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The paper presents a project concerning the digital education for families. The paediatrician is the central figure in this project and leads parents towards a conscious management of digital media, giving them and their children specific indications for all age groups, starting from birth. The project, developed with the direct involvement of paediatricians in multidisciplinary groups, is based on scientific evidence and has been the subject of extensive experimentation in the field. Parents are offered not only limits but also alternative and complementary activities, useful for the development of their children and the improvement of the quality of their personal relationships. The continuous training of paediatricians, the annual updating of materials and research for impact assessment are the basis for the implementation of the project. The territorial educational alliance is a fundamental step in the digital education for the family, which is a subject that poses several open challenges in which the family paediatrician is called to play a central role.

Extreme online challenges consist in taking part in challenges proposed on web and sharing the results in videos posted on social media. The use of social networks is widespread among the very young, giving easy access to potentially dangerous content with consequences on health.The aim of this literature review is to describe the most common challenges involving children and adolescents over the last 20 years. We focused on participants features (such as age, sex and psychological background) and health implications. The review included research articles and reviews published between 2000 and 2021. We used Pubmed, Scopus and Web of science as search engines.Many types of online challenges emerged from the analysis of the literature. The most common challenges are those that lead to self-harm, which involve acts at risk of choking and challenges that potentially lead to suicide and ingestion of substances. The extreme challenge phenomenon is a public health issue that affects a vulnerable population, as it is young and susceptible to peer pressure influence. Participants often showed problematic personality traits, making them more likely to get involved in these behaviors.It is necessary for parents, teachers and health workers to be aware of the spread of the online challenges, to improve prevention interventions in the age groups involved.

The paper presents a project concerning the digital education for families. The paediatrician is the central figure in this project and leads parents towards a conscious management of digital media, giving them and their children specific indications for all age groups, starting from birth. The project, developed with the direct involvement of paediatricians in multidisciplinary groups, is based on scientific evidence and has been the subject of extensive experimentation in the field. Parents are offered not only limits but also alternative and complementary activities, useful for the development of their children and the improvement of the quality of their personal relationships. The continuous training of paediatricians, the annual updating of materials and research for impact assessment are the basis for the implementation of the project. The territorial educational alliance is a fundamental step in the digital education for the family, which is a subject that poses several open challenges in which the family paediatrician is called to play a central role.

In recent years, the quick spread of Internet has brought many children and teenagers to be increasingly connected online without adult control. The use of Internet offers many opportunities, but at the same time it exposes young users to multiple risks. Among these, the consumption of sexually explicit internet material (SEIM) is one of the most relevant. The aim of the present study is to describe the epidemiology of this phenomenon regarding its prevalence and distribution among sexes and different age groups.A literature search was performed on PubMed and ScienceDirect using the query "(pornography OR sexually explicit internet material) AND (adolescent OR child OR young)." Only papers published between 2013 and 2018 were included in the analysis.According to selected studies (N.=21), the prevalence of boys approaching SEIM ranges from 56% to 100%, whereas the percentage widely varies between 7.6% and 82% for girls. The first exposure to SEIM happens in a purely accidental way in over half of cases and at a mean age of 12 years for males and 14.5 years for females. The risk of exposure is doubled for smartphone and tablet owners.The spread of pornography and SEIM among minors seems to be epidemic and even pandemic. We need to consider its possible effects on the psychophysical welfare of the very young, influencing their growth and development. Therefore, the impact that pornography may have on the physical, psychological, and sexual health of younger people warrants further investigation.

