Professional Development Needs Assessment for Environmental Educators

To assess the training needs of environmental educators, a survey was designed and distributed to members of environmental education organizations. This survey included a list of 28 professional competencies representing five overarching areas that was compiled with a team of professionals and practitioners and informed by the North American Association for Environmental Education’s (NAAEE) Guidelines for Excellence (2019). Respondents to the survey were asked to rate each professional competency in terms of 1.) how important they think it is, and 2.) how well prepared they feel to perform it in their current position as an environmental educator. These two scores were used to create a Mean Weighted Discrepancy Score which measured the “gap” between importance and preparedness to perform. Competency items and areas with larger Mean Weighted Discrepancy Scores indicate a greater need for more high-quality training. Our results showed that environmental educators have the greatest need for increased and enhanced training in the areas of Diversity, Equity, and Inclusion (DEI) and communicating about complex and controversial issues. We also found that environmental educators have different training needs based on their age and their level of experience. This information can be used by environmental education organizations and providers to prioritize professional development that will benefit their employees the most

Population-level cure of colorectal cancer in Malta: An analysis of patients diagnosed between 1995 and 2004.

AIM: The aim of this study was to estimate the population-level 'cure' of Maltese colorectal cancer patients diagnosed between 1995 and 2004, and to estimate the median survival time for the 'uncured' patients. METHODS AND STUDY POPULATION: Analysis was conducted on 1470 cases registered by the Malta National Cancer Register between 1995 and 2004 and followed up to end of 2010. The mean age of the patients was 66.4 (95%CI 65.8-67.1), and the number of men and women were equal. Background mortality for 1995-2010 was extracted from publicly available life tables. A mixture model with Weibull survival distribution and identity link was used to model 'cure'. RESULTS: The overall 'cured' proportion for the patients diagnosed in 1995-1999 was 45.3% (95%CI 40.2-50.5) while the 'cured' proportion for the patients diagnosed in 2000-2004 was 52.3% (95%CI 47.2-57.5). Median survival time for the 'uncured' patients increased in the second calendar period from 1.25 years (95%CI 1.04-1.45) to 1.42 years (95%CI 1.15-1.76). CONCLUSION: In Malta, as in the rest of Europe, improvements have been made in short- and long-term survival over the 15-year period under study. To continue this improvement, differences by age that still persist must be investigated and efforts focused to reduce any gaps between Malta and other European countries

A novel ecological methodology for constructing ethnic-majority life tables in the absence of individual ethnicity information.

BACKGROUND: Deprivation-specific life tables have been in use for some time, but health outcomes are also known to vary by ethnicity over and above deprivation. The mortality experiences of ethnic groups are little studied in the UK, however, because ethnicity is not captured on death certificates. METHODS: Population data for all Output Areas (OAs) in England and Wales were stratified by age-group, sex and ethnic proportion, and matched to the deaths counts in that OA from 2000 to 2002. We modelled the relationship between mortality, age, deprivation and ethnic proportion. We predicted mortality rates for an area that contained the maximum proportion of each ethnic group reported in any area in England and Wales, using a generalised linear model with a Poisson distribution adjusted for deprivation. RESULTS: After adjustment, Asian and White life expectancies between 1 and 80 years were very similar. Black men and women had lower life expectancies: men by 4 years and women by around 1.5 years. The Asian population had the lowest mortality of all groups over age 45 in women and over 50 in men, whereas the Black population had the highest rates throughout, except in girls under 15. CONCLUSIONS: We adopted a novel ecological method of constructing ethnic-majority life tables, adjusted for deprivation. There is still diversity within these three broad ethnic groups, but our data show important residual differences in mortality for Black men and women. These ethnic life tables can be used to inform public health planning and correctly account for background mortality in ethnic subgroups of the population

What might explain deprivation-specific differences in the excess hazard of breast cancer death amongst screen-detected women? Analysis of patients diagnosed in the West Midlands region of England from 1989 to 2011.

BACKGROUND: Breast cancer survival is higher in less deprived women, even amongst women whose tumor was screen-detected, but reasons behind this have not been comprehensively investigated. METHODS: The excess hazard of breast cancer death in 20,265 women diagnosed with breast cancer, followed up to 2012, was estimated for screen-detected and non-screen-detected women, comparing more deprived to less deprived women using flexible parametric models. Models were adjusted for individual and tumor factors, treatment received and comorbidity. For screen-detected women, estimates were also corrected for lead-time and overdiagnosis. RESULTS: The excess hazard ratio (EHR) of breast cancer death in the most deprived group, adjusted only for age and year of diagnosis, was twice that of the least deprived among screen-detected women (EHR=2.12, 95%CI 1.48-2.76) and 64% higher among non-screen-detected women (EHR=1.64, 95%CI 1.41-1.87). Adjustment for stage at diagnosis lowered these estimates by 25%. Further adjustment had little extra impact. In the final models, the excess hazard for the most deprived women was 54% higher (EHR=1.54, 95%CI 1.10-1.98) among screen-detected women and 39% higher (EHR=1.39, 95%CI 1.20-1.59) among non-screen-detected women. CONCLUSION: A persistent socio-economic gradient in breast cancer-related death exists in this cohort, even for screen-detected women. The impact of differential lifestyles, management and treatment warrant further investigation

The Long or the Post of It? Temporality, Suffering, and Uncertainty in Narratives Following COVID-19

Long COVID affects millions of individuals worldwide but remains poorly understood and contested. This article turns to accounts of patients' experiences to ask: What might narrative be doing both to long COVID and for those who live with the condition? What particular narrative strategies were present in 2020, as millions of people became ill, en masse, with a novel virus, which have prevailed three years after the first lockdowns? And what can this tell us about illness and narrative and about the importance of literary critical approaches to the topic in a digital, post-pandemic age? Through a close reading of journalist Lucy Adams's autobiographical accounts of long COVID, this article explores the interplay between individual illness narratives and the collective narrativizing (or making) of an illness. Our focus on temporality and suffering knits together the phenomenological and the social with the aim of opening up Adams's narrative and ascertaining a deeper understanding of what it means to live with the condition. Finally, we look to the stories currently circulating around long COVID and consider how illness narratives-and open, curious, patient-centered approaches to them-might shape medicine, patient involvement, and critical medical humanities research