Little red riding hood in the social forest. Online grooming as a public health issue: a narrative review.

INTRODUCTION: 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. OBJECTIVES: 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. METHODS: Our literature review included research articles and reviews published between January 2014 and March 2019, as well as reference lists of included studies. RESULTS: 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. CONCLUSIONS: 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.

[Epidemiology of sexting]. / Sexting: epidemiologia del fenomeno.

AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

[What new fathers know, think and do: a survey about fathering's attitudes, beliefs and behaviors in a sample of 570 men just after the birth of their newborn]. / Cosa sanno, cosa pensano, cosa fanno i neo-papà: indagine su attitudini, conoscenze e comportamenti di 570 uomini rispetto al proprio ruolo paterno a poche ore dalla nascita del loro bambino.

AIM: The aim of this paper was to know and analyze information, attitudes and behaviors related with transformations occurring in men when they become fathers. METHODS: A self-administered questionnaire has been given out to all men whose newborns were born in the Hospitals located into Borgosesia, Ivrea, Novara, Verbania and Vercelli (Piedmont region in north west of the Italy) in the last quarter of 2006. The questionnaire was created ad hoc and filled out on the day of discharge; results underwent statistical analyses through SPSS system. RESULTS: For the duration of the research, out of 870 men who became fathers in the hospitals were involved in this study, 570 responded voluntarily to the self-administered questionnaire (65.6% of the total sample). They showed a lack of information about how to take care of their newborns and the emotional turmoil of women after delivery (58% think children are blind when they are born, 52% think it is better to breastfeed newborns at fixed times and 47% ignore that mothers can enter a depression state). Eighty-eight percent of respondents were in the delivery room to see their child's birth, 56% took a leave from job to stay with mother and child in the hospital and 58% of them report the intention to take an additional 2-3 days leave after coming home from the hospital; 27% had trouble sleeping during pregnancy and are afraid not to be good fathers for their child; 90% believe that their newborn will make them change life habits. Most of the new fathers had difficulties in sharing emotions and feelings related with their status of fathers-to-be with other men. Some of these results are significantly different in older fathers, fathers having their first child and fathers with a lesser level of education. CONCLUSION: During pregnancy and in the first months after their child is born, fathers-to-be and new fathers must be considered a potential target for educational interventions aiming at promoting their parenting information and reinforcing their positive attitudes and beliefs related with their fathering status.

Epistaxis in children under the age of two: possible marker of abuse/neglect? A retrospective study in North-Eastern Piedmont hospitals.

AIM: Epistaxis is an extremely common event at all ages; however, under two years of age epistaxis is a very rare event and recent studies carried out in Great Britain concern this event as related to possible non-accidental trauma. To date, no other studies carried out in Italy are available on this topic. METHODS: A file review of all cases of epistaxis occurred in children under the age of 2 who were admitted into the ED in our area over a period of two years was carried out. RESULTS: We have collected data concerning 10 cases of epistaxis occurred in children under 2 years of age with an incidence of 10.4 cases per 10000 accessions to the ED of children under the age of 2. Four of the cases had attendances for head injury or facial trauma. CONCLUSION: The results obtained are higher than the results of the British studies adopting the same methodology, but comparable to their surveillance data on the general population. Through the analysis of the collected data, two correlated assumptions have been made: a possible relationship between epistaxis and neglect, and a relation between epistaxis and domestic accidents.

The reverse pyramid: a quali-quantitative study about food advertising inside children's television programmes.

AIM: Considering how eating habits affect the health of children and taking into account the influence of advertising messages, we wanted to investigate the quantity and the typology of advertising on air during children's television programmes. METHODS: The research was conducted beginning in January 2008 up to March 2008. During this period all children's television programmes, in which cartoons are aired were recorded during third week of each month, for a total of 179 hours 27 minutes and 18 seconds. RESULTS: The research allowed to analyze 3495 adverts; 485 (13.88%) of them promoted foodstuffs, and among these a massive presence of confectionery product ads (304 out of 485, i.e. 62.68%) stands out. CONCLUSION: In conclusion a food pyramid based exclusively on the typology of foodstuffs advertised in the examined adverts has been built, in order to compare it to the correct food pyramid. The base of the pyramid we obtained is constantly composed by sweets and the top by fruits and vegetables. A child watching a television program addressed to him, must see commercials that advertise foodstuffs in 42.45% of cases, and among these 58.59% advertise sweets. This highlights the absolute need to protect children from aggressive marketing and advertising of foodstuffs through alimentary and media educational programmes, as well as through legislation regulating food commercials directed to children, as already happens in many European countries.