Online grooming is an active communicative entrapment network involving a wide range of techniques. The interactions that groomers have with minors online are complex. The purpose of the present literature review was to contribute to the existing knowledge base regarding online sex offender typologies, predatory tactics and techniques.We conducted a review of the current literature by an initial database research of papers published since 1990. Three independent reviewers selected relevant articles, initially based on title and abstract analysis, then by full text in order to make a final determination. After the final selection, a total of 21 articles were reviewed.Overall, abundant data describing both groomer characteristics and grooming strategies are available in the literature, with authors attempting to analyze and adapt these to ever-complex models. However, the various models often feel redundant, determining a certain difficulty in understanding which would be the most suitable model to apply, making comparing data from different studies oftentimes troublesome.In our opinion, it would be desirable to reach a consensus on fewer univocally-interpretable models that would be easier to adopt as preventive tools against online grooming, in combination with other strategies. The present study may provide parents and guardians with information useful for keeping their youth safer while online, as well as data that may assist in the development of policy recommendations and prevention strategies, overall aiming to reduce the phenomenon of online grooming.

Online grooming is a manipulative process through which an adult attempts to arrange a sexual interaction with a minor using internet. Children are constantly exposed to the online world, posing online grooming as a public health issue.The aim of this narrative review is to describe the state of online grooming preventive strategies in recent literature through an overview of online grooming phenomenon.Our literature review included research articles and reviews published between January 2014 and March 2019, as well as reference lists of included studies.The analysis provides a picture of online grooming phenomenon, identify recurrent features of perpetrators and victims. Several preventive strategies have been implemented, but they lack any kind of efficacy evaluation and miss a theory driven approach. Fragmentation of preventive initiatives is a critical issue, in contrast with the need of an institutional public health strategy.While the attention around online grooming is growing, there is still the need of further sensitizing the involved stakeholders and developing evidence based preventive strategies under an institutional guidance.

Introduction Since its diffusion in the 1990s, the Internet has developed into a fully integrated component of the lives of teenagers across the globe. As use of the Internet by underage youth has evolved and increased over the past decades, concerns about how technology may contribute to minors becoming victims of online sex crimes, including online grooming, have heightened. The present literature review contributes to the existing knowledge base regarding the epidemiology of the online grooming process, exploring key themes and issues arising in this area. Evidence acquisition We conducted a review of the current literature by an initial database research of papers published since 1990. Three independent reviewers selected relevant articles, initially based on title and abstract analysis, then by full text in order to make a final determination. After the final selection, a total of 37 articles were reviewed. Evidence synthesis The articles reviewed report highly heterogenous results with regards to epidemiological data, estimating a prevalence of the online grooming phenomenon between 9% and 19%. Factors influencing minors' risk of online grooming included increasing age, gender, sexual minority orientation, diagnosis of mental disease, conflictual relationships with parents and risk-taking behaviors (e.g. chat room and social networking site use). Conclusions Although the true prevalence of online grooming is not available, it is a significant issue among minors. Thus, it is important to educate youth on responsible internet use, starting at the earliest age and continuing during adolescence.

Background Nowadays adolescents and children are more and more exposed to sexually explicit internet material (SEIM), but most parents and healthcare professionals neglect this issue. The aim of the present study is to evaluate the impact of online pornography on minors' health with a specific focus on the effects produced on their behavioural, psychophysical and social development. Methods A literature search was performed on PubMed and ScienceDirect in March 2018 with the query "(pornography OR sexually explicit internet material) AND (adolescent OR child OR young) AND (impact OR behaviour OR health)". Results published between 2013 and 2018 were analysed and compared with previous evidence. Results According to selected studies (n = 19), an association between consumption of online pornography and several behavioral, psychophysical and social outcomes - earlier sexual debut, engaging with multiple and/or occasional partners, emulating risky sexual behaviors, assimilating distorted gender roles, dysfunctional body perception, aggressiveness, anxious or depressive symptoms, compulsive pornography use - is confirmed. Conclusions The impact of online pornography on minors' health appears to be relevant. The issue can no longer be neglected and must be targeted by global and multidisciplinary interventions. Empowering parents, teachers and healthcare professionals by means of educational programs targeting this issue will allow them to assist minors in developing critical thinking skills about pornography, decreasing its use and obtaining an affective and sex education that is more suitable for their developmental needs.

