Weekend-Based Parent-Group Intervention to Reduce Stress in Parents of Children and Adolescents with Type 1 Diabetes: A Pilot Study

Diagnosis of type 1 diabetes (T1D) in a child is often associated with anger, denial, fear, and depression from the parents. The aim of the study was to improve parents' adaptation to the diagnosis of diabetes of their child. Sixty-two parents (29 mothers, 33 fathers) of 36 children with type 1 diabetes (mean age=11.3-3.3 years; diabetes duration>1 year; HbA1c=57 +/- 11 mmol/mol) participated in a three-day educational working group pilot intervention study. Intervention was based on the reexamination of the traumatic event of diagnosis of T1D through spatial and time-line anchorage, retracing of the future, emotional awareness, and interactive discussion. Relaxing technique, diaphragmatic breathing, and guided visualization were used by 2 psychologists and 1 pediatric endocrinologist. The study was approved by EC and participants filled a consent form. At baseline and after intervention, parents filled in a questionnaire including Diabetes-Related Distress (DRD), Parent Health Locus of Control Scale (PHLOC), Parent Stress Index Short Form (PSI-SF), Hypoglycemia Fear Survey-Parents (HFS-P) and Hypoglycemia Fear Survey-Parents of Young Children (HFS-P-YC), and Health Survey Short Form-36 (SF-36). Three months after the intervention, both parents reported a reduction in the "difficult child" subscale of the PSI-SF (p<0.05) and increased scores of social functioning of the SF-36 (p<0.05). DRD score was significantly reduced in mothers (p=0.03), while the "parental distress" subscale of the PSI-SF was significantly improved in fathers (p=0.03). This weekend-based parent group intervention seems to reduce stress and improve social functioning of parents of children and adolescents with type 1 diabetes

The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

To compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019

Factors Influencing Functional Recovery during Rehabilitation after Severe Acquired Brain Injuries: A Retrospective Analysis

Severe acquired brain injuries (sABI) represent one of the main causes of disability and limitation in social life participation that need an intensive rehabilitation approach. The purpose of this study was to identify a possible correlation between different supposed conditioning factors and the efficiency of rehabilitation interventions. In this retrospective study, data were processed regarding 44 patients admitted to a neurorehabilitation department after sABI. A significant correlation with the efficiency of the rehabilitation intervention (expressed as the variation of the Barthel score between discharge and admittance in relation to the duration of the rehabilitative hospitalization) was found for both the etiology of the brain injury (p = 0.023), the precocity of the rehabilitation treatment (p = 0.0475), the presence of a tracheal cannula (p = 0.0084) and forms of nutrition other than oral (p < 0.0001). The results of this study suggest that improving the management of the respiratory system, swallowing and nutritional aspects, and favoring an early and personalized rehabilitation treatment, can help to optimize the overall care of patients suffering from sABI, thus allowing a reduction in complications, improvement in functional recovery and ensuring a better management of economic, social and health resources

Factors Influencing Functional Recovery during Rehabilitation after Severe Acquired Brain Injuries: A Retrospective Analysis

Severe acquired brain injuries (sABI) represent one of the main causes of disability and limitation in social life participation that need an intensive rehabilitation approach. The purpose of this study was to identify a possible correlation between different supposed conditioning factors and the efficiency of rehabilitation interventions. In this retrospective study, data were processed regarding 44 patients admitted to a neurorehabilitation department after sABI. A significant correlation with the efficiency of the rehabilitation intervention (expressed as the variation of the Barthel score between discharge and admittance in relation to the duration of the rehabilitative hospitalization) was found for both the etiology of the brain injury (p = 0.023), the precocity of the rehabilitation treatment (p = 0.0475), the presence of a tracheal cannula (p = 0.0084) and forms of nutrition other than oral (p &lt; 0.0001). The results of this study suggest that improving the management of the respiratory system, swallowing and nutritional aspects, and favoring an early and personalized rehabilitation treatment, can help to optimize the overall care of patients suffering from sABI, thus allowing a reduction in complications, improvement in functional recovery and ensuring a better management of economic, social and health resources

Peripheral Precocious Puberty due to Functioning Adrenocortical Tumor: Description of Two Cases

BACKGROUND: Adrenocortical tumors (ACTs) represent less than 0.2% of all childhood neoplasms. Frequent clinical manifestations are virilization, hypercortisolism, and peripheral precocious puberty (PPP). CASES: We describe two cases in which ACTs were responsible for virilization (case 1) and PPP (case 2) in prepubertal girls. In both cases an ACT diagnosis was made after 5-6 months from the first appearance of clinical signs. Surgery was performed within 1 month of diagnosis, and the benign nature of tumors was histologically confirmed. Despite complete tumor resection, virilizing features persisted. SUMMARY AND CONCLUSIONS: Adrenocortical tumors should be considered early in the assessment of PPP. There is often a significant delay between the onset of symptoms and accurate diagnosis but early treatment is essential to limit the clinical manifestations of androgen overproduction

Body emotional map: an innovative and useful tool to improve parents´ adaptation to the diagnosis of type 1 diabetes of their child

