Diabetic patient education and motivation. Available in 2 volumes.

Diabetes mellitus is a condition which requires a high degree of patient cooperation in self-management to achieve optimal glycaemic control. The concept of patient education, to enhance the treatment and management of diabetes, is well recognised. Several diabetes education programmes have already been described, but increased knowledge of diabetes did not necessarily result in improved self-mangement or glycaemic control. Other factors, such as attitudes and motivations, may therefore be particuarly important. The aims of the present study were to investigate the influence of patients' attitudes to diabetes, and to develop motivational aspects which enable the application of knowledge to enhance self-management and compliance with treatment. Thirty-one insulin-dependent diabetic (IDD) patients entered into a 12 month educational programme, particularly designed to increase motivation. Patients' attitudes to diabetes, their knowledge and self-management skills were assessed using questionnaires and practical tests, and parameters of glycaemic control were measured. The progress of these patients was compared at intervals with a close matched group of 25 control IFF patients who continued to receive routine clinic care. Patients completing the educational programme achieved better glycaemic control (p< 0.05), greater knowledge (p< 0.001), more favourable attitudes (p< 0.03) and increased competence in management skills (p< 0.02) compared with the control group. Evaluation procedures indicated that the programme was acceptable to the patients, and was successful in terms of increasing patient motivation. Six months after completion of the programme, glycaemic control deteriorated, although knowledge, attitudes and management skills were unchanged. This might reflect the withdrawal of extrinsic motivation, attention and supervision provided during the programme. It is recommended that consideration be given to the development of patients' intrinsic motivation to achieve maximum benefit from diabetes education programmes.

Bringing engineering education to life:an empirical approach

This paper focuses upon the argument that the role played by the engineering profession within today's society has changed markedly over the past several years from providing the foundations for contemporary life to leading societal change and becoming one of the key driver's of future social development. Coining the term 'Engineering-Sociology' this paper contributes to engineering education and engineering education research by proposing a new paradigm upon which future engineering education programmes and engineering education research might build. Developed out of an approach to learning and teaching practice, Engineering-Sociology encapsulates both traditional and applied approaches to engineering education and engineering education research. It suggests that in order to meet future challenges there is a need to bring together what are generally perceived to be two diametrically opposed paradigms, namely engineering and sociology. Building on contemporary theoretical and pedagogical arguments in engineering education research, the paper concludes that by encouraging engineering educators to 'think differently', Engineering-Sociology can provide an approach to learning and teaching that both enhances the student experience and meets the changing needs of society.

"Crack down on the celebrity junkies": does media coverage of celebrity drug use pose a risk to young people?

This study analysed news media content to examine the role played by celebrity drug use in young people's perceptions of drug use. We know that young people have access to discourses of drug use through music and other media which may emphasise short term gains (of pleasure or sexual success) over longer term health and social problems. This study goes beyond a simple modelling approach by using Media Framing Analysis (MFA) to take an in-depth look at the messages themselves and how they are 'framed'. New stories about Amy Winehouse's drug use were used and we conducted focus groups with young people asking them questions about drugs, celebrity and the media. Frames identified include: 'troubled genius', 'losing patience' and 'glamorization or gritty realism'. Initially, the press championed Winehouse's musical talent but soon began to tire of her recklessness; the participants tended to be unimpressed with Winehouse's drug use, characterising her as a promising artist who had 'gone off the rails'. Young people were far more critical of Winehouse than might be expected, demonstrating that concerns about the influence of celebrity drug use and its impact on future health risk behaviour among young people may have been over-simplified and exaggerated. This study illustrates the need to understand young people and their frames of reference within popular culture when designing drug awareness information relevant to them. Furthermore, it indicates that critical media skills analysis may contribute to health risk education programmes related to drug use.

Drug information in general practice pharmacy

The drug information sources currently available to general practice pharmacists have been identified. The use of and attitudes to these sources were assessed as well as the perceived information needs of practising pharmacists. The special requirements of women pharmacists and pharmacists working part-time were studied. The relationship of the medical representative as an information source for pharmacists was evaluated. Participation in continuing education programmes as a vital means of ensuring current information awareness and knowledge for the practising profession has been considered. Investigations were mainly pursued by questionnaire survey, while computer facilities were used for the processing and the analyses of data. The desirability of collated and evaluated information from one or more independent authoritative sources has been discussed. The increasing advisory role of the general practice pharmacist and the needs of the patient and potential customer have been discussed, with projections for the pharmacist's future health care contribution.

Editorial : which weight loss diet?

