Planet Patrolling: A citizen science brand audit of anthropogenic litter in the context of national legislation and international policy.

Anthropogenic Litter (AL) is ubiquitous in distribution and diverse in type and impact. Citizen science AL clean-ups engage citizens with the environment and have the potential to generate data that can inform policy. Here we present a detailed citizen science survey of AL across freshwater, terrestrial, and coastal environments of the United Kingdom (UK), coordinated by the not-for-profit Planet Patrol throughout 2020. Key materials, industries, brands, and parent companies associated with AL are identified. Plastic dominated AL (63%), followed by metal (14%), and composite materials (12%). The majority of AL (56%) had been used as beverage containers and non-beverage packaging, and 38.8% of AL was branded. Of the branded AL, 26% was associated with The Coca-Cola Company, Anheuser-Busch InBev, and PepsiCo. These three companies were associated with significantly more branded litter than any other. We place these data in the context of upcoming UK legislation and the Environmental Social Governance (ESG) statements of the companies associated with the majority of the recorded litter. Knowledge gaps and recommendations for AL surveying are made, and the focus of corporate and government actions are discussed.

Family physician virtual care during COVID-19 in London-Middlesex, Ontario, Canada: a mixed methods exploration.

Context: On March 14, 2020, the Ontario, Canada health insurance plan approved COVID-19 physician virtual billing codes; family physicians (FPs) rapidly adopted a new model of care. Virtual care may remain post-pandemic; however, its future should be informed by evidence that considers access and continuity. Objective: 1) to determine FP virtual visit volumes and patient characteristics and 2) to explore FPs' perspectives on virtual visit adoption and implementation. Study Design: Mixed methods: Secondary analysis of health administrative (HA) data and semi-structured qualitative interviews with FPs. Setting or Dataset: London and Middlesex County, Ontario, Canada. HA data through ICES, Ontario entity holding data. Population studied: FPs and their patients. Outcome Measures: Volumes of FP in-person and virtual visits during early pandemic; characteristics of patients receiving care; FPs' perspectives on adopting and delivering virtual care. Results: Overall visit volume dropped by 36% during first wave, recovered to pre-pandemic levels by October 2020. Sharp in-person visit drop of 73% and virtual visit uptake from 0.08% of total visits to 57% within two weeks of March 2020. FPs described this initial drop in volume as patients not seeking care and practices lacking PPE. The move to virtual care was largely to telephone visits. Patient characteristics compared to pre-pandemic, the proportion seeking care were older (46 vs 50 years), more vulnerable (38% vs 41%), and more multimorbidity (33% vs 41%). This was consistent with FP reports that healthier patients stayed away, routine care deferred, sicker patients needed to be seen. FPs believed most vulnerable patients had access to care but cautioned highly vulnerable such as those homeless did not have cell phone access or a safe place to receive calls. Rural FPs reported access issues because of lack of high-speed internet. FPs attributed success of virtual care to the continuity in relationships they had with patients that were established in person pre-pandemic. Conclusions: FPs moved rapidly to virtual care. FP offices remained open despite PPE concerns but overall volumes dropped initially. Vulnerable and sicker patients received care but FPs expressed concern for highly vulnerable and rural residents. FPs believed they could offer patient-centred care over the phone but indicated the importance of maintaining in-person care to build relationships.

Botany in Edinburgh's Medical Curriculum.

In the early 18th century, at the founding of Edinburgh University Medical School, the study of botany was regarded as an essential component of medical training. Botanical teaching began as basic instruction in the recognition of medical plants, considered a vital aspect of a physician's Materia Medica studies. Over the next hundred years growing importance was given to the study of botany as a science, its popularity peaking under John Hutton Balfour's tenure as Professor (1845-1879). The relevance of botanical study later declined in the undergraduate medical curriculum until its cessation in 1961 .This paper considers the history of botanical studies in Edinburgh, including the reasons for its introduction and its changing importance over time.