'Urine testing is a waste of time': newly diagnosed Type 2 diabetes patients' perceptions of self-monitoring

Aims To date, there is no convincing evidence that non-insulin treated patients who undertake self-blood glucose monitoring (SBGM) have better glycaemic control than those who test their urine. This has led to a recommendation that non-insulin dependent patients undertake urine testing, which is the cheaper option. This recommendation does not take account of patients' experiences and views. This study explores the respective merits of urine testing and SBGM from the perspectives of newly diagnosed patients with Type 2 diabetes. Methods Qualitative study using repeat in-depth interviews with 40 patients. Patients were interviewed three times at 6-monthly intervals over 1 year. Patients were recruited from hospital clinics and general practices in Lothian, Scotland. The study was informed by grounded theory, which involves concurrent data collection and analysis. Results Patients reported strongly negative views of urine testing, particularly when they compared it with SBGM. Patients perceived urine testing as less convenient, less hygienic and less accurate than SBGM. Most patients assumed that blood glucose meters were given to those with a more advanced or serious form of diabetes. This could have implications for how they thought about their own disease. Patients often interpreted negative urine results as indicating that they could not have diabetes. Conclusions Professionals should be aware of the meanings and understandings patients attach to the receipt and use of different types of self-monitoring equipment. Guidelines that promote the use of consistent criteria for equipment allocation are required. The manner in which negative urine results are conveyed needs to be reconsidered.

Cleavage initiation in the intercritically reheated coarse-grained heat affected zone:Part II. Failure criteria and statistical effects

In part 1 of this article, cleavage initiation in the intercritically reheated coarse-grained heat affected zone (IC CG HAZ) of high-strength low-alloy (HSLA) steels was determined to occur between two closely spaced blocky MA particles. Blunt notch, crack tip opening displacement (CTOD), and precracked Charpy testing were used in this investigation to determine the failure criteria required for cleavage initiation to occur by this mechanism in the IC CG HAZ. It was found that the attainment of a critical level of strain was required in addition to a critical level of stress. This does not occur in the case of high strain rate testing, for example, during precracked Charpy testing. A different cleavage initiation mechanism is then found to operate. The precise fracture criteria and microstructural requirements (described in part I of this article) result in competition between potential cleavage initiation mechanisms in the IC CG HAZ.

Early design verification of complex assembly variability using a hybrid - model based and physical testing - methodology

Design verification in the digital domain, using model-based principles, is a key research objective to address the industrial requirement for reduced physical testing and prototyping. For complex assemblies, the verification of design and the associated production methods is currently fragmented, prolonged and sub-optimal, as it uses digital and physical verification stages that are deployed in a sequential manner using multiple systems. This paper describes a novel, hybrid design verification methodology that integrates model-based variability analysis with measurement data of assemblies, in order to reduce simulation uncertainty and allow early design verification from the perspective of satisfying key assembly criteria.