[Preadolescents' nutritional habits: a survey in the secondary schools in Brianza]. / Le abitudini alimentari dei preadolescenti: indagine nelle scuole medie della Brianza.

AIM: This study was aimed at assessing eating habits among preadolescents living in Brianza, with a special focus on snacking' and breakfast' habits. METHODS: The research was carried out in 12 post-primary schools in Brianza and included 802 students attending 43 different classes (49.3% males and 50.7% females; mean age:12.6 years). The research tool was an ad hoc questionnaire administered to the preadolescents attending school on the day of the research. Data were analyzed using program Epi Info 6. RESULTS: Many students (78.3%) had breakfast in the morning of the questionnaire's administration. Among those perceiving themselves as overweight, not having breakfast is more common than among others. This information is the opposite of what preadolescents say when inquired about their habit to have ''a good breakfast'': only 36.8% of the responders declare that it happens on a daily basis. As to snacking, 18.7% of the students declare to be used to having multiple snacking during the day; during school recess on the day of the survey, 39.9% of respondents declared that they had eaten various industrial snacks, while 27.4% had cakes or fresh bread, 1.2% both of them and 0.6% fruit. On a daily basis, 59.5% report to eat various and different fruits and 62.9% report the same when inquired about vegetables. CONCLUSION: Considering the importance of a correct nutrition during developmental age and the importance of the phase of adolescence in establishing permanent nutritional habits that will last life-long, it is thus an educational priority to help preadolescents to choose the best foods for their health and well being.

[Tobacco- and alcohol-related behaviors among adolescents attending high schools in Lodi, Milano (City and Province) in the period 2000-2003: results from two multicentric studies]. / Consumi di tabacco e alcol durante il triennio 2000-2003 tra gli adolescenti delle scuole superiori di Lodi e di Milano (Città Provincia): risultati di due rilevazioni multicentriche.

Tobacco- and alcohol-related behaviors are important public health problems under the sanitary, economic and political point of view; even if the negative consequences of these substances' use and abuse are clear and well recognized, the prevalence of the phenomenon remains however high. Therefore to put in action prevention effective procedures, it is useful to know causes and consequences of the behaviour, but also to be able to quantify them and follow them up. This research is aimed at assessing the spread of tobacco's and alcohol's consumptions among students attending high school in Lodi and Milano (City and Province) during school year 2002-2003 and allows to compare these data with those obtained through a similar study carried out during school year 2000-2001. Data have been collected using a translated and adapted version of the YRBSS questionnaire implemented by CDC to monitor the prevalence of high-risk behaviors among U.S. teens. Tobacco habits appears still high but have not increased in the considered period, while alcohol-related behaviors are growing in popularity and performed by a greater number of adolescents,compared with what happened three years earlier This proves to be particolarly true for girls. Prevention implications are presented on the basis of these results.

[Pre-adolescents and sport: results of a health survey in some secondary schools of Brianza]. / I preadolescenti e lo sport: risultati di un'indagine in alcune scuole medie dell'area brianzola.

This study is aimed at assessing time dedicated to, motivation and involvement in physical activity on behalf of pre-adolescents. 802 students (49.3% boys and 50.7% girls; mean age: 12.6) attending 43 classes of 11 Brianza's post-elementary schools. A questionnaire was prepared and administered to the involved sample. Classes took part in this study through randomized selection and data were analyzed using program Epi Info 6. Most of the respondents (60.1%) stay involved in sport because "it makes me feel good" and 32.4% because sport is "enjoyable and entertaining". Pre-adolescents chose the sport in which they become engaged on the basis of personal inclination (40%), in order to share experiences and their free time with friends (15.4%); 13.7% declare to prefer sport to be practiced in team. (13.7%). The most practiced sport are: football (51.3% boys, 4.5% girls), volley (3.9%-36.4%), dance (0.8%-25.2%) e swimming (9.4%-14%). 80.8% in the sample practice physical activity in settings outside schools and, among these, 51.7% dedicate three or more hours weekly to extra-school activities. There are significant differences (p < 0.05) between males' and females' engagement in physical activity (mean value: 4.1 hours; males: 4.6 h, females: 3.5 h). Among pre-teens, 18% declare to be physically inactive at all; 15.7% do not take part in sport activities because afraid to be bullied or shamed by peers. Research show that males are significantly more involved in physical activity than females.

