Artificial intelligence to predict bed bath time in Intensive Care Units

OBJECTIVES

to assess the predictive performance of different artificial intelligence algorithms to estimate bed bath execution time in critically ill patients.

METHODS

a methodological study, which used artificial intelligence algorithms to predict bed bath time in critically ill patients. The results of multiple regression models, multilayer perceptron neural networks and radial basis function, decision tree and random forest were analyzed.

RESULTS

among the models assessed, the neural network model with a radial basis function, containing 13 neurons in the hidden layer, presented the best predictive performance to estimate the bed bath execution time. In data validation, the squared correlation between the predicted values and the original values was 62.3%.

CONCLUSIONS

the neural network model with radial basis function showed better predictive performance to estimate bed bath execution time in critically ill patients.

A global survey on national standard care for newborn bathing

AIM

To describe national standard care for newborn bathing and its influential factors.

METHODS

A global survey was conducted using a web-based questionnaire. The targeted countries were 166 member countries of either the International Confederation of Midwives (ICM) or the International Council of Nurses (ICN). An eligible person included someone well informed of midwifery education/training or neonatal care, including newborn bathing, in their country. To examine the factors associated with the standard care for newborn bathing, information on mean annual temperature, precipitation, gross domestic product per capita, and basic water coverage was collected as external factors. Student's t tests and Chi-square tests were used for analysis.

RESULTS

Care standards were identified in 46 countries: seven from Africa, eight from the Americas, 15 from Asia, 14 from Europe, and two from Oceania. In most countries, newborns were bathed with warm water in a tub within 10 min. Bathing frequency, moisturization, and use of soap or cleanser varied by country. There were significant associations between bathing frequency and temperature and between moisturization and precipitation.

CONCLUSION

The national standard care for newborn bathing in each country was unique. Standard bathing care was associated with the climate. More consideration should be given to the differences in standard care for newborn bathing between countries when interpreting existing studies and conducting future studies on neonatal skin care.

Development of educational videos about bathing in bed newborns admitted to a neonatal unit

OBJECTIVE

to develop and analyze evidence of content validity of educational videos about bathing newborns in bed in a neonatal unit.

METHOD

applied and methodological research, carried out from December/2020 to February/2022, in three phases: pre-production, production, post-production. Validity was carried out by nurses specializing in social communication and nursing professionals, including the Brazilian Sign Language and assessment by nursing students. The Content Validity Index and Cronbach's alpha above 0.8 were considered for analysis.

RESULTS

the videos were entitled "Best practices: bathing newborns in the heated crib" and "Best practices: bathing newborns in the incubator", lasting seven minutes each, divided into six scenes that demonstrated the approach to parents, environment and material organization, preparing newborns, bathing and after-bath care.

CONCLUSION

the videos will support permanent education processes, academic training and professional training in nursing.

Association of soap use when bathing 18-month-old infants with the prevalence of allergic diseases at age 3 years: The Japan Environment and Children's Study

BACKGROUND

Atopic march is defined as the progression from atopic dermatitis (AD) during early life to other allergic diseases in later childhood. In a nationwide birth cohort study, the Japan Environment and Children's Study, we investigated the association of bathing habits, which are known to affect skin conditions, for infants with their later development of allergic diseases.

METHODS

Pregnant women who lived in 15 designated regional centers throughout Japan were recruited. We obtained information on bathing habits for their 18-month-old infants and the prevalence of allergic diseases when they were aged 3 years.

RESULTS

Data for 74,349 children were analyzed. Most 18-month-old infants were bathed or showered almost every day. When they were divided into four groups according to the frequency of soap use during bathing (every time, most of the time, sometimes, and seldom), the risk of AD later at age 3 was shown to increase in association with a decreasing frequency of soap use [most of the time: adjusted odds ratio (aOR) 1.18, 95% confidence interval (CI) 1.05-1.34; sometimes: aOR 1.72, 95% CI 1.46-2.03; seldom: aOR 1.99, 95% CI 1.58-2.50], compared with soap use every time during bathing at 18 months of age. Similar results were obtained for food allergy but not for bronchial asthma.

CONCLUSIONS

Frequent soap use when bathing 18-month-old infants was associated with a decreased risk of them developing allergic diseases at age 3. Further well-designed clinical studies are warranted to determine an effective bathing regimen for preventing the development of allergic diseases.