Full editorial: A recent study evaluating the long-term (2 yr) weight reducing efficacy of different types of diets – high or low in carbohydrates (CHOs), protein or fat - confirmed that it is calorie deficit not dietary composition that determines the loss and maintenance of body weight.1 Is there any advantage in following a specific weight loss diet? Short-term use of nutritionally complete commercially available (very) low calorie diets has benefited people with diabetes when  supported by education programmes.2 Initial weight loss has been encouraging with some fad diets eg the Atkins and the South Beach diets, but these diets are difficult to maintain and there are safety issues regarding their short- and long-term use – especially in people with diabetes.3 The types of macronutrients consumed can have a considerable impact on glycaemic control and energy metabolism. Although a low CHO diet additionally enhances initial weight loss by reducing cellular water content, if fat is not proportionally reduced the diet may not benefit the lipid profile for vascular disease risk. High fat and high protein diets – which are simultaneously low in CHOs – increase vulnerability to hypoglycaemia in people taking insulin secretagogues or on insulin therapy, and may promote excess fat metabolism and ketogenesis, particularly in people vulnerable to lack of insulin. Very low protein diets are not recommended as lean body mass tends to be reduced in diabetes. Altering the macronutrient balance has implications for the micronutrient mix: deficiencies are higher if more foods are excluded and conversely specific micronutrient excess can occur with some fad diets. The altered nutrient mix affects intestinal fauna and flora, and gut motility and glycaemic control are influenced by the quantity and type of fibre consumed. Support programmes help individuals achieve long term weight loss and there is mounting evidence that community schemes which educate and promote lifestyle changes may stem the rising tide of obesity and consequent type 2 diabetes.4 Consuming smaller portions of a balanced diet (and adjusting antidiabetic medications accordingly) will create an energy deficit to promote healthy weight loss. Increased movement/exercise will enhance this energy deficit. Knowledge (eg 1g fat has 2.25 times more energy than 1g CHO) allows sensible food choices and compensation for inclusion of small volumes of  ‘naughty but nice’ foods. Ultimately weight control requires self control. References 1. Sacks FM, Bray GA, Carey VJ et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 2009;360:859–73. 2. Bennett P. Obesity, diabetes and VLCD. Br J Diabetes Vasc Dis 2004;4:328–30. 3. Baldwin EJ. Fad diets in diabetes. Br J Diabetes Vasc DIs 2004;4:333–7. 4. Romon M, Lommoz A, Tafflet M et al. Downward trends in the prevalence of childhood overweight in the setting of 12-year school- and community-based programmes. Public Health Nutr 2008; Dec 28, 1–8 [Epub ahead of print].

Why value based management goes wrong

The authors introduce and describe a relatively new approach to management entitled Value Based Management which is concerned with creating long term value for shareholders by matching or exceeding their expectations. They outline what VBM is and does, describes the typical adopter of the programme and the procedures VBM initiatives take. They list some of the drawbacks including the type of people who champion VBM inside the company (who tend to come from a finance or strategic background), the consultants (who tend to be like-minded), inadequate education programmes and tendency to exclude employees from full participation. The authors conclude that while VBM has been less than spectacularly successful it would be wrong to conclude that it had failed completely. Its biggest contribution has been in reducing the incidence and frequency of reckless, value destroying decisions.

Peer mentoring in higher education:a multidimensional approach to conceptualising the role of peer mentoring programmes in enhancing the first year undergraduate experience

Across the literature researchers agree that the concept of mentoring results in positive outcomes for both mentors and mentees alike (Enrich et al, 2004). From a pedagogical perspective, student focused mentoring activities in Higher Education are generally perceived to comprise dyadic or triadic relationships that encapsulate a diverse range of learning strategies and/or support mechanisms. Whilst there exists a significant amount of literature regarding the wider value of Peer Mentoring in Higher Education, there remains a notable gap in knowledge about the value of such programmes in enhancing the first year undergraduate experience and thus promoting a smooth transition to University. Using the emergent study findings of a large international project, a multidimensional conceptual framework bringing together the theoretical, conceptual and contextual determinants of Peer Mentoring is proposed. This framework makes a distinctive contribution to current pedagogical theory and practice – particularly in relation to the first year experience.

Adverse drug reaction teaching in UK undergraduate medical and pharmacy programmes

Objectives: To assess the extent of teaching about the Committee on Safety of Medicine's Yellow Card scheme and adverse drug reactions within UK Schools of Medicine and Pharmacy. Methods: A self-completed questionnaire sent to all heads of undergraduate schools of medicine and pharmacy within the UK. Results: The majority of undergraduate syllabuses feature the Yellow Card Scheme. Knowledge of the Yellow Card Scheme was assessed in 79% of pharmacy programmes and 57% of medical schools. Specialist speakers on the Yellow Card Scheme were infrequently used. Fewer than half of respondents provided students with a guide to reporting ADRs (43% pharmacy and 43% medical). There is some disagreement about the value of supplying students with printed material about the Yellow Card Scheme. Half of medical Schools did not think that supplying 'Current Problems In Pharmacovigilance' would be useful. Conclusions: It was found that in both medicine and pharmacy, courses differed substantially in teaching about the Yellow Card Scheme and adverse drug reactions (ADRs). There is scope for increased involvement of the Medicines and Healthcare products Regulatory Agency in undergraduate education, in line with recommendations from the National Audit Office.

