Why do the items in Pictems start out so large, and how do I resize and rotate them?

The items start out large to make it easy to get a handle on them. You resize them by putting two fingers on the screen, and then moving them closer or farther apart. Rotation is similar, just move one finger and keep the other stationary.

Because it's so hard to get both fingers on a small item, you only need to touch the item with your first finger - it'll highlight, to let you know you've selected it, then you can put your other finger on the screen somewhere else and resize the item.

When I load a new picture, all of the pictems I added to the previous version are still there. How do I remove them?

This is to make it easier to add the same items to multiple pictures. If you want to remove all the items and start over, use the trash can button.