Do Ureaplasma urealyticum infections in the genital tract affect semen quality?

Aim： To investigate the relationship between Ureaplasma urealyticum （UU） infection and semen quality. Methods： From 2001 to 2003, 346 eligible patients aged 20-45 years were invited from two hospitals in Shanghai, China, to participate in an investigation which included questionnaires about general and reproductive health, an external genital tract examination, UU culture and semen analysis. Multiple linear regression models were used to examine whether UU had a significant effect on semen quality after adjustment for confounding factors. Results： Findings suggested that UU infection was associated with higher semen viscosity and lower semen pH value. Sperm concentration was lower in UU positive subjects than that in UU negative subjects （54.04 × 10^6/mL vs.70.58 × 10^6/mL）. However, UU did not significantly affect other semen quality indexes. Conclusion： UU infection of the male genital tract could negatively influence semen quality.

Do reproductive hormones explain the association between body mass index and semen quality？

Aim： To examine whether reproductive hormones play a role in the association between body mass index （BMI） and semen quality. Methods： Semen quality and testosterone （T）, luteinizing hormone （LH）, follicle-stimulating hormone （FSH） and estradiol （E2） were evaluated in 990 fertile males with age 38.9 ± 9.7 （mean ＋ SD） years recruited from the Chinese general population in 2001 and 2002. Results： Semen quality was reduced among underweight （BMI 〈 18.5） compared with normal （BMI 18.5-24.9） and overweight （BMI 25.0-29.9）, but the associations were independent of reproductive hormones. After adjustment for the potential confounders, underweight men had reductions in sperm concentration （22.4 × 10^6/mL）, total sperm count （52.9× 10^6） and percentage of normal sperm forms （6.9%） compared with men with normal BMI. Being underweight may be a risk factor for low sperm concentration （OR： 4.68, 95% confidence intervals [CI]： 2.01-10.91）. Otherwise, being overweight may be a protected factor for low sperm concentration （OR： 0.25; 95% CI： 0.08-0.83） and low total sperm count （OR： 0.37, 95% CI： 0.15-0.87）. Conclusion： Low BMI was associated with reduced semen quality. The associations between BMI and semen quality were found statistically significant even after adjustment for reproductive hormones. Reproductive hormones cannot explain the association between BMI and semen quality.

An Intervention Study of Reproductive Tract Infections among Married Women of Reproductive Age in Shanghai

Objective To evaluate the impacts of reproductive tract infections （RTIs） intervention on RTIs-related knowledge, attitudes, practices and prevalence of married women at reproductive age. Methods Four sub-districts from Xuhui district, Shanghai were selected by multistage cluster random sampling and residence committees were randomly assigned to either an intervention group or a control one. RTIs intervention was implemented in intervention group, while routine family planning program was conducted in control group. Results Compared with control group, intervention group have improved the following targets： the increment of RTI knowledge score was higher than that in control group （OR=9. 22, 95%CI： 7.01 - 2.14）; the increment score of individual health behaviors （6. 31） was higher than that in control group （4.50） （OR=1.60, 95%CI： 1.21 -2.10）; the increase of condom use frequency in intervention group was higher than that in control group （4.12% vs 0.69%） （OR=1.84, 95%CI： 1.31-2.57）; the decreased RTIs rate was higher than that in control group （7.45% vs 0.96%） （OR=0.68, 95%CI： 0.49-0.95）. Conclusion It is an effective way to conduct community-based intervention to increase women＇s RTIs knowledge, improve RTIs-related attitudes, promote good individual health behaviors, so as to decrease RTIs prevalence.

Relationship between Contraceptive Knowledge,Cognition and Behaviors among Vocational High School Students

Objective To study the relationship between contraceptive knowledge, cognition and behaviors among vocational high school students. Methods A cross-sectional survey was anonymously self-administrated by way of computer to all the 1st graders＇ among three vocational high schools in a district of Shanghai. Four cognition indicators, including perceived benefits, perceived barriers, perceived risks and self eJficacy were applied according to Health Belief Model. Results The percentage of respondents who reported ever sexual practices and contraceptives use at first sex was 7.01% and 56.64% respectively. Condom （58. 70%） and oral contraceptive pills （27.78%） were used by the majority. Main reasons for non-use were ＂shy to buy it＂ （26.53%） and ＂partner don＇t want to use any＂ （18.37%）. Proportion of respondents who ever had sex regarded withdrawal and rhythm as effective were 68.35% and 68.42% respectively. Proportion of respondents having sex knew ＂If a person was infected with STDs, he/she might not have noticeable symptoms＂ were 22.86%. Proportion of respondents who reported non-use of contraceptives at first sex considered that ＂infrequent intercourse could not cause a girl pregnant even she had experienced her menstruation＂ were 40.63%. Proportion of respondents who had ever used condom got full score of knowledge on ＂how to correctly use condom＂ were 23,26%. Perceived risks were poorest among four cognition indicators. High level of contraceptive knowledge was connected with high rate of contraceptives use at first sex, whereas high level contraceptive cognition was connected with high rate of contraceptive use both at first and recent sex. Conclusions It is important to provide youth-friendly services as well as message on contraceptives among vocational school students.

