Elena Pietro - Academia.edu (original) (raw)

Papers by Elena Pietro

Childhood obesity (Print), 2017

Research has provided evidence that obesity is associated with peer victimization and low levels ... more Research has provided evidence that obesity is associated with peer victimization and low levels of self-concept. No study has examined the relationship between BMI z-score, self-concept in multiple domains, and peer victimization. The aim of the research was to investigate the interplay between BMI z-score, self-concept in multiple domains (physical, athletic, social), and peer victimization, testing direct, mediated, and moderated associations. Eighty hundred fifteen outpatient children and adolescents were consecutively recruited in 14 hospitals distributed over the Italian country. The sample consisted of 419 males and 396 females; mean age 10.91 ± 1.97 years (range 6-14 years) and mean BMI z-score 1.85 ± 0.74 (range -0.97 ± 3.27). Peer victimization and self-concept were assessed with a revised Olweus Bully/Victim Questionnaire and with the Self-Perception Profile for Children. A structural equation model approach was used to determine the associations among variables, testing ...

Minerva pediatrica

A rigorous scientific definition of obesity in childhood is not yet available: in fact, there is ... more A rigorous scientific definition of obesity in childhood is not yet available: in fact, there is not agreement among researchers on the adiposity index to use and on the best cut-off to define overweight and obesity. In this review, the reference methods for the diagnosis of childhood obesity in the clinical practice in Italy are reported. All the statements are based on evidences of the literature and obtained the consensus of the pediatricians of the Study Group on Obesity of the Italian Society of Pediatric Diabetology and Endocrinology. Obesity is caused by an excess of body fat. The methods more frequently used to measure body fat are the measure of subcutaneous skinfold thickness, bioimpedence assessment and DXA. The measure of skinfolds is preferable in the clinical setting because it is easy to use and cheap, although reproducibility is modest. Triceps skinfold is commonly used to define obesity: children with triceps higher than the 85(th) centile for age and gender, using Tanner's tables, are obese. An estimation of fat mass obtained, for instance, with skinfolds is always suggested in addition to the measure of weight and height. It is possible to define a child as obese calculating the ratio between weight (kg) and height squared (m). This ratio is an index, called body mass index (BMI), which is strictly associated to the level of adiposity in children, reproducible and valid. The BMI was recently proposed as the reference index for the diagnosis of childhood obesity at the international level. The use of the centiles of BMI may offer useful information on the changes of weight excess, simplifying the follow-up of the patient and the sensitivity to treatment. The cut-off limits of BMI to define overweight or obesity are still debated. However, in agreement with Cole et al., the choice to use the BMI cut-offs centiles passing through the adult BMI cut-off of 30, is reasonable. However, it is always preferable to use population specific BMI reference tables.

Family Science, 2014

ABSTRACT Since family context is considered to be an important environmental factor for the attit... more ABSTRACT Since family context is considered to be an important environmental factor for the attitude of children towards eating, the perception of psychological distress in children and the parental perception of child behavioural and emotional problems were investigated. School-age children (n = 665; 8–11 years of age), selected from different schools, were classified into weight categories according to their BMI. The children completed the Self-Administrated Psychiatric Scales for Children and Adolescents and their parents completed the Child Behaviour Checklist. Obese children reported more psychological distress compared to the other children, while their parents did not show a greater perception of emotional problems, compared to parents of normal-weight children. This suggests that the psychological distress of obese children might not be recognised by their parents. Our results highlight the role of this lack of parental awareness in child development, and in the progress of the psychological distress related to eating problems.

Neuropsychiatric Disease and Treatment, 2013

Journal of Neuropsychiatry, 2012

Journal of Child Neurology, 2012

This article describes a case of pyruvate dehydrogenase deficiency in a 3-year-old boy who presen... more This article describes a case of pyruvate dehydrogenase deficiency in a 3-year-old boy who presented generalized hypotonia, severe psychomotor development delay, and generalized and partial seizures and was refractory to antiepileptic drugs. After the diagnosis, the patient was put on a ketogenic diet. Six months later, seizure frequency was reduced and psychomotor development had improved. At the same time he presented some side effects, such as 2 episodes of significant increases in cholesterol and triglycerides associated with viral respiratory infections. The latter decreased with a supplementation of ω-3 fatty acids and an increase in caloric intake.

