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Abstract Background This pilot study examines the widespread phenomenon of “sharenting” and how it is perceived by parents. Given the increasing prevalence of this practice, the study aims to explore parental awareness of its potential risks and assess whether it is perceived as a form of child abuse, particularly regarding the violation of children’s privacy. While traditional forms of child abuse inflict direct harm on the child, sharenting can damage the child’s image and pose risks to their well-being, both in the present and the future. We evaluated the potential correlation between specific demographic characteristics and parents’ social media usage. The study aimed to assess the possibility of expanding the research by involving European pediatric societies to obtain comparable data and develop family education programs with the goal of limiting this phenomenon. It also emphasizes the important role that pediatricians and schools can play in these programs. Methods The study was designed using a survey model, one of the recognized quantitative research methods described in the literature and was conducted by the Pediatric Department of the University Hospital Campus Bio-Medico in Rome between November 2023 and January 2024. Results Data from this study indicate that gender, age, education level, number of children, and number of social media accounts were not associated with sharenting phenomenon and suggest that the frequency and the onset time of sharenting were the main influencing variables in the perception of sharenting phenomenon as neglect and abuse. Conclusions Preventive interventions, such as counseling and parental education, are essential to safeguard children’s well-being and prioritize their best interests, including their privacy and identity. Moreover, while the data from this study are limited, they underscore the importance of expanding data collection efforts across different countries. Establishing a comprehensive database could be beneficial for local and European governments in developing policies and educational programs aimed at mitigating potential risks associated with the improper exploitation of personal data, thus safeguarding children in both the short and long term.

Ensuring a stable routine is crucial for every child, particularly during their hospitalization. Children facing illness undergo treatments that often require strict care routines, involving invasive medical procedures, lengthy hospital stays, and separation from familiar environments like home or school. These prolonged hospitalizations disrupt their usual schedules, resulting in feelings of isolation from family and friends for extended and uncertain periods. These difficulties may impede medical treatments and could contribute to psychological distress, further impacting the well-being of both the patient and their family.Community education distributes its educational role among all those stakeholders who collaborate to promote an equitable and inclusive learning environment. While the school typically serves as the primary educational institution, for hospitalized children, their educational experience may differ significantly from that of their peers. Therefore, the hospital school encompasses a diverse team of professionals working collaboratively to deliver a tailored educational experience. This article emphasizes the critical importance of expanding such programs within hospital environments. It highlights the necessity of developing robust educational frameworks capable of adapting to the diverse needs and evolving structures of healthcare systems. Finally, the article emphasizes the imperative of upholding high-quality education, ensuring the right to education for all, and honoring the principles of special educational needs as outlined in the 1994 UNESCO Salamanca Statement

Abstract Background In response to the imperative need for standardized support for adolescent Gender Dysphoria (GD), the Italian Academy of Pediatrics, in collaboration with the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, Italian Society of Adolescent Medicine and Italian Society of Child and Adolescent Neuropsychiatry is drafting a position paper. The purpose of this paper is to convey the author's opinion on the topic, offering foundational information on potential aspects of gender-affirming care and emphasizing the care and protection of children and adolescents with GD. Main body Recognizing that adolescents may choose interventions based on their unique needs and goals and understanding that every individual within this group has a distinct trajectory, it is crucial to ensure that each one is welcomed and supported. The approach to managing individuals with GD is a multi-stage process involving a multidisciplinary team throughout all phases. Decisions regarding treatment should be reached collaboratively by healthcare professionals and the family, while considering the unique needs and circumstances of the individual and be guided by scientific evidence rather than biases or ideologies. Politicians and high court judges should address discrimination based on gender identity in legislation and support service development that aligns with the needs of young people. It is essential to establish accredited multidisciplinary centers equipped with the requisite skills and experience to effectively manage adolescents with GD, thereby ensuring the delivery of high-quality care. Conclusion Maintaining an evidence-based approach is essential to safeguard the well-being of transgender and gender diverse adolescents.