Effects of Cesarean Section on Infant Health in China:Matched Prospective Cohort Study

Objective To compare the medical outcomes of infants delivered by cesarean section with those of infants delivered vaginally. Methods A total of 301 healthy women with cesarean section and a matched control group of 301 women delivered vaginally were identified at three district-level hospitals in Shanghai from May 2001 to February 2003. Two groups were matched according to their medical indications for cesarean section. Their infants were assessed at delivery, 1 month, 6 month and 1 year after birth. Results The incidence of neonatal complications and infant morbidities at all measurement occasions did not differ significantly between groups. Rehospitalization was found to be more likely among infants delivered by cesarean section in the first month after birth. However, there was no difference between two groups in the incidence of rehospitalization in the first year after birth. Cesarean section was also associated with a higher risk of infant diarrhea （adjusted relative risk=1.25, 95% CI： 1.01, 1.56）. Conclusion Infants did not have health benefits from cesarean section if the pregnancy was at low risk.

Survey on Attitude of Middle School Educators for Sex and Reproductive Health Education

Objective To get a general picture of the attitudes of middle school educators on sex and reproductive health education. Methods A cross-sectional survey was carried out among 144 middle school educators in three districts of Shanghai from September to October 2005 using anonymous self-administered questionnaire. Results The majority of the educators thought that it was necessary to launch the sex and reproductive health education in all of the middle schools in Shanghai （97. 02%）. They were aware that the age of the students＇puberty were earlier now than before （94.41%）, but the reproductive health knowledge of students was neither sufficient nor correct （78.34%）. The sex and reproductive health education had been involved in the curriculum of many middle schools （66.11%）. Lacking of qualified education staffs contributed most （90. 71%） in the schools which had not launched the sex and reproductive health education. Lacking of qualified education staffs （90.91%） challenged most in the schools which had carried the education. Conclusion The middle school educators thought it was necessary to carry the sex and reproductive health education in all of the middle schools in Shanghai while the major challenges were lacking of qualified education staffs and sufficient teaching time.

Study on the Effects of Infant Fostering Interventions in Xuhui District,Shanghai

Objective To assess the effects of fostering interventions on the infants and their families through the community. Methods A total of 309 infants born on 1st August, 2003 to 30th August, 2004 and their families were recruited as participants by cluster sampling in Longhua and Kantian sub-districts of Xuhui district, Shanghai. The newborns were randomly assigned to intervention group （156 cases） and control group （153 cases）. The infants and their families will be followed up during 3-year interventions. Results After 6 months＇ intervention, the proportion of infants who could turn over the body in the intervention group （88.46%） was higher than that in control group （75.16%）. The morbidity of upper-respiratory tract infection in intervention group （20.51%） was significantly lower than that in control group （32.68%）. The incidence rates of pneumonia, diarrhea and anemia in intervention group were all lower than that in control group, except for pneumonia, the differences were not significant. Both of the knowledge about how to foster infants and service utility in intervention group were higher than that in control group. Conclusion The fostering interventions through the community promote the prevention and control of infants disease, increase the knowledge level and service util ity of families.

