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In the COVID-19 pandemic, an unprecedented number of individuals required endotracheal intubation. To safely face these challenges, expert intubation teams were formed in some institutions. Here, we report on the experience of emergency rapid intubation teams (ERITs) in two Canadian hospitals.We retrospectively collected data on all airway management procedures in confirmed or suspected COVID-19 patients performed by ERITs at two academic hospitals between 3 April and 17 June 2020. The co-primary outcomes were incidence of periprocedural adverse events (hypoxemia, hypotension, and cardiac arrest within 15 min of intubation) and first-attempt intubation success rate. Secondary outcomes included number of intubation attempts, device used to achieve successful airway management, and adherence to personal protective equipment (PPE) protocols.During the study period, 123 patients were assessed for airway management, with 117 patients receiving airway interventions performed by the ERIT. The first-attempt success rate for intubation was 92%, and a videolaryngoscope was the final successful device in 93% of procedures. Hypoxemia (peripheral oxygen saturation [SpOIn this cohort of critically ill patients with respiratory failure requiring time-sensitive airway management, specialized ERIT teams showed high rates of successful airway management with high adherence to PPE use. Hypoxemia and hemodynamic instability were common and should be anticipated within the first 15 min following intubation.www.ClinicalTrials.gov (NCT04689724); registered 30 December 2020.RéSUMé: CONTEXTE: Pendant la pandémie de COVID-19, un nombre sans précédent de patients ont dû bénéficier d’une intubation endotrachéale. Pour faire face en toute sécurité à ces défis, des équipes d’experts en intubation ont été formées dans certains établissements. Nous rendons compte ici de l’expérience d’équipes d’intubation rapide d’urgence (ou ERIT, pour Emergency Rapid Intubation Team) dans deux hôpitaux canadiens. MéTHODE: Nous avons colligé rétrospectivement les données concernant toutes les interventions de prise en charge des voies aériennes chez les patients COVID-19 confirmés ou suspectés réalisées par les ERIT dans deux hôpitaux universitaires entre le 3 avril et le 17 juin 2020. Les deux critères d’évaluation principaux étaient l’incidence d’événements indésirables péri-procédure (hypoxémie, hypotension et arrêt cardiaque dans les 15 minutes suivant l’intubation) et le taux de réussite de l’intubation à la première tentative. Les critères d’évaluation secondaires comprenaient le nombre de tentatives d’intubation, le dispositif utilisé pour parvenir au succès de la prise en charge des voies aériennes et le respect des protocoles concernant les équipements de protection individuelle (EPI). RéSULTATS: Au cours de la période à l’étude, 123 patients ont été évalués pour une prise en charge des voies aériennes, et 117 patients ont bénéficié d’interventions au niveau des voies aériennes réalisées par l’ERIT. Le taux de réussite de la première tentative d’intubation était de 92 %, et un vidéolaryngoscope a été le dispositif menant à une intubation réussie dans 93 % des interventions. Des épisodes d’hypoxémie (saturation périphérique en oxygène [SpO

Patients with implanted medical devices are increasingly referred for hyperbaric oxygen therapy (HBOT), and the safety of exposing some of these devices to hyperbaric environments has not previously been explored. There is a paucity of evidence surrounding the management of implanted neurological devices such as neurostimulators and intrathecal drug delivery (IDD) pumps in the context of HBOT. However, these devices can be expected to harbor unique risks; for example, vacant space in the reservoir of an implanted IDD pump may change in pressure and volume during the compression and decompression phases of HBOT, resulting in a damaged or dysfunctional device. We present the case of a 27-year-old woman with cerebral palsy referred for HBOT to manage a necrotizing soft tissue infection cultured from a dehiscent abdominal wound at the previous implantation site of an intrathecal baclofen pump. An HBOT protocol was ultimately chosen in partnership with the patient and her family, but treatment was not performed due to a paucity of evidence that the implanted IDD pump could safely withstand hyperbaric exposure. In this review, we have synthesized manufacturer recommendations regarding the management of implanted neurological devices before, during, and after HBOT to inform future decision-making in this setting. Among these recommendations, we highlight that neurostimulators should be switched off for the duration of HBOT and implanted pumps should be refilled prior to each treatment session to minimize empty reservoir space.

