A highly selective Hg2+ colorimetric sensor and antimicrobial agent based on green synthesized silver nanoparticles using Equisetum diffusum extract.

Plasmonic nanoparticles such as Ag have gained great interest in the biomedical domain and chemical analysis due to their unique optical properties. Herein, we report a simple, cost-effective, and highly selective colorimetric sensor of mercury(ii) based on E. diffusum (horsetail) extract-functionalized Ag nanoparticles (ED-AgNPs). The ED-AgNPs were synthesized by exploiting the coordination of Ag+ with the various functional groups of ED extract under sunlight exposure for only tens of seconds. ED-AgNPs (63 nm) were characterized using various techniques such as UV-vis, FTIR, DLS, SEM and EDX. FTIR spectra suggested the successful encapsulation of the AgNPs surface with ED extract and XRD confirmed its crystalline nature. This ED-AgNPs colorimetric sensor revealed remarkable selectivity towards Hg2+ in aqueous solution among other transition metal ions through a redox reaction mechanism. Besides, the sensor exhibited high sensitivity with rapid response and a detection limit of 70 nM. The sensor demonstrated feasibility for Hg(ii) detection in spiked tap and river water samples. In addition, the synthesized ED-AgNPs revealed enhanced antimicrobial activity with higher efficacy against the Gram-positive bacterium (L. monocytogenes with an inhibition zone of 18 mm) than the Gram-negative bacterium (E. coli with an inhibition zone of 10 mm). The simplicity and adaptability of this colorimetric sensor render it a promising candidate for on-site and point-of-care detection of heavy metal ions in diverse conditions.

Comparing the scopes of practice of geriatric-focused physicians in Canada: a qualitative study of core competencies.

BACKGROUND: Given long-standing deficits of medical expertise to care for a growing population of older adults, it is important to understand the geriatric medical workforce. We aimed to describe and compare the scopes of practice of the 3 geriatric-focused physician providers in Canada (i.e., family physicians with certification in Care of the Elderly [FM-COE], geriatricians and geriatric psychiatrists). METHODS: We conducted a qualitative study to compare competencies across geriatric-focused physician provider types in Canada, using a directed content analysis approach. We identified and obtained relevant publicly available documents that described the competencies required for certification by searching the websites of The College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada between June 2 and July 31, 2020. An inductive content analysis was used to compare content within each CanMEDS Role according to the CanMEDS Framework. RESULTS: We identified and obtained 4 relevant publicly available documents describing the competencies required for geriatric-focused certification for the 3 geriatric-focused physician provider types. We found substantial overlaps in the expected medical expertise of FM-COE and geriatricians. The few substantive differences across providers may result from different priorities about which competencies were made explicit for providers. The focused nature of mental health care is apparent in several competencies unique to geriatric psychiatry. INTERPRETATION: This work highlights substantial overlaps in the scopes of practice for FM-COE and geriatricians. Our findings may encourage efforts to develop more robust delineations between the scopes of practice of these related professionals to facilitate inter-specialty collaboration to lead to more equitable and accessible medical care for older adults.

Nursing Home Resident Admission Characteristics and Potentially Preventable Emergency Department Transfers.

OBJECTIVES: To determine which nursing home (NH) resident-level admission characteristics are associated with potentially preventable emergency department (PPED) transfers. DESIGN: We conducted a population-level retrospective cohort study on NH resident data collected using the Resident Assessment Instrument-Minimum Data Set Version 2.0 and linked to the National Ambulatory Care Reporting System for ED transfers. SETTING: We used all NH resident admission assessments from January 1, 2017, to December 31, 2018, in Ontario. PARTICIPANTS: The cohort included the admission assessment of 56,433 NH residents. METHODS: PPED transfers were defined based on the International Classification of Disease, Version 10 (Canadian) We used logistic regression with 10-fold cross-validation and computed average marginal effects to identify the association between resident characteristics at NH admission and PPED transfers within 92 days after admission. RESULTS: Overall, 6.2% of residents had at least 1 PPED transfer within 92 days of NH admission. After adjustment, variables that had a prevalence of 10% or more that were associated with a 1% or more absolute increase in the risk of a PPED transfer included polypharmacy [of cohort (OC) 84.4%, risk difference (RD) 2.0%], congestive heart failure (OC 29.0%, RD 3.0%), and renal failure (OC 11.6%, RD 1.2%). Female sex (OC 63.2%, RD -1.3%), a do not hospitalize directive (OC 24.4%, RD -2.6%), change in mood (OC 66.9%, RD -1.2%), and Alzheimer's or dementia (OC 62.1%, RD -1.2%) were more than 10% prevalent and associated with a 1% or more absolute decrease in the risk of a PPED. CONCLUSIONS AND IMPLICATIONS: Though many routinely collected resident characteristics were associated with a PPED transfer, the absence of sufficiently discriminating characteristics suggests that emergency department visits by NH residents are multifactorial and difficult to predict. Future studies should assess the clinical utility of risk factor identification to prevent transfers.

Are residents of downtown Toronto influenced by their urban neighbourhoods? Using concept mapping to examine neighbourhood characteristics and their perceived impact on self-rated mental well-being.