Study on Bone Mineral Density and its Influencing Factors among 1214 Older Adults in Xuhui District,Shanghai

Objective To understand the status of the forearm bone mineral density （BMD） in older adults, and to identify the potentialfactors influencing BMD. Methods A total of 1 214 older adults were examined, in Tianlin, Fenglin and Xietu sub-districts, of Xuhui district, Shanghai. BMD was tested at the left forearm, including distal radius and ulna 1/3 total, distal radius where the distance of radius and ulna is 8 mm, ultra-distal radius, by single energy X-ray densitometer. Results The BMD at all of the four sites decreased with the age increased. The average BMD was higher in male than in female for the same age and measured site. Distal radius 1/3 total had the highest BMD among the four sites. The incidence of low BMD and osteoporosis in distal forearm 1/3 radius total ascended with the age increased. Multiplied logistic regression showed that males had a lower risk to be low BMD （OR=0. 19） compared with female. Compared with the group aged from 50 to 54, the odds ratio in the group aged from 55 to 59, 60 to 64, and 65 to 70 were respectively 3.17, 5.13, 15.03. Compared with those whose monthly salary was less than 1 000, the odds ratio was O. 70 in those whose salary was more than 1 000. Conclusion The incidence of low BMD was high in older adults, and it is related with sex, age, monthly salary.

Survey on Pre-pregnancy Health Knowledge and Service Demands among Un-pregnant Married Women

Objective To understand the pre-pregnancy health knowledge and service needs among un-pregnant married women in Shanghai. Methods A total of 968 newly-married un-pregnant women in Changqiao, Lingyun sub-districts and Huajing town of Xuhui district, Shanghai, were recruited and interviewed by structured questionnaire to collect the information on pre-pregnancy health knowledge and service demands. Results 1） Newly-married women thought the contraceptive methods suitable for them was male condom（84.4%）, followed by oral contraceptives（54%）, emergent contraceptive（52.5%） and contraceptive suppository （48.3%）. 2） The score of pre-pregnancy health knowledge was 54.7±14.5 among the subjects. The participants with junior college or a bachelor had more knowledge than those with junior or senior high school, and those who were engaged in medicine /education/science field had higher score. 3） They had higher knowing rate on the common knowledge, and the rate was above 80%. But the knowing rate on the knowledge of birth defect was low, and all below 50%. 4）A proportion of 52. 7% of the respondents knew that there was a station for reproductive health service in their communities, but only 45.5% received the service from the station, 87.0% thought they had insufficient or scarce knowledge, 73.6% planned to consult before pregnancy training courses on preparing pregnancy. and 63.6% were willing to attend the Conclusion The participants had certain pre-pregnancy health knowledge, but still need being improved,＂ in addition, they had higher needs on knowledge and service of birth defect prevention, at the same time they can＇t make full use of the existing reproductive health institution.

Evaluation of Impact of Life-planning Skills Training among Senior High School Students in Shangcai County

Objective To evaluate the impact of sex and reproductive health education using lifeplanning skills training among senior high school students in a rural county. Methods The study was conducted in three senior high schools of Shangcai County with comparable socio-cultural, economic, and demographic characteristics, two as intervention sites and one as the control. A three-month life-planning skills training course was conducted among all grade one students in the intervention schools. The baseline survey was conducted prior to the intervention, once again three months after the intervention was initiated. Data were collected through questionnaires, FGDs and 1Dis to evaluate the effect of the intervention program. Results After the intervention, the median score of reproductive health knowledge was higher in the intervention group （55.66） than that in control group （38.68）. Students from the intervention group were also more comfortable with their developmental changes which were going through, In the end line survey, 92.70% of the students in the intervention group suggested that reproductive health education should be carried out among all middle school students in Shangcai County. Multivariate analysis also indicated that peers and family had a significant effect on students＇ sex-related knowledge, attitudes and behaviors. Conclusion Sex and reproductive health education via provision of life-planning skills training can significantly increase students＇ sex and reproductive health knowl- edge and was welcomed by students, teachers and parents.

Effect of Community Interventions on Intelligence Development of Infants

Objective To assess the interventions effect on intelligence of the infants through the community. Methods A total of 309 newborns and their families were recruited in Xuhui district, Shanghai. They were asked to fill out the baseline questionnaires. The newborns＇ intelligence quotients were measured by Developmental Screening Test for Child Under Six, and physical examinations were conducted at the same time. The newborns were randomly assigned to intervention group （156 cases） and control group （153 cases）. The infants and their families were followed up every 6 months. A questionnaire of follow-up was completed by face-to-face interview at the communities and infant intelligence quotients were measured and had their physical check-ups again at the end of the 6th month. Results After 6 months＇ intervention, the means of MI and DQ in the intervention group were respectively 5.96 and 9.80 higher than those in control group after adjustment of the baseline scores. Conclusion Early intelligence education in the community may promote the intelligence development of infants.

