Annamaria Sbordone

The Role of Pediatricians in Caring for the Well-Being of Children Living in New Types of Families

in New Types of Families Pietro Ferrara, MD, Giovanni Corsello, MD, Annamaria Sbordone, MD, Costanza Cutrona, MD, Jochen Ehrich, MD, DCMT, and Massimo Pettoello-Mantovani, MD, PhD Each person is born into a family characterized by different biological and cultural bonds. Close clan structures developed and persisted in the majority of countries, especially in times and areas of environmental danger, because they can best protect individual family members. On the other hand, clans are based on collectivism and conformism, which are roots of inequality concerning socialization, education, and health care. The long-term success of a clan depends on the number and health of offspring, and thus, the protection and support of children should be at the center of collectivist desires. Decreasing social and economic insecurity typically leads to the development of individualistic desires of adults, and consequent changes in the structures of families. Individuality is an important human and social asset, and a driving force for authenticity and creativity of the mature members of the society. Nonetheless, it should not be forgotten that the rights and well-being of children must always remain at the center of the adult activities to guarantee social success. The model of two biological parents with 1-4 children, which emerged as the “modern” family in the Western world after the Industrial Revolution, has evolved in recent years after remaining relatively stable for many decades under constraints of various social and economic limitations. These changes can be attributed to several factors, including high divorce rates and heterogeneous family structures, that extend beyond biological or conjugal relationship boundaries. These factors have been investigated over the years for possible psychological and physical risk factors to child health, which require further attention. Pediatricians are on the front line of child care and advocacy, and it is their role to promote children’s well-being and to help parents raise healthy children, independent of the configuration of their families. This report aims to draw attention to the evolving social scenarios and to emphasize that pediatricians must be trained to coordinate new challenges that may arise from differently configured families, particularly single-parent and same-sex–parent families.

Internet Addiction: Starting the Debate on Health and Well-Being of Children Overexposed to Digital Media

P revious articles published in the European Paediatric Association (EPA) pages have discussed the importance of children’s well-being and its role in different areas of children’s health, such as well-child care and child-friendly health care. The goal of this commentary is to raise pediatricians’ awareness on the risks of children’s overexposure to digital media. It is important to protect the psychological and emotional health of children from uncontrolled external influences to preserve their well-being. We also emphasize the importance of alerting parents and tutors to the risks related to the unrefrained use of the Internet.

The "Invisible Children": Uncertain Future of Unaccompanied Minor Migrants in Europe.

From the Italian Society of Pediatrics (SIP), Italy; Institute of Pediatrics, Catholic University Medical School; Campus Bio-Medico University Medical School, Rome, Italy; European Pediatric Association-Union of National European Pediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany; Institute of Pediatrics, University of Palermo, Palermo, Italy; Italian Federation of Pediatricians (FIMP), Italy; Children’s Hospital, Hannover Medical School, Hannover, Germany; and Institute of Pediatrics and Residency program, University of Foggia, Foggia, Italy O ver the last few years, several countries of the European Union (EU) have dealt with increasing numbers of unaccompanied minor migrants, mainly originating from countries experiencing armed conflicts and oppression, or abuses of human rights. These children, also defined as “separated children,” are under 18 years of age, are outside their home country, apart from their parents or their previous legal or customary primary caregiver, and are traveling to Europe typically to escape conditions of serious deprivation or exploitation. These children are fragile, whether physically, intellectually, or socially. They lack the care and protection of their caregivers, and may be easily exposed to abuse and neglect. Because of their particular helpless condition, the unaccompanied minor migrants are at serious risk to be further deprived of their rights, and to become de facto “invisible” to the authorities, to the public health services, and in general to the public opinion. Furthermore, when they arrive at a destination, or during their journey through Europe, many children often vanish. The full dimension of such phenomenon that further hits the unaccompaniedminors along their European migration routes currently is unknown. However, the intense migration that has affected the south Mediterranean borders of the EU over the last 10 years has allowed the collection of sufficient data to raise the high concern of several European pediatric societies about the “invisible” condition of the unaccompanied migrant minors traveling through Europe, including the phenomenon of the vanishing children. The aim of this article is to raise awareness of the “invisible children,” particularly in those countries that only recently have experienced a mass migration of populations from different endangered parts of the world.

