[Analysis on condom use negotiation with sex partners and condom use in female sex workers].

Objective: To know condom use negotiation with clients and regular sex partners and condom use in female sex workers (FSWs), and provide reference for the development of comprehensive HIV/AIDS intervention for FSWs. Methods: The cross sectional survey was conducted in Jianshui county and Mengzi county in Honghe Hani and Yi autonomous prefecture. A total of 476 FSWs aged 16 years and above were recruited from entertainment venues, and the information about their demographic characteristics, condom use negotiation and condom use were collected by using questionnaires. Logistic regression model was used to analyze related factors of condom use after negotiation between FSWs and clients unwilling use condom. Results: A total of 852 FSWs who aged (24.29±8.44) years old participated in the survey. In past month, 499 FSWs had negotiation for condom use with unwilling clients (58.6%, 499/852), after negotiation, 441 FSWs (88.4%, 441/499) had consistent condom use in each sex with the clients. In the past one month, 99 FSWs had negotiation for unwilling use condom with regular sex partners (14.4%, 99/687), after negotiation, 54 FSWs (54.5%, 54/99) had consistent condom use in each sex with regular sex partners. Among the FSWs, 266 (53.3%, 266/499) reported that they could say "It is a mandatory requirement" to persuade clients who were unwilling to use condom. 97(19.4%, 97/499) reported that they could say "There is risk for infection" to persuade clients who were unwilling to use condoms. 115 (23.1%,115/499) reported that they could say "It is a mandatory requirement" and "there is risk for infection" to persuade their unwilling clients to use condoms. 21 (4.2%, 21/499) reported that they used other strategies. 22 (4.4%, 22/499) felt that it was difficult to persuade clients to use condoms. Multivariate logistic regression analysis showed that compared with FSWs who felt difficult in persuading clients to use condoms, FSWs who felt moderate difficulty were more likely to have consistent condom use after negotiation (OR=4.00, 95%CI: 1.55-10.32) and FSWs who felt easy in persuading clients to use condoms were also more likely to have consistent condom use (OR=30.17, 95%CI: 3.22-282.44). Compared with FSWs used other strategies to persuade their clients to use condoms, FSWs who said it was a mandatory requirement were more likely to have consistent condom use after negotiation (OR=4.44, 95%CI: 1.41-14.01) and FSWs who said it was a mandatory requirement and there was risk for infection were also more likely to have consistent condom use (OR=5.52, 95%CI: 1.55-19.73). Conclusions: Negotiation for condom use increased the rate of condom use in FSWs in sex with clients who were unwilling to use condom. The negotiation strategy of "It is a mandatory requirement" would promote condom use in FSWs in sex with clients who were unwilling to use condom. Besides, the negotiation strategy of saying "there is risk for infection" had additional effects.

[Study on the relationship between lung cancer at preclinic stage and psycho-social factor. A case-control study].

A case-control study of primary lung cancer patients including 309 case (male 193, female 116) and 1,231 controls (male 768, female 463) was carried out in the monitored population for SINO-MONICA Project (WHO) during 1990-1993. This was a population based case-control study involved 0.75 million population in order to detect the relationship between lung cancer at preclinic stage and 6 psychosocial factors. There were 3 factors positively associated with lung cancer. They were 1) burst of "emotion and could not be controlled" (OR 1.82 P < 0.01), 2) "poor working circumstances" including poor relationship with colleagues (OR 1.37 P < 0.05) and superiors (OR 1.55 P < 0.01) and 3) the "depressive feeling for a long time" (OR 4.14 P < 0.01), when we considered "long standing depressive feeling" as a risk factor for lung cancer and calculated by an exposure rate of 8.8%, the population attributable risk percent (PAR%) would be 21.6% (male 18.7%, female 26.4%). Our findings suggested that the relationship between lung cancer at preclinic stage and psycho-social factor did exist.

Chronic airways obstruction leading to chronic hypoxemic respiratory failure: an estimate of the size and trend of the problem in Canada.

