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PubMed2005

Molecular identification of potential pathogens in water and air of a hospital therapy pool.

Indoor warm-water therapy pool workers in a Midwestern regional hospital were diagnosed with non-tuberculosis pulmonary hypersensitive pneumonitis and Mycobacterium avium infections. In response, we conducted a multiseason survey of microorganisms present in this therapy pool water, in biofilms associated with the pool containment walls, and in air immediately above the pool. The survey used culture, microscopy, and culture-independent molecular phylogenetic analyses. Although outfitted with a state-of-the-art UV-peroxide disinfection system, the numbers of bacteria in the therapy pool water were relatively high compared with the potable water used to fill the pool. Regardless of the source, direct microscopic counts of microbes were routinely approximately 1,000 times greater than conventional plate counts. Analysis of clone libraries of small subunit rRNA genes from environmental DNA provided phylogenetic diversity estimates of the microorganisms collected in and above the pool. A survey of >1,300 rRNA genes yielded a total of 628 unique sequences, the most common of which was nearly identical to that of M. avium strains. The high proportion of clones with different Mycobacterium spp. rRNA genes suggested that such organisms comprised a significant fraction of microbes in the pool water (to >30%) and preferentially partition into aerosols (to >80%) relative to other waterborne bacteria present. The results of the study strongly validate aerosol partitioning as a mechanism for disease transfer in these environments. The results also show that culture protocols currently used by public health facilities and agencies are seriously inadequate for the detection and enumeration of potential pathogens.

Air Microbiology↗
PubMed2003

Safety first.

Many aquatic therapy and rehabilitation practitioners have excellent protocol knowledge, but little knowledge of codes, regulations, and safety issues. Surveys of attendees at ATRI training events show many practitioners are working one-on-one in pools with no other staff in the facilities. Appropriate rescue equipment is not available and most have never seen or heard of a rescue tube. Emergency communication systems are hit-or-miss. There are no lifeguards on deck. The aquatic therapy industry is extremely fortunate not to have accident cases documented. As the popularity of aquatic therapy expands, it is essential to train and educate practitioners to assess their environment, patients, training, and safety. Standards provide the guidelines. Spread the word that help is available. The ATRI continues to promote all facets of training and education. It is there to answer questions and to support aquatic therapy and rehabilitation practitioners.

Humans↗
PubMed1990

Incidence of occult athlete's foot in swimmers.

Athlete's foot is a dermatophytic infection frequently found in adults. This disease is, in some cases, asymptomatic. In order to evaluate the incidence of subclinical infection, we obtained 300 toe-web samples from the fourth interdigital space of 150 regular swimmers. More over, 66 specimens from the pool area were analysed. The method used was the carpet technique described by Mariat et al. (10). The fungal isolates were identified according to standard methods. A list of epidemiological data was completed for every swimmer. In our results, 22 swimmers had positive cultures (15%), 8 of these cases had no lesions (36%). They included 7 infections with Trichophyton mentagrophytes (87.5%) and one with T. rubrum (12.5%). We observed one case with a dual infection. Only one sample from the inanimate environment was positive. This study showed a significant incidence of occult athlete's foot in swimmers. To control this endemic problem, adequate preventive measures must be taken.

Adolescent↗
PubMed1994

Young children's ability to climb fences.

Three studies were performed to evaluate the fence-climbing abilities of children who are in the high-risk age group for drowning in residential pools. Study 1 examined the ability of children in the age range of 24 to 54 months to climb commonly used fences (common chain link, small chain link, picket, iron, and stockade) at a 4-ft (1.22-m) height. Study 2 examined children's abilities to climb fences retrofitted with features that would potentially make them more difficult to climb. Study 3 examined children's abilities to climb 5-ft (1.52-m) fences. Results of the three studies show that the common chain-link fence is easy to climb even by two-year-old toddlers. Other fence types offered more effective barriers, especially for younger children.

Architectural Accessibility↗
PubMed2006

Prolonged outbreak of giardiasis with two modes of transmission.

Large outbreaks of giardiasis caused by person-to-person transmission, or a combination of transmission routes, have not previously been reported. A large, prolonged giardiasis outbreak affected families belonging to a country club in a suburb of Boston, Massachusetts, during June-December 2003. We conducted a retrospective cohort study to determine the source of this outbreak. Giardiasis-compatible illness was experienced by 149 (25%) respondents to a questionnaire, and was laboratory confirmed in 97 (65%) of these cases. Of the 30 primary cases, exposure to the children's pool at the country club was significantly associated with illness (risk ratio 3.3, 95% confidence interval 1.7-6.5). In addition, 105 secondary cases probably resulted from person-to-person spread; 14 cases did not report an onset date. This outbreak illustrates the potential for Giardia to spread through multiple modes of transmission, with a common-source outbreak caused by exposure to a contaminated water source resulting in subsequent prolonged propagation through person-to-person transmission in the community. This capacity for a common-source outbreak to continue propagation through secondary person-to-person spread has been reported with Shigella and Cryptosporidium and may also be a feature of other enteric pathogens having low infectious doses.

