Paid sick leave benefits among essential frontline workers serving people experiencing homelessness in Canada during the COVID-19 pandemic.

OBJECTIVES: This study examined the prevalence and factors associated with paid sick leave benefits among direct service providers who work with people experiencing homelessness. STUDY DESIGN: Cross-sectional study using an online survey disseminated during the second wave of the COVID-19 pandemic in Canada. METHODS: Survey data from 572 direct service providers working in the homeless, supportive housing, and harm reduction service sectors were analyzed for this study. Univariate and multivariate logistic regression models were used to examine predictors of paid sick leave benefits. RESULTS: One hundred one (17.7%) participants did not have any paid sick leave benefits. In the univariate models, paid sick leave was associated with older age, greater family income, full-time work, specific employment settings (supportive housing and not emergency shelters or harm reduction programs), having a regular medical doctor, and fewer occupational impacts of the COVID-19 pandemic. Older age, full-time work, and non-receipt of emergency financial benefits remained statistically significant predictors in the multivariate model. CONCLUSIONS: Although the majority of service providers working with people experiencing homelessness have some amount of paid sick leave benefits, there is a precariously employed subset of individuals who are younger and working part-time in the sector. Temporary expansion of paid sick leave and removal of waiting periods for new employees to qualify for benefits are recommended.

A national study of Indigenous youth homelessness in Canada.

OBJECTIVE: This study was designed to address the need for more detailed information about Indigenous homeless youth, a group overrepresented in the homeless population, using a national-level data set. STUDY DESIGN: The study used a cross-sectional, self-report survey design. METHODS: Surveys were used to gather demographic, mental health, and quality of life data from a sample of 1103 Canadian youth accessing homeless services with data collected in 2015. This article focused on the 332 Indigenous respondents, using both comparisons with non-Indigenous youth and within-group comparisons across key domains. RESULTS: These findings suggested greater mental health and addiction challenges among Indigenous homeless youth compared with non-Indigenous respondents as well as evidence of a more problematic role of child protection. Within-group comparisons suggested that female and sexual and gender minority youth are particularly at risk among Indigenous youth with some added child protection and justice implications for reserve-raised youth. Child protection history and street-victimization were particularly relevant to the current distress levels. CONCLUSION: Overall, such findings reinforce calls for Indigenous-specific interventions for these populations-including policy-driven prevention initiatives to address the legacy of colonization.

Prevalence, incidence and geographical distribution of serovars of Salmonella on dairy farms in England and Wales.

A study of randomly selected dairy farms in England and Wales was made between October 1999 and February 2001 to estimate the prevalence and incidence of Salmonella serovars. The farms were enrolled through five milk-buying companies, which represented 63 per cent of the dairy farms in England and Wales, and they were sampled on up to four occasions (449 farms at visit 1, 272 farms at visit 2, 251 farms at visit 3 and 243 farms at visit 4). In total, 19,296 samples of pooled faecal pats and slurry were collected. The farm-specific prevalence of all serovars of Salmonella ranged from 12.1 per cent (95 per cent confidence interval [CI] 8.2 to 16.0 per cent) to 24.7 per cent (95 per cent CI 19.4 to 30.1 per cent) at each visit. The most common serovars identified were Salmonella Dublin (3.7 to 6.6 per cent farm-specific prevalence at each visit), Salmonella Agama (1.8 to 7.6 per cent) and Salmonella Typhimurium (2.6 to 4.1 per cent) The prevalence varied by region and month of sampling and increased in late summer. The incidence rate of all serovars of Salmonella was 0.43 (95 per cent CI 0.34 to 0.54) cases per farm-year at risk. There was no significant difference between the incidence rates of the common serovars S Typhimurium (0.07), S Dublin (0.06) and S Agama (0.13). A total of 29 Salmonella serovars were isolated. Few of the isolates were resistant to the 16 antimicrobial agents tested, except the isolates of S Typhimurium dt104, of which 67.9 per cent were resistant to at least five of them.

Antioxidant intake is associated with semen quality in healthy men.

