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Although sex work can bring significant economic benefit there are serious downsides, not least vulnerability to adverse sexual health outcomes. Focus-groups discussions and in-depth interviews were conducted with 70 female sex workers to explore the context in which they started sex work, their motivations to leave, and their experiences of trying to leave. The pathway to becoming a sex worker was underscored by poverty, with disruptive events leading to increasing vulnerability and increasingly difficult life choices. A sizeable minority of women became sex workers while working as house-girls, a position associated with financial, physical and sexual vulnerability. The majority of participants were still working as sex workers, citing financial reasons for not leaving. Motivations to leave sex work included experiencing a frightening incident, peer pressure and concerns about dependent children. Those who left often described a change in their financial circumstances that enabled them to leave. Some had left but had returned to sex work following a financial crisis or because they found their new life too hard. House-girls are particularly vulnerable and therefore an appropriate focus for prevention. Programmes assisting women to leave need to include financial safety nets so that a time of financial difficulty does not necessitate a return to sex work.

Background: Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is often followed by recurrent wheezing episodes during childhood. The effect of postbronchiolitis wheezing on the well-being of the child is not known. This study aimed to determine the impact of RSV LRTI hospitalization before age 13 months on health-related quality of life (HRQoL) at age 3 years., Methods: HRQoL was measured in a previously described cohort of children with a history of RSV infection and compared with control term children from the open population. HRQoL was determined during the winter season in index and control children. We used a validated questionnaire, which measures the health status of children in 13 domains weighted by the impact of the health status problems on well-being. The lung domain was the focus of this study. In addition daily respiratory symptoms of the index children were recorded prospectively up to age 3 years and correlated with HRQoL scores., Results: HRQoL was lower in index children (n = 128) than in control children (n = 340) for the lung, gastrointestinal tract and sleeping domains. HRQoL scores for social and developmental domains were similar for index and control children. As anticipated the largest difference between index and control children was found in the lung domain (77.6 +/- 2.2 vs. 93.9 +/- 0.8, P < 0.01). HRQoL in the lung domain was lower during the winter than during the summer season (77.6 +/- 2.2 vs. 85.6 +/- 1.9, P < 0.01), which was explained by increased airway morbidity during the winter season. We found a high correlation between lung HRQoL scores and total number of wheezing days during follow-up., Conclusions: Postbronchiolitis wheezing has broad implications for long-term well-being of children. Decreased HRQoL was attributed to postbronchiolitis wheezing, but not to preexistent risk factors, such as premature birth. This study underscores the importance of developing new strategies to prevent and treat long term airway morbidity after RSV LRTI.

Fifty-three patients with incapacitating patellofemoral arthritis and minimal tibiofemoral changes underwent a total knee replacement. Their results were compared with the results of a concomitant series of patients with tricompartmental osteoarthritis. Preoperatively group of patients with patellofemoral arthritis had more individuals with a lateral patellar tilt and inability to climb stairs in a bipedal manner than in the group with tricompartmental arthritis. Furthermore, fewer patients in the group of patients with patellofemoral arthritis could rise independently from a chair than could those patients with tricompartmental arthritis. The mean followup period was 7.4 years. The rate of lateral parapatellar releases was three times greater in the patients with patellofemoral arthritis. The group of patients with patellofemoral arthritis had higher knee scores and a greater ability to climb stairs in a bipedal manner as compared with the patients with tricompartmental arthritis. Residual anterior knee pain was present in approximately 7% of patients in both groups. Total knee replacement resulted in better outcomes for older patients with patellofemoral arthritis as compared with patellofemoral replacement, debridement procedures, and patellectomy.

Dysplastic acetabula were augmented during total hip replacement by superolateral autografts. In cases of primary arthroplasty these were taken from the excised femoral head and in revision surgery from the iliac crest. Two or (usually) three small grafts were used to facilitate revascularisation; they were fixed with lag screws to the roughened iliac bone above the acetabulum. We reviewed 84 hips (63 primary arthroplasties and 21 revisions) more than five years (mean 10.1) after operation. All but one of the grafts showed consolidation within three months and they had become structurally integrated with the iliac bone, as evidenced by the trabecular reorientation. Resorption, which has caused early socket failure when large bone grafts have been used, did not occur.