How people with diabetes integrate self-monitoring of blood glucose into their self-management strategies

Background The benefit of self-monitoring of blood glucose by patients has been questioned, and UK policy is generally not to support this, although it is identified that there may be unidentified subgroups of people who would benefit from being supported to self-monitor. The purpose of this paper is to explore the self-management approaches of people with diabetes, and how self-testing of blood glucose contributes to self-management strategies. Methods This qualitative study of patients’ experiences drew data from contributors to online discussion boards for people living with diabetes. The principles of qualitative content analysis were used on posts from a sample of four Internet discussion boards. Results Contributors described how they were using self-testing within their self-management strategies. Most saw it as a way of actively maintaining control of their condition. The amount of testing carried varied over time; more testing was done in the early days, when people were still learning how to stay in control of their diabetes. Some people had experienced a lack of support for self-testing from healthcare professionals, or had been expected to change their self-management to fit national policy changes. This was seen as unhelpful, demotivating, stressful, and harmful to the doctor–patient relationship. Conclusions The Internet is a valuable source of information about peoples’ self-management behaviours. Patients who are using, or who wish to use, self-testing as part of their self-management strategy are one of the subgroups for whom self testing is beneficial and who should be supported to do so

Cohort profile of the UK Biobank: diagnosis and characteristics of cerebrovascular disease

Purpose: The UK Biobank is a large-scale biomedical resource, containing sociodemographic and medical information, including data on a previous diagnosis of stroke or transient ischaemic attack (TIA). We described these participants and their medication usage. Participants: We identified participants who either self-reported or were identified from a nurse-led interview, having suffered a stroke or a TIA and compared them against participants without stroke ort TIA. We assessed their risk factor burden (sex, age, deprivation, waist to hip ratio (WHR), hypertension, smoking, alcohol intake, diabetes, physical exercise and oral contraception use (oral contraceptive pill, OCP)) and medication usage. Findings: to date We studied 502 650 people (54.41% women), 6669 (1.23%) participants self-reported a stroke. The nurse-led interview identified 7669 (1.53%) people with stroke and 1781 (0.35%) with TIA. Hypertension, smoking, higher WHR, lower alcohol consumption and diabetes were all more common in people with cerebrovascular disease (p<0.0001 for each). Women with cerebrovascular disease were less likely to have taken the OCP (p=0.0002). People with cerebrovascular disease did more exercise (p=0.03). Antithrombotic medication was taken by 81% of people with stroke (both self-report and nurse-led responders) and 89% with TIA. For self-reported stroke, 63% were taking antithrombotic and cholesterol medications, 54% taking antithrombotic and antihypertensive medications and 46% taking all 3. For the nurse-led interview and TIA, these figures were 65%, 54% and 46%, and 70%, 53% and 45%, respectively. Future plans: The UK Biobank provides a large, generalisable and contemporary data source in a young population. The characterisation of the UK Biobank cohort with cerebrovascular disease will form the basis for ongoing research using this data source

A note on Gabriel Uzquiano's 'Varieties of Indefinite Extensibility'

Gabriel Uzquiano has offered an account of indefinite extensibility for sets in the context of a modal logic. The modal operators are interpreted in terms of linguistic extensibility. After reviewing the proposal, I argue that the view should be understood as a version of in rebus structuralism about set theory. As such it is subject to the usual problems for in rebus structuralism. In particular, there is no good extra set-theoretic reason to assent to an ontology of sufficient cardinality to make true the theorems of ZFC

Rosy with Sider? The case of the Metaphysical Liar

An important trend in contemporary metaphysics denies that the structure of natural language is an important datum for investigating fundamental structure. Ted Sider proceeds on this basis to propose a metaphysical semantics for natural language. Within this framework he argues that natural language and a fundamental, ‘jointcarving’, language could be subject to distinct logics. Developing an argument of Hartry Field’s, I show that Sider’s preferred option of fundamental classicality combined with non-fundamental non-classicality trivialises within the framework of Siderian metaphysical semantics. The position can be saved only by revising key claims about truth and metaphysical semantics. This has serious implications for methdology in the metaphysics of logic

Plasma properties and Stokes profiles during the lifetime of a photospheric magnetic bright point

Aims: to investigate the evolution of plasma properties and Stokes parameters in photospheric magnetic bright points using 3D magneto-hydrodynamical simulations and radiative diagnostics of solar granulation. Methods: simulated time-dependent radiation parameters and plasma properties were investigated throughout the evolution of a bright point. Synthetic Stokes profiles for the FeI 630.25 nm line were calculated, which allowed the evolution of the Stokes-I line strength and Stokes-V area and amplitude asymmetries to also be investigated. Results: our results are consistent with theoretical predictions and published observations describing convective collapse, and confirm this as the bright point formation process. Through degradation of the simulated data to match the spatial resolution of SOT, we show that high spatial resolution is crucial for the detection of changing spectro-polarimetric signatures throughout a magnetic bright point's lifetime. We also show that the signature downflow associated with the convective collapse process is reduced towards zero as the radiation intensity in the bright point peaks, due to the magnetic forces present restricting the flow of material in the flux tube.Comment: 14 pages, 12 figures, accepted to A&

Detecting the 21 cm Forest in the 21 cm Power Spectrum

We describe a new technique for constraining the radio loud population of active galactic nuclei at high redshift by measuring the imprint of 21 cm spectral absorption features (the 21 cm forest) on the 21 cm power spectrum. Using semi-numerical simulations of the intergalactic medium and a semi-empirical source population we show that the 21 cm forest dominates a distinctive region of $k$-space, $k \gtrsim 0.5 \text{Mpc}^{-1}$. By simulating foregrounds and noise for current and potential radio arrays, we find that a next generation instrument with a collecting area on the order of $\sim 0.1\text{km}^2$ (such as the Hydrogen Epoch of Reionization Array) may separately constrain the X-ray heating history at large spatial scales and radio loud active galactic nuclei of the model we study at small ones. We extrapolate our detectability predictions for a single radio loud active galactic nuclei population to arbitrary source scenarios by analytically relating the 21 cm forest power spectrum to the optical depth power spectrum and an integral over the radio luminosity function.Comment: 20 pages, 17 figures, accepted for publication in MNRA

What e-patients want from the doctor-patient relationship: content analysis of posts on discussion boards.

People with long-term conditions are encouraged to take control and ownership of managing their condition. Interactions between health care staff and patients become partnerships with sharing of expertise. This has changed the doctor-patient relationship and the division of roles and responsibilities that traditionally existed, but what each party expects from the other may not always be clear. Information that people with long-term conditions share on Internet discussion boards can provide useful insights into their expectations of health care staff. This paper reports on a small study about the expectations that people with a long-term condition (diabetes) have of their doctors using information gleaned from Internet discussion boards

The papers of John Buddle, colliery viewer, in the mining institute, Newcastle on Tyne: an annotated list of assessment of their value to the economic historian

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