The Journal of Alternative and Complementary Medicine, 2013

European Psychiatry, 2011

European Journal of Clinical Nutrition, 2014

European Eating Disorders Review, 2012

This study evaluates the psychometric properties of self-administered psychiatric scale for child... more This study evaluates the psychometric properties of self-administered psychiatric scale for children and adolescents with psychogenic eating disorders (SAFA P)--a brief self-report designed to screen and assess eating disorders (ED) in children and adolescents. Although SAFA P belongs to a broad battery of tests (SAFA) that explores different psychiatric conditions, it has not undergone appropriate validation until now. We administered SAFA P and Eating Disorder Inventory 2 (EDI-2) to 87 ED patients, with an average age of 15.4 ± 1.6 years. The internal reliability of SAFA P is good (Cronbach α = .776). Convergent validity with EDI-2 was assessed: both SAFA P subscale P1 (p < .005) and EDI-2 subscale bulimia (p < .001) showed a statistically significant difference among the three diagnostic categories (anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified). Sensibility and specificity range from 62 to 91%, depending on the subscales. McNemar's test did not reveal statistically significant differences in assessing the concordance of the two measures. Statistically significant correlations were found between specific couples of subscales (p < .001). Cross-validation with EDI-2 showed good results. SAFA P may be an alternative, useful and reliable instrument for assessing cursory ED in childhood and adolescence.

Digestive and Liver Disease, 2013

PLOS ONE, 2015

Being overweight or obese is one of the most common reasons that children and adolescents are tea... more Being overweight or obese is one of the most common reasons that children and adolescents are teased at school. We carried out a study in order to investigate: i) the relation between weight status and school bullying and ii) the relation between weight status categories and types of victimization and bullying in an outpatient sample of Italian children and adolescents with different degrees of overweight from minimal overweight up to severe obesity. Nine-hundred-forty-seven outpatient children and adolescents (age range 6.0-14.0 years) were recruited in 14 hospitals distributed over the country of Italy. The participants were classified as normal-weight (N = 129), overweight (N = 126), moderately obese (N = 568), and severely obese (N = 124). The nature and extent of verbal, physical and relational bullying and victimization were assessed with an adapted version of the revised Olweus bully-victim questionnaire. Each participant was coded as bully, victim, bully-victim, or not involved. Normal-weight and overweight participants were less involved in bullying than obese participants; severely obese males were more involved in the double role of bully and victim. Severely obese children and adolescents suffered not only from verbal victimization but also from physical victimization and exclusion from group activities. Weight status categories were not directly related to bullying behaviour; however severely obese males perpetrated more bullying behaviour compared to severely obese females. Obesity and bullying among children and adolescents are of ongoing concern worldwide and may be closely related. Common strategies of intervention are needed to cope with these two social health challenges.

Childhood obesity (Print), 2017

Research has provided evidence that obesity is associated with peer victimization and low levels ... more Research has provided evidence that obesity is associated with peer victimization and low levels of self-concept. No study has examined the relationship between BMI z-score, self-concept in multiple domains, and peer victimization. The aim of the research was to investigate the interplay between BMI z-score, self-concept in multiple domains (physical, athletic, social), and peer victimization, testing direct, mediated, and moderated associations. Eighty hundred fifteen outpatient children and adolescents were consecutively recruited in 14 hospitals distributed over the Italian country. The sample consisted of 419 males and 396 females; mean age 10.91 ± 1.97 years (range 6-14 years) and mean BMI z-score 1.85 ± 0.74 (range -0.97 ± 3.27). Peer victimization and self-concept were assessed with a revised Olweus Bully/Victim Questionnaire and with the Self-Perception Profile for Children. A structural equation model approach was used to determine the associations among variables, testing ...

Minerva pediatrica

A rigorous scientific definition of obesity in childhood is not yet available: in fact, there is ... more A rigorous scientific definition of obesity in childhood is not yet available: in fact, there is not agreement among researchers on the adiposity index to use and on the best cut-off to define overweight and obesity. In this review, the reference methods for the diagnosis of childhood obesity in the clinical practice in Italy are reported. All the statements are based on evidences of the literature and obtained the consensus of the pediatricians of the Study Group on Obesity of the Italian Society of Pediatric Diabetology and Endocrinology. Obesity is caused by an excess of body fat. The methods more frequently used to measure body fat are the measure of subcutaneous skinfold thickness, bioimpedence assessment and DXA. The measure of skinfolds is preferable in the clinical setting because it is easy to use and cheap, although reproducibility is modest. Triceps skinfold is commonly used to define obesity: children with triceps higher than the 85(th) centile for age and gender, using Tanner's tables, are obese. An estimation of fat mass obtained, for instance, with skinfolds is always suggested in addition to the measure of weight and height. It is possible to define a child as obese calculating the ratio between weight (kg) and height squared (m). This ratio is an index, called body mass index (BMI), which is strictly associated to the level of adiposity in children, reproducible and valid. The BMI was recently proposed as the reference index for the diagnosis of childhood obesity at the international level. The use of the centiles of BMI may offer useful information on the changes of weight excess, simplifying the follow-up of the patient and the sensitivity to treatment. The cut-off limits of BMI to define overweight or obesity are still debated. However, in agreement with Cole et al., the choice to use the BMI cut-offs centiles passing through the adult BMI cut-off of 30, is reasonable. However, it is always preferable to use population specific BMI reference tables.