This brief article emphasizes the vital significance of mastering the intricate skill of crafting scientific articles effectively, especially in the context of pediatric research. A well-crafted scientific article not only showcases the depth of research conducted, but also serves as a conduit for sharing valuable insights and discoveries with the wider scientific community. The article highlights that scientific publications are not mere compilations of data; they are instruments of knowledge transfer, enabling medical professionals, researchers, and policymakers to stay abreast of the latest developments in pediatric healthcare. By adhering to the highest standards of scientific writing, researchers can effectively bridge the gap between complex research outcomes and their practical implications. Medical practitioners and healthcare providers rely on these publications to inform their decision-making processes, ensuring that the treatments and interventions provided to young patients are rooted in the latest scientific research. Moreover, policymakers and funding agencies use these articles to make informed decisions about resource allocation, ultimately influencing the trajectory of pediatric healthcare at a societal level.In conclusion, this article emphasizes why the mastery of scientific writing in the context of medical research is not just an academic pursuit, but it is also a powerful catalyst for progress and innovation in the field of medicine. By honing their skills in crafting meticulously written scientific articles, researchers contribute significantly to the advancement of pediatric healthcare, ultimately improving the lives of people around the world.

This article addresses the critical issue of violence against children, defined as a violation of their rights across interpersonal, community, societal, and global settings, encompassing both physical and psychological actions targeting them or their parents. Globally, WHO estimates that an unacceptably large number of children aged 2–17 years, experience physical, sexual, or emotional violence or neglect yearly. War stands out as a major contributor to the infringement of children's fundamental human rights. Those in conflict zones undergo traumatic experiences, including the loss of family members, disruptions to social networks, displacement, and the denial of basic needs. The severe deprivation of essential resources and opportunities, coupled with the stress of warfare, poses a grave threat to the emotional and cognitive development of children, increasing the risk of physical and mental illnesses, disabilities, social problems, and intergenerational consequences. The article aims to draw attention to this issue and advocates for the development of appropriate academic and post-academic educational courses and training programs. This will better equip pediatricians and healthcare professionals to effectively combat violence against children in any context.

The present article introduces the special issue “EPA-UNEPSA Hot Topics in Europaediatrics 2023″ published in the journal Global Pediatrics, which includes articles authored by leading pediatric experts on significant selected topics discussed upon during the Hot Topics in Europaediatrics conference in Belgrade from October 6–8, 2023. The aim is to underscore the critical importance of continuous professional growth and education for general pediatric practitioners across Europe. The importance of continuous updating for general pediatricians in Europe reflects a proactive approach to delivering quality healthcare, adapting to changes in medical knowledge, and ultimately providing the best possible care for children across the continent. Continuing education meetings are essential for professionals across various fields of pediatrics, providing ongoing learning opportunities beyond formal academic training. The importance of these meetings extends to individual growth, career advancement, and the overall progress of in the diverse areas of the medicine. Continuing education meetings are therefore integral to the ongoing development and success of professionals, as they provide a structured and accessible avenue for learning, networking, and staying current in an ever-evolving professional landscape.

Abstract Complementary and alternative medicine (CAM) consist of a broad group of restorative resources often linked to existing local cultures and established health care systems and are also increasingly used in children with some serious illnesses. In this narrative review, we examine the epidemiology of the use, efficacy, and safety of complementary and alternative medicine in pediatric oncology, neurology, and hepatology. We searched for relevant articles published in Pubmed evaluating CAM use and its efficacy in safety in children affected by oncologic, neurologic and liver diseases. CAM is used to improve the success of conventional therapies, but also to alleviate the pain, discomfort, and suffering resulting from the diseases and their treatment, which are often associated with a significant burden of adverse effects. CAM use must be evaluated in children with neurological, oncological and liver diseases.

During recent years, Endocrine Disruptor chemicals (EDCs) have been the subject of particular attention because they are ubiquitous and able to cause adverse effect in humans, and particularly in children. Substances capable of interfering with the normal activity of the endocrine system can be of both man-made and natural origin. They often come into contact with the body through diet, water, air or skin. However, although the body is continuously exposed to their action, it is difficult to fully quantify the negative effects of these substances. Available data show that individuals most exposed to endocrine disruptors more frequently have cancers, reproductive, (ie: infertility, endometriosis, miscarriage.), metabolic (ie: diabetes) and/or immune disorders. Behavioral and developmental disorders are also observed in children exposed to Endocrine Disruptors. The presence of EDCs has been demonstrated during pregnancy in maternal blood, urine, and hair. At the placental level, EDCs can affect normal development and endocrine function and promote inflammatory reactions. The aim of this brief narrative review is to raise the attention of general pediatricians on the most prevalent multiple or interconnecting risks caused by EDCs to children's health by summarizing the existing knowledge on these toxic chemicals. Authors also report the effort made by the European Union to develop an effective Hazard Control Decision Support System which aim is to improve risk-based procedures able of detecting, monitoring and managing toxic substances in food chain.