BACKGROUND: We seek to determine whether dietary and supplement intake of specific micronutrients (zinc and folate) and antioxidants (vitamins C, E and beta-carotene) is associated with semen quality. METHODS: Ninety-seven healthy, non-smoking men provided semen and were interviewed. Average daily nutrient intake from food and supplements was derived from a self-administered food frequency questionnaire. Intake levels were summarized as low, moderate and high. Semen volume, sperm concentration, total sperm count, motility, progressive motility and total progressively motile sperm count (TPMS) were measured. RESULTS: After controlling for covariates, a high intake of antioxidants was associated with better semen quality but, in almost all cases, there was no clear dose relationship in that moderate intake groups had the poorest semen quality. For example, positive associations were observed between vitamin C intake and sperm number as reflected in the higher mean count (P=0.04), concentration (P=0.05) and TPMS (P = 0.09); between vitamin E intake and progressive motility (P = 0.04) and TPMS (P = 0.05); and between beta-carotene intake and sperm concentration (P = 0.06) and progressive motility (P = 0.06). Folate and zinc intake were not associated with improved semen quality. CONCLUSIONS: In a convenience sample of healthy non-smoking men from a non-clinical setting, higher antioxidant intake was associated with higher sperm numbers and motility.

Prevalence of faecal excretion of verocytotoxigenic Escherichia coli O157 in cattle in England and Wales.

During the decade to 1999, the incidence of human infections with the zoonotic pathogen verocytotoxin-producing Escherichia coli O157 (VTEC O157) increased in England and Wales. This paper describes the results of a survey of 75 farms to determine the prevalence of faecal excretion of VTEC O157 by cattle, its primary reservoir host, in England and Wales. Faecal samples were collected from 4663 cattle between June and December 1999. The prevalence of excretion by individual cattle was 4.2 per cent (95 per cent confidence interval [CI] 2.0 to 6.4) and 10.3 per cent (95 per cent CI 5.8 to 14.8) among animals in infected herds. The within-herd prevalence on positive farms ranged from 1.1 to 51.4 per cent. At least one positive animal was identified on 29 (38.7 per cent; 95 per cent CI 28.1 to 50.4) of the farms, including dairy, suckler and fattening herds. The prevalence of excretion was least in the calves under two months of age, peaked in the calves aged between two and six months and declined thereafter. The phage types identified most widely were 4, 34 and 2, which were each found on six of the 29 positive farms.

The association of age and semen quality in healthy men.

BACKGROUND: Although the effect of maternal age on fertility is well known, it is unclear whether paternal age also affects fertility. This cross-sectional study sought to characterize the association between age and semen quality, a well-known proxy of fertility status. METHODS: A convenience sample of 97 non-smoking men (aged 22-80 years) without known fertility problems was recruited from a national government laboratory. The men provided semen samples and information relating to lifestyle, diet, medical and occupational details. Semen volume (ml), sperm concentration (x10(6)/ml), total sperm count (x10(6)), motility (%), progressive motility (%) and total progressively motile sperm count (x10(6)) were measured. RESULTS: After adjusting for covariates, semen volume decreased by 0.03 ml per year of age (95% CI: -0.05, -0.01); motility decreased by 0.7% per year (95% CI: -0.92, -0.43); progressive motility decreased by 3.1% per year (95% CI: -4.5, -1.6); and total progressively motile sperm count decreased by 4.7% per year (95% CI: -7.2, -2.2). There was a suggested decrease in sperm concentration and count. The proportion of men with abnormal volume, concentration and motility was significantly increased across the age decades. CONCLUSIONS: In a convenience sample of healthy men from a non-clinical setting, semen volume and sperm motility decreased continuously between 22-80 years of age, with no evidence of a threshold.

Faecal carriage of verocytotoxin-producing Escherichia coli O157 in cattle and sheep at slaughter in Great Britain.

A 12-month abattoir survey was conducted between January 1999 and January 2000, to determine the prevalence of faecal carriage of verocytotoxin-producing Escherichia coli O157 (VTEC O157) in cattle and sheep slaughtered for human consumption in Great Britain. Samples of rectum containing faeces were collected from 3939 cattle and 4171 sheep at 118 abattoirs, in numbers proportional to the throughput of the premises. The annual prevalence of faecal carriage of VTEC O157 was 4.7 per cent (95 per cent confidence interval 4.1 to 5.4) for cattle and 1.7 per cent (1.3 to 2.1) for sheep, values which were statistically significantly different from each other (P < 0.001). The organisms were recovered from both cattle and sheep slaughtered throughout the year and at abattoirs in all regions of the country, but the highest prevalence was in the summer. The most frequency recovered VTEC O157 isolates were phage types 2, 8 and 21/28 in cattle and 4 and 32 in sheep, the five most frequently isolated phage types associated with illness in people in Great Britain during the same period.

Sperm aneuploidy in fathers of children with paternally and maternally inherited Klinefelter syndrome.