Nationwide Database Analysis of Risk Factors Associated with Decreased Activities of Daily Living in Patients with Alzheimer's Disease

BACKGROUND

Preserving activities of daily living (ADL) is the key issue for Alzheimer's disease (AD) patients and their caregivers.

OBJECTIVE

To clarify the ADL level of AD patients at diagnosis and the risk factors associated with decreased ADL during long-term care (≤3 years).

METHODS

Medical records of AD patients in a Japanese health insurance claims database were analyzed retrospectively to determine ADL using the Barthel Index (BI) and identify the risk factors associated with decreased ADL.

RESULTS

A total of 16,799 AD patients (mean age at diagnosis: 83.6 years, 61.5% female) were analyzed. Female patients were older (84.6 versus 81.9 years; p < 0.001) and had lower BI (46.8 versus 57.6; p < 0.001) and body mass index (BMI) (21.0 versus 21.7 kg/m2; p < 0.001) than male patients at diagnosis. Disability (BI≤60) increased at age≥80 years and was significantly higher in females. Complete disability was most frequent for bathing and grooming. Risk factors for decreased ADL were determined separately by sex through comparing the ADL-preserved and ADL-decreased groups using propensity score matching by age and BI and multivariable logistic regression analysis. In males, decreased ADL was significantly associated with BMI < 21.5 kg/m2, stroke, and hip fracture, and inversely associated with hyperlipidemia. In females, decreased ADL was significantly associated with BMI < 21.5 kg/m2 and vertebral and hip fractures, and inversely associated with lower back pain.

CONCLUSION

AD patients with low BMI, stroke, and fractures had increased risks of decreased ADL; such patients should be identified early and managed appropriately, including rehabilitation to preserve ADL.

Evaluating the task effectiveness and user satisfaction with different operation modes of an assistive bathing robot in older adults

Bathing robots have the potential to foster the independence of older adults who require assistance with bathing. Making human-robot interaction (HRI) for older persons as easy, effective, and user-satisfying as possible is, however, a major challenge in the development of such robots. The study aimed to evaluate the effectiveness (coverage, step effectiveness) and user satisfaction (After-Scenario Questionnaire, ASQ) with three operation modes (autonomous operation, shared control, tele-manipulation) for the HRI with a bathing robot in potential users. Twenty-five older adults who require bathing assistance tested these operation modes in a water rinsing task for the upper back. Autonomous operation led to maximum effectiveness (100%), which was significantly worse in the shared control (51.6-79.4%, p ≤ 0.001) and tele-manipulation mode (43.9-64.4%, p < .001). In the user-controlled modes, effectiveness decreased with decreasing robot assistance (shared control: 51.6-79.4% vs. tele-manipulation: 43.9-64.4%, p = 0.009-0.016). User satisfaction with the autonomous operation (ASQ: 2.0 ± 1.0pt.) was higher than with the tele-manipulation mode (ASQ: 3.0 ± 1.4pt., p = 0.003) and in trend also than with the shared control mode (ASQ: 2.5 ± 1.5pt., p = 0.071). Our study suggests that for an effective and highly satisfying HRI with a bathing robot in older users, operation modes with high robot autonomy requiring a minimum of user input seem to be necessary.

Association between before-bedtime passive body heating and nocturia during the cold season among older adults

Background Cold exposure induces lower urinary tract symptoms including nocturia. Cold-induced detrusor overactivity can be alleviated by increasing skin temperature in rats. However, no study has shown an association between passive heating with hot-water bathing and nocturia among humans.Methods We included 1,051 Japanese community-dwelling older adults (mean age 71.7 years) in this cross-sectional study from 2010 to 2014. The number of nocturnal voids was recorded in a self-administered urination diary. Nocturia was defined as ≥2 nocturnal voids. We evaluated bathing conditions in the participants' houses.Results Hot-water bathing (n = 888) was associated with a lower prevalence of nocturia than no bathing (n = 163), independent of potential confounders including age, sex, obesity, income, physical activity, diabetes, medication (diuretics, nondiuretic antihypertensives, and hypnotics), depressive symptoms, indoor/outdoor temperature, and day length (odds ratio [OR]: 0.68, 95% confidence interval [CI]: 0.48-0.97; p = 0.035). Compared with the quartile group with the longest bath-to-bed interval (range: 161-576 min), the second and third quartile groups (range: 61-100 and 101-160 min, respectively) were associated with a lower prevalence of nocturia, after adjusting for water temperature and bathing duration besides the same covariates (OR: 0.60, 95% CI: 0.38-0.96; p = 0.031 and OR: 0.59, 95% CI: 0.37-0.94; p = 0.025, respectively).Conclusion Hot-water bathing, particularly with a bath-to-bed interval of 61-160 min, was significantly associated with a lower prevalence of nocturia among older adults.