BACKGROUND: There is ample evidence that residential neighbourhoods can influence mental well-being (MWB), with most studies relying on census or similar data to characterize communities. Few studies have actively investigated local residents' perceptions. METHODS: Concept mapping was conducted with residents from five Toronto neighbourhoods representing low income and non-low income socio-economic groups. These residents participated in small groups and attended two sessions per neighbourhood. The first session (brainstorming) generated neighbourhood characteristics that residents felt influenced their MWB. A few weeks later, participants returned to sort these neighbourhood characteristics and rate their relative importance in affecting residents' 'good' and 'poor' MWB. The data from the sorting and rating groups were analyzed to generate conceptual maps of neighbourhood characteristics that influence MWB. RESULTS: While agreement existed on factors influencing poor MWB (regardless of neighbourhood, income, gender and age), perceptions related to factors affecting good MWB were more varied. For example, women were more likely to rank physical beauty of their neighbourhood and range of services available as more important to good MWB, while men were more likely to cite free access to computers/internet and neighbourhood reputation as important. Low-income residents emphasized aesthetic attributes and public transportation as important to good MWB, while non-low-income residents rated crime, negative neighbourhood environment and social concerns as more important contributors to good MWB. CONCLUSION: These findings contribute to the emerging literature on neighbourhoods and MWB, and inform urban planning in a Canadian context.

Development of a framework for effective community engagement in Ontario, Canada.

OBJECTIVES: This study aims to: (1) conceptualize effective community engagement (CE) within the Local Health Integration Networks (LHIN) of Ontario, Canada, (2) develop an effective CE framework and (3) compare the CE framework to public engagement (PE) frameworks and assess their relevance to the LHIN context. METHODS: We implemented "concept mapping," a participatory, mixed-methods approach, with LHIN staff. The method includes three components: (1) "Brainstorming" where participants generated statements describing effective CE; (2) "Sorting and Rating" where participants grouped statements and rated their relative importance to generate a "cluster map" and (3) "Mapping" where participants reviewed and named the clusters to yield the effective CE framework. RESULTS: Staff generated a list of 64 statements. Participants reviewed the cluster map to generate six categories for the framework: (1) collaboration, (2) accessibility, (3) accountability, (4) education, (5) principles and (6) organizational capacity. CONCLUSIONS: The effective CE framework overlaps with PE frameworks with two caveats. First, applications of PE evaluation frameworks to the LHINs may yield incomplete results given that partnerships with service providers and organizations are integral to CE strategies. Second, "organizational capacity," largely not captured within existing frameworks, must be integrated as a feature given that emerging research identifies its importance to the successful implementation of engagement strategies.

Standardized observation of neighbourhood disorder: does it work in Canada?

BACKGROUND: There is a growing body of evidence that where you live is important to your health. Despite numerous previous studies investigating the relationship between neighbourhood deprivation (and structure) and residents' health, the precise nature of this relationship remains unclear. Relatively few investigations have relied on direct observation of neighbourhoods, while those that have were developed primarily in US settings. Evaluation of the transferability of such tools to other contexts is an important first step before applying such instruments to the investigation of health and well-being. This study evaluated the performance of a systematic social observational (SSO) tool (adapted from previous studies of American and British neighbourhoods) in a Canadian urban context. METHODS: This was a mixed-methods study. Quantitative SSO ratings and qualitative descriptions of 176 block faces were obtained in six Toronto neighbourhoods (4 low-income, and 2 middle/high-income) by trained raters. Exploratory factor analysis was conducted with the quantitative SSO ratings. Content analysis consisted of independent coding of qualitative data by three members of the research team to yield common themes and categories. RESULTS: Factor analysis identified three factors (physical decay/disorder, social accessibility, recreational opportunities), but only 'physical decay/disorder' reflected previous findings in the literature. Qualitative results (based on raters' fieldwork experiences) revealed the tool's shortcomings in capturing important features of the neighbourhoods under study, and informed interpretation of the quantitative findings. CONCLUSIONS: This study tested the performance of an SSO tool in a Canadian context, which is an important initial step before applying it to the study of health and disease. The tool demonstrated important shortcomings when applied to six diverse Toronto neighbourhoods. The study's analyses challenge previously held assumptions (e.g. social 'disorder') regarding neighbourhood social and built environments. For example, neighbourhood 'order' has traditionally been assumed to be synonymous with a certain degree of homogeneity, however the neighbourhoods under study were characterized by high degrees of heterogeneity and low levels of disorder. Heterogeneity was seen as an appealing feature of a block face. Employing qualitative techniques with SSO represents a unique contribution, enhancing both our understanding of the quantitative ratings obtained and of neighbourhood characteristics that are not currently captured by such instruments.

Language impairment and sexual assault of girls and women: findings from a community sample.

Both children and adults with disabilities face increased prevalence of abuse and assault, including sexual assault. Women and girls are disproportionately the victims of sexual assault in both disabled and nondisabled populations. Communication difficulties have been identified as a factor that may increase the vulnerability of individuals with disabilities to sexual assault. However, few studies have examined whether language impairment increases risk for sexual assault. This study reports on a community sample of children with speech or language impairment, followed to age 25. Sexual assault history was assessed based on two questions from the Composite International Diagnostic Interview Posttraumatic Stress Disorder module. Women with language impairment (n = 33) were more likely than women with unimpaired language (n = 59) to report sexual abuse/assault, controlled for socioeconomic status. Sexual assault was associated with higher rates of psychiatric disorders and poorer functioning. Women with neither language impairment nor a history of sexual assault had fewer psychiatric disorders and higher functioning than women with language impairment and/or a history of sexual assault.