BACKGROUND: It is unclear whether frequency of sperm aneuploidy is associated with risk of fathering children with trisomy. METHODS: We recruited 36 families with a boy with Klinefelter syndrome (KS), interviewed the fathers about their exposures and medical history, received a semen sample from each father, and collected blood samples from the mother, father and child. We applied a multicolour fluorescent in-situ hybridization assay to compare the frequencies of sperm carrying XY aneuploidy and disomies X, Y and 21 in fathers of maternally and paternally inherited KS cases. RESULTS: Inheritance of the extra X chromosome was paternal in 10 and maternal in 26 families. Fathers of paternal KS cases produced higher frequencies of XY sperm (P = 0.02) than fathers of maternal KS cases. After controlling for age, the major confounding variable, the difference between the two groups was no longer significant (P less-than-or-equal 0.2). Also, there were no significant differences between the parental origin groups for disomy X, Y or 21. CONCLUSIONS: Men who fathered a child with a Klinefelter syndrome produced higher frequencies of XY sperm aneuploidy, which is explained, in part, by both paternal age and parent of origin.

Dental disease indices and caries-related microflora in children with glycogen storage disease.

OBJECTIVE: To establish the levels of dental caries, bacterial dental plaque, gingivitis and caries-related microflora in children with glycogen storage disease (GSD). Patients with GSD are treated with regular intakes of glucose polymer and uncooked cornstarch to prevent hypoglycaemia. Dental health data are scarce. STUDY GROUP: The study group comprised 21 children with GSD attending the Great Ormond Street Hospital for Children. OUTCOME MEASURES: These included the number of decayed, missing and filled teeth, and surfaces in both the primary and permanent dentitions, plaque and gingivitis scores. Both plaque and saliva were collected from each child and cultured for Mutans streptococci, Lactobacilli and Candida. RESULTS: The study group included 13 boys and eight girls, aged from 2.7 to 15.5 years. Four of the 21 children had some caries experience. The mean dmft was 0.5 and the mean DMFT, 0.06. Mean plaque and gingivitis scores were 4.8 and 5.9, respectively, for plaque and gingivitis adjacent to the primary teeth, and 11.6 and 12 for those related to permanent teeth. CONCLUSIONS: Only a small proportion of the children had caries experience but most were found to have plaque associated with both primary and permanent teeth. Preventive care should be targeted to improve plaque control thus minimizing the risk of developing periodontal disease as adults.

Effects of male age on semen quality and fertility: a review of the literature.

OBJECTIVE: To review the literature on the association between male age and semen quality (semen volume, concentration, motility, and morphology) and fertility status (pregnancy rate and time to pregnancy/subfecundity). METHOD(S): Review of English language-published research over the last 20 years from January 1, 1980, through December 31, 1999, using MEDLINE and Biosis databases. Studies with insufficient numbers of subjects, case reports, case series, or anecdotal data were excluded. RESULT(S): Among the methodologically stronger studies, decreases in semen volume of 3%-22%, decreases in sperm motility of 3%-37%, and decreases in percent normal sperm of 4%-18% were likely when comparing 30-year-old men to 50-year-old men. Most studies examining fertility status suggest a relationship between male age and fertility, but the results are most likely confounded by female partner age. Among studies that did control for female age, comparisons between men under 30 and men over 50 found relative decreases in pregnancy rates between 23% and 38%. A comparison of the various age categories showed that the increased risks for subfecundity ranged from 11% to 250%. CONCLUSION(S): The weight of the evidence suggests that increased male age is associated with a decline in semen volume, sperm motility, and sperm morphology but not with sperm concentration.

NMDA and AMPA receptors in the dorsal nucleus of the lateral lemniscus shape binaural responses in rat inferior colliculus.