Effects of Bathing in a Tub on Physical and Psychological Symptoms of End-of-Life Cancer Patients: An Observational, Controlled Study

This observational, controlled study explored the effects of bathing on the physical and psychological aspects of terminal cancer patients on a palliative care ward. With nurses' assistance, the patients evaluated and recorded the severity of their symptoms at 10:00 am, 30 minutes after initial bathing, and at 5:00 pm. The bathing care was provided as routine care according to the patients' wishes. Twelve symptoms were measured using 9 items (numbers 1-9) from the Edmonton Symptom Assessment System-Revised Japanese version and 3 items from the Cancer Fatigue Scale. Outcomes were compared between bathing days and nonbathing days (control) and between before and after bathing. Of the 57 bathers, data were available for both bathing days and nonbathing days for 42 bathers. In the comparison between bathing and nonbathing days, tiredness was significantly improved (effect size [ES], 0.35; P = .02). On the basis of the pre-post bathing comparison, 6 symptoms, namely, tiredness (ES, 0.40; P < .01), lack of appetite (ES, 0.36; P = .01), decreased well-being (ES, 0.33; P = .01), anxiety (ES, 0.36; P = .01), pain (ES, 0.31; P = .02), and depression (ES, 0.30; P = .02), were significantly improved. Bathing in a tub effectively improves tiredness and might be effective for distressing symptoms in end-of-life cancer patients.

Effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults: A systematic review

Aim

To evaluate the effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults.

Design

A systematic review based on the PRISMA guidelines.

Methods

We searched for quantitative studies published between 2004–2020, using the PubMed, MEDLINE and CINAHL. The remaining 25 studies were appraised by the JBI tool.

Results

Only four of the included studies were of high quality. Studies of above moderate quality demonstrated that disposable towels were as effective as cotton towels for skin lesions and bacterial removal. Applying a hot towel maintained the skin barrier function and provided warmth; cotton towels were effective for cleaning even with weak pressure, and post‐bed bath moisturizer treatment contributed to skin integrity.

Conclusion

Although various methods have been examined, the available evidence is inadequate for establishing best practices. It is necessary to verify empirical research with rigorous methodology involving elderly inpatients and to develop instruments that measure patients' comfort.

Relationship between the skin barrier function of 2-week-old infants after bathing and facial skin problems during the first 6 weeks of life: A prospective observational cohort study

AIM

This study aimed to identify the relationship between the skin barrier function after bathing at 2 weeks of age and subsequent facial skin problems during the first 6 weeks of life.

METHODS

A prospective observational study was conducted from July 2017 to February 2018 on healthy newborns aged 2 weeks. Skin barrier function was evaluated before bathing and at 30 and 90 min after bathing by measuring transepidermal water loss (TEWL), stratum corneum hydration (SCH), sebum secretion, and skin pH. Infantile facial skin problems were assessed using skin condition diaries maintained by a parent for 4 weeks.

RESULTS

Analysis of the data from 56 infants showed that 29 infants (51.8%) experienced facial skin problems from 2 to 6 weeks of age. A lesser change in the sebum secretion on the forehead before bathing to 90 min after bathing and a higher SCH of the forehead before bathing were less likely to result in facial skin problems (adjusted odds ratio [AOR] = 0.98, 95% confidence interval [CI]: 0.97-0.99; AOR = 0.96, 95% CI: 0.92-0.99).

CONCLUSIONS

A greater change in the sebum secretion on the forehead before bathing to 90 min after bathing and a lower SCH of the forehead before bathing were associated with subsequent infantile facial skin problems, indicating that a better ability to recover after bathing is important to prevent facial skin problems. Future studies should identify factors that enhance the recuperative functions of infantile skin.

Traditional Chinese herbal bath therapy for insomnia: A protocol for systematic review

INTRODUCTION

Insomnia is a major public health problem. Due to the side effects of pharmacological therapy, people are seeking to choose complementary and alternative therapies for insomnia disorder. Traditional Chinese herbal bath therapy is an important complementary therapy which combines advantages of Chinese herbs and bathing therapy. This protocol describes the methodology of a systematic review assessing the effectiveness and safety of traditional Chinese herbal bath therapy for insomnia.

