Stress and Coping in Adults with Type 2 Diabetes Who Initiate Insulin Therapy

Type 2 diabetes affects 90% of people who live with this chronic disease. A primary goal of healthcare professionals is to assist patients with Type 2 diabetes to achieve optimal glycemic control to prevent the devastating complications of this disease. Research has demonstrated that optimal glycemic control can minimize or prevent macrovascular complications such as heart attack or stroke and the microvascular complications of retinopathy, nephropathy, and neuropathy. Historically insulin has been one of the last agents to be added in type 2 diabetes despite its efficacy and long term treatment data. Reluctance by both patients and clinicians to add insulin to treatment regimens, a phenomenon known as psychological insulin resistance, remains an issue. The perception of stress and ways of coping in participants who were initiating insulin therapy were examined in this research. The relationship between participants\u27 stress and the education they received was also examined. The education provided was based upon a Registered Nurses Association of Ontario (RNAO) Best Practice Guideline (BPG). In a pretest / posttest design, participants (N = 105) who were seen at a Diabetes Education Centre for initiation of insulin therapy were surveyed prior to receiving insulin initiation education and six weeks following the initiation of their insulin therapy. Three surveys were completed, the Perceived Stress Scale, Ways of Coping Questionnaire, and the Confidence in Administering Insulin and Managing Diet Scale at the pre/post timepoints. A BPG evaluation tool was also completed during the posttest appointment. A mediated regression analysis demonstrated coping to be a mediator of the relationship between stress and insulin self-efficacy. There was a statistically significant decrease in participants\u27 stress and a statistically significant increase in insulin self-efficacy. Analysis of the BPG evaluation tool demonstrated that 80% of the BPG content was recalled by participants. This study provided evidence that the needs of these patients can be met with structured education through the use of a Best Practice Guideline and the assessment of patient stress and coping can improve patient self-efficacy with insulin therapy and decrease their stress burden

Prospective Memory in the Red Zone: Cognitive Control and Capacity Sharing in a Complex, Multi-Stimulus Task

© 2019 American Psychological Association. Remembering to perform a planned action upon encountering a future event requires event-based Prospective Memory (PM). PM is required in many human factors settings in which operators must process a great deal of complex, uncertain information from an interface. We study event-based PM in such an environment. Our task, which previous research has found is very demanding (Palada, Neal, Tay, & Heathcote, 2018), requires monitoring ships as they cross the ocean on a display. We applied the Prospective Memory Decision Control Model (Strickland, Loft, Remington, & Heathcote, 2018) to understand the cognitive mechanisms that underlie PM performance in such a demanding environment. We found evidence of capacity sharing between monitoring for PM items and performing the ongoing surveillance task, whereas studies of PM in simpler paradigms have not (e.g., Strickland et al., 2018). We also found that participants applied proactive and reactive control (Braver, 2012) to adapt to the demanding task environment. Our findings illustrate the value of human factors simulations to study capacity sharing between competing task processes. They also illustrate the value of cognitive models to illuminate the processes underlying adaptive behavior in complex environments

Annihilation of Charged Particles

The kinetics of irreversible annihilation of charged particles performing overdamped motion induced by long-range interaction force, $F(r)\sim r^{-\lambda}$, is investigated. The system exhibits rich kinetic behaviors depending on the force exponent $\lambda$. In one dimension we find that the densities decay as $t^{-1/(2+\lambda)}$ and $t^{-1/(1+2\lambda)}$ when $\lambda>1$ and $1/2<\lambda<1$, respectively, with logarithmic correction at $\lambda=1$. For $\lambda \leq 1/2$, the asymptotic behavior is shown to be dependent on system size.Comment: 17 pages, plain TeX, 3 figures available upon request from [email protected]