Regulating the effects of depletion through monitoring

A robust finding is that participants who perform a depleting initial self-regulatory task are less persistent on a contiguous second task than are those who perform a less arduous initial self-regulatory task. We explain this regulatory depletion effect in terms of a monitoring process. According to this view, depleted individuals focus on the resources they have devoted to a second task, neglect to monitor their performance against their standards for such activities, and prematurely suspend their performance. Consistent with this view, we demonstrate that the regulatory depletion effect can be eliminated when individuals are encouraged to monitor their performance against some standard (Studies 1, 2, and 4) or when they have a proclivity to engage in such monitoring (Studies 3 and 4). © 2008 by the Society for Personality and Social Psychology, Inc.postprin

Spirituality, religion and health: evidence and research directions

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146567/1/mja201040.pd

The Social Determinants of Health Disparities: The Role of Social and Temporal Contexts.

The goal of this dissertation is to examine contextual determinants of racial disparities in health across the life course. I progress from “downstream” to “upstream” processes by focusing in one chapter on the prenatal context, in another on health behaviors and family context, and in the third, on the neighborhood context. Chapter 2 examines the relationship between lifetime exposure to abuse among pregnant women in the Boston area and elevated cord blood IgE. Results demonstrate that greater exposure to violence throughout the mother’s life course is associated with increased risk of offspring elevated IgE at birth, after adjusting for maternal and family-level confounders. Abuse occurring more proximate to pregnancy is not correlated with elevated cord blood IgE, suggesting that the cumulative exposure to violence (i.e., chronic abuse) may have the most salient fetal effects. The results indicate that the detrimental effects of violence may a) accumulate over the life course and b) transmit across generations through the fetal environment. Chapter 3 explores the intergenerational transmission of disadvantage by examining the relationship between teen childbearing and offspring health among a nationally representative sample of children ages 5-19. Logistic regressions reveal no increased risk of low birthweight, chronic illness, obesity or asthma among offspring of teens versus non-teens and a slight decrease in obesity among offspring of teens, suggesting that the timing of one’s pregnancy may matter less than other contextual factors in influence offspring health. Chapter 4 uses multilevel methods to investigate the extent to which one’s residential environment is linked to currently active asthma. No association is found between neighborhood sociodemographic factors and asthma. Random-slope models demonstrate significant effects of affluence and immigrant concentration for non-blacks; however, the unexpected direction of the coefficients and the small sample size call into question the reliability and validity of these findings. Emerging from these three studies is a complex picture of how contextual factors may affect health disparities. The findings confirm the value of incorporating social contexts in studying health disparities, while underscoring the pitfalls in overlooking the diversity in age, ethnicity, life stage, and health outcomes within such research.Ph.D.Public Policy & SociologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/64666/1/mjste_1.pd

Assessment of Barriers to Improve Diabetes Management in Older Adults: A randomized controlled study

OBJECTIVE To evaluate whether assessment of barriers to self-care and strategies to cope with these barriers in older adults with diabetes is superior to usual care with attention control. The American Diabetes Association guidelines recommend the assessment of age-specific barriers. However, the effect of such strategy on outcomes is unknown. RESEARCH DESIGN AND METHODS We randomized 100 subjects aged ≥69 years with poorly controlled diabetes (A1C >8%) in two groups. A geriatric diabetes team assessed barriers and developed strategies to help patients cope with barriers for an intervention group. The control group received equal amounts of attention time. The active intervention was performed for the first 6 months, followed by a “no-contact” period. Outcome measures included A1C, Tinetti test, 6-min walk test (6MWT), self-care frequency, and diabetes-related distress. RESULTS We assessed 100 patients (age 75 ± 5 years, duration 21 ± 13 years, 68% type 2 diabetes, 89% on insulin) over 12 months. After the active period, A1C decreased by −0.45% in the intervention group vs. −0.31% in the control group. At 12 months, A1C decreased further in the intervention group by −0.21% vs. 0% in control group (linear mixed-model, P < 0.03). The intervention group showed additional benefits in scores on measures of self-care (Self-Care Inventory-R), gait and balance (Tinetti), and endurance (6MWT) compared with the control group. Diabetes-related distress improved in both groups. CONCLUSIONS Only attention between clinic visits lowers diabetes-related distress in older adults. However, communication with an educator cognizant of patients’ barriers improves glycemic control and self-care frequency, maintains functionality, and lowers distress in this population

Sybil tolerance and probabilistic databases to compute web services trust

© Springer International Publishing Switzerland 2015. This paper discusses how Sybil attacks can undermine trust management systems and how to respond to these attacks using advanced techniques such as credibility and probabilistic databases. In such attacks end-users have purposely different identities and hence, can provide inconsistent ratings over the same Web Services. Many existing approaches rely on arbitrary choices to filter out Sybil users and reduce their attack capabilities. However this turns out inefficient. Our approach relies on non-Sybil credible users who provide consistent ratings over Web services and hence, can be trusted. To establish these ratings and debunk Sybil users techniques such as fuzzy-clustering, graph search, and probabilistic databases are adopted. A series of experiments are carried out to demonstrate robustness of our trust approach in presence of Sybil attacks

Colectomy rate in steroid-refractory colitis initially responsive to cyclosporin: a long-term retrospective cohort study

BACKGROUND: There is consistent evidence that 50% of patients with acute, steroid-resistant flare of ulcerative colitis (UC) may achieve remission and avoid colectomy if treated with cyclosporin (CsA). However, follow-up of the responders has shown that most of them relapse and need surgery shortly after the response. We compared the records of our CsA-treated patients with those of other groups in order to help clarify this matter. METHODS: All patients admitted consecutively to our Unit with an attack of UC and treated with CsA between January 1991 and December 1999 were studied. Patients were begun on continuously-infused CsA at 2 mg/kg/day (1991–1996), or on NEORAL at an initial dose of 5 mg/kg/day (1996–1999). The maintenance treatment included oral CsA for 3–6 months with or without azathioprine (AZA). CsA failure was defined as a relapse requiring steroids with or without progression to colectomy; the cumulative probability of relapse/colectomy was assessed by Fisher's exact tests and Kaplan-Meier analysis. RESULTS: Among the patients, 39/61 (63%) initially responded. These 39 included a fatality and 4 drop-outs (unrelated to the side-effects of CsA), leaving 34 patients for the study. Of these, 61% and 35% were colectomy-free at 1 and 7 years, respectively; the corresponding figures were 80 and 60% respectively in the subset treated with AZA, but 47% and 15% in the AZA-untreated subgroup (p= 0.0007 at 7 years). Among the 34 patients, 44% were relapse-free at 1 year, but all had relapsed at 7 years (p = 0.0635). The overall resort to colectomy was 72%, while 19% of the patients remained colectomy-free. CONCLUSION: Sixty percent of a cohort of patients with steroid-refractory colitis responded to CsA and 60% of these responders retained the colon after 1 year. These figures fell to 35% at 7 years but improved to 60% on AZA. The overall need for colectomy remains high in these patients and toxicity must be monitored