METHODS AND ANALYSIS

Reporting of this review will be adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We will electronically search the following seven databases from inception to January 23, 2020: PubMed, Cochrane database (CENTRAL), EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database, and Wanfang Database. Parallel randomized controlled trials evaluating the effectiveness and safety of traditional Chinese herbal bath therapy for insomnia will be included. Study selection, data extraction and assessment of risk of bias will be performed independently by two researchers. The sleep quality will be assessed as the primary outcome. Global symptom improvement, anxiety and depression, and adverse events will be evaluated as secondary outcomes. The Cochrane's risk of bias tool will be utilized for assessing the methodological quality of included studies. Revman software (v.5.3) will be used for data synthesis and statistical analysis. Data will be synthesized by either fixed-effects or random-effects model according to a heterogeneity test. If it is not appropriate for a meta-analysis, a descriptive analysis will be conducted. GRADE system will be used to assess the quality of evidence.

PROSPERO REGISTRATION NUMBER

CRD42020168507.

The effectiveness of ultrasound bath and probe treatments on the quality of baking and shelf life of cupcakes

Uniform dispersion of emulsion particles of cake batter is very effective on the quality of the final product. A proper aeration process can produce a favorable spongy texture and desirable qualities in the product. Air containment and uniform distribution with smaller particles in the entire texture would be effective in achieving these goals. One of the newest physical methods to accomplish this matter is the use of ultrasound waves. The aim of this study was to investigate the effect of sounding the cake batter using two types of baths and ultrasound probes with two intensities (70% and 100%) over 0, 4, 6, and 8 min on the quality of cake baking and its shelf life. Porosity, cake texture and sensory acceptance, symmetry and uniformity indicator, water activity, and mold and yeast test for cake samples were taken during 14 days of storage in a factorial design. Examining the results showed that the probe ultrasound waves directly affected the quality of the cake, both bath and probe ultrasound types, which were applied for 6 min, improved the desired characteristics, while the increase in sounding time for up to 8 min decreased these parameters.

Effects of differences in wiping pressure applied by nurses during daily bed baths on skin barrier function, cleanliness, and subjective evaluations

AIM

To clarify the actual condition and examine the effects of differences in wiping pressure applied by clinical nurses during daily bed baths on skin barrier function, cleanliness, and subjective evaluations.

METHODS

For the purposes of the present quasi-experimental interventional study, "wiping pressure" was defined as the "force applied vertically to the skin surface during bed baths." Two types of bed baths, one using ordinary wiping (pressure: 23-25 mmHg) and the other using weak wiping (pressure: 12-14 mmHg), were performed on the forearms (right and left) of 30 healthy adult men and women, and the effects on transepidermal water loss, stratum corneum hydration, cleanliness, and subjective evaluations were examined.

RESULTS

The results showed no differences between ordinary and weak wiping pressure in regard to the effects on skin barrier function and cleanliness. In terms of subjective evaluations, a significant association was seen between wiping pressure and the "sensation of having dirt removed" (P = .036). Regarding "degree of pain," some participants reported that the wiping pressure felt "slightly painful" under both conditions (ordinary: 31.1%; weak: 10.7%), while some with sensitive skin reported feeling pain even during weak wiping pressure.

CONCLUSIONS

The results of the present study suggest that skin assessments should be performed before and after bed baths, and that wiping pressure should be controlled and evaluated while considering the patient's feelings.

First bathing time of newborn infants after birth: A comparative analysis

PURPOSE

The study was designed as an experimental study to describe the effect of the first bathing time on the body temperature and skin moisture of a newborn after birth.

DESIGN AND METHODS

The study population consisted of term newborns between January and June 2016 in the Istanbul University, Cerrahpaşa Medical Faculty Hospital at Istanbul. The sample group was randomly divided into two groups according to different bathing times. The first group (39 infants) was given a bath 24 hr after birth, and the second group (34 infants) was given a bath 48 hr after birth. The infants in both the groups were dried with the first towel and then wrapped in a second dry towel, and a cap put to prevent hypothermia and to minimize any minor fluid loss. The body temperature and skin moisture level were measured before the bath, after the bath, and 10 min after the bath.

