Alda Troncone

Evaluating the Experience of Children With Type 1 Diabetes and Their Parents Taking Part in an Artificial Pancreas Clinical Trial Over Multiple Days in a Diabetes Camp Setting

OBJECTIVE To explore the experiences of children with type 1 diabetes and their parents taking part in an artificial pancreas (AP) clinical trial during a 7-day summer camp. RESEARCH DESIGN AND METHODS A semistructured interview, composed of 14 questions based on the Technology Acceptance Model, was conducted at the end of the clinical trial. Participants also completed the Diabetes Treatment Satisfaction Questionnaire (DTSQ, parent version) and the AP Acceptance Questionnaire. RESULTS Thirty children, aged 5–9 years, and their parents completed the study. A content analysis of the interviews showed that parents were focused on understanding the mechanisms, risks, and benefits of the new device, whereas the children were focused on the novelty of the new system. The parents’ main concerns about adopting the new system seemed related to the quality of glucose control. The mean scores of DTSQ subscales indicated general parents’ satisfaction (44.24 ± 5.99, range 32–53) and trustful views of diabetes control provided by the new system (7.8 ± 2.2, range 3–12). The AP Acceptance Questionnaire revealed that most parents considered the AP easy to use (70.5%), intended to use it long term (94.0%), and felt that it was apt to improve glucose control (67.0%). CONCLUSIONS Participants manifested a positive attitude toward the AP. Further studies are required to explore participants’ perceptions early in the AP development to individualize the new treatment as much as possible, and to tailor it to respond to their needs and values.

Effects of Narrative Identities and Attachment Style on the Individual’s Ability to Categorize Emotional Voices

This research aimed to assess individual’s abilities in decoding emotional vocal expressions according to attachment styles and Narrative Identities. To this aims 30 students (15 females, 15 males; mean age = 21.4 ± 2.47) were recruited at the Second University of Naples (Italy) and underwent an emotional-voice-decoding task after being tested through the “Experience in Close Relationships” (ECR) and Personality Meaning (PMQ) Questionnaire to assess their attachment styles and Narrative Identities. The results showed that Outward subjects were more accurate in decoding joy and surprise especially in the group of individuals with an Insecure attachment style, suggesting that emotional regulation dynamics and attachment parameters shape the ways individuals develop their ability to decode other emotional feelings.

Using computerized text analysis to assess communication within an Italian type 1 diabetes Facebook group.

The purpose of this study was to assess messages posted by mothers of children with type 1 diabetes in the Italian Facebook group “Mamme e diabete” using computerized text analysis. The data suggest that these mothers use online discussion boards as a place to seek and provide information to better manage the disease’s daily demands—especially those tasks linked to insulin correction and administration, control of food intake, and bureaucratic duties, as well as to seek and give encouragement and to share experiences regarding diabetes and related impact on their life. The implications of these findings for the management of diabetes are discussed.

Mood Effects on the Decoding of Emotional Voices

This study examines the effect of mood induction on the decoding of emotional vocal expressions. An adequate sample of 145 students (71 females, 74 males; mean age = 23.37 ± 2.05) was recruited at the Second University of Naples (Italy). Subjects were randomly assigned to one of three (sad, fear or neutral) emotion conditions induced by viewing short movies. The results showed a significant general decrease in the decoding accuracy in the mood induction conditions when compared to the accuracy of the participants who did not received such mood induction. Post hoc analyses revealed that recognition of emotional vocal voices conveying anger was especially impaired by mood induction conditions. No findings consistent with mood congruity theory were observed. This study contributes to emotion regulation research by showing differences in emotion decoding tasks by voices due to mood induction procedures, as already observed in studies exploiting the decoding of emotional faces.

The evaluation of body image in children with type 1 diabetes: A case-control study

This study evaluated the body image perception in children with type 1 diabetes in order to identify symptoms of disordered eating behaviours early. Children with type 1 diabetes and controls showed underestimation and dissatisfaction with body size. The patients, especially girls, were more accurate in their perception of body size than the control group. The study sheds light on some of the underlying factors that may contribute to the development of disordered eating behaviours in adolescence. The causes of the differences of perception of body size are discussed.

What Relatives and Caregivers of Children with Type 1 Diabetes Talk About: Preliminary Results from a Computerized Text Analysis of Messages Posted on the Italian Facebook Diabetes Group

Although Facebook groups dedicated to diabetes are widely available on the Internet, little is known about the conversation in them. This study aims to evaluate the content of communication in an Italian Facebook group dedicated to type 1 diabetes “Mamme e diabete”. Messages posted by participants from June to September 2014 were collected and assessed using computerized text analysis. Textual analysis revealed 5 dominant thematic clusters: “food and correction” (33.6 %), “diabetes and life” (18.47 %), “hi group” (16.87 %), “bureaucracy” (15.82 %) and “needle” (15.32 %). Findings suggested that the focus of conversations is on daily management of diabetes and all the topics related. Mothers use online discussion boards also as a place to compare and share experiences regarding diabetes and related impact on their lives and seek and give encouragement by means of the group to better face the burden associated with the illness, its duration and effects on the child and family.