The natural, economic and public health crises that have periodically struck the world over the past two decades have often revealed a low degree of self-sufficiency and a high degree of unpreparedness on the part of European and non-European countries. It is generally the most vulnerable who suffer the consequences, and adverse events have shown their effects and direct negative impact mainly on the population aged 0–18 years, with major implications for families and communities. Climate change and environmental pollution are certainly prominent among the natural disasters impacting children's health. In particular, environmental pollution events have been increasingly correlated with health conditions, including allergic diseases related to increased allergen production, infectious diseases, diabetes, respiratory diseases, and cardiovascular diseases. Data from the literature have shown how chemicals can interfere with children's health, and special attention has been paid to endocrine disruptors because of their possible damage on various endocrine and nonendocrine systems. This brief overview explores the important impacts of climate change and environmental pollution on children's health, with the goal of further raising awareness among pediatricians and public health authorities on this critical issue for the future of children's health.

Compared to adults, children are less able to survive extreme weather events. Therefore, the climate crisis is creating a real crisis of children's rights. Environmental hazards, shock and stress are already having devastating effects on the well-being of the youngest children, who face a crisis of water, health, education, protection and participation in social life and the economic benefits that should flow from it. The realization that fundamental changes are needed to address both growing inequality and climate chaos will have to be a globally shared concept, to avoid failing our children, whose voices and interests are often not heard or not taken seriously enough in the adults’ world. This brief commentary briefly discusses the impact of climate changes and related economic downturn on children's health.

The first 1,000 days of life represent the period between conception and the age of two years. It is possible to identify, within the first 1,000 days, some basic periods of development: pre-conception and conceptional, first trimester of pregnancy, second and third trimesters of pregnancy, labor-birth, first month of life, first year of life, and second year of life. During this period, the foundations are laid for proper physical and psychological development of the child; therefore, putting in place appropriate preventive measures specific to each stage allows the child's future to be built, influencing its entire future existence. The purpose of this brief overview is to emphasize some important aspects of this period that is fundamental to the child's future life.

The natural, economic and public health crises that have periodically struck the world over the past two decades have often revealed a low degree of self-sufficiency and a high degree of unpreparedness on the part of European and non-European countries. It is generally the most vulnerable who suffer the consequences, and adverse events have shown their effects and direct negative impact mainly on the population aged 0–18 years, with major implications for families and communities. Climate change and environmental pollution are certainly prominent among the natural disasters impacting children’s health. This brief commentary is aimed at raising the attention of general pediatricians on the serious insult caused by climate change to children’s health, emphasizing that climate change will affect the health of children born today throughout their live.

Owing to increasing populations and global threats, the integrity and safety of global food chains are at risk. In many countries, simply getting enough to eat can be an issue, with poor quality food often contaminated with hazardous agents, whereas in developed countries the pressure to deliver cheap, affordable food may affect quality and safety. The purpose of this Special issue on Safe food for infants is to emphasize the importance of pursuing integrated approaches to monitor and reduce the risks of biological, chemical, and physical hazards in infant food. A careful integrated approach is proposed to be instrumental in order to minimize the hazards to infant health during the key developmental years and protect children from penalizing nutritional disorders and gastrointestinal diseases.

The EU-project SAFFI targets food for EU's 15 million and China's 45 million children under the age of three. It aims at developing an integrated approach to enhance the identification, assessment, detection and mitigation of health risks raised by microbial and chemical hazards along EU and China infant food chains.SAFFI will benchmark the main risks through an extensive hazard identification system based on multiple data sources and a risk ranking procedure. It will also develop procedures to enhance top-down and bottom-up hazard control by combining management options with a panel of technologies for the detection and mitigation of priority hazards. Furthermore, it will explore unexpected contaminants by predictive toxicology and improve risk-based food safety management of biohazards by omics and predictive microbiology. SAFFI will co-develop with and deliver to stakeholders a decision-support system (DSS) to enhance safety control all along the food chain. This DSS will integrate the databases, procedures and methods described above and will be a framework for a generic DSS dedicated to other food.This overall methodology will also be implemented in a complementary Chinese side of the project, and exemplified for each side, with four case studies that were selected to cover priority hazards, main ingredients, processes and control steps of the infant food chain. Resulting databases, tools and procedures will be shared, cross-validated, concatenated, benchmarked and finally harmonized for further use in the EU and China.This EU-China multi-actor consortium of 20 partners involves academia, food safety authorities, infant food companies, a paediatrics association and technological and data-science SMEs.

