Bibliographic record
Abstract
The National Service Framework (England) for diabetes has been developed from the principles of the NHS Plan1 which highlights the needs for services to be patient centered as well as delivered as locally as possible. This presents a challenge for those of us providing diabetes services to try and develop our services for those with diabetes so that the health care system that they are trying to navigate through during their life with diabetes does not confuse them and that they don't have to see any more health care professionals than they need to. The review article on page 180 of this edition of Practical Diabetes International by Worth and Vyas starts addressing this problem by considering the integration of the role of the specialist/advanced dietitian further into that of a diabetes educator. They highlight the need for healthcare professionals to extend their roles to provide seamless diabetes education. A number of diabetes specialist nurses will already be developing or have developed ‘advanced’ skills in the dietetic management of diabetes either to ensure that their patients get all the information they need from a single visit to a diabetes services or because they cannot get access to specialist dietetic time in sufficient amounts! So, as two of the key roles in diabetes education start to emerge, what challenges does that bring to the world of diabetes care in the UK? Those reading this in the US, Australia and Canada will not be surprised by the concept. They have Certified Diabetes Educator organsiations and accreditation systems which support the work suggested by Worth and colleagues. But we often hear in conversation with our colleagues working within these systems that the scope of practice (starting/adjusting insulin for example) will still depend on the professional regulation of the ‘certified educator’. Perhaps a different model is necessary for the UK – a registered diabetes care advisor? A further dilemma that faces us in the UK (and across the world) is that with increasing numbers of people with diabetes, the increasing complexity of their care requirements and the recognition of the need for structured education to facilitate effective disease self management, will we have enough health care professionals to deliver services in the way we current deliver them? The potential roles identified by Worth et al. in the ‘scope of the educator’ lists a number of activities that may be delivered by either health care technicians, generic health care workers or the person with diabetes themselves! Whilst the numbers of doctors and nurses are at last on the increase in the UK, there may still not be sufficient to deliver care within the current models of care. The numbers of dietitians and podiatrists are not rising and in some areas, diminishing2 – leading us all to consider two things urgently. Firstly, if we are only going to have a few dietitians and podiatrists, how best should that resource be used to help people with diabetes? Secondly, what or how should the care gap that is now developing be filled? Should the role of a diabetes educator be developed from the population of unregistered health care support workers? In Portsmouth, as in other areas, the role of a foot care assistant has now developed (through training and job evaluation) into that of a specialist diabetes foot care advisor. This person is now assisting with the running of education workshops for those with newly diagnosed Type 2 diabetes – and it will not be long until the role is that of specialist diabetes self care advisor for those people with Type 2 diabetes. The new challenges that we face require new ways of delivering services and new roles for those who deliver them. Practical Diabetes International would welcome views and experiences of readers!
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.016 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".