A study protocol for a pilot randomised trial of a structured education programme for the self-management of type 2 diabetes for adults with intellectual disabilities

BACKGROUND: The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmes are not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID. This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrative details.

METHODS/DESIGN: This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical, psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial.

DISCUSSION: The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are significant benefits to be gained globally, if structured education programmes are adapted and shown to be successful for people with ID and other cognitive impairments.

TRIAL REGISTRATION: Registered with International Standard Randomised Controlled Trial (identifier: ISRCTN93185560 ) on 10 November 2014.

Civic engagement and the arts and humanities: a UK perspective

Higher education in the UK is in a state of flux and this is having particular impact on the humanities. On the one hand the pressure to support a STEM agenda is seen by some as forcing higher education down a narrow economic agenda, while government requirements for assessing the social and economic impact of research has raised concerns about excessive utilitarianism and a downgrading of ‘disinterested enquiry’. This paper argues that these concerns may be misplaced. The research impact agenda has the potential to promote more socially engaged research and more democratic engagement in the creation and dissemination of knowledge. In the US concerns about the democratic role of higher education more often seem to focus on the student experience. By contrast, in the UK concerns about citizenship education and democratic participation more often focus on high school students, perhaps because university students are more likely to have a formal role in institutional governance. The paper concludes that the papers in this forum have a very American feel, but the issues they address resonate on a much wider scale.

Civic engagement in a divided society: the role of Queen’s University Belfast in Northern Ireland

The purpose of this paper is to examine the role of a university in a society emerging from decades of political violence and to show ways in which public engagement can help promote democratic practice and contribute to the strengthening of peace. Our understanding of the concept of public engagement follows the UK National Coordinating Centre for Public Engagement definition:

'Public engagement describes the myriad of ways in which the activity and benefits of higher education and research can be shared with the public. Engagement is by definition a two-way process, involving interaction and listening, with the goal of generating mutual benefit .'

The case study is provided by the example of Queen's University Belfast. We will begin by examining some of the history and context of the university, then discuss the political and social context of Northern Ireland, before going on to examine some of the publicly engaged work being carried out by Queen's and consider how this might be taken forward.

Community engagement in Belfast: Queen's University and the Sandy Row community

This chapter examines a case study of a university-community civic engagement project involving a homework club in an area of significant educational and social disadvantage. The chapter gives voice to community leaders who talk about the role of the initiative and their relationship with the university.

The impact of an integral student engagement approach on teaching Operations and Supply Chain Management

In this study we investigate the influence of the implementation of multidimensional engagement on students’ academic, social and emotional outcomes in the teaching of Operations and Supply Chain Management (OSCM) modules. Next to the academic and behavioural engagement dimensions, which are traditionally used to engage students in OSCM courses, we also incorporate a cognitive dimension to enhance integral student engagement. Up to know, integral student engagement is not reported in the OSCM literature. Cognitive engagement is based on implementation of summative self- and peer-assessment of weekly assignments. Our investigation is based on action research, conducted in an OSCM module over two consecutive years. We found that, in general, multidimensional engagement results in higher levels of academic performance, development of relationships with academic staff and their peers and emotional satisfaction. These findings are discussed in relation to several contextual factors: nature of the study material, gender, and the home location of students.

Turing’s Menagerie: Talking Lions, Virtual Bats, Electric Sheep and Analogical Peacocks: Common Ground and Common Interest are Necessary Components of Engagement

This theoretical paper attempts to define some of the key components and challenges required to create embodied conversational agents that can be genuinely interesting conversational partners. Wittgenstein’s argument concerning talking lions emphasizes the importance of having a shared common ground as a basis for conversational interactions. Virtual bats suggests that–for some people at least–it is important that there be a feeling of authenticity concerning a subjectively experiencing entity that can convey what it is like to be that entity. Electric sheep reminds us of the importance of empathy in human conversational interaction and that we should provide a full communicative repertoire of both verbal and non-verbal components if we are to create genuinely engaging interactions. Also we may be making the task more difficult rather than easy if we leave out non-verbal aspects of communication. Finally, analogical peacocks highlights the importance of between minds alignment and establishes a longer term goal of being interesting, creative, and humorous if an embodied conversational is to be truly an engaging conversational partner. Some potential directions and solutions to addressing these issues are suggested.