Adolescent↗
PubMed2005

Exercise in fibromyalgia.

PURPOSE OF REVIEW: Several studies have indicated that physical exercise is beneficial for patients with fibromyalgia. The aim of this article is to review the recent literature relating to exercise in fibromyalgia, specifically articles published between September 2003 and September 2004, to highlight developments in the field. RECENT FINDINGS: Previous studies indicate that aerobic exercise performed at adequate intensity for an individual can improve function, symptoms, and well-being. A recent study of aerobic exercise showed that training in sedentary women with fibromyalgia using short bouts of exercise produces improvements in health outcomes. A study of aerobic walking resulted in improvements in physical function, symptoms, and distress. Two studies of low-intensity pool exercise reported a positive impact on fibromyalgia symptoms and distress. Two studies of qigong movement therapy were reported, one indicating improvements in symptoms and the other in movement harmony, indicating that this mode of exercise needs to be evaluated further. SUMMARY: The recent studies support existing literature on the benefits of exercise for patients with fibromyalgia. The outcomes appear to be related to the program design and the characteristics of the populations studied. As the patients with fibromyalgia form a heterogeneous population, more research is required to identify the characteristics of patients who benefit from specific modes of exercise. Moreover, long-term planning is needed to motivate the patients to continue regular exercise. Informing patients about the benefits of exercise and adjusting the exercise intensity to individual limitations enhances adherence. The social support gained by exercising in groups also enhances adherence to exercise.

Breathing Exercises↗
PubMed2004

From the bush to the beach: water safety in rural and remote New South Wales.

OBJECTIVE: To describe the types of aquatic locations attended by residents of rural and remote New South Wales (NSW), to record self-reported water safety-related behaviour, and identify preferred communication mediums for water safety messages. METHODS: A stratified random telephone survey was conducted of 500 NSW residents aged greater than 15 years residing in moderately accessible, remote and very remote locations in NSW. RESULTS: Results indicate that around two-thirds of respondents had been in or on the water at a pool, beach, lake, river or dam in the past 6 months. The most common type of aquatic facilities used were rivers, creeks or streams (53.5%), beaches (45.7%), public pools (45.5%), private pools (40.7%), dams (40.6%) and lakes (27.0%). Time spent at each of these locations and time of day each location was visited varied. Overall, the majority of respondents reported practicing water-related safe behaviour. Preferred communication mediums for water safety messages included television, schools and newspapers. CONCLUSIONS: Water safety education, especially in relation to beach conditions, remains just as important a topic for public health authorities and key water safety agencies in regional and remote NSW as it is in coastal suburbs. Responses from the survey, along with key stakeholder advice, will be used to inform the development of appropriate strategies aimed to reduce drowning deaths in rural and remote locations in NSW.

Adolescent↗
PubMed2001

Exercise in 94 degrees F water for a patient with multiple sclerosis.

BACKGROUND AND PURPOSE: The purpose of this case report is to describe the examination, intervention, and outcome of a patient with multiple sclerosis (MS) who participated in a comprehensive rehabilitation program that included aquatic therapy with a pool temperature of 94 degrees F. There are few descriptions of aquatic exercise programs on muscle force, exercise tolerance, and functional outcomes in individuals with MS, and most authors recommend a water temperature of less than 85 degrees F to prevent an exacerbation of symptoms. DESCRIPTION: The patient was a 33-year-old woman. Before, during, and after the aquatic program, she was monitored for body temperature, heart rate, blood pressure, and perceived exertion. She was also assessed for muscle force and functional abilities. OUTCOMES: The patient did not experience heat sensitivity or fatigue throughout the program, and her manual muscle test grades and mobility improved. DISCUSSION: This patient's participation in aquatic therapy, in conjunction with land-based interventions, may have been associated with the improvement in functional abilities.

Activities of Daily Living↗
PubMed1991

[Swimmers' dermatitis in an excavation pool--an incentive for the status analysis of the water and for the preparation of an ecology-friendly utilization concept].