Melatonin’s Effect on the Efficacy of Desmopressin in the Treatment of Enuresis

Purpose This study aims to evaluate and compare the efficacy of exogenous melatonin associated with desmopressin (dDAVP) and dietary recommendations. Methods A total of 189 patients were enrolled from the Service of Pediatrics, Campus Bio-Medico University Hospital of Rome, from January 2013 to June 2015. Of the 189 original patients, 153 children, aged between 5 and 14 years (mean age, 8.7 years) were included in the study. After clinical evaluation and a 3-month period of observation without treatment, children were assigned to receive treatment in one of 3 groups: group 1, dDAVP at a dose of 120 mcg a day (Minirin); group 2, dDAVP at a dose of 120 mcg and dietary recommendations; or group 3, dDAVP at a dose of 120 mcg, dietary recommendations, and melatonin at a dose of 1 mg a day (Melamil plus). Each patient was treated for 3 months. Results After the 3 months of therapy, a desiderable response was achieved in 30 of 51 patients (58.82%) treated with dDAVP, 35 of 53 patients (66.04%) treated with dDAVP and dietary recommendations, and 35 of 49 patients (71.43%) treated with dDAVP, dietary recommendations, and melatonin. Conclusions Although not statistically significant, the results show that the association between dDAVP treatment with dietary recommendations and melatonin could be considered a safe and effective treatment of NE. Considering that the statistically insignificant results might be due to the small sample size, the study will be continued to increase the number of subjects.

Child abuse and neglect: A review of the literature

Child maltreatment is a complex life experience occurs when a parent or caregiver does an intentional or potential damage to a child, including acts of commission and omission. Child abuse is not an uncommon event, but it is not always recognized. Identifying the real number of maltreated children is a challenge because of the large variability in reported prevalence data across studies. Unfortunately, in the United States, it affects 1 in 8 children, by the age of 18 years, annually. Paediatricians may encounter a variety of forms of maltreatment such as neglect, emotional, physical and sexual abuse. These aspects should be recognised, examined and evaluated by employing a systematic approach and focusing on basic needs of children that may not be met. Child maltreatment is a global problem with serious life-long physical and psychological or psychiatric outcomes. It is associated with important economic and social costs (such as physical and mental health, productivity losses, child welfare, criminal justice and special education costs) due to its high prevalence and its long-term and short-term consequences. In the United States, the average cost of nonfatal maltreatment is

Femicide and murdered women’s children: which future for these children orphans of a living parent?

210,012 per children and the cost of fatal maltreatment is

Focus on children murdered by parents in Italy: A sad reality

1,272,900. General Practitioners are quite prepared to face the problem of child maltreatment: since they have the opportunity to meet several members of the same family, they can detect stressors that put children at risk of maltreatment. All health professionals have the responsibility to protect children from abuse and neglect.Child maltreatment is a complex life experience happening when a parent or caregiver does an intentional or potential damage to a child, including acts of commission and omission. Child abuse is not an uncommon event, but it is not always recognized. Identifying the real number of maltreated children is a challenge because of the large variability in reported prevalence data across studies. Unfortunately, in the United States, it affects 1 in 8 children, by the age of 18 years, annually. Paediatricians may encounter a variety of forms of maltreatment such as neglect, emotional, physical and sexual abuse. These aspects should be recognised, examined and evaluated by employing a systematic approach and focusing on basic need of children that may not be met. Child maltreatment is a global problem with serious life-long physical and psychological or psychiatric outcomes. It is associated with important economic and social costs (such as physical and mental health, productivity losses, child welfare, criminal justice and special education costs) due to its high prevalence and its long-term and short-term consequences. In the United States, the average cost of nonfatal maltreatment is

Enuresis and Punishment: The Adverse Effects on Child Development and on Treatment

210,012 per children and the cost of fatal maltreatment is

Which treatment for upper respiratory tract infections

1,272,900. General Practitioners are quite prepared to face the problem of child maltreatment: since they have the opportunity to meet several members of the same family, they can detect stressors that put children at risk of maltreatment. All health professionals have the responsibility to protect children from abuse and neglect. Language: en

The Thin Line between Munchausen Syndrome and Munchausen Syndrome by Proxy

BackgroundTo assess the prevalence of femicides in Italy over the last three years and the potential long lasting effects of these traumatic events for the children of a woman who dies a violent death.MethodsThe data used in this study come from an internet search for the number of femicides occurring in Italy between 1st January, 2012 and 31st October, 2014.ResultsThe total number of femicides was 319; the average age of murdered women was 47.50 ± 19.26. Cold arms in the form of sharp object -mostly knives- have caused the death of 102/319 women; firearms were used in 87/319 cases; asphyxiation was the chosen method in 52/319 cases. About the place where the femicides occurred, 209/319 were committed inside the victim’s house. Children of women who died a violent death were 417 with a total of 180 minors in less than three years. A total of 52/417 children were witness to the killing and, among these 30/52 were minors; in 18/417 cases, children were murdered together with their mother and among these 9/18 were minors.ConclusionsLong-term studies are needed to ascertain what happens to these children, to understand what are the most appropriate psychological treatments, the best decisions about the contact with their father and the best placement for these children.