Psychological outcomes of injection port therapy in children and adolescents with type 1 diabetes and their primary caregivers

For children with type 1 diabetes (T1DM), the large number of daily injections can induce discomfort, pain, and distress and have been described as one of the negative predictors of adherence to insulin therapy [1]. Poor adherence to diabetes regimens impairs good metabolic control, which is described as significantly associated with better youth-rated quality of life and lower perceived family burden [2]. Advances in insulin delivery systems and diabetes technology, such as the insulin pump (CSII) and continuous glucose monitoring system, have been found to improve glycemic control and positively impact quality of life for children and family with T1DM [3]. Similarly, evidence describes indwelling catheters as insulin infusion devices as able to minimize distress during injections [4]. To further explore the psychosocial impact of such implantable devices in youth patients with T1DM, this study evaluated the effects of injection port usage on participants’ quality of life and on caregivers’ burden and treatment satisfaction. Methods

Il disegno della figura umana in bambini con diabete tipo 1 ed in controlli sani: quali differenze?

Lo scopo del presente studio e stato valutare la presenza di problematiche psicologiche in bambini con diabete tipo 1 attraverso l’uso del disegno della figura umana. 81 pazienti consecutivi con diagnosi di diabete tipo 1 afferenti ad un centro di diabetologica pediatrica del sud Italia e 219 soggetti di controllo, appaiati ai primi per sesso ed eta, sono stati valutati attraverso il disegno della figura umana secondo la procedura Draw a Person: Screening Procedure for Emotional Disturbances (DAP:SPED). Il valore medio dell’emoglobina glicosilata (Hb1Ac) e stato usato come indicatore del controllo metabolico negli ultimi 3 mesi. Non sono emerse differenze significative nei punteggi totali DAP:SPED, anche differenziando i soggetti in base al genere ed al peso. Confrontando i disegni in base ai singoli item e emerso che i bambini con diabete tipo 1 disegnano figure piu piccole dei controlli per altezza e larghezza che risultano caratterizzate piu frequentemente da dita appuntite e assenza di vestiti. I risultati hanno indicato la presenza di elementi distintivi nei disegni tali da suggerire l’esistenza di aspetti dell’immagine corporea nei bambini con diabete tipo 1 differenti rispetto ai controlli sani. Le differenze osservate supportano l’esigenza di monitorare le caratteristiche dell’immagine corporea nei bambini con diabete tipo 1 durante il loro sviluppo allo scopo di prevenire l’insorgenza di disagi psicologici.

Changes in body image and onset of disordered eating behaviors in youth with type 1 diabetes over a five-year longitudinal follow-up

OBJECTIVE To examine changes over a five-year period in body image accuracy and dissatisfaction, as well as relationships with disordered eating behaviors (DEBs), in young patients with type 1 diabetes. METHODS Of 81 children (42 male, 39 female) with type 1 diabetes first assessed at ages 5.1-10.06 years, 67 (83%) were re-enrolled and interviewed as adolescents (aged 10.07-15.08 years) at follow-up. DEBs were assessed using a parent-report standardized measure. Height and weight were determined, and BMI was calculated. Glycemic control was assessed by glycated hemoglobin. RESULTS BMI increased from childhood to adolescence. The general tendency towards body size underestimation (i.e., perceiving the body to be smaller than it is) and dissatisfaction, already described at baseline, was found unchanged at follow-up, revealing continuing attitude towards body image problems. Body-size perception accuracy, degree of body-size dissatisfaction, and HbA1c did not increase significantly over five years, but the presence of DEBs was observed. Degree of body dissatisfaction was found to be a significant predictor for DEBs (standardized beta = 0.272, p < 0.05). CONCLUSION Body image problems persisted over the five-year study period and were found associated with higher levels of DEBs. Identification of such body image characteristics may be useful in developing strategies for intervention early in the course of illness.

Nonverbal intelligence and scholastic performance in children with type 1 diabetes

This study examined nonverbal intelligence and scholastic achievement in children with type 1 diabetes. In a retrospective case–control study, 69 children (35 males) ages 5–10 years with type 1 diabetes and 69 healthy controls matched to patients by age, gender and socioeconomic status were compared according to their performance on Raven’s Coloured Progressive Matrices and their scholastic grades. No differences in nonverbal intelligence and grades were observed between children with type 1 diabetes and healthy control subjects. Raven’s Coloured Progressive Matrices scores inversely correlated with duration of illness both in children with early onset of type 1 diabetes and poor metabolic control. Possible explanations of the results and implications are discussed.