Engineering education for the 21st century:scholarship, synergy and student success

Starting with the question “How can University level Engineering Education be developed in such a way so as to enhance the quality of the student learning experience?”, this discussion paper proposes an approach to engineering education developed by a senior engineering educator working alongside a pedagogical researcher in an attempt to engage colleagues in contemporary debates about the issues currently faced across the Sector. Such issues include difficulties with recruiting students onto programmes as well as high levels of student attrition and failure. Underpinned by three distinctive concepts: Synergy, Variety & Relationships (S+V+R), the approach brings together pedagogic and engineering epistemologies in an empirically grounded framework in such a way so as to provide an accessible and relevant learning approach that, if followed, engenders student success [S2]. Specifically developed with the intention of increasing retention and positively impacting student success [S2], the S+V+R=S2 approach provides a scholarly and Synergetic (S) approach to engineering education that is both innovative and exciting. Building on the argument that Variety (V) in education is pivotal to promoting originality and creativity in learning and teaching, this paper shows how, by purposefully developing a range of learning and teaching approaches, student engagement and thus success can be increased. It also considers the importance of Relationships (R) in higher education, arguing that belonging and relationships are crucial factors impacting student experiences. When taken together (Synergy, Variety and Relationships) and applied within an Engineering Education context, students are provided with a unique learning environment – one that both promotes individual success and improves organisational effectiveness. The uniqueness of the approach is in the synthesis of these three concepts within an Engineering Education epistemology.

Advanced education and training in bioenergy in Europe

The paper explains how bioenergy education and training is growing in Europe. Employment estimates are included for renewable energy in general, and bioenergy in particular, to highlight the need for a broadly based education and training programme that is essential to build a knowledgeable workforce that can drive Europe's growing bioenergy sector. The paper reviews current provisions in bioenergy at Masters and PhD levels across the 27 members of the EU (EU27) plus Norway and Switzerland. This identifies a very active and expanding bioenergy education provision. 65 English-language Masters Courses in bioenergy (either focussing completely on bioenergy or with significant bioenergy content or specialisation) were identified. 231 providers of PhD studies in bioenergy were found.Masters Course offerings have grown rapidly across Europe during the last five years, but where data is available, enrolment has been quite low suggesting that there is an oversupply of courses and that course organisers are being optimistic in their projections. Existing provisions in Europe at Masters and PhD levels are clearly more than sufficient for short term needs, but further work is needed to evaluate the take-up rate and the content and focus of the provisions. To ensure talented graduates are attracted to these programmes, better promotion, stronger links with the research community and industry, and increased collaboration among course providers are needed. Short Courses of two to five days are an excellent way of meeting post-experience training needs but require further growth and development to serve the needs of the bioenergy community. © 2011 Elsevier Ltd.

Designing and implementing a blended learning approach to executive SCM education:a case study from Ireland

The National Institute for Transport and Logistics (NITL) is Ireland’s centre of excellence for supply chain management (SCM). As part of its mission to promote the development of supply chain expertise in Irish business, it designs and delivers executive modular learning programmes. In 2004, as part of a drive to create more flexible learning opportunities for course participants, NITL designed and implemented an eLearning programme, which involved converting traditionally tutored modules to online modules. This paper describes the rationale behind this initiative and the significance of technology as an enabling tool for executive education, as well as detailing the design and implementation processes for the pilot module. The paper concludes with a critique of the expected and actual benefits realised, as well as future development considerations.

Practice based learning approaches in collaborative design and engineering education:a case study investigation into the benefits of a crossdisciplinary practice based learning strategy

This study explores the ongoing pedagogical development of a number of undergraduate design and engineering programmes in the United Kingdom. Observations and data have been collected over several cohorts to bring a valuable perspective to the approaches piloted across two similar university departments while trialling a number of innovative learning strategies. In addition to the concurrent institutional studies the work explores curriculum design that applies the principles of Co-Design, multidisciplinary and trans disciplinary learning, with both engineering and product design students working alongside each other through a practical problem solving learning approach known as the CDIO learning initiative (Conceive, Design Implement and Operate) [1]. The study builds on previous work presented at the 2010 EPDE conference: The Effect of Personality on the Design Team: Lessons from Industry for Design Education [2]. The subsequent work presented in this paper applies the findings to mixed design and engineering team based learning, building on the insight gained through a number of industrial process case studies carried out in current design practice. Developments in delivery also aligning the CDIO principles of learning through doing into a practice based, collaborative learning experience and include elements of the TRIZ creative problem solving technique [3]. The paper will outline case studies involving a number of mixed engineering and design student projects that highlight the CDIO principles, combined with an external industrial design brief. It will compare and contrast the learning experience with that of a KTP derived student project, to examine an industry based model for student projects. In addition key areas of best practice will be presented, and student work from each mode will be discussed at the conference.