RESULTS

It was determined that the 10th-minute body temperatures of the infants with the first bathing time 48 hr after birth were significantly higher compared with the infants with the first bath time 24 hr after birth (Z = -2.654; p = .008).

PRACTICAL IMPLICATIONS

Postponing of the first bathing time of newborns to 48 hr after birth was effective in preserving the body temperature of the infant. Postponing the bath to the 48th hr improved moisture, which may improve skin integrity and aid with skin development.

Unintentional fatal child drowning in the bath: A 12-year Australian review (2002-2014)

AIM

To establish the prevalence of unintentional fatal drowning in baths involving children <18 years in Australia and to identify causal factors to underpin prevention.

METHODS

We report a total population study of all childhood (0-17 years) unintentional drowning fatalities in baths (bathtubs, spa baths and showers) in Australia between 1 July 2002 and 30 June 2014. Demographic, forensic and aetiological data (including co-bathing, use of bath aids, supervision and enactment of cardiopulmonary resuscitation) were documented for each victim.

RESULTS

Seventy-eight children were identified; two thirds (66.7%) were under 2 years old, of which 43.6% were aged less than 1 year (1.0/100 000/annum) and 23.1% 1-2 years (0.27/100 000/annum). Nine older children (10-17 years) also drowned. Common causes included: infants and children unable to hold their head out of water while unsupervised and associated pre-existing medical conditions, including epilepsy. All children who drowned were left without adult supervision. No child drowned in a bath with water deeper than 40 cm (M = 19.4 cm). Custodian-reported 'time left unsupervised' ranged from 30 s to 60 min. Children with pre-existing medical conditions were, on average, older (9.9 years; confidence interval: 7.9-11.9) and left unsupervised for longer (M = 15.4 min; confidence interval: 3.8-27.1) than those without.

CONCLUSIONS

On average, 6.5 children drown every year in baths in Australia. Children aged younger than 1 year are most affected, with both genders equally represented. Infants and toddlers left unsupervised, false confidence in the preventive role of bath aids, unrealistic expectations in the supervisory capabilities of co-bathing children and epilepsy remain threats to children in the bath.

Effect of water bath temperature on physiological parameters and subjective sensation in older people

AIM

In Japan, the incidence of water bathing-related cardiopulmonary accidents among older people is high in winter. The purpose of the present study was to investigate alterations in physiological characteristics and subjective thermal sensations of older people when bathing in a cool environment.

METHODS

We assessed the skin temperature, rectal temperature, blood pressure, pulse rate, body fluid loss (sweat and urine), and subjective thermal responses of 11 older healthy male and 10 young male volunteers throughout 42°C and 39°C bathing in a room at 20°C with 50% humidity.

RESULTS

At 42°C bathing, the rectal temperature during bathing and in the post-bathing period were significantly lower in the older men than in the young men, and skin temperature during the post-bathing period decreased gradually in the older men. Systolic blood pressure and pulse rate immediately increased just after entering 42°C water and decreased during bathing in the older men. With the activities of dressing, systolic blood pressure increased followed by a decrease during the post-bathing period. Thus, double product (pulse rate × systolic blood pressure) increased during the bathing period. Although there was no significant difference in body fluid loss between the older and younger men in 42°C water, the older men produced significantly less sweat. The older men also reported feeling less warm after 42°C bathing, and feeling less cold during the post-bathing period after 39°C bathing.

CONCLUSIONS

These results suggest that hot water bathing during cold seasons might induce more serious physiological changes in older people. Geriatr Gerontol Int 2017; 17: 2164-2170.

Effect of daily chlorhexidine bathing on the acquisition of methicillin-resistant Staphylococcus aureus in a medical intensive care unit with methicillin-resistant S aureus endemicity

BACKGROUND

Universal decolonization is recommended in intensive care units (ICUs) that have unacceptably high rates of methicillin-resistant Staphylococcus aureus (MRSA) despite implementation of basic prevention strategies.

METHODS

An interrupted time series study was performed to evaluate the effect of daily chlorhexidine bathing on the acquisition of MRSA in a medical ICU with MRSA endemicity. There was a 14-month control period and a 16-month chlorhexidine bathing period. Segmented Poisson regression analysis was performed to assess the impact of daily chlorhexidine bathing on the incidence density of MRSA. Also, chlorhexidine susceptibility testing with polymerase chain reaction for the qacA/B gene was performed on MRSA isolates collected during the chlorhexidine bathing period.

