@article {10829, title = {Pain Intensity and Risk of Bone Fracture in Children With Minor Extremity Injuries.}, journal = {Pediatr Emerg Care}, year = {2018}, month = {2018 Jan 23}, abstract = {

OBJECTIVES: Injuries are one of the most common causes of pediatric emergency department (ED) visit. The aim of this study was to investigate the relationship between the intensity of pain at the ED visit of children presenting with an extremity injury and the risk of fracture.

METHODS: We conducted a retrospective study, considering all patients presenting to the ED of a children{\textquoteright}s hospital in Italy, with an accidental extremity injury, between May and December 2015. We selected all children aged 8 to 17 years who underwent an x-ray. Children with major, multiple, or nonextremity injuries were excluded. Age, sex, spontaneous and palpation pain, local swelling, time between injury, and medical evaluation were recorded. Sensibility and specificity of spontaneous and palpation pain in detecting a fracture were calculated.

RESULTS: We reviewed 994 medical records; of these, 344 (34.6\%) reported a fracture. Children{\textquoteright}s median age was 12 years (interquartile range [IQR], 10-14). Median spontaneous pain at the ED visit was not significantly different between children with and without a fracture: 4.0 (1.0-6.0) and 5 (1.0-6.0), respectively (P = 0.129). Children with mild palpation pain and children without an increase of pain of at least 2 points between spontaneous and palpation pain were fractured in 3.2\% and 0.97\% of cases, respectively.

CONCLUSIONS: In this series, pain intensity in children with a minor extremity injury was not a good marker of fracture. Nevertheless, children with mild palpation pain or with a mild increase of pain between spontaneous and palpation pain had a low risk of fracture.

}, issn = {1535-1815}, doi = {10.1097/PEC.0000000000001418}, author = {Zanchi, Chiara and Giangreco, Manuela and Ronfani, Luca and Germani, Claudio and Giorgi, Rita and Calligaris, Lorenzo and Norbedo, Stefania and Liccari, Giulio and Cozzi, Giorgio and Barbi, Egidio} } @article {3548, title = {Piccolipi{\`u}, a multicenter birth cohort in Italy: protocol of the study.}, journal = {BMC Pediatr}, volume = {14}, year = {2014}, month = {2014}, pages = {36}, abstract = {

BACKGROUND: The fetal and infant life are periods of rapid development, characterized by high susceptibility to exposures. Birth cohorts provide unique opportunities to study early-life exposures in association with child development and health, as well as, with longer follow-up, the early life origin of adult diseases. Piccolipi{\`u} is an Italian birth cohort recently set up to investigate the effects of environmental exposures, parental conditions and social factors acting during pre-natal and early post-natal life on infant and child health and development. We describe here its main characteristics.

METHODS/DESIGN: Piccolipi{\`u} is a prospective cohort of expected 3000 newborns, who will be recruiting in six maternity units of five Italian cities (Florence, Rome, Trieste, Turin and Viareggio) since October 2011. Mothers are contacted during pregnancy or at delivery and are offered to participate in the study. Upon acceptance, their newborns are recruited at birth and followed up until at least 18 years of age. At recruitment, the mothers donate a blood sample and complete a baseline questionnaire. Umbilical cord blood, pieces of umbilical cord and heel blood spots are also collected. Postnatal follow-up currently occurs at 6, 12, and 24 months of age using on-line or postal self administered questionnaire; further questionnaires and medical examinations are envisaged. Questionnaires collect information on several factors, including mother{\textquoteright}s and/or child{\textquoteright}s environmental exposures, anthropometric measures, reproductive factors, diet, supplements, medical history, cognitive development, mental health and socioeconomic factors. Health promotion materials are also offered to parents.

DISCUSSION: Piccolipi{\`u} will broaden our understanding of the contribution of early-life factors to infant and child health and development. Several hypotheses on the developmental origins of health can be tested or piloted using the data collected from the Piccolipi{\`u} cohort. By pooling these data with those collected by other existing birth cohorts it will be possible to validate previous findings and to study rare exposures and outcomes.