Background. Chronic neuropathic pain is a condition affecting an increasing proportion of the general population and its management requires a comprehensive, multidisciplinary program. A growing body of evidence supports the use of hyperbaric oxygen therapy (HBOT) in several chronic neuropathic pain conditions; however, its role and efficacy remain unclear. Purpose. To summarize current evidence for the mechanistic rationale of HBOT in chronic neuropathic pain conditions and to evaluate its clinical efficacy. Methods. This narrative review was conducted after searching the following databases (Medline, Embase, Cochrane, PsycINFO, the Web of Science, Scopus, ClinicalTrials. gov, WHO ICTRP, and ProQuest Digital Dissertation) from January 1946 to March 2020. Articles published in English that involved either animal or human studies with acute or chronic neuropathic pain evaluating any HBOT-related intervention were included. Results. A total of 2971 citations were identified. A total of 29 studies were included in this review. The mechanisms of action for HBOT use in neuropathic conditions included the primary effects of hyperoxia and edema resolution, as well as the secondary effects pertinent to the production of oxygen and nitrogen reactive species (serving as pain signaling molecules), nitric oxide-dependent release of opioid peptides, and reduction of inflammatory mediators. A robust evidence for HBOT use in the clinical setting was associated with chronic regional pain syndrome and chronic primary bladder pain syndrome. Some evidence supported its use for chronic secondary (peripheral) neuropathic pain including radiation-induced plexus neuropathies, postherpetic neuralgia, and trigeminal neuralgia. Conclusions. HBOT has been shown to have antinociceptive and analgesic effects in animal models of inflammatory, neuropathic, and chronic pain. Human studies demonstrated beneficial effects of HBOT in improving clinical outcomes such as pain scores, pain-related symptoms, and quality of life. A systematic methodology of HBOT application is necessary to confirm its safety and efficacy.

Hip fractures are debilitating in older adults because of their impact on quality of life. Opioids are associated with adverse effects in this population, so oral acetaminophen is commonly prescribed to minimize opioid use. Intravenous (iv) acetaminophen has been reported to have superior efficacy and bioavailability than oral acetaminophen. Nevertheless, its effect on postoperative outcomes in emergency hip fractures is unclear. This systematic review assessed the effect of iv acetaminophen on postoperative outcomes in older hip fracture patients.We searched multiple databases from inception to June 2021 for studies on adults50 yr of age undergoing emergency hip fracture surgery who received iv acetaminophen (or paracetamol) and that reported postoperative outcomes. Relevant titles, abstracts, and full texts were screened based on the eligibility criteria. The Newcastle-Ottawa scale was used to assess the quality of the selected papers.Of 3,510 initial studies, four met the inclusion criteria. One was a prospective cohort study and three were retrospective cohort studies. All four studies used historical control groups. Three studies reported a significantly lower mean opioid dose with iv acetaminophen than with oral acetaminophen. Three studies also reported a significantly shorter hospital stay. One study each reported a significant decrease in the number of missed physical therapy sessions, the need for one-to-one supervision, and episodes of delirium.There is very limited low-level evidence that iv acetaminophen improves preoperative and postoperative analgesia and shortens hospital stay in older hip fracture patients. Nevertheless, our results should be interpreted with caution since there are no prospective randomized trials investigating whether iv acetaminophen improves postoperative outcomes in this patient population.PROSPERO (CRD42021198174); registered 15 August 2021.RéSUMé: OBJECTIF: Les fractures de la hanche sont débilitantes chez les personnes âgées en raison de leur impact sur leur qualité de vie. Les opioïdes sont associés à des effets indésirables chez cette population, de sorte que l’acétaminophène par voie orale est couramment prescrit pour minimiser la consommation d’opioïdes. L’acétaminophène par voie intraveineuse (IV) a une efficacité et une biodisponibilité supérieures à celles de l’acétaminophène par voie orale. Néanmoins, son effet sur les devenirs postopératoires dans les fractures d’urgence de la hanche n’est pas clair. Cette revue systématique a évalué l’effet de l’acétaminophène IV sur les devenirs postopératoires chez les patients âgés avec une fracture de la hanche.Nous avons effectué des recherches dans plusieurs bases de données de leur création à juin 2021 pour en tirer les études portant sur des adultes50 ans bénéficiant d’une chirurgie d’urgence pour une fracture de la hanche et ayant reçu de l’acétaminophène IV (ou paracétamol), et qui rapportait les devenirs postopératoires. Les titres, résumés et textes intégraux pertinents ont été sélectionnés en fonction des critères d’admissibilité. L’échelle de Newcastle-Ottawa a été utilisée pour évaluer la qualité des articles sélectionnés.Sur les 3510 études initiales, quatre ont répondu aux critères d’inclusion. L’une était une étude de cohorte prospective et trois étaient des études de cohorte rétrospectives. Les quatre études ont utilisé des groupes témoins historiques. Trois études ont rapporté une dose moyenne d’opioïdes significativement plus faible avec l’acétaminophène IV qu’avec de l’acétaminophène par voie orale. Trois études ont également rapporté un séjour à l’hôpital significativement plus court. Une diminution significative du nombre de séances de physiothérapie manquées a été rapporté dans une étude, une autre a rapporté une diminution significative de la nécessité de supervision individuelle, et une troisième une réduction des épisodes d’état confusionnel aigu.: Il n’existe que très peu de données probantes qui sont de faible qualité et selon lesquelles l’acétaminophène IV améliore l’analgésie préopératoire et postopératoire et réduit la durée de séjour à l’hôpital chez les patients âgés atteints d’une fracture de hanche. Néanmoins, nos résultats doivent être interprétés avec prudence car il n’existe pas d’étude randomisée prospective évaluant si l’acétaminophène IV améliore les issues postopératoires dans cette population de patients. ENREGISTREMENT DE L’éTUDE: PROSPERO (CRD42021198174); enregistrée le 15 août 2021.