RESULTS

There was a significant reduction in trend (-0.056; 95% confidence interval, -0.095 to -0.017; P = .005) of incidence density of MRSA despite a significant increase in both level and trend of MRSA prevalence rates during the chlorhexidine bathing period. However, there was no significant reduction in level of incidence density of MRSA during the interventional period. Minimum inhibitory concentration of chlorhexidine and the detection rates of the qacA/B gene for a total of 174 MRSA isolates did not increase during the chlorhexidine bathing period.

CONCLUSIONS

Daily chlorhexidine bathing resulted in a significantly decreasing trend of MRSA acquisition rates irrespective of increased MRSA prevalence rates in the medical ICU. There was no shift of chlorhexidine-resistant MRSA strains.

A case-control study of maternal bathing habits and risk for birth defects in offspring

BACKGROUND

Nearly all women shower or take baths during early pregnancy; however, bathing habits (i.e., shower and bath length and frequency) may be related to the risk of maternal hyperthermia and exposure to water disinfection byproducts, both of which are suspected to increase risk for multiple types of birth defects. Thus, we assessed the relationships between bathing habits during pregnancy and the risk for several nonsyndromic birth defects in offspring.

METHODS

Data for cases with one of 13 types of birth defects and controls from the National Birth Defects Prevention Study delivered during 2000-2007 were evaluated. Logistic regression analyses were conducted separately for each type of birth defect.

RESULTS

There were few associations between shower frequency or bath frequency or length and risk for birth defects in offspring. The risk for gastroschisis in offspring was increased among women who reported showers lasting ≥15 compared to <15 minutes (adjusted odds ratio: 1.43, 95% confidence interval: 1.18-1.72). In addition, we observed modest increases in the risk for spina bifida, cleft lip with or without cleft palate, and limb reduction defects in offspring of women who showered ≥15 compared to <15 minutes. The results of comparisons among more specific categories of shower length (i.e., <15 minutes versus 15-19, 20-29, and ≥ 30 minutes) were similar.

CONCLUSIONS

Our findings suggest that shower length may be associated with gastroschisis, but the modest associations with other birth defects were not supported by analyses of bath length or bath or shower frequency. Given that showering for ≥15 minutes during pregnancy is very common, further evaluation of the relationship between maternal showering habits and birth defects in offspring is worthwhile.

Physical methods for treating fever in children

BACKGROUND

Health workers recommend bathing, sponging and other physical methods to treat fever in children and to avoid febrile convulsions. We know little about the most effective methods, or how these methods compare with commonly used drugs.

OBJECTIVES

To evaluate the benefits and harms of physical cooling methods used for managing fever in children.

SEARCH STRATEGY

We searched the Cochrane Infectious Diseases Group specialized trials register (February 2003), the Cochrane Central Register of Controlled Trials (Issue 1, 2003), MEDLINE (1966 to February 2003), EMBASE (1988 to November 2002), CINHAL (1982 to February 2003), LILACS (February 2003), Science Citation Index (1981 to February 2003), and reference lists of articles. We also contacted researchers in the field.

SELECTION CRITERIA

Randomized and quasi-randomized trials comparing physical methods with a drug placebo or no treatment in children with fever of presumed infectious origin. Studies where children in both groups were given an antipyretic drug were included.

DATA COLLECTION AND ANALYSIS

Two reviewers independently assessed trial methodological quality. One reviewer extracted data and the other checked the data for accuracy. Results were expressed as Relative Risk (RR) with 95% confidence intervals (CI) for discrete variables, and weighted mean differences for continuous outcomes.

MAIN RESULTS

Seven trials, involving 467 participants, met the inclusion criteria. One small trial (n = 30), comparing physical methods with drug placebo, did not demonstrate a difference in the proportion of children without fever by one hour after treatment in a comparison between physical methods alone and drug placebo. In 2 studies, where all children received an anti-pyretic drug, physical methods resulted in a higher proportion of children without fever at one hour (n=125, RR 11.8, CI 3.39 to 40.8). I; in a third study (n=130), which only reported mean change in temperature, no differences wereas detected. Mild adverse events (shivering and goose pimples) were more common in the physical methods group (3 trials, RR 5.09; CI 1.56 to 16.60).

REVIEWER'S CONCLUSIONS

A few small studies demonstrate that tepid sponging helps to reduce fever in children.