Promoting Reproductive Health among Newly Married Couples in Shanghai

Objective To explore the effect of health education promotion among newly married couples who need reproductive health knowledge and service. Methods An intervention study was conducted at three sub-districts, Xuhui district, Shanghai, which aimed to improve reproductive health of newly married couples. The main intervention activities included creating educational web pages, organizing participatory activities, distributing leaflets, and providing relevant counseling and technique service. Results After intervention, the knowledge of family planning and reproductive health and their sanitary habit for these newly married couples were much improved. Conclusion This project produced a model to improve reproductive health at sub-district level and this model can be expanded to provide relevant service to other groups of people.

Condom Use and Breakage among Women in Shanghai

Objective To determine the frequency of condom breakage and understand if couple took any measure（s） to protect against pregnancy when condom breakage happened. Methods It＇s a prospective follow-up study. A total of 1 562 subjects in 9 districts of Shanghai were selected. Subjects were divided into two groups. Totally 812 subjects were in condomlemergency contraceptive pills（ECP） combined regimen group and 750 subjects were in the group of condom only. Each subject used daily diary card to record the presence or absence of menstrual bleeding or spotting, each act of sexual intercourse, condom problem, together with brief details about use of condom/postcoital ECP. The selected subjects were interviewed at the end of 1st, 3rd, 6th, 9th and 12th month after enrollment with their diary to＇c＇ollect information mentioned above. Results The total condom breakage rate （CBR） of whole year was 0.53 per 1 000 condoms. The condom breakage ratio per 1 000 person months （CBRp） was 2.58. The result of multiple logistic regression showed that husbands＇ age, occupation and couples＂ condom using experience might affect the condom breakage. Compared with 〈30 years old husbands, subjects whose husbands were 30-34 years old and ≥35 years old could have higher CBR （RR=2.29, 4.07, respectively）. Compared with subjects whose husbands were medical staff, subjects whose husbands were teacher and scientific technician, manager, worker and service worker could have higher risk of condom breakage （RR=3.88, 9.30, 4.00 and 8.28, respectively）. Subjects with condom using experience might have lower risk of condom breakage （RR=0.44）. Conclusion The condom breakage rate was age, husband＇s occupation and condom using affecting the condom breakage. significant associated with husband＇s experience. Those might be the factors

Analysis of Childhood Sexual Abuse among 1099 University Students in Shanghai

Objective To understand the situations of childhood sexual abuse （CSA） and to examine associations of CSA with demographic factors and with later risk behaviors among university students in Shanghai, China. Methods A two-stage random sampling method was adopted to conduct the survey anomalously using electronic questionnaire and computer-assisted-structured-interview method. Results About 15.1% （10.2% among male, 18.2% among female） university students reported having had experienced CSA before age 14, 1.2% university students reported having had experienced abuse of attempted vaginal or anal intercourse and 0.8% university students experienced abuse of forced vaginal or anal intercourse. The perpetrators were mainly strangers （accounting for 40.3%） and classmates or friends of the victims （23.9%）. Family members or relatives accounted for 11.3% of the perpetrators. Female students who came from cities （21.9%） reported more CSA experiences than those who came from townships （10.1%） or rural areas （8.2%）. Association between CSA experiences of victims and their parents education levels was not found. Those respondents who had ever experienced CSA before age 14 had reported more later risk behaviors than those who had not experienced CSA： males with CSA reported more experiences of ever fighting and more often involved in forced sexual intercourse than those without CSA, while females with CSA reported more experiences of smoking, running away from home, ever fighting, watching pornography and more unmarried sexual intercourse than those without CSA. Conclusion CSA is not rare among university students and associated with later risk sexual behaviors. It is important and urgent to pay attention to the issue of CSA and take prevention measures to protect children.

Unmet Needs for Reproductive Health Knowledge among Unmarried Migrant Youth

Objective To explore the deep reason for the lack of reproductive knowledge among migrant youth.Methods Qualitative research method was used with in-depth interview as the major approach to collect data.Results The results showed that lack of formal sexual education and the special social status were deep reason for their knowledge lack. Very few of them had received sex education in school. Before falling in love and beginning to date, most girls and some boys have no interest in sexual related knowledge. The knowledge they have usually come first from peer communication and are full of mistakes. As growing up, mass media, like TV and magazines begin to be their major knowledge sources. But many get the information from TV dramas, novels or advertisements, and few from formal educational programs. Working long hours each day, with little leisure time and living isolated in cities, migrant people rarely benefit from the ongoing education activities in cities.Conclusion Special sexual and reproductive health education program are needed urgently among unmarried migrant youth, particularly female.