Objectives: The diagnosis of type 1 diabetes mellitus (T1DM) in a child is a traumatic event for parents. The path of a good adaptation to the child´s disease is a purpose of the therapeutic education to attain and keep a good quality of life. Aim of this study was to demonstrate the effectiveness of the new tool Body Emotional Map (BEM) in helping parents to overcome the trauma of T1DM diagnosis and to achieve the best adaptation. Methods: Sixty-two parents (29 mothers, 33 fathers) of 36 children with T1DM (age = 11.3 3.3 yrs; T1DM duration >1 yr; HbA1c = 57 11 mmol/mol) were recruited in a 3-days educational group intervention study. The re-examine of the traumatic event of the T1DM diagnosis through the BEM path included spatial and time-line anchorage, retrace of the future, emotional awareness, interactive discussion. Relaxing technique, diaphragmatic breathing, and guided visualization were used by 1 psychologist, 1 counselor and 1 pediatric diabetologist. Self-report questionnaires [Diabetes Related Distress (DRD), Parent Stress Index Short Form scale (PSI-SF), Fear of Hypoglycemia Survey (FHS), Parent Health Locus of Control Scale (PHLOC), and Health Survey Short Form-36 (SF-36)] were filled by parents at baseline, 1 month (M1), and 3 months (M3) after the intervention. Results: Respect to baseline, at time M3 we found a significant score reduction of the “difficult child” subscale of the PSI-SF in both parents (p < 0.05), of the DRD in mothers (59.0 2.6 vs. 52.4 2.7, p = 0.03), and of the “parental distress” subscale of the PSI-SF in fathers (24.9 1.5 vs. 21.8 1.5, p = 0.04) . Moreover, the social functioning score of the SF-36 was significantly improved in fathers at time M1 (81.3 3.2 vs. 88.3 3.2, p = 0.03). Conclusions: In T1DM we must always to consider the emotional reaction occurring when the diagnosis is given both in children and parents. BEM path seems to reduce stress and to improve social functioning of parents of children and adolescents with T1DM

BODY EMOTIONAL MAP: STRUMENTO INNOVATIVO ED UTILE PER MIGLIORARE L\u2019ADATTAMENTO DEI GENITORI ALLA DIAGNOSI DI DIABETE DI TIPO 1 DEL LORO BAMBINO

OBIETTIVI La comunicazione della diagnosi di diabete di tipo 1 (DM1) in un bambino rappresenta un evento traumatico per i genitori. Il raggiungimento di un buon adattamento alla malattia del proprio figlio, per poter mantenere una buona qualit\ue0 della vita, \ue8 uno degli obiettivi dell\u2019educazione terapeutica. Scopo di questo studio longitudinale \ue8 stato quello di dimostrare l\u2019efficacia del nuovo metodo Body Emotional Map (BEM) per aiutare i genitori a superare il trauma della diagnosi di DM1 e per ottenere il miglior adattamento alla malattia. METODI Nello studio sono stati reclutati 62 genitori (29 madri, 33 padri) di 36 bambini con DM1 (11.3\ub13.3 anni; durata DM1 >1 anno; HbA1c=57\ub111 mmol/mol) che hanno partecipato ad intervento di gruppo della durata di tre giorni. Il riesame dell\u2019evento traumatico della diagnosi di DM1 \ue8 stato eseguito attraverso il percorso BEM caratterizzato da attivit\ue0 di ancoraggio spaziale e temporale, ripresa del futuro, consapevolezza emotiva e discussione interattiva. La tecnica rilassante, la respirazione diaframmatica e la visualizzazione guidata sono stati utilizzati da 1 psicologo, 1 counselor e 1 diabetologo pediatra. I questionari autosomministrati [Diabetes Related Distress (DRD), Parent Stress Index Short Form scale (PSI-SF), Fear of Hypoglycemia Survey (FHS), Parent Health Locus of Control Scale (PHLOC), e Health Survey Short Form-36 (SF-36)] sono stati compilati dai genitori al baseline, 1 mese (M1) e 3 mesi (M3) dopo l\u2019intervento BEM. RISULTATI Rispetto al baseline, al tempo M3 abbiamo dimostrato una riduzione statisticamente significativa dei punteggi dell\u2019item \u201cbambino difficile\u201d nel questionario PSI-SF (p<0.05) in entrambi i genitori, del DRD nelle madri (59.0\ub12.6 vs. 52.4\ub12.7, p=0.03) e dell\u2019item \u201cdistress parentale\u201d nel questionario PSI-SF nei padri (24.9\ub11.5 vs. 21.8\ub11.5, p=0.04). Inoltre, il punteggio dell\u2019item \u201cfunzionamento sociale\u201d nel questionario SF-36 \ue8 migliorato in modo statisticamente significativo nei padri al tempo M1 (81.3\ub13.2 vs. 88.3\ub13.2, p=0.03). CONCLUSIONI Nel DM1 dobbiamo sempre tenere in considerazione la reazione emotiva che si verifica allorquando viene comunicata la diagnosi, sia nei bambini che nei genitori. Il percorso BEM sembra essere uno strumento innovativo ed utile per ridurre lo stress e migliorare il funzionamento sociale dei genitori di bambini e adolescenti con DM1