Introduction and Objective: We asked how a diabetes distress (DD) intervention fostered changes in diabetes-related emotion management, diabetes problem solving, and HbA1C; and to test a hypothesized 4-Stage, sequential pathway whereby reductions in DD were linked with improved glycemic outcomes. Methods: PWDs with T1D (n=276) with elevated DD and HbA1c were assigned to: StreamLine, a diabetes self-management program; TunedIn, an ACT-based (Acceptance and Commitment Therapy), emotion-focused DD program; or FixIt, an integration of Streamline and TunedIn. 12-month changes in DD (Stage 1), diabetes-related emotion management (Stage 2), diabetes-related problem solving (Stage 3), and HbA1C (Stage 4) were each evaluated. A structural equation model was then specified to evaluate the hypothesized 4-Stage sequence of change over time. Results: Improvements occurred in all 3 groups at all 4 stages. However, TunedIn and FixIt, compared to StreamLine, displayed significantly greater improvements in Stages 1, 2 and 3; while StreamLine and TunedIn displayed greater improvements in HbA1C (Stage 4) than FixIt. The structural equation model supported the hypothesized 4-Stage sequence, such that associations between reductions in DD and glycemic change were explained through improvements in emotion management and problem solving. Two plausible, alternative models also were tested: reversing Stages 1 and 2; reversing stages 3 and 4. In both cases, the model fit indices indicated worse fit, thus supporting the original 4-Stage model. Conclusion: Overall, TunedIn an emotion-focused intervention, demonstrated the most comprehensive, impactful intervention benefits. The model demonstrated how reductions in DD are linked with improved glycemic outcomes through changes in emotion management, which then allow for improved diabetes-related problem solving. This sequence can assist in designing effective intervention programs to reduce DD and improve overall diabetes management. L. Fisher: None. S. Guzman: Consultant; Abbott. W.H. Polonsky: Consultant; Abbott. Research Support; Abbott. Consultant; Dexcom, Inc. Research Support; Dexcom, Inc. Other Relationship; Ascensia Diabetes Care. L.A. Strycker: None. K. Greenberg: None. D.M. Hessler: None. Diabetes and Digestive and Kidney Diseases (R01DK121241)
Much qualitative research has drawn an association between social media and domestic terrorism, with the studies reaching different conclusions. However, few empirical studies have evaluated whether the surge in social media participation affects domestic terrorist events. Controlling for common explanations in the literature, we conduct a cross-national, time-series analysis of up to 151 countries from 2000 to 2019 to assess the impact of social media penetration on domestic terrorism. We ?nd that greater social media penetration increases the likelihood of domestic terrorism in countries as it supports extremists' ability to recruit, mobilize, and train terrorists. Using mediation analysis, we also find that greater social media penetration amplifies online and political polarization, increasing the likelihood of domestic terrorism events. Our work indicates the possible mechanisms linking social media and domestic terrorism and the need to develop and apply appropriate counterterrorism strategies to mitigate terrorist operations.
"Relating to voices using compassion focused therapy: a self help companion." Psychosis, ahead-of-print(ahead-of-print), pp. 1–2
Offspring from obese pregnancies have an elevated risk for childhood obesity and chronic metabolic diseases. Using a Japanese macaque model of early-life maternal Western-style diet (mWD) exposure, we previously observed decreased oxidative capacity and elevated markers of mitophagy in skeletal muscle of 3-yr-old offspring. We also found substantial reductions in VDAC1 content, the loss of which significantly correlated with decreased whole-muscle lipid peroxidation in mWD offspring. For this study, we isolated the impact of mWD from mWD-induced obesity by studying offspring from both lean (Ln, body fat <25%) or obese (Ob, body fat >30%) dams fed a WD or lean dams fed a control diet (CD) prior to and throughout pregnancy and lactation. All offspring were weaned to CD and offspring gastrocnemius was collected at 40 months of age. This design created three offspring groups: LnCD, LnWD and ObWD. In offspring muscle, VDAC1, but not VDAC2, was significantly decreased in LnWD, and was further reduced in ObWD. In contrast to whole-tissue, lipid peroxidation in a mitochondrial-enriched fraction was increased in offspring muscle from LnWD and ObWD groups. Markers of mtDNA damage were also elevated in ObWD muscle. Lastly, Sirt3 abundance, a master regulator of mitochondrial antioxidant defense, was reduced in muscle from both LnWD and ObWD. These data suggest that ROS are retained within the mitochondrial compartment due, in part, to VDAC1 suppression, resulting in an overall reduction in cellular oxidant burden. These findings elucidate a long-term adaptation to early life stress caused by mWD and obesity which limits cellular damage at the expense of mitochondrial function. Disclosure K.T.Greyslak: None. C.E.Mccurdy: None. Funding National Institutes of Health (R24DK090964); Eugene Evonuk Memorial Graduate Fellowship