How education should link with career paths

How good is your pharmacy practice? And what does “good” look like? Take a look back at the education and training you have received in your career to date. Has it stood you in good stead? Certainly there is a need to establish a model of professional education and development that produces good pharmacists — you should be able to demonstrate your competence regardless of your sector of work. It may help if we move away from the view that excellence in pharmacy practice is primarily defined by where you practise and the kind of job that you do. The Modernising Pharmacy Careers programme’s aspirations to integrate the undergraduate degree with the preregistration training year are bold and to be applauded — provided the outcome delivers changes that are more than superficial. The new model needs to deliver greater integration of education with practice, while retaining an adequate science base. Theory should be put into the context of practice-based, cross-sector learning needs and opportunities. For example, is the classroom really the best environment in which to learn dispensing? Pharmacokinetic theory could be put into context through creatively designed work placements. And it might make more sense to learn patient counselling in a community pharmacy, and so on. Is it resources we lack to make this happen? Or do we lack the collective will to be imaginative, to be radical and to conceive new approaches to professional education? Implicit in this new approach to education is the expectation that pharmacists should teach and mentor and, conversely, that those who teach should also engage in relevant practice. University education must produce graduates whose knowledge and competence are useful to employers. Moreover, graduates must be adequately prepared to enter any area of the profession endowed with professional self-confidence (something, arguably, that needs further development within the pharmacy psyche). Of course, becoming qualified is just the beginning. Post-qualification, pharmacists need structured career paths that foster this professional confidence, support learning and ensure recognition. To this end, the Royal Pharmaceutical Society-led professional curriculum group is working to define knowledge, skills and experience for all areas of advanced practice. More than ever, the profession needs to adopt a culture of learning, teaching and practice research that is unified. The question is: how do we move away from merely collecting qualifications (trophies) to developing meaningful careers? Pharmacists in all areas and at all levels of the profession need to consider their own willingness to make this shift. The RPS and MPC are leading the way, but are we following?

Applicability of non-modular assessment in construction management and allied undergraduate programmes:perspective of the academics involved

Undergraduate programmes on construction management and other closely related built environment disciplines are currently taught and assessed on a modular basis. This is the case in the UK and in many other countries globally. However, it can be argued that professionally oriented programmes like these are better assessed on a non-modular basis, in order to produce graduates who can apply knowledge on different subject contents in cohesion to solve complex practical scenarios in their work environments. The examples of medical programmes where students are assessed on a non-modular basis can be cited as areas where this is already being done. A preliminary study was undertaken to explore the applicability of non-modular assessment within construction management undergraduate education. A selected sample of university academics was interviewed to gather their perspectives on applicability of non-modular assessment. General acceptance was observed among the academics involved that integrating non-modular assessment is applicable and will be beneficial. All academics stated that at least some form of non-modular assessment as being currently used in their programmes. Examples where cross-modular knowledge is assessed included comprehensive/multi-disciplinary project modules and creating larger modules to amalgamate a number of related subject areas. As opposed to a complete shift from modular to non-modular, an approach where non-modular assessment is integrated and its use further expanded within the current system is therefore suggested. This is due to the potential benefits associated with this form of assessment to professionally aligned built environment programmes

A matter of professionalism? Reflection and reflexivity in continuing engineering education and practice

The argument that this paper sets out to critique is that in order to promote professionalism in Engineering Education and Practice, graduate level engineering programmes need to introduce the concepts of reflection and reflexivity into the curriculum right from the onset. By focusing upon the delivery of a newly developed „Work Based‟ Master’s level programme in Professional Engineering, this paper provides an overview of the first part of an empirical study which sets out to investigate the challenges associated with embedding reflection and reflexivity into Engineering Education. The paper concludes by noting that whilst student engineers may struggle with the concepts of reflection and reflexivity, with support and encouragement such difficulties can be overcome. Moreover, by encouraging students to reflect upon their Professional Practice, the programme not only enables students to consider how they may apply what they have learnt to their Professional Practice, but also encourages them to think about how they can link their experiences as Professional Engineers to what and how they learn both whilst on the programme but also as lifelong learners.