Family Science, 2014

ABSTRACT Since family context is considered to be an important environmental factor for the attit... more ABSTRACT Since family context is considered to be an important environmental factor for the attitude of children towards eating, the perception of psychological distress in children and the parental perception of child behavioural and emotional problems were investigated. School-age children (n = 665; 8–11 years of age), selected from different schools, were classified into weight categories according to their BMI. The children completed the Self-Administrated Psychiatric Scales for Children and Adolescents and their parents completed the Child Behaviour Checklist. Obese children reported more psychological distress compared to the other children, while their parents did not show a greater perception of emotional problems, compared to parents of normal-weight children. This suggests that the psychological distress of obese children might not be recognised by their parents. Our results highlight the role of this lack of parental awareness in child development, and in the progress of the psychological distress related to eating problems.

Neuropsychiatric Disease and Treatment, 2013

Journal of Neuropsychiatry, 2012

Journal of Child Neurology, 2012

This article describes a case of pyruvate dehydrogenase deficiency in a 3-year-old boy who presen... more This article describes a case of pyruvate dehydrogenase deficiency in a 3-year-old boy who presented generalized hypotonia, severe psychomotor development delay, and generalized and partial seizures and was refractory to antiepileptic drugs. After the diagnosis, the patient was put on a ketogenic diet. Six months later, seizure frequency was reduced and psychomotor development had improved. At the same time he presented some side effects, such as 2 episodes of significant increases in cholesterol and triglycerides associated with viral respiratory infections. The latter decreased with a supplementation of ω-3 fatty acids and an increase in caloric intake.

The Journal of Alternative and Complementary Medicine, 2013

European Psychiatry, 2011

European Journal of Clinical Nutrition, 2014

European Eating Disorders Review, 2012

This study evaluates the psychometric properties of self-administered psychiatric scale for child... more This study evaluates the psychometric properties of self-administered psychiatric scale for children and adolescents with psychogenic eating disorders (SAFA P)--a brief self-report designed to screen and assess eating disorders (ED) in children and adolescents. Although SAFA P belongs to a broad battery of tests (SAFA) that explores different psychiatric conditions, it has not undergone appropriate validation until now. We administered SAFA P and Eating Disorder Inventory 2 (EDI-2) to 87 ED patients, with an average age of 15.4 ± 1.6 years. The internal reliability of SAFA P is good (Cronbach α = .776). Convergent validity with EDI-2 was assessed: both SAFA P subscale P1 (p < .005) and EDI-2 subscale bulimia (p < .001) showed a statistically significant difference among the three diagnostic categories (anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified). Sensibility and specificity range from 62 to 91%, depending on the subscales. McNemar's test did not reveal statistically significant differences in assessing the concordance of the two measures. Statistically significant correlations were found between specific couples of subscales (p < .001). Cross-validation with EDI-2 showed good results. SAFA P may be an alternative, useful and reliable instrument for assessing cursory ED in childhood and adolescence.

Digestive and Liver Disease, 2013

PLOS ONE, 2015

Being overweight or obese is one of the most common reasons that children and adolescents are tea... more Being overweight or obese is one of the most common reasons that children and adolescents are teased at school. We carried out a study in order to investigate: i) the relation between weight status and school bullying and ii) the relation between weight status categories and types of victimization and bullying in an outpatient sample of Italian children and adolescents with different degrees of overweight from minimal overweight up to severe obesity. Nine-hundred-forty-seven outpatient children and adolescents (age range 6.0-14.0 years) were recruited in 14 hospitals distributed over the country of Italy. The participants were classified as normal-weight (N = 129), overweight (N = 126), moderately obese (N = 568), and severely obese (N = 124). The nature and extent of verbal, physical and relational bullying and victimization were assessed with an adapted version of the revised Olweus bully-victim questionnaire. Each participant was coded as bully, victim, bully-victim, or not involved. Normal-weight and overweight participants were less involved in bullying than obese participants; severely obese males were more involved in the double role of bully and victim. Severely obese children and adolescents suffered not only from verbal victimization but also from physical victimization and exclusion from group activities. Weight status categories were not directly related to bullying behaviour; however severely obese males perpetrated more bullying behaviour compared to severely obese females. Obesity and bullying among children and adolescents are of ongoing concern worldwide and may be closely related. Common strategies of intervention are needed to cope with these two social health challenges.