In Italia esiste ampia eterogeneita nei programmi di educazione sessuale. Abbiamo condotto un’analisi comparativa delle linee guida europee e statunitensi, riscontrando globalmente una differenza nell’approccio all’educazione sessuale: in quelle europee e intesa come apprendimento graduale e omnicomprensivo che permea le eta della vita e gli aspetti cognitivo-relazionali, mentre a livello statunitense emerge la necessita di colmare le lacune del sistema scolastico per il suo ruolo marginale. Entrambi gli approcci sono funzione del contesto socio-culturale da cui scaturiscono. In Italia e necessario avviare percorsi strutturati di educazione alla sessualita e conoscenza del proprio corpo, con la doppia ottica della consapevolezza e del rispetto delle differenze, strumenti fondamentali per la prevenzione dell’abuso sessuale all’infanzia.

A survey for estimation of goitre in school children in the Rural Health Training Centre, Shirur area was undertaken. A total of 4664 students from 17 schools were surveyed. The goitre prevalence was found to be 59.8% with visible goitre rate of 6.2% in pre- and peri-adolescent (10–19 years) age group. Thus a highly endemic goitre focus was located in Shirur, area in Pune District (Maharashtra). This area is located on the eastern tail-end slopes of Sahyadri Hills in Balaghat ranges, situated at an altitude of 533 metres. The area is generally drought prone and receives scanty rain, with poor agricultural practices. Environmental deficiency of iodine was found to be the main cause for this high prevalence of goitre.

Table of contents A1 Preterm and low birth weight nutrition in the first month life: implications for the outcome Massimo Agosti A2 Behind human milk and breastfeeding: not only food, not only growth Carlo Agostoni A3 To prevent obesity: importance and issues of cultural adaptation from weaning to 3 years of age Serge Chalons A4 Diet before and during pregnancy and child health: lessons from animal models Pascale Chavatte-Palmer A5 Infant nutrition: an opportunity to optimize future health José Manuel Moreno Villares A6 Complementary feeding strategies to facilitate acceptance of fruits and vegetables Sophie Nicklaus A7 Diet of young children in the Mediterranean region Luís Pereira-da-Silva A8 Proposal of 10 good practices to help prevent obesity in the first 1,000 days Angelo Pietrobelli, the MeNu Group A9 Macronutrient intakes in early life and subsequent risk of obesity Marie Françoise Rolland-Cachera A10 The burden of childhood obesity in Italy and the results of Nutrintake study Gian Vincenzo Zuccotti A11 Growth body composition and growth hormone therapy: linear growth Marco Cappa A12 Early nutrition pattern and late metabolic consequences Manuela Caruso-Nicoletti A13 Nutrition and Insulin-like Growth Factor (IGF) System Elena Inzaghi, Stefano Cianfarani A14 Nutrition of preterm infants Mario De Curtis A15 Early nutrition patterns and later metabolic outcomes- I part: Genetic and metabolic mechanisms Laura Guazzarotti A16 Diagnosis of metabolic disease by imaging techniques Lorenzo Iughetti A17 Nutrition, growth and cardiovascular diseases Francesco Chiarelli, Laura Comegna, Simone Franchini A18 Body fat mass and gender Laura Perrone, Giuseppina Rosaria Umano A19 Lifestyle interventions for an appropriate birth weight Elisabetta Petrella, Raffaele Bruno, Valentina Bertarini, Giulia Pedrielli, Isabella Neri, Fabio Facchinetti A20 Nutrition, growth and body composition Flavia Prodam A21 Nation-specific reference growth charts in the daily practice Alessandro Sartorio, John M. H. Buckler, Nicoletta Marazzi A22 Growth patterns in inflammatory bowel diseases (IBD) and in cystic fibrosis (CF) Maria E. Street, Viviana D. Patianna, Paola Accorsi, Sara Lo Scocco, Sergio Amarri A23 Newborn in the digital era and their body feeling: physical exercise to counteract hyperphagia Alberto Pellai A24 Nutrition, young athletes and effects of exercise. Practical suggestions Giampiero Merati A25 Physical exercise as a way to prevent criminality in minors and teenagers Isabella Merzagora A26 The measurement of daily energy expenditure in children. Evaluation of a new wrist portable device vs breath-by-breath metabolimeter Susanna Rampichini, Arsenio Veicsteinas A27 Probiotic and inflammasomes Mario Clerici A28 Probiotics and newborns Paolo Manzoni, Elena Tavella, Elena Boano, Daniele Farina A29 Relationship between gut microbiota and obesity Fabio Pace