Chronic airways obstruction is a common cause of morbidity and mortality in Canada. It may progress to hypoxic respiratory failure and then to death. Only a few studies of the prevalence of chronic airways obstruction have been reported from Canada, but a number of studies have been reported from the United States and the United Kingdom, countries with similar socioeconomic conditions and ethnic compositions to those in Canada. The prevalence of chronic airflow limitation in these studies averages 9.3%. In each study, tobacco smoke exposure is the most prominent etiologic agent. Other contributing factors identified in the studies are air pollution, occupational exposure, respiratory infections and childhood respiratory illness. Endogenous modifiers of these risk factors demonstrated in the published studies include age, elevated peripheral blood leukocyte count and familial factors. Although epidemiologic studies have been able to identify the prevalence of functional impairment associated with chronic airways obstruction, risk factors associated with its development and modifiers of these risk factors, it is not possible to determine the prevalence of severe chronic airways obstruction resulting in hypoxemic respiratory failure. An estimate of this prevalence has been calculated based on certain assumptions. It was assumed that patients dying of chronic airways obstruction were likely, in a high proportion of cases, to have hypoxemic respiratory failure. It has been demonstrated that only one-half of all patients dying of chronic airways obstruction are correctly designated on death certificates. It was assumed, conservatively, that the median survival of patients with hypoxemic respiratory failure is two years. From these assumptions, it was estimated that the prevalence of hypoxemic respiratory failure in 1986 in Canada was 100 per 100,000 population. This is higher than the present rate of oxygen therapy, indicating that some patients currently eligible for this treatment may not be receiving it.

Antigenic relationship between H1 and H2 of influenza A virus.

Using cloned viruses of proven purity, and by the methods of hemagglutination inhibition, single radial hemolysis, strain-specific complement fixation and neutralization tests we have demonstrated the serological cross reaction between late H1N1 variant (Dutch/56) and H2N2 of influenza A virus with fowl and hamster antisera. Such a cross reaction is not detected with earlier H1N1 variants. Serological crossing covers variants of H2N2 virus isolated from 1957-1966 but in decreasing titers, and disappears with the last variant of H2N2 isolated late in 1967. Analysis with mono-specific antisera or antigens prepared with recombinants reveal that the hemagglutinins of late H1N1 and H2N2 are related, while their neuraminidases are distinct. We have discussed the bearing of such antigenic relationships to previous epidemiological observations on the partial protection of patients convalescent from late H1N1 disease against H2N2 and to the recombination theory for the origin of H2N2 virus.

[Staphylococcal colonization rate on neonatal nares and umbilical cord in a newborn nursery].

Staphylococcus aureus and Staphylococcus epidermidis were the most important gram positive pathogens found in a five-year study (1985-1989) of nosocomial infection in this hospital. They caused 56.2% of all nosocomial infections in this newborn nursery, particularly skin infections. To determine the reasons, and to decrease effectively the neonatal staphylococcal colonization rate, three different disinfection methods were selected for management of neonatal umbilical cords. A total of 1578 swabs from neonatal nares and umbilical cords were collected. During the first period no disinfectant was applied to the cord after bathing the baby. Beta-iodine in alcohol and bacitracin ointment were used for the second and the third periods, respectively. The result showed a significant difference (P less than 0.05) in staphylococcal colonization rate on neonatal umbilical cord using different disinfectants even after the first day. The same result for neonatal nares was also found, after infants had been in the nursery for two days. During the third period, no case of skin infection was found. Most Staphylococcus aureus isolated were resistant to ampicillin, erythromycin, tetracycline and penicillin. The percentage of this antibiogram found in neonatal nares and umbilical cords was 44% and 56% respectively. Besides nosocomial infection control and surveillance of medical personnel, environment, materials, instruments and isolation techniques, it is really necessary to choose an effective disinfectant (bacitracin ointment is recommended) to reduce the staphylococcal colonization in newborn nurseries.

Seroepidemiology and molecular epidemiology of the Chinese rotavirus.

The Chinese rotavirus which causes epidemics of diarrhoea in adult humans was isolated in 1983. This virus, designated adult diarrhoea rotavirus (ADRV), resembles typical rotaviruses morphologically and has a genome made up of 11 discrete segments of double-stranded RNA. Because the Chinese rotavirus has a unique RNA pattern on polyacrylamide gel electrophoresis and is antigenically distinct from group A rotaviruses, it is tentatively included in group B. Infection with ADRV or ADRV-related viruses (as shown by serological study) is detected in human populations as widespread as mainland China, Hong Kong, Australia, the United States and Canada, and in some domestic animals. RNA co-electrophoresis has shown homology of isolates from 12 different outbreaks (with some minor variations at segments 10, 11, 3 and 5). cDNA probes and monoclonal antibodies have been prepared to improve the detection and further characterization of the virus.