}, keywords = {Adolescent, Child, Child Development, Child Welfare, Child, Preschool, Cohort Studies, Environmental Exposure, Humans, Infant, Infant, Newborn, Italy, Prospective Studies, Socioeconomic Factors}, issn = {1471-2431}, doi = {10.1186/1471-2431-14-36}, author = {Farchi, Sara and Forastiere, Francesco and Vecchi Brumatti, Liza and Alviti, Sabrina and Arnofi, Antonio and Bernardini, Tommaso and Bin, Maura and Brescianini, Sonia and Colelli, Valentina and Cotichini, Rodolfo and Culasso, Martina and De Bartolo, Paolo and Felice, Laura and Fiano, Valentina and Fioritto, Alessandra and Frizzi, Alfio and Gagliardi, Luigi and Giorgi, Giulia and Grasso, Chiara and La Rosa, Francesca and Loganes, Claudia and Lorusso, Paola and Martini, Valentina and Merletti, Franco and Medda, Emanuela and Montelatici, Veronica and Mugelli, Isabella and Narduzzi, Silvia and Nistic{\`o}, Lorenza and Penna, Luana and Piscianz, Elisa and Piscicelli, Carlo and Poggesi, Giulia and Porta, Daniela and Ranieli, Antonella and Rapisardi, Gherardo and Rasulo, Assunta and Richiardi, Lorenzo and Rusconi, Franca and Serino, Laura and Stazi, Maria Antonietta and Toccaceli, Virgilia and Todros, Tullia and Tognin, Veronica and Trevisan, Morena and Valencic, Erica and Volpi, Patrizia and Ziroli, Valentina and Ronfani, Luca and Di Lallo, Domenico} } @article {3595, title = {Promoting effective child development practices in the first year of life: does timing make a difference?}, journal = {BMC Pediatr}, volume = {14}, year = {2014}, month = {2014}, pages = {222}, abstract = {

BACKGROUND: There is an increasing need for parenting programs aimed at promoting parent-child interaction. A variety of interventions have been proposed. The use of audiovisual materials for parents has been shown to be effective but limited information is available on the optimal timing for its use, particularly for new parents during the first year of life of their children. The aim of this study is to compare the effectiveness of a video administered at two different times to first-time parents in modifying parental knowledge, attitudes and intentions with regards to effective care practices.

METHODS: Open randomized controlled trial carried out in a referral mother and child hospital. Eligible parents were randomly assigned to receive a video at one month (early intervention) or at seven months (late intervention) of age of their child. The video addressed four specific activities related to early child development: reading aloud to the baby, early exposure to music, promotion of early socialization for parents and for children. The primary outcome was the proportion of parents who declared that their knowledge, attitudes and intentions changed after having seen the video at one or seven months of age of the child.

RESULTS: One hundred and five families were randomly allocated either to the early (53) or to the late (52) intervention group. For 99 families (52 in the early and 47 in the late group) a complete outcome evaluation was available. Parents included in the early administration group more frequently reported modifications in their knowledge of the suggested practices while parents in the late group more frequently reported a change in their attitudes. This finding was consistent across all four practices. The video was found to influence parental intentions in the great majority of interviewed parents with no significant difference between groups (82.7\% and 87.2\% in the early and late intervention group, respectively).

CONCLUSIONS: Audiovisual materials can be an effective complementary tool in programs aimed at supporting parents, particularly those dealing with their first baby. The results provide some useful insights into the differential benefits of using audiovisual aids at different times during the first year of life of the baby.

TRIAL REGISTRATION: ClinicalTrials.gov NCT02120430.

}, issn = {1471-2431}, doi = {10.1186/1471-2431-14-222}, author = {Roia, Anna and Paviotti, Elena and Ferluga, Valentina and Montico, Marcella and Monasta, Lorenzo and Ronfani, Luca and Tamburlini, Giorgio} }