These data were reviewed independently by an orthopaedic surgeon, an accident and emergency physician, a neurosurgeon, and an anaesthetist. Each, while blinded to the opinions of the other reviewers, gave an opinion as to whether the patient could have survived their injuries, given cardiopulmonary care by general public bystanders and prehospital care by a trained paramedic team. The deaths were categorised into "potential survivor", "definite death", and "unclear/insufficient information".The four sets of independent opinions were then read in conjunction to ascertain the degree of agreement between specialists on the most likely outcome in each case. For each patient the number of "potential survivor" and "definite death" responses was recorded.

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In the UK there are currently no national structured education programmes for people newly diagnosed with type 1 diabetes. In Leicester we developed a programme for people to attend within six months of diagnosis with the aim of increasing patients' self‐efficacy in managing their diabetes.Forty‐two people attended the group over a 12‐month period. The participants completed a questionnaire based on a 10‐point Likert scale to assess confidence to participate in daily activities while managing their insulin and blood glucose levels, both at baseline and after the structured education intervention.Participants self‐reported improved confidence levels aligned to different situations, including the ability to adjust insulin accordingly and achieve target blood glucose (4–7mmol/L). Scores increased significantly in a number of scenarios, e.g. confidence to do a sporting activity 8(6.5–8.2) to 9(8.0–9.0), confidence to adjust insulin for the activity 5(3.8–6.2) to 8(6.9–8.3), and confidence that glucose levels will be in target after insulin adjustment 4(3.4–5.6) to 8(6.6–8.0).Attendance at a structured group education programme can significantly increase individuals' self‐efficacy to manage type 1 diabetes. Copyright © 2012 John Wiley & Sons.

Structured education programmes support and enable people with diabetes to develop self‐management skills. Insulin management central to DAFNE is restricted to those with type 1 diabetes of at least six months' duration and on multiple dose regimens. DESMOND is available for all with type 2 diabetes but does not include guidance on how to self‐manage diabetes with insulin. Our aims were to develop an education programme for people with type 1 or 2 diabetes already on insulin and who may be using a variety of insulin regimens, to enable effective self‐management, improve confidence, reduce hypoglycaemia and enable peer group support. An evidence‐based curriculum, developed in line with NICE principles, was piloted. This consisted of three half‐day sessions held during a one‐month period with up to 10 participants and supporters invited to attend. Four further programmes were held; education was tailored to the individual needs of groups and verbal evaluation was undertaken. Anonymised patient satisfaction questionnaires were posted at programme completion. Audit included clinical data, demographics, patient satisfaction and health care professional assessment of content. There were 40 participants over five courses; 20% (n=8) were type 1, 68% (n=27) were male, average age was 58 years (range 35–82 years), and 55% were South Asian (n=22). In 38 of 40 participants where a recorded pre‐ and three months post‐intervention was available, an average HbA1c reduction of 1.18% was achieved – i.e. 9.02% reduced to 7.84% (75.1mmol/mol reduced to 62.2mmol/mol). Twenty‐five participants (62.5%) returned the survey form: 96% (24/25) said diabetes control improved, and all felt more confident to adjust insulin; 96% (23/24) felt more confident to treat ‘hypos’ (one stated ‘hypos’ had not reduced) and 96% (24/25) felt they learned more by attending the programme. This programme met participants' individual needs, increased confidence in insulin management and improved glycaemic control in a high ethnic mix poulation. Copyright © 2014 John Wiley & Sons. Practical Diabetes 2014; 31(2): 54–57