L'articolo presenta teorie e modelli di intervento finalizzati alle strategie di prevenzione primaria e secondaria rivolte alla promozione della salute in etŕ evolutiva. In particolare vengono analizzate azioni preventive che sono l'applicazione pratica degli assunti teorici presenti nella teoria dell'attaccamento di J. Bowlby, oltre ad interventi promossi in ambito scolastico e rivolti sia ai bambini, che agli adolescenti. Una particolare attenzione č dedicata al modello della Life Skills Based Education ed all'educazione tra pari, metodi privilegiati per la promozione del benessere in etŕ evolutiva. Il contributo del modello cognitivista e il ruolo dello psicoterapeuta vengono messi in evidenza, pur sottolineando l'importanza di un approccio multidisciplinare e transteorico.

Although many epidemiological studies defining child sexual abuse prevalence rates in many countries of the world are now available, Italy presents a lack of data regarding this specific issue. Only recently some attempts to define the epidemiology of this public health problem have been tried. Between 2003 and 2010, the Department of Public Health at University of Milan was in charge of one of the more important study of this kind in Italy, involving almost 3000 students aged 18 attending secondary schools in the City of Milan who filled out an anonymous questionnaire aiming at detecting their previous experiences of sexual victimization during childhood and adolescence. After this first edition, the study was replicated among students attending secondary schools in the city of Varese, in the area of Piedmont and in Basilicata (area of Lauria), using the same investigational model and questionnaire. This paper presents the main data collected through four different epidemiological studies using the same methodology and survey tool. Considering at least one of the five different forms of child sexual abuse surveyed (being exposed to pornography, being touched on private parts, being forced to masturbate an older person, being forced to perform oral sex, or being penetrated), the prevalence rate among our samples ranges between a minimum of 12.5% (Varese) and a maximum of 34.1% (Lauria). In Lauria the research reveals a higher prevalence rate of child sexual abuse, especially among the male population, for all typologies of abuse but being touched in their private parts. In all other geographical areas and for all typologies of abuse, there is always a higher prevalence among girls, with the only exception of abuse such as being exposed to pornographic materials.

Internet e i new media rappresentano un nuovo strumento potenzialmente alleato di chi vuole adescare minori per compiere reati sessuali. Gli studi epidemiologici disponibili confermano che il fenomeno č in crescita, cosě come il numero di arresti ad esso correlati, e che le vittime spesso agiscono consenzienti, consapevoli di comunicare con adulti estranei, mentre raramente parlano di ciň con gli adulti di riferimento (genitori/insegnanti). Il rischio di vittimizzazione cresce con l'etŕ della vittima e per le femmine. Strategie preventive efficaci devono comprendere non solo interventi normativi, ma anche programmi educativi volti ad aiutare gli adolescenti a costruire competenze che li rendano capaci di affrontare le esigenze ed i cambiamenti propri dell'etŕ evolutiva, in linea con il modello delle life skills proposto dall'OMS.

Fata Lina’s secret: a child sexual abuse prevention project for grades 5-8 - This paper describes a new child sexual abuse school-based prevention program targeting schoolchildren attending grades 5-8. This curriculum is based on a special episode, titled “Fata Lina’s secret”, belonging to the popular RAI3 television show for children named Melevisione. The paper allows to understand this curriculum’s rationale, goals, structure and format. Some activities, included in this curriculum, are presented to show how teachers, educators and parents can easily involve children in child sexual abuse prevention activities. Key words: child sexual abuse, school-based programs, primary prevention. Parole chiave: abuso sessuale, programmi scolastici, prevenzione primaria.