This article discusses the issue of food hazards and child health during the first thousand days of life. The aim is to raise the attention of decision makers, healthcare officers and professionals, including pediatricians, pediatric surgeons, obstetricians, nurses, midwives, dieticians and lactation consultants, on the importance of protecting infants and their families during a most critical period for the mother-child binomial. The conclusions emphasize the importance of encouraging the adoption of integrated strategies, useful at establishing adequate preventive efforts and a game-changing perspective shift in order to develop and adopt efficient monitoring strategies and procedures, able to minimize the risks due to hazards in food throughout the first thousand days of life, as a first line of prevention in children's health.

Abstract Background Child abuse and neglect, or maltreatment, is a serious public health problem, which may cause long-term effects on children’s health and wellbeing and expose them to further adulthood vulnerabilities. Studies on child maltreatment performed in Europe are scarce, and the number of participants enrolled relatively small. The aim of this multi-national European pilot study, was to evaluate the level of understanding and perception of the concepts of child abuse and neglect by European paediatricians working in different medical settings, and the attitude toward these forms of maltreatment in their practice. Methods The study was performed by a cross-sectional, descriptive, online survey, made available online to European paediatricians members of 50 national paediatric, who belonged to four different medical settings: hospital, family care, university centres and private practice. The questionnaire, designed as a multiple choice questions survey, with a single answer option consisted of 22 questions/statements. Frequency analyses were applied. Most of the data were described using univariate analysis and Chi-squared tests were used to compare the respondents and answers and a significance level of p ≤ 0.05 applied. Results Findings show that European paediatricians consider the training on child maltreatment currently provided by medical school curricula and paediatric residency courses to be largely insufficient and continuing education courses were considered of great importance to cover educational gaps. Physical violence was recognized by paediatricians mostly during occasional visits with a significant correlation between detecting abuse during an occasional visit and being a primary care paediatrician. Results also showed a reluctance by paediatricians to report cases of maltreatment to the competent judicial authorities. Conclusions Data of this study may provide useful contribution to the current limited knowledge about the familiarity of European paediatricians with child maltreatment and their skills to recognize, manage and contrast abusive childhood experiences in their practice. Finally, they could provide local legislators and health authorities with information useful to further improve public health approaches and rules able to effectively address shared risk and protective factors, which could prevent child abuse and neglect from ever occurring.

This article has been published in English before [1].

Abstract Background Consumers’ conviction of the benefits of probiotics is influenced by their existing beliefs and by the information they receive from healthcare professionals. The attitude of healthcare professionals towards commercially available probiotics will, therefore, determine how trustworthy and beneficial these products are perceived by consumers. Furthermore, due to European Union legislation, companies are prohibited from displaying information on product packaging; therefore, consumers are dependent primarily on healthcare professionals for correct information and guidance on the use of these products. The aim of this pilot study was to explore the understanding and use of probiotics in clinical practice by professionals who are involved in child healthcare in different European countries and to assess how much they value the scientific evidence behind these products. Methods The study was performed using a cross-sectional, descriptive, 30-question online questionnaire circulated among healthcare professionals belonging to three professional categories that are typically involved in childhood probiotic prescription: paediatricians, dieticians and general practitioners. The questionnaire was developed using web-based standard guidelines, and the questions were modelled on those used in previously published probiotics studies. Results Overall, 27,287 healthcare professionals belonging to three major European scientific societies were contacted by the organizations participating in the study. In total, 1360 valid questionnaires were recorded, and the results were statistically analysed. Conclusions The results emphasize the importance for healthcare professionals to be properly educated and updated on probiotics. An improved knowledge about probiotics led to increased prescriptive confidence. To disseminate accurate information on probiotics, healthcare professionals look for appropriate and scientifically validated educational platforms to acquire information, explore concerns and barriers and look for positive approaches towards recommending probiotics.

