Efficacy and safety of acarbose in insulin-treated patients with type 2 diabetes

OBJECTIVE: To demonstrate the efficacy, tolerability, and safety of acarbose compared with placebo in patients with type 2 diabetes inadequately controlled with diet and insulin. RESEARCH DESIGN AND METHODS: A multicenter randomized double-blind placebo-controlled parallel-group comparison study was conducted. The trial was 26 weeks with a 2-week screening period and a 24-week period of treatment with acarbose or placebo, with forced titration from 25 mg t.i.d. to 50 mg t.i.d. after 4 weeks, and titration of 50 mg t.i.d. to 100 mg t.i.d. after 12 weeks based on glucose control. The dosage of insulin was to remain stable. The primary efficacy variable was mean change from baseline in HbA1c, and secondary efficacy variables included mean changes in fasting and postprandial plasma glucose and triglyceride levels. RESULTS: The addition of acarbose to the treatment of patients receiving background insulin and diet therapy resulted in a statistically significant reduction in mean HbA1c of 0.69% compared with placebo. There were statistically significant reductions in postprandial plasma glucose and glucose area under the curve, and in postprandial serum triglyceride levels in the acarbose-treated patients. Gastrointestinal side effects were more frequently reported in the acarbose-treated patients. There were no significant differences in hypoglycemic events or liver transaminase elevations between groups. CONCLUSIONS: This study demonstrated that the addition of acarbose to patients with type 2 diabetes who are inadequately controlled with insulin and diet is safe and generally well tolerated and that it significantly lowers HbA1c and postprandial glucose levels.     

Is death really the worm at the core? Converging evidence that worldview threat increases death-thought accessibility.

According to terror management theory, if the cultural worldview protects people from thoughts about death, then weakening this structure should increase death-thought accessibility (DTA). Five studies tested this DTA hypothesis. Study 1 showed that threatening Canadian participants' cultural values (vs. those of another culture) increased DTA on a word-fragment completion task. Study 2 showed that when participants could dismiss the threat, DTA remained low. Study 3 replicated the results of Study 1, but DTA was measured using a lexical decision task. Response latencies to death, negative, and neutral content were measured. Worldview threat increased DTA relative to accessibility for negative and neutral content. Study 4 showed that the DTA effect emerged independently of the arousal of anger or anxiety. Finally, Study 5 demonstrated that participants with a pro-creation (vs. pro-evolution) worldview had higher DTA after reading an anti-creation article. Discussion focused on theoretical implications and directions for further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A theoretical and empirical review of the death-thought accessibility concept in terror management research.

Terror management theory (TMT) highlights the motivational impact of thoughts of death in various aspects of everyday life. Since its inception in 1986, research on TMT has undergone a slight but significant shift from an almost exclusive focus on the manipulation of thoughts of death to a marked increase in studies that measure the accessibility of death-related cognition. Indeed, the number of death-thought accessibility (DTA) studies in the published literature has grown substantially in recent years. In light of this increasing reliance on the DTA concept, the present article is meant to provide a comprehensive theoretical and empirical review of the literature employing this concept. After discussing the roots of DTA, the authors outline the theoretical refinements to TMT that have accompanied significant research findings associated with the DTA concept. Four distinct categories (mortality salience, death association, anxiety-buffer threat, and dispositional) are derived to organize the reviewed DTA studies, and the theoretical implications of each category are discussed. Finally, a number of lingering empirical and theoretical issues in the DTA literature are discussed with the aim of stimulating and focusing future research on DTA specifically and TMT in general. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stereotypes and terror management: Evidence that mortality salience enhances stereotypic thinking and preferences.

If stereotypes function to protect people against death-related concerns, then mortality salience should increase stereotypic thinking and preferences for stereotype-confirming individuals. Study 1 demonstrated that mortality salience increased stereotyping of Germans. In Study 2, it increased participants' tendency to generate more explanations for stereotype-inconsistent than stereotype-consistent gender role behavior. In Study 3, mortality salience increased participants' liking for a stereotype-consistent African American and decreased their liking for a stereotype-inconsistent African American; control participants exhibited the opposite preference. Study 4 replicated this pattern with evaluations of stereotype-confirming or stereotype-disconfirming men and women. Study 5 showed that, among participants high in need for closure, mortality salience led to decreased liking for a stereotype-inconsistent gay man. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Converging Toward an Integrated Theory of Self-Esteem: Reply to Crocker and Nuer (2004), Ryan and Deci (2004), and Leary (2004).