Aim of the present study was to assess the prevalence of sexting, defined as "the sharing of images or videos of sexually explicit content", identifying the age groups involved and assessing the possible cultural ties. The study also aimed at providing a clear picture of the phenomenon to educators and parents, an essential starting point for planning any effective educational program.We performed a literature search on Medline (PubMed) database. In addition, the 2011 and 2012 surveys released by Eurispes and Telefono Azzurro were also consulted. "Google Trends" application provided additional details.In Italy teenagers from 12 to 18 years who received sexually oriented material increased from 10.2% in 2011 to 25.9% in 2012. In the USA 69.4% declared having received sexually oriented material, while 66.7% reported having sent it. In Italy, 1 out of 10 teenagers (age range 16-18) found himself in danger for having posted his nude photos online.The practice of sexting involves a wide age range with different legal implications. Teenagers practice sexting to attract attention and prove to be involved in a relationship. Sexting usually does not have any consequence but in rare cases, about 4%, malicious behavior such as sexting for money, to tease or take someone under threat has been reported. Moreover, during the past decade the cases of online harassment increased, especially involving young women. Only by closely monitoring the phenomenon and studying its deeper motivations it could be possible to plan effective educational programs, integrating sexting and the correct use of new media into a structured sexual education project.

Sexual abuse is a problem affecting the psychosocial development of many children all over the world. Epidemiological studies have demonstrated that sexual abuse is spread across all demographic, ethnic and family groups, in both males and females, and perpetrators can include those outside the family circle as well as within it. In the last decade the whole new phenomenon of Internet-based sexual offending against minors has brought new challenges for those working in both the clinical and prevention fields. In the world today, most victims of child sexual abuse still remain silent, alone and without help. At the same time, most children and teens do not receive basic sex education, preventive information and life skills that they need to grow up healthy, safe and happy. And after the promotion of programmes targeting children, there is growing evidence that perpetrators also need to become a target for prevention. If they are detected, recognized and helped at an early stage of their abusing career, extinction of their sexual drive towards children can be promoted effectively and with positive long-term effects. This paper describes what has been done to date in the field of school-based primary prevention to decrease victimisation risks among the new generations. It discusses how primary prevention has been developed in the past and the new prevention needs of children and teens belonging to the “digital natives” generation. Despite the lack of clear evidence derived from studies of effectiveness to show that concerted action in schools is the best resource for primary prevention in this field, to date the available meta-analyses and guidelines confirm that this is one of the methods with the best potential for effectiveness in this field. In the light of these remarks, the article also discusses how the contribution of the neurosciences has made possible the promotion of new procedures for preventive activities with children and adolescents, with particular reference to the Life Skills Based Education (LSBE) model adopted by the World Health Organisation as the paradigm for the implementation of prevention projects aimed at children and adolescents.

This study describes the prevalence rate of overweight and thinness in a population of teens living in two different areas of Italy and explores the body self-image perception and unhealthy eating behaviours and strategies to lose weight. A questionnaire was administered to a sample of 2,121 teenage students (1,084 males; 1,037 females). Results showed that teen females and males build and perceive their body images in very different ways. Most of the overall sample perceived their weight as normal, while a relevant 31.6% defined themselves as overweight and another 4.4% as heavily overweight. Analysis based on BMI (calculated through self-referred weight and height) showed that only 9.2% of our sample could be considered overweight and 1,7% obese. Most of female teen students (485 out of 1,037) were trying to lose weight, demonstrating that strategies to lose weight were undertaken also by girls perceiving themsleves as normal in relation to body weight; 46.8% girls were using strategies to lose weight compared with 21.9% boys. These strategies included very problematic behaviours like self-induced vomiting (3.3% F vs. 1.7% M) and dieting pills (2.8% F vs. 1.5% M) undertaken along with more usual thinning strategies like dieting and exercising. Girls were more prone than boys to exercise as a way to lose weight (41% vs. 31.7%). This study showed that there is a deep gap between actual weight and perceived body-image and weight. This study is one of the first of this kind in Italy and calls for primary prevention and health education programs aimed at improving teen body-image as a strategy to reduce the eating disorder epidemics spreading among young people.