[Risk assessment for eating disorders in a high school: a study based on the Eating Attitudes Test 26]. / Analisi del rischio per i disturbi del comportamento alimentare in una scuola media superiore: una ricerca basata sull'Eating Attitudes Test 26.

AIM: Disordered eating behaviours can lead to clinically evident and serious eating disorders (ED). Aim of this paper is to determine their extent among adolescents and to evaluate the associated characteristics. METHODS: All students of a high school (age 14-18) have been asked to fill up the Eating Attitudes Test (EAT-26) anonymously. EAT-26 is a self-reported questionnaire identifying subjects at risk for ED. This questionnaire included also an integrative section, aimed at investigating some ED-related variables (family composition, diet among relatives, social relationships, spare time activities, self-esteem). Collected data have been analyzed using EpiInfo6. RESULTS: The study involved all the 902 students of the school; 833 questionnaires have been distributed and 701 were collected (89.4% from girls, 10.3% from boys). The percentage of EAT-26 positive boys (i.e. scoring = or > 20) is 3%, while for girls is 13.7%. A positive test significantly correlates with low self-esteem (OR = 46.67, CI = 13.16-182.04), contentious relationships with the mother (OR = 2.20, CI = 1.12-4.29) and the father (OR=2.45, CI=1.24-4.80). No significant correlation has been found for being an only child, living in a single-parent family having limited/not having social relationships, having unsatisfactory social relationships, spending spare time mostly alone, watching TV more than 2 h per day. CONCLUSION: Our data suggest an increasing diffusion in the risk for ED among adolescents. Personal characteristics and behaviours related to this risk are good start points to program projects focusing on primary and secondary prevention of ED in high schools.

[Survey of physical activity and doping in a sample of 6,915 students aged 14-18 years]. / Rilevazione dell'attività motoria e dell'uso di integratori e sostanze dopanti in un campione di 6915 studenti di età compresa fra i 14 e i 18 anni.

AIM: Promoting physical activity is one of the main goals of health-promotion policies. The period of adolescence is characterised by a high rate of abandonment of any physical activity. In this age range, moreover, the risk of assuming substances in order to improve muscular-mass or athletic results is concrete. This study quantifies the involvement in physical activities and substance assumption in a sample of 6915 students aged 14 to 18 years and living in 7 different areas, mostly in northern Italy. METHODS: The survey's tool is an adapted and modified vision of the Youth Risk Behaviour Surveillance questionnaire, created by US Centers for Disease Control and Prevention (CDC). RESULTS: The study showed a high percentage of the sample not involved in any form of physical activity out of school (33.8%), more among girls (44.1%) than boys (21.2%). Between 14 and 18 years, a continuous reduction of involvement in physical activity is evident, while the percentage of totally physically inactive subjects rises from 30.1% to 43%. Finally, 5.6% in our sample admitted to have been using substances to improve muscular-mass or athletic results at least once in the past. CONCLUSION: According to this study, only a minority of the interviewed adolescents is involved in a regular physical activity. In males, using substances to improve physical strength showed to be rather diffused. Specific health promotion projects are suggested.

[Child sexual abuse primary prevention: outcome evaluation of a health education project implemented in Milan's elementary schools]. / Prevenzione primaria dell'abuso sessuale all'infanzia. Valutazione di efficacia di un progetto di educazione alla salute realizzato nelle scuole elementari di Milano.

The study we present is aimed at evaluating the efficacy of a child sexual abuse prevention program that involved children attending 4th and 5th grade in Milan's (Italy) elementary schools. The project involved 53 classes (10 of 4th, 43 of 5th grade) during school year 2000-2001. Children filled a questionnaire before the beginning of the project and two months after the end; the questionnaire evaluates children's perception of risk and their self-efficacy skills in adopting protective strategies when involved in at risk situations. Final analysis has involved 674 children, 51.8% girls, 48.2% boys; 19.6% of children attended 4th grade, 80.4% 5th grade. Percentage of children that recognize the potential danger in the suggested at-risk situation is higher in post-test then in pre-test (87.9% vs 73.2%) and the number of them that does not adopt any self-defence strategy decreases (from 35.3% to 21.0%). The project increased the number of children that know body puberal changes (from 16.0% to 32.8%). According to these results it is evident that the program increased children's capacity to recognize and use self defence strategies in at risk situations. These results call for a potential extention and replication of this health education program.