For its specific qualitative characteristics human donor milk (DM) is the main alternative to preterm infants nutrition and growing. How several studies suggest child's physical and mental development is influenced by breastfeeding that prevents the necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and sepsis common in preterm newborns. Our research was conducted in NICU's Human Milk Bank (HMB) “Allattiamolavita.” Our study was based on macronutrients analysis (MA) of 100 DM samples taken until 10 days since childbirth and analyzed by spectroscopic infrared innovative method (MIRIS). This is a specific method to analyse fat (F), crude proteins (CP), true proteins (TP), carbohydrate (CHO), and total solids (TS). We also analyzed the 100 donors' clinic-metabolic profile by blood tests (PMT). Both data was collected between September 2015 and February 2018. The research was structured in two parts. In the first part we compared PMT with qualitative and quantitative characteristics of MA while in the second one we studied every DM macronutrient finding furthermore possible relations between them. Statistical Package for Social Sciences (SPSS-IBM 24) was used to compare data and reporting coefficient of determination using Spearman's Rho and Kendall's Tau. We also analyzed samples using Kolmogorov–Smirnov test, Student T-test, ANOVA, Whitney U-test, and chi-square test. Statistically significant correlations were noted between maternal serum proteins and CP—TP of DM. The research showed also significant correlations between azotaemia and TP and an inverse correlation between serum creatinine and CP. No statistically significant correlation was observed between donors' glycaemia and CHO. Mineral concentrations of DM emerged independent of blood minerals (P, Ca, Fe, Na). We also calculated a normal range for individual macronutrient of human transitional milk (TM) that was not established in literature yet. Our experience allowed us to underline that human milk is a privileged site compared to donors' clinical and metabolic disorders. Our analysis showed the major role of the HMB to provide DM to improve clinical status, growing, and neurocognitive short and long term outcome of preterm infants.

Urea at post-dialysis levels induces increased ROS in a number of cell types. The aim of this study was to determine whether urea-induced production of ROS remains elevated after urea is no longer present, and, if it does, to characterize its origin and effects. Human arterial endothelial cells were incubated with 20 mM urea for two days, and then cells were incubated for an additional two days in medium alone. Maximal ROS levels induced by initial urea continued at the same level despite urea being absent. These effects were prevented by either MnSOD expression or by Nox1/4 inhibition with GKT13781. Sustained urea-induced ROS caused a persistent reduction in mtDNA copy number and electron transport chain transcripts, a reduction in transcription of mitochondrial fusion proteins, an increase in mitochondrial fission proteins, and persistent expression of endothelial inflammatory markers. The SOD-catalase mimetic MnTBAP reversed each of these. These results suggest that persistent increases in ROS after cells are no long exposed to urea may play a major role in continued kidney damage and functional decline despite reduction of urea levels after dialysis.

Vitamin A. Kraisid Tontisirin. Lalita Bhattacharjee. others The New Nutrition Mark Wahlqvist, Hélène Delisle, others Ultra-processing Barry Popkin, Carlos Monteiro John Waterlow David Picou The ICN Claudio Schuftan

OBJECTIVES: (1) To examine relationships among changes in physical activity, physical fitness and some psychosocial determinants of activity behavior in a clinical sample of obese children involved in a multi-component program; (2) to investigate the causal relationship over time between physical activity and one of its strongest correlates (i.e. perceived physical ability). METHODS: Self-reported physical activity and health-related fitness tests were administered before and after a 9-month intervention in 24 boys and 20 girls aged 8 to 11 years. Individuals' perceptions of strength, speed and agility were assessed using the Perceived Physical Ability Scale, while body image was measured using Collins' Child Figure Drawings. RESULTS: Findings showed that body mass index, physical activity, performances on throwing and weight-bearing tasks, perceived physical ability and body image significantly improved after treatment among obese children. Gender differences were found in the correlational analyses, showing a link between actual and perceived physical abilities in boys, but not in girls. For the specific measurement interval of this study, perception of physical ability was an antecedent and not a potential consequence of physical activity. CONCLUSIONS: Results indicate that a multi-component activity program not based merely on a dose-effect approach enhances adherence of the participants and has the potential to increase the lifelong exercise skills of obese children. Rather than focusing entirely on diet and weight loss, findings support the inclusion of interventions directed toward improving perceived physical ability that is predictive of subsequent physical activity.