In this response to the commentaries regarding their terror management analysis of self-esteem (T. Pyszczynski, J. Greenberg, S. Solomon, J. Arndt, & J. Schimel, 2004). the authors focus on the convergence on certain points regarding self-esteem as a way of progressing toward an integrative perspective. In doing so, they briefly discuss how the need for self-esteem relates to anxiety, interpersonal relations, growth, evolution, and death. They also discuss sources of self-esteem, whether the pursuit of self-esteem is good or bad, and whether such a pursuit could fruitfully be abandoned. They conclude that self-esteem buffers anxiety, is greatly influenced by social relations, and can either facilitate or undermine growth and that the value of the pursuit of self-esteem depends on the sources on which it is based but that its pursuit is too inextricably woven into the way people manage their anxieties and regulate their behavior to ever be abandoned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Running from the shadow: Psychological distancing from others to deny characteristics people fear in themselves.

Four experiments tested the hypothesis that people distance themselves from others who display characteristics they fear in themselves. In Study 1, participants were given false feedback that they were high or low in repressed anger and were given information about a person who became angry and responded in a violent or nonviolent manner. High anger feedback participants distanced themselves only from the violent person. In Study 2, high anger feedback led to distancing from a violent other but not a dishonest other, whereas dishonesty feedback led to distancing from a dishonest other but not a violent other. The results of Studies 3 and 4 replicated and extended the distancing effect with an anger induction: Participants who were insulted distanced themselves from an angry/violent person, and verbalizing their emotions about being insulted eliminated this effect. Implications for understanding defenses against undesirable self-attributions are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Evaluation of hyperspectral data for pasture estimate in the Brazilian Amazon using field and imaging spectrometers

We used two hyperspectral sensors at two different scales to test their potential to estimate biophysical properties of grazed pastures in Rondônia in the Brazilian Amazon. Using a field spectrometer, ten remotely sensed measurements (i.e., two vegetation indices, four fractions of spectral mixture analysis, and four spectral absorption features) were generated for two grass species, Brachiaria brizantha and Brachiaria decumbens. These measures were compared to above ground biomass, live and senesced biomass, and grass canopy water content. The sample size was 69 samples for field grass biophysical data and grass canopy reflectance. Water absorption measures between 1100 and 1250 nm had the highest correlations with above ground biomass, live biomass and canopy water content, while ligno-cellulose absorption measures between 2045 and 2218 nm were the best for estimating senesced biomass. These results suggest possible improvements on estimating grass measures using spectral absorption features derived from hyperspectral sensors. However, relationships were highly influenced by grass species architecture. B. decumbens, a more homogeneous, low growing species, had higher correlations between remotely sensed measures and biomass than B. brizantha, a more heterogeneous, vertically oriented species. The potential of using the Earth Observing-1 Hyperion data for pasture characterization was assessed and validated using field spectrometer and CCD camera data. Hyperion-derived NPV fraction provided better estimates of grass surface fraction compared to fractions generated from convolved ETM+/Landsat 7 data and minimized the problem of spectral ambiguity between NPV and Soil. The results suggest possible improvement of the quality of land-cover maps compared to maps made using multispectral sensors for the Amazon region.     

To belong or not to belong, that is the question: Terror management and identification with gender and ethnicity.

The terror management prediction that reminders of death motivate in-group identification assumes people view their identifications positively. However, when the in-group is framed negatively, mortality salience should lead to disidentification. Study I found that mortality salience increased women's perceived similarity to other women except under gender-based stereotype threat. In Study 2, mortality salience and a negative ethnic prime led Hispanic as well as Anglo participants to derogate paintings attributed to Hispanic (but not Anglo-American) artists. Study 3 added a neutral prime condition and used a more direct measure of psychological distancing. Mortality salience and the negative prime led Hispanic participants to view themselves as especially different from a fellow Hispanic. Implications for understanding in-group derogation and disidentification are briefly discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why Do People Need Self-Esteem? A Theoretical and Empirical Review.

Terror management theory (TMT; J. Greenberg, T. Pyszczynski, & S. Solomon, 1986) posits that people are motivated to pursue positive self-evaluations because self-esteem provides a buffer against the omnipresent potential for anxiety engendered by the uniquely human awareness of mortality. Empirical evidence relevant to the theory is reviewed showing that high levels of self-esteem reduce anxiety and anxiety-related defensive behavior, reminders of one's mortality increase self-esteem striving and defense of self-esteem against threats in a variety of domains, high levels of self-esteem eliminate the effect of reminders of mortality on both self-esteem striving and the accessibility of death-related thoughts, and convincing people of the existence of an afterlife eliminates the effect of mortality salience on self-esteem striving. TMT is compared with other explanations for why people need self-esteem, and a critique of the most prominent of these, sociometer theory, is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)