In recent years, swimmer's itch occurred in several ground water lakes dud excavation pools in sporadic or epidemic outbreaks in the upper Rhine valley. They were caused by Trichobilharzia szidati. The Public Health Offices in Offenburg and Freiburg have been dealing extensively with this problem. They were also requested to comment on the use of lakes within a framework for regional development (Landschaftsrahmenplan) by the Southern Upper Rhine Regional Authority. An ecological study of water quality was prepared in summer 1989 in Offenburg. Hydrological and biological criteria were applied. Eutrophication due to excessive nutrient input proved to be the main problem. Measures for reduction were proposed that also included determining water use. Thus, specific use should either be prescribed from the beginning for each lake and made possible via ecologically oriented long-term maintenance measures, or use should be adapted to the natural succession process. Thus, after gravel quarrying, water sports including bathing would be possible, followed by fish farming and finally reservation as protected area.

Animals↗
PubMed2003

Prevention of drowning in home pools--lessons from Australia.

As an affluent and warm weather country, Australia faced an epidemic of drowning in children under five as the popularity of home pools increased in the late 1960s and early 1970s. In one state child drowning rose by 6.62 per 100,000 in the five years from 1968. Variation across jurisdictions in actions to regulate domestic pools has resulted in Australia representing an unfortunate natural experiment in interventions to prevent child drowning in pools. Mechanisms adopted by various authorities were analysed in detail to identify factors that contributed to success and failure in regulating domestic pools. Despite early identification of the problem and development of what were later demonstrated to be effective interventions, best practice solutions were not established in any jurisdiction until 2002, 25 years after identification of the problem. Key failures in intervention were found to be: failure to act in a timely way, flawed regulation, blockage of timely action and repeal of effective state regulation under political pressure, and blockage of effective standards. Lessons are identified as: inherent weaknesses in the standard setting process, failure of interventions to address major risk categories, failure to act before the hazard grew, failure to consider lesser interventions for tactical reasons, failure to pay attention to advocates, and the need for continuing effort. The paper argues that analysis of the identification of the problem, development of interventions and implementation of mechanisms of prevention illustrate where systemic changes are required and indicate lessons that should be applied in developing and implementing future interventions.

Accidents, Home↗
PubMed2003

Beneficial effects of water-based exercise in patients with chronic kidney disease.

The possible beneficial effect of regular aquatic exercise on cardiorespiratory, renal lipid parameters and oxidative stress status was studied in patients with mild to moderate renal failure. The exercise group did low-intensity aerobic exercise in the pool during a period of 12 weeks, twice a week, with sessions lasting for 30 min. Matched control participants remained sedentary. The results showed that in the exercise group all cardiorespiratory functional parameters improved and resting blood pressure lowered significantly. Proteinuria and cystatin-C were diminished significantly and glomerular filtration rate was enhanced. To evaluate the changes in oxidative stress status in the serum, products of lipid peroxidation (LPO) and serum glutathione values were measured. LPO was reduced significantly and reduced glutathione levels showed significant improvement after the exercise-conditioning programme. In the control group the data either remained the same or worsened in the same period of time. In conclusion, regular water-based exercise has beneficial effects on the cardiorespiratory, renal functional parameters and oxidative stress status in patients with moderate renal failure, and can be used in the complex rehabilitation of chronic renal failure patients, together with blood pressure control, dietary consultation, encouragement and education to prevent physical worsening and to postpone cardiovascular and renal atherosclerotic complications.

Adult↗
PubMed1977

Green hair.

Explore the source record for details and available documents.

Adolescent↗
PubMed1978

Pseudomonas folliculitis acquired from a health spa whirlpool.

Three cases of an unusual Pseudomonas skin infection acquired from a health spa whirlpool were reported, and an epidemiologic survey showed 17 additional cases. This dermatosis is characterized by the abrupt onset of urticarial papules and superficial and deep papulopustules that spare only the head and neck and occur eight to 48 hours after using the whirlpool. Cultures from one patient's pustules and from the spa whirlpool environment were positive for P aeruginosa, serotype O-11. The condition cleared in all but one patient, without treatment, within seven to ten days. This patient continues to have recurrent follicular pustules three months after exposure. Samples from whirlpools at six other selected establishments were also positive for P aeruginosa.

Adult↗
PubMed1991

Juvenile rheumatoid arthritis. Aquatic exercise and lower-extremity function.

This pilot study investigates the effects of aquatic therapeutic exercise on lower-extremity range of motion, gait, balance, and functional mobility in children with juvenile arthritis. Eleven patients, aged 4-13, with lower-extremity joint involvement, diagnosed as functional class I-III, completed a 6-week program of aquatic exercise aimed at increasing lower-extremity range of motion and strength. Despite the small sample size and short duration of the study program, significant improvement was noted in external and internal hip rotation, bilaterally (p < 0.05). Improvement was noted in the median scores for most other parameters; however, these did not reach statistical significance. Aquatic exercises performed in a group setting can serve as an enjoyable and beneficial part of therapy for children with arthritis. Further investigation is recommended to determine fully the effects of aquatic therapeutic exercise on mobility and fitness in children with juvenile arthritis.

Adolescent↗