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Pediatricians have observed a significant decrease in in-person child health visits during the COVID-19 pandemic. In the post lockdown period, the coronavirus trend remains positive in Italy but fears of a second wave have recently grown in Italy due to active hotbeds of contagion. The pandemic may negatively affect the care of pediatric patients and overall children welfare as it may present with severe signs and symptoms or it may complicate. The Italian Pediatric Society recommend to separate well visits from sick ones, to educate families and to promote hygienic strategies to provide an adequate pediatric assistance in case of a second pandemic wave.

In the last 6-7 years there has been a progressive increase in the use of nurses or secretaries in Paediatric Primary care setting. Regional incentives (few) and the rising (remarkable) of the workload and patients’ requests, convinced about the 40% of the italian Family Paediatricians (FP) to hire new staff. In the 70% of cases the employers were organized in working group in one private practice that, thanks to the costs’ sharing, frequently had nurses in their staff (the data represent the situation at the end of 2013 and were obtained asking directly FP's professional organizations). Solo Paediatricians and Associated Paediatricians (that work in several private practices in coordination each other), on the other hand, hired more frequently secretaries with a working time generally reduced if compared to working groups’ colleagues. Economic factors (the fear to be unable to fulfill the expenses related to hiring) and those concerning organization and management (the not perfect knowledge of how best to use the staff) are the main causes that prevent most of Paediatricians to employ [1]. Who decided to use co-workers, did it to delegate certain duties, to filter patients’ requirements, to share work experience [1]. Secretaries can officiated the following tasks: sorting incoming calls, appointments, advise on admission to medical consultation, set up patient's recording (1st consultation), illustration and delivery of the services charter, delivery questionnaires, registration of diagnostic services, recurrent prescriptions, preparation of medical certificates, patients’ active call for programmed medical examinations, billing, payment deadlines and commitments, check of the monthly payment slips obtained by the Health Service, registration deadlines of drugs and medical devices, suppliers list, mantainance men and contracts list, health servicices summaries, statistics, chart statistic diagrams, waiting room monitoring (games, cartoons, magazines, books, etc.), appointment calendar update. Nurses can perform the following functions: Telephone Triage; Telephone advices based on defined protocols that are recorded in the electronic patient health card, auxological recordings, performing diagnostic tests and screening (urine examination, rapid Strep test, RCP, Blood Count, Prick Test, oximetry, spirometry, eye test, Lang test, Boel test, Plicometry, etc.), infant care, clinical and epidemiological research, health education messages in the waiting room, drugs and medical devices deadlines monitoring, provisions supervision, medical equipment efficiency preservation, health care protocols update and recording, check office's e-mails. In the near future the decrease of FP's number, the need to take care of a larger number of patients and to organize work in some way of collaboration, will push more and more colleagues to hire staff.

Andrological disorders in paediatric age are important: they may cause serious repercussions on normal fecundity [1] and sometimes ease cancer outbreak if not properly and adequately treated. Andrological disorders in paediatric age are: 1) frequently observed disorders, 2) less frequently observed disorders, 3) rare observed disorders. Frequently observed disorders are cryptorchidism, left-sided varicocele, communicating hydrocele and funicular cyst, inguinal hernia, phimosis and hypospadias. Less frequently observed disorders are epididymitis, testicular torsion, microlithiasis, Leydig cells hyperplasia [2] and gynecomastia. Rare observed disorders are gonadal cancer, hypogonadism and ambiguous genitalia. The first cause of male infertility is left-sided varicocele; the second is cryptorchidism. Prevention plays a fundamental role: if these disorders are diagnosed and treated precociously, the risk of infertility is considerably reduced. The authors suggest a new prevention model based on an Andrological Form to be included in the periodical medical examination by the family paediatrician. If the paediatrician detects an andrological disorder during periodical checks, he/she should refer the patient to the paediatric andrologist or paediatric surgeon. The Andrological Form consists of 11 sections to be filled by the family paediatrician (postnatal, at 6 months, at 1, 5, 10, 11, 12, 13 years and at the age of 14 for the last andrological checks before addressing the patient to the general doctor). The first section consists of the patient's records, weight and height included. Second: patient's pubertal development. Third: testicular volume according to Prader. Forth: testicular position. Fifth section: the presence of varicocele. Sixth: penis disorders (phimosis, hypospadias, balano-preputial adhesions). Seventh: gynecomastia (mono or bilateral and level). Eight: occurrence of other associated genito-urinary disorders. Ninth: previous andrological surgery interventions. Tenth: previous medical therapies. Eleventh: sport practicing. The Andrological form should be filled at the following ages: 1) 6 months (testicular position, hypospadias, peritoneo-vaginal duct disorders); 2) 1 year old (testicular position, hypospadias, peritoneo-vaginal duct disorders); 3) 5 years old (phimosis, balano-preputial adhesions, peritoneo-vaginal duct disorders); 4) 10 years old (pubertal development, left-sided varicocele, gynecomastia); 5) at 11, 12, 13 and 14 years old (left-sided varicocele, pubertal development, gynecomastia). The periodic compilation of the Andrological Form [3], therefore, allows a precocious identification and treatment of these disorders and male infertility prevention.

Very few data are available on pediatrics malpracticeclaims. We report the first data obtained in Italy onpediatrics regarding a wide population study during a8 years survey. Data concerning 164 claims are pre-sented and discussed. Our data suggest how big is theproblem and they may be helpful to face it.IntroductionPediatrics is not a high-risk specialty in terms of thenumber of claims, although some of the largest financialpayouts have been for multiple disabled children withperinatal injuries and long life expectancy [1-5]. Wereport the first data obtained in Italy on pediatricsregarding a wide population study.Materials and methodsWe conducted a retrospective, descriptive analysis of anation-wide database on pediatric malpractice claims, inwhich patients alleged a permanent impairment relatedto a medical misconduct. The Italian Society of Pediatrics(Societa Italiana di Pediatria; SIP) has developed a link –thorough insurance broker Willis Italian SpA– with aninsurance company (CARIGE Assicurazioni SpA) thatinsures a wide proportion of Italian pediatricians (nearly60% out of 8000 physicians).We asked Willis to perform a query of its database,looking at malpractice claims reported between January,1