Interactive programme to enhance protective factors for eating disorders in girls with type 1 diabetes

"This is the peer reviewed version of the following article: [Wilksch, S. M., Starkey, K., Gannoni, A., Kelly, T. and Wade, T. D. (2013), Interactive programme to enhance protective factors for eating disorders in girls with type 1 diabetes. Early Intervention in Psychiatry, 7: 315–321], which has been published in final form at [http://dx.doi.org/10.1111/eip.12012]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms"AIMS: This study evaluated the effectiveness of a pilot programme in enhancing protective factors for eating disorders in young girls with type 1 diabetes (T1D). METHODS: Twenty girls with T1D (M age = 11.06 years) attended two 4-h group sessions. A 4-week baseline control period was compared against changes at post-programme and at 1-month follow-up on measures of eating disorder risk factors and indicators of glycaemic control. RESULTS: At post-intervention, significant improvements were found for self-efficacy related to diabetes management, self-esteem, body-esteem,thin-ideal internalization and perfectionism. These gains were maintained at 1-month follow-up. Participants were also rated by their parents as assuming more responsibility for specific diabetes-related tasks at follow-up. CONCLUSIONS: A brief interactive programme can favourably impact protective factors for disordered eating. The development of effective disordered eating prevention strategies for girls with T1D is an urgent priority and the current study is a first step in this direction

High‐resolution impedance manometry parameters enhance the esophageal motility evaluation in non‐obstructive dysphagia patients without a major Chicago Classification motility disorder

This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'. © 2017 John Wiley & Sons, Inc. All rights reserved.Background High‐resolution impedance manometry (HRIM) allows evaluation of esophageal bolus retention, flow, and pressurization. We aimed to perform a collaborative analysis of HRIM metrics to evaluate patients with non‐obstructive dysphagia. Methods Fourteen asymptomatic controls (58% female; ages 20–50) and 41 patients (63% female; ages 24–82), 18 evaluated for dysphagia and 23 for reflux (non‐dysphagia patients), with esophageal motility diagnoses of normal motility or ineffective esophageal motility, were evaluated with HRIM and a global dysphagia symptom score (Brief Esophageal Dysphagia Questionnaire). HRIM was analyzed to assess Chicago Classification metrics, automated pressure‐flow metrics, the esophageal impedance integral (EII) ratio, and the bolus flow time (BFT). Key Results Significant symptom‐metric correlations were detected only with basal EGJ pressure, EII ratio, and BFT. The EII ratio, BFT, and impedance ratio differed between controls and dysphagia patients, while the EII ratio in the upright position was the only measure that differentiated dysphagia from non‐dysphagia patients. Conclusions & Inferences The EII ratio and BFT appear to offer an improved diagnostic evaluation in patients with non‐obstructive dysphagia without a major esophageal motility disorder. Bolus retention as measured with the EII ratio appears to carry the strongest association with dysphagia, and thus may aid in the characterization of symptomatic patients with otherwise normal manometry