance expansion and financial support were above 3 points. Legal support and support for caring of children were low in the care needs. 6) In the special care need category the there were 15 items. Informational need about immunization and informational need about effects of disease on growth and development were high, above 4.1 points. Need for decubitus care and prevention, sitz bath and incontinence care were low, below 2 points. 7) There were significant differences in degree of care need according to admission rate, education level, marital status, religion and caregiver's religion. In conclusion, homecare needs perceived by hospitalized patient's with cancer was moderate, but informational need was higher than direct care needs, leading to the conclusion that the provision of sufficient information to patients with cancer at discharge is needed. Nursing interventions should be developed considering the patient's background.
Baths ; Child ; Diet ; Education ; Financial Support ; Growth and Development ; Health Personnel ; Hospitals, General ; Humans ; Hygiene ; Immunization ; Insurance ; Marital Status ; Nursing ; Surveys and Questionnaires ; Statistics as Topic

This study was performed to explore relationships between depression and discomfort of patients with cast or traction. 112 patients were selected from several hospitals in Jeon-buk province. Data were collected from Feb. 26th. to March, 2nd. of 1996 using survey interview designed by the investigator. Data analysis included percentage, mean, and standard deviation, t-test ANOVA, Pearson Correlation Coefficient. Results were as follows: 1. The depression score and the discomfort score were positively correlated (r=.3654, p=.0001) 2. The result shows that the score of ADLs (activities of daily living) and the score of discomfort were negatively correlated and they were statistically significant (activity r=-.1980, p=.0363; eating r=-.3483, p=.0002; bathroom r=-.4207, p=.0001; wearing r=-.4602, p=.0001. bathing r=-.3489, p=.0002).
Activities of Daily Living ; Baths ; Depression* ; Eating ; Humans ; Jeollabuk-do ; Research Personnel ; Statistics as Topic ; Traction*