The optimal age to start the lessons is childhood, between one and four years of age. Feeling overly tired reduces swimming performance. This exhaustion can be rapidly aggravated by anxious movements motivated by fear during or in anticipation of drowning. An overconfident appraisal of ones own physical capabilities can lead to "swimming out too far" and exhaustion before returning to solid footing. Free access to water can be hazardous, especially to young children. Barriers can prevent young children from gaining access to the water. Ineffective supervision. Drowning can occur anywhere there is water, even in the presence of lifeguards. Risk can vary with location depending on age. Children between one and four more commonly drown in home swimming pools than elsewhere. Drownings in natural water settings increase with age. More than half of drownings occur among those fifteen years and older and occurred in natural water environments. Familial or genetic history of sudden cardiac arrest (SCA) or sudden cardiac death (SCD) can predispose children to drown. Extensive genetic testing and/or consultation with a cardiologist should be done especially when there is a high suspicion of familial history and/or clinical evidence of sudden cardiac arrest or sudden cardiac death. Individuals with undetected primary cardiac arrhythmias, as cold water immersion or aquatic exercise can induce these arrhythmias to occur.Population groups at risk in the US are generally the old and young. Youth: drowning rates are highest for children under five years of age and people fifteen to twenty-four years of age.
Cream vehicle
Clocortolone pivalate 0.1% is formulated in a cream that contains three ingredients which assist in stratum corneum permeability barrier integrity: white petrolatum (occlusive), mineral oil (humectant), and stearyl alcohol (long-chain fatty alcohol emollient). This cream does not contain lanolin, fragrance, nor propylene glycol, all of which have been known to be problematic for some patients. Clinical studies
In Phase III trials, Cloderm was found to be especially useful in treating eczema, atopic dermatitis, and psoriasis. Phase III trials also showed rapid action and relief for the majority of the patients involved. There is no age restriction on the use of clocortolone pivalate 0.1% cream. Clinical trials comparing clocortolone pivalate 0.1% topical cream with vehicle in atopic dermatitis/eczematous dermatitis, psoriasis, and contact dermatitis included pediatric patients (N=44). The mean age of pediatric subjects was 10 years (range 3–14 years). Clocortolone pivalate 0.1% cream was efficacious for the majority (75%) of the pediatric patients in these trials, with no serious adverse effects occurring in either group.In six parallel, double-blind, placebo-controlled trials, patients with atopic dermatitis/eczematous dermatitis were randomized to treatment with clocortolone pivalate 0.1% topical cream (total n=109) or vehicle (total n=100), applied three times daily over a duration of 14 days.