Hyperbaric oxygen therapy (HBOT) is widely used to treat several pathologies. The hemodynamic changes during HBOT, particularly the magnitude of arterial blood pressure (ABP) increase, are not completely understood. No clinical predictors for HBOT-induced ABP increase have been described. The purpose of this study was to quantify ABP changes in patients undergoing HBOT and to examine their predictors. This retrospective longitudinal cohort study examined 3291 elective HBOT sessions. Non-invasive ABP was recorded before and after each session. The primary outcome was to quantify the HBOT-induced ABP rise. The secondary outcome was to determine the ABP-rise predictors among demographic and clinical variables. Overall, ABP increased significantly after HBOT, this finding was more evident in the hypertensive subgroup compared to the normotensive one (+6 vs. +16.2 mmHg). Clinical predictors of significant post-HBOT ABP change were history of hypertension and pre-session baseline ABP classification. This study demonstrates an absolute HBOT-induced ABP rise. This change is clinically relevant in patients with history of hypertension. A higher baseline ABP seems a risk factor for clinically relevant ABP change. Pre-session ABP should be used clinically as an indicator for strict ABP monitoring during HBOT, future studies are recommended to explore the ABP optimization before starting an HBO treatment.

Neuroplasticity and recovery after stroke can be enhanced by a rehabilitation program pertinent to upper limb motor function exercise and mental imagery (EMI) as well as hyperbaric oxygen therapy (HBOT). We assessed feasibility and safety of the combined approach utilizing both HBOT and EMI, and to derive preliminary estimates of its efficacy. In this randomized controlled trial, 27 patients with upper extremity hemiparesis at 3–48 months after stroke were randomized to receive either a complementary rehabilitation program of HBOT-EMI (intervention group), or EMI alone (control group). Feasibility and safety were assessed as total session attendance, duration of sessions, attrition rates, missing data, and intervention-related adverse events. Secondary clinical outcomes were assessed with both objective tools and self-reported measures at baseline, 8 weeks (end of treatment), and 12-weeks follow-up. Session attendance, duration, and attrition rate did not differ between the groups; there were no serious adverse events. Compared with baseline, there were significant sustained improvements of objective and subjective outcomes’ measures in the intervention group, and a single improvement in an objective measure in the control group. Between-group outcome comparisons were not statistically significant. This study demonstrated that the combination HBOT-EMI was a safe and feasible approach in patients recovering from chronic stroke. There were also trends for improved motor function of the affected upper limb after the treatments. ClinicalTrials.gov registration no.: NCT02666469. Novelty HBOT combined with an upper limb exercise and mental imagery rehabilitation program is feasible and safe in chronic stroke patients. This combined approach showed trends for improved functional recovery.

Study design Case report (level IV evidence). Objective To describe a potential novel application of hyperbaric oxygen therapy (HBOT) in the successful treatment of a postoperative spinal cord injury. Summary of background data A 68-year-old man presented with an acute spinal cord injury (ASIA impairment scale D), on the background of degenerative lower thoracic and lumbar canal stenosis. He underwent emergent decompression and instrumented fusion (T9-L5), with an uncomplicated intraoperative course and no electrophysiological changes. Immediate postoperative assessment demonstrated profound bilateral limb weakness (1/5 on the Medical Research Council [MRC] grading scale, ASIA impairment scale B), without radiological abnormality. Methods Conventional medical management (hypertension, level 2 care) was instigated with the addition of Riluzole, with no effect after 30 hours. At 36 hours 100% oxygen at 2.8 atmospheres was applied for 90 minutes, and repeated after 8 hours, with a further three treatments over 48 hours. Results The patient demonstrated near-immediate improvement in lower limb function to anti-gravity (MRC grading 3/5) after one treatment. Motor improvement continued over the following treatments, and after 2 weeks the patient was ambulatory. At 4 months, the patient demonstrated normal motor function with no sphincteric disturbance. Conclusion The application of HBOT contributed to the immediate and sustained improvement (ASIA B to ASIA E) in motor recovery after postoperative spinal cord injury. HBOT may represent a new avenue of therapy for spinal cord injury, and requires further prospective investigation. Level of evidence 4.