[Tobacco habits in a cohort of 4,135 adolescents attending high school in northern Italy. Results of a multicenter study]. / Abitudini tabagiche in una coorte di 4135 adolescenti che frequentano la scuola superiore nel Nord Italia. Risultati di uno studio multicentrico.

Assuming that adolescence--a high risk age as far as this behavior is concerned--is the crucial stage for prevention procedures, we don't know much about Italian adolescents' tobacco related behaviors, regardless of the fact that tobacco smoking is one of the most relevant problems of Public Health. The goal of this research has been assessing, through a multicentric study using an anonymous questionnaire, how spread is this behavior among 4135 students attending high school in five different areas of Northern Italy. The research points out a remarkable spreading of the phenomenon and suggests to anticipate prevention procedures during compulsory education, taking in account gender features.

[Assessment of eating disorders-related risk in a cohort of adolescents living in Northern Italy. Results from a multicenter study]. / Valutazione del rischio di disturbi del comportamento alimentare negli adolescenti del Nord Italia. Risultati di uno studio multicentrico.

BACKGROUND: Clinical evidence and epidemiological research show an increasing number of subjects trying to become lean and reaching consequently harmful weight conditions. Aim of this paper is to assess the risk for eating disorders during adolescence. METHODS: In a multicentric study high school students of 5 different districts of Northern Italy have been asked to fill up anonymously the Italian version of the American YRBSS (Youth Risk Behaviour Surveillance System) questionnaire. For each school a section has been selected and between January and March 1999, students of every level have been involved. The data enrollected have been analysed using EpiInfo6. RESULTS: The study involved 4135 adolescents (57% girls and 43% boys) coming from 260 classes and 47 different schools. The proportion of boys perceiving themselves as overweight and underweight was the same (22%), while the proportion of girls considering themselves overweight raised up to 42%. The majority of the girls (53%) is trying to slim making use of physical activity (48%), diets (32%), vomiting (8%) and drugs (5%). CONCLUSIONS: Our data suggest that specific projects focusing on primary and secondary prevention of eating disorders should be considered for high schools. In addition, further studies are suggested to understand characteristics and behaviours related to eating disorders.

[Evaluation of the efficacy of the "Spazi Giovani" of family clinics. Results of 3 ASL services of the City of Milan]. / Valutazione di efficacia degli Spazi Giovani dei consultori familiari. Risultati di una ricerca in tre servizi della ASL Città di Milano.

"Spazio Giovani" is a service offered once a week by many Family Counselling Services and aimed at addressing the needs of tenagers and young people who can access it free of charge and without booking an appointment. This kind of services started in the Eighties to address the needs of young people who were sexually active and often not accessing conventional services. The objective of this study has been to assess how attitudes for unprotected sex and at risk sex behaviours decrease in a population attending the Youth Corner on a regular basis in comparison with the same attitudes and behaviours in a group of first-time users of the service over a six month period. The research, involving 301 teen and young females showed significant differences in protected behaviours between the two groups. No significant differences in attitudes were put in evidence by the study.

[Early deterioration of the mother-child relation. "Time with families" as a model for prevention and therapy]. / La distorsione relazionale precoce tra madre e bambino. Il tempo con le famiglie quale modello ponte tra prevenzione e terapia.

"Time with families" is the model of service presented in this paper. Its approach is rooted in the theory of attachment by J. Bowlby. Starting from the observation of attachment patterns in mothers and children, this Service aims at promoting short-term, cost-effective and highly focused interventions enabling the child to structure secure "Internal Working Models". "Time with families" started in 1988 in the area served by the Health Welfare District 36 in Lombardia, as an integrated socio-sanitary program aimed at preventing problems in the early relations between mother and child. This program is the result of a cooperation between different services, including SIMEE, Family and Pediatric Counselling Services and Social Services. Three are the main components of the program: 1) the "First Days" program, based on health visits made by professionals to support the new mother in taking care of the newborn; 2) the clinic of child neuropsychiatry to evaluate and treat problems in the early relation between mother and child during his first three years of life through two technical approaches: short mother-child psychotherapy and functions' integrated therapy; 3) "Time with families", with a Day Center open for parents and children to ease their reciprocal relationships in this period of life, to start and realize clinical interventions and to offer individual and group counselling to parents. Thanks to this varied offer of services, its flexibility and multidisciplinarity of its approach, "Time with families" can be considered a bridge service between prevention and therapy, able to monitor and follow-up parents' and children's health conditions and to determine their styles of attachment so to intervene in at-risk situations to prevent future complications or long term consequences.