Learning needs assessment: assessing the need

Learning needs assessment has a fundamental role in education and training, but care is needed to prevent it becoming a straitjacket It might seem self evident that the need to learn should underpin any educational system. Indeed, the literature suggests that, at least in relation to continuing professional development, learning is more likely to lead to change in practice when needs assessment has been conducted, the education is linked to practice, personal incentive drives the educational effort, and there is some reinforcement of the learning.1 Learning needs assessment is thus crucial in the educational process, but perhaps more of this already occurs in medical education than we suspect. The key lesson might be for those who design new systems of education and training: for example, the postgraduate education allowance system in general practice was felt to fail the profession because it did not include needs assessment and so led to ad hoc education to fulfil the time requirements of the system rather than the needs of individual doctors or the profession as a whole. On the other hand, basing learning in a profession entirely on the assessment of needs is a dangerous and limiting tactic. So a balance must be struck

Solar Ultraviolet B Radiation Compared with Prostate Cancer Incidence and Mortality Rates in United States

OBJECTIVE To investigate whether the prostate cancer incidence and mortality rates in the United States correlate inversely with solar ultraviolet (UV) B radiation levels computed from a mathematical model using forecasted ozone levels, cloud levels, and elevation. Another objective was to explore whether the annual prostate cancer rates correlated more strongly with the cumulative UVB exposure for the year or for exposure during certain seasons. METHODS The age-adjusted incidence and mortality cancer rates for black and white men in the continental United States were correlated with the mean UV index values averaged for the year and for each season. RESULTS We found an inverse correlation between the UVB levels and prostate cancer incidence (R= −0.42, P \u3c 0.01) and mortality rates (R= −0.53, P \u3c 0.001) for white men and for incidence (R= −0.40, P \u3c 0.05) for black men, but the strength of the correlation depended on the season of UVB irradiance. No statistically significant results for black male mortality were found. The annual prostate cancer incidence and mortality rates for white men correlated most strongly with UVB exposure levels in the fall and winter, and incidence rates for black men correlated with UVB exposure levels in the summer. CONCLUSIONS Increased solar UVB radiation might reduce the risk of prostate cancer, but the efficacy depends on the season of UVB irradiance

Lifestyle behaviour change in adults with intellectual disabilities: an exploratory investigation of carers’ causal attributions and motivation to support change

Abstract Background: Carers and families have a key role in supporting adults with intellectual disabilities to make lifestyle behaviour changes. This study explores paid and family carers’ motivation to support change and their attributions around physical activity choices in the individuals that they support. Methods: A between subjects questionnaire design, using two questionnaires adapted specifically for this study, was used to investigate carers’ motivation to support behaviour change and explore how this related to their attributions of physical activity choices. The influence of gender, age and level of intellectual disabilities of the individual that the carer supports were examined. Results: 18 carers participated in the study. There was evidence to suggest that carers’ motivation to support change and attributions were correlated. In addition, motivation and attributions were related to age and level of intellectual disabilities of the individual supported by the carer. Conclusion: Carer attributions might present a barrier to motivation to support change. This may indicate a training need for carers. Further research is required to further explore carer attributions and to further examine the utility of the questionnaire measures adapted for this study

Community perceptions of the socio-economic structural context influencing HIV and TB risk, prevention and treatment in a high prevalence area in the era of antiretroviral therapy.

Following calls for targeted HIV prevention interventions in so-called "hotspots", we explored subjective perceptions of community members in places considered to be high HIV and tuberculosis (TB) transmission areas and those with low prevalence. Although more people now have access to antiretroviral therapy (ART), some areas are still experiencing high HIV transmission rates, presenting a barrier to the elimination of HIV. A rapid qualitative assessment approach was used to access a sample of 230 people who contributed narratives of their experiences and perceptions of transmission, treatment and prevention of HIV and TB in their communities. Theoretical propositions case study strategy was used to inform and guide the thematic analysis of the data with Research Department of Epidemiology & Public Health, University College London, London, UK. Our results support the concept of linking perceived control to health through the identification of structural factors that increase communities' sense of agency. People in these communities did not feel they had the efficacy to effect change in their milieu. The few socio-economic opportunities promote social mobility in search of better prospects which may have a negative impact on community cohesion and prevention strategies. Communities were more concerned with improving their immediate social and economic situations and prioritised this above the prevention messages. Therefore approaches that focus on changing the structural and environmental barriers to prevention may increase people's perceived control. Multifaceted strategies that address the identified constructs of perceived control may influence the social change necessary to make structural interventions successful

Gender-specific epidemiology of diabetes: a representative cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Diabetes and its associated complications are part of a chronic disease global epidemic that presents a public health challenge. Epidemiologists examining health differences between men and women are being challenged to recognise the biological and social constructions behind the terms 'sex' and/or 'gender', together with social epidemiology principles and the life course approach. This paper examines the epidemiology of a population with diabetes from the north-west metropolitan region of South Australia.</p> <p>Methods</p> <p>Data were used from a sub-population with diabetes (n = 263), from 4060 adults aged 18 years and over living in the north-west suburbs of Adelaide, South Australia. Eligible respondents were asked to participate in a telephone interview, a self-report questionnaire and a biomedical examination. Diabetes (undiagnosed and diagnosed) was determined using self-reported information and a fasting blood test administered to participants. Data were analysed using SPSS (Version 10.0) and EpiInfo (Version 6.0).</p> <p>Results</p> <p>Factors associated with diabetes for both men and women were being aged 40 years and over, and having a low gross annual household income, obesity and a family history of diabetes. In addition, being an ex-smoker and having low cholesterol levels were associated with diabetes among men. Among women, having a high waist-hip ratio, high blood pressure and reporting a previous cardiovascular event or mental health problem were associated with diabetes.</p> <p>Conclusion</p> <p>The results found that men and women with diabetes face different challenges in the management of their condition. Public health implications include a need for quality surveillance data, including epidemiological life course, social, behavioural, genetic and environmental factors. This will enrich the evidence base for health promotion professionals and allow policy makers to draw inferences and conclusions for interventions and planning purposes.</p

Ultrastructure and complex polar architecture of the human pathogen Campylobacter jejuni

Campylobacter jejuni is one of the most successful food-borne human pathogens. Here we use electron cryotomography to explore the ultrastructure of C. jejuni cells in logarithmically growing cultures. This provides the first look at this pathogen in a near-native state at macromolecular resolution (~5 nm). We find a surprisingly complex polar architecture that includes ribosome exclusion zones, polyphosphate storage granules, extensive collar-shaped chemoreceptor arrays, and elaborate flagellar motors