This study aimed to identify the number of gifted children, and the teachers’ (mis) conception about giftedness. The study was carried out in public schools in the city of Bauru in the state of São Paulo, Brazil. Data was collected by asking teachers to fill in a standardized form about the characteristics of gifted children and to answer a questionnaire agreeing or disagreeing with assumptions regarding gifted students’ behavior. The research was carried out with 111 teachers from elementary school: 82% with a major degree in pedagogy and 22.5% with a post-graduation (lato sensu) course. This research revealed important and relevant data that may be used as guidelines to plan teacher development courses and seminar on the subject, including that 29% of the teachers have little knowledge on the subject; 36,9% teacher were currently teaching gifted students and 93,6% of them had students with three or more characteristics of giftedness in their classes. Gifted children were mostly reported in Arts (19.82%), secondly in logical reasoning (5.41%), and thirdly in intelligence (4.5%). Este estudio tuvo como objetivo identificar la cantidad de niños superdotados y la concepción (errónea) de los maestros sobre la superdotación. El estudio se realizó en escuelas públicas de la ciudad de Bauru en el estado de Sao Paulo, Brasil. La fecha se recopiló solicitando a los maestros que rellenen un formulario estandarizado sobre las características de los niños superdotados y que respondan a un cuestionario de acuerdo o en desacuerdo con los supuestos sobre el comportamiento de los alumnos superdotados. La investigación se realizó con 111 docentes de la escuela primaria: 82% con especialización en pedagogía y 22.5% con un curso de posgrado (lato sensu). Esta investigación reveló datos importantes y relevantes que pueden usarse como pautas para planificar cursos y seminarios de desarrollo docente sobre el tema, incluido que el 29% de los maestros tienen poco conocimiento sobre el tema; el 36.9% de los maestros actualmente enseñaban a estudiantes superdotados y el 93.6% de ellos tenían estudiantes con tres o más características de superdotados en sus clases. Los niños superdotados se informaron principalmente en Artes (19.82%), en segundo lugar en razonamiento lógico (5.41%) y en tercer lugar en inteligencia (4.5%).

The present study aimed to evaluate the partial pressure of arterial blood gases on breath-hold divers performing a submersion at 40 m. Eight breath-hold divers were enrolled for the trials held at “Y-40 THE DEEP JOY” pool (Montegrotto Terme, Padova, Italy). Prior to submersion, an arterial cannula in the radial artery of the non-dominant limb was positioned. All divers performed a sled-assisted breath-hold dive to 40 meters. Three blood samplings occurred: at 10 minutes prior to submersion, at 40 meters depth, and within 2 minutes after diver’s surfacing and after resuming normal ventilation. Blood samples were analyzed immediately on site. Six subjects completed the experiment, without diving-related problems. The theoretically predicted hyperoxia at the bottom was observed in 4 divers out of 6, while the other 2 experienced a reduction in the partial pressure of oxygen (paO2) at the bottom. There were no significant increases in arterial partial pressure of carbon dioxide (paCO2) at the end of descent in 4 of 6 divers, while in 2 divers paCO2 decreased. Arterial mean pH and mean bicarbonate (HCO3-) levels exhibited minor changes. There was a statistically significant increase in mean arterial lactate level after the exercise. Ours was the first attempt to verify real changes in blood gases at a depth of 40 m during a breath-hold descent in free-divers. We demonstrated that, at depth, relative hypoxemia can occur, presumably caused by lung compression. Also, hypercapnia exists at depth, to a lesser degree than would be expected from calculations, presumably because of pre-dive hyperventilation and carbon dioxide distribution in blood and tissues.

Submitted by Elana Simone Schiavo Caramano null (lanacaramano@gmail.com) on 2017-03-21T12:24:57Z No. of bitstreams: 1 Dissertação_MESTRADO_Docencia_ElanaCaramano2017.pdf: 6428227 bytes, checksum: 25b42f3c8b34b4e9f22db1ae1d16e337 (MD5) Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2017-03-23T18:28:10Z (GMT) No. of bitstreams: 1 caramano_ess_me_bauru.pdf: 6428227 bytes, checksum: 25b42f3c8b34b4e9f22db1ae1d16e337 (MD5) Made available in DSpace on 2017-03-23T18:28:10Z (GMT). No. of bitstreams: 1 caramano_ess_me_bauru.pdf: 6428227 bytes, checksum: 25b42f3c8b34b4e9f22db1ae1d16e337 (MD5) Previous issue date: 2017-02-24 Parece não ser mais possível pensar na Educação de Jovens e Adultos sem contemplar o uso das Tecnologias Digitais de Informação e Comunicação (TDIC), uma área aberta à exploração para a criação de novas e efetivas situações de ensino e aprendizagem. Tendo em vista o atendimento a um público tão heterogêneo quanto o do CEEJA, em sua modalidade semipresencial, objetiva-se, neste trabalho, apresentar uma proposta de elaboração de videoaulas