Binaural responses of single neurons in the rat's central nucleus of the inferior colliculus (ICC) were recorded before and after local injection of excitatory amino acid receptor antagonists (either 1,2, 3,4-tetrahydro-6-nitro-2,3-dioxo-benzo[f]quinoxaline-7-sulfonamide disodium [NBQX], (+/-)-3-(2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid [CPP], 6-cyano-7-nitroquinoxaline-2,3-dione [CNQX], or (+/-)-2amino-5-phosphonovaleric acid [APV]) into the dorsal nucleus of the lateral lemniscus (DNLL). Responses were evoked by clicks delivered separately to the two ears at interaural time delays between -1.0 and +30 ms (positive values referring to ipsilateral leading contralateral click pairs). The neurons in our sample were excited by contralateral stimulation and inhibited by ipsilateral stimulation, and the probability of action potentials was reduced as the ipsilateral stimulus was advanced. Binaural inhibition resulted in response suppression that lasted up to 30 ms. Injection of excitatory amino acid antagonists into the DNLL contralateral to the recording site reduced the strength of binaural inhibition in the ICC. The alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist NBQX preferentially affected responses at small interaural time intervals (0-1.0 ms), whereas the N-methyl-D-aspartate (NMDA) antagonist CPP preferentially affected responses at longer intervals (1-30 ms). Both CNQX and APV produced a release from binaural inhibition, but neither drug was selective for specific intervals. The data support the idea that binaural inhibition in the rat ICC is influenced by both AMPA and NMDA receptor-mediated excitatory events in the contralateral DNLL. The results suggest that the AMPA receptors contribute selectively to the initial component of binaural inhibition and the NMDA receptors to a longer lasting component.

Contribution of the commissure of Probst to binaural evoked responses in the rat's inferior colliculus: interaural time differences.

Binaural evoked responses were recorded with glass micropipettes from the central nucleus of the rat's inferior colliculus (ICC) before and after transection of the commissure of Probst (CP) with a microsurgical knife. The peak-to-peak amplitude of the averaged evoked response was measured for binaural clicks with interaural time differences (ITDs) between -1.0 and +30.0 ms (positive values reflecting ipsilateral-leading-contralateral click pairs). Before transection, the amplitude of the evoked response decreased as the ITD was shifted in favor of larger ipsilateral lead times. After transection of the CP, acoustic stimulation of the ipsilateral ear was much less effective in reducing evoked response amplitude. Responses to both short (+/-1.0 ms) and long (1.0-30.0 ms) ITD intervals were affected. After recordings were made, both anterograde and retrograde tract tracing methods were used to verify that the CP was completely transected and that all crossed projections from the dorsal nucleus of the lateral lemniscus (DNLL) to ICC were destroyed. The surgery completely eliminated the retrograde transport of fluorogold from the ICC to the opposite DNLL and blocked the anterograde transport of biotinylated dextran to contralateral DNLL and ICC. The physiological consequences of CP transection are attributed to the complete destruction of decussating, inhibitory (GABAergic) efferent projections from the DNLL.

Monaural and binaural response properties of single neurons in the rat's dorsal nucleus of the lateral lemniscus.

Extracellular recordings were made with microelectrodes from single neurons in the rat's dorsal nucleus of the lateral lemniscus (DNLL) and response characteristics were determined for monaural and binaural acoustic stimulation. The vast majority of DNLL neurons were narrowly tuned to sound frequency and their temporal responses to contralateral tone pulses fell into one of three broad categories: onset (57%), sustained (21%) or onset-pause-sustained (22%). Most DNLL neurons fired multiple action potentials to a single click delivered to the contralateral ear. The majority (77%) of DNLL neurons showed a monotonic increase in the number of spikes elicited by contralateral tone pulses of increasing sound pressure level; the remaining cells were weakly non-monotonic. No obvious tonotopic pattern was found in the distribution of characteristic frequency of neurons in DNLL. Most DNLL neurons exhibited either excitatory/inhibitory (74%) or excitatory/excitatory (9%) binaural response patterns. The remaining cells (17%) were monaural and driven exclusively by stimulation of the contralateral ear. The binaural neurons in DNLL were sensitive to both interaural intensity and interaural time differences as determined by presentation of dichotic tone bursts and clicks respectively. The responses of DNLL neurons could be distinguished on the basis of monaural and binaural response characteristics from those in surrounding areas including the sagulum, paralemniscal zone and the intermediate nucleus of the lateral lemniscus.

A cohort study of pregnancy outcome after amniocentesis in twin pregnancy.

We conducted a retrospective cohort study to assess the risk of amniocentesis in twin pregnancy for adverse outcomes. The study base consisted of women who had an amniocentesis performed during twin pregnancy and a comparison representative sample of women who carried a twin pregnancy, but did not have invasive prenatal diagnosis. The 227 women in each of the exposed and non-exposed groups were residents of the state of New South Wales, Australia, over the period 1980-92, and were matched on maternal age and period of the infant's birth. Nearly 10% of twin pregnancies among the women having an amniocentesis were affected by a stillbirth, and the stillbirth rate among exposed fetuses (5.3%) was nearly twice as high as among non-exposed fetuses (3.1%). After adjustment for confounding and excluding abnormalities, there was a non-significant elevated relative risk of stillbirth after exposure to amniocentesis. The analysis by type of amniocentesis (with and without methylene blue dye) was limited by small numbers, but the burden of risk was primarily among women who had dye exposure during amniocentesis (relative risk = 3.64, 95% confidence interval = 1.15, 11.48). This increase remained after adjusting for confounding, although the confidence interval was wide. In conclusion, we were unable to establish with certainty whether an increased risk of stillbirth could be ruled out among women who had any type of amniocentesis in twin pregnancy.

Contribution of the dorsal nucleus of the lateral lemniscus to binaural responses in the inferior colliculus of the rat: interaural time delays.

The contribution of the dorsal nucleus of the lateral lemniscus (DNLL) to binaural responses in the inferior colliculus of the rat was determined for a wide range of interaural time differences (ITDs). Single-unit action potentials were recorded from the inferior colliculus before and after local injection of the excitatory amino acid antagonist kynurenic acid into the DNLL. Binaural properties were determined by manipulating the time difference between paired clicks delivered to the ears ipsilateral and contralateral to the recording site. The probability of an action potential decreased as contralateral stimulation was delayed, relative to ipsilateral stimulation. These data generated a sigmoidal ITD curve for delays between -1.0 and + 1.0 msec. By extending the time intervals beyond 1 msec, it was possible to determine the trailing edge of the inhibition produced by ipsilateral stimulation. The duration of the inhibitory effect varied from cell to cell but lasted as long as 20 msec in some cases. Injection of kynurenic acid into the DNLL contralateral to the recording site reduced the extent of both short (0-1 msec) and long-lasting (1-20 msec) inhibition in the inferior colliculus. No effect was seen after injections ipsilateral to the recording site. The data demonstrate that the DNLL plays an important role in shaping ITD responses in the inferior colliculus and contributes to both the short and long-lasting inhibition produced by stimulation of the ipsilateral ear.

Fetal death after exposure to methylene blue dye during mid-trimester amniocentesis in twin pregnancy.

Methylene blue dye use during mid-trimester amniocentesis in twin pregnancy is associated with a high risk of small intestinal atresia. It is plausible that the effects of methylene blue as a fetotoxic agent may also lead to fetal death. We conducted a retrospective cohort study of all women who had an amniocentesis during twin pregnancy from 1980 through 1991 in New South Wales, Australia. Women who were exposed to methylene blue dye during the procedure were compared with women who had amniocentesis without dye exposure. Fetal death occurred in 31.8 per cent of pregnancies that had exposure to a high concentration of methylene blue, compared with 14.5 per cent of pregnancies exposed to a low concentration and 4.3 per cent of pregnancies with no exposure to dye. The unadjusted and adjusted risks and 95 per cent confidence intervals (CIs) for fetal death after any exposure to dye were 5.03 (2.12-11.91) and 8.52 (2.28-31.80), respectively. The adjusted odds ratio and 95 per cent CIs for the low and high concentration dye solutions were 4.63 (0.93-23.13) and 14.98 (3.40-66.08), respectively (chi-squared test for trend P < 0.001). Fetus papyraceous was significantly more likely among pregnancies exposed to a high concentration of methylene blue (P < 0.001) than among unexposed pregnancies. These results support the hypothesis that methylene blue dye use during mid-trimester amniocentesis in twin pregnancy increases the risk of fetal death.

The incidence of congenital heart defects in the first year of life.

Data on the incidence of congenital heart defects (CHD) in the first year of life were collected on a cohort of infants born between 1981 and 1984 in New South Wales and the Australian Capital Territory. There was a total of 1479 cases among 343,521 births, an incidence of 4.3 per 1000 livebirths. The following results were obtained after restricting the analysis to cases diagnosed definitively by echocardiography, cardiac catheterization, operation or autopsy. A significant association was found between older maternal age and having an infant with CHD, both before (RR = 1.27, CI = 1.13, 1.44) and after (RR = 1.17, CI = 1.02, 1.33) excluding chromosomally related cases. Significant associations were found between having an infant with ventricular septal defect and Italian parentage (RR = 2.50, CI = 1.11, 5.65), and for having an infant with coarctation of the aorta and Lebanese parentage (RR = 3.82, CI = 1.71, 8.52). The incidence of CHD in this Australian population is similar to overseas studies that used comparable diagnostic criteria and ascertainment. An active surveillance system for CHD is recommended as is further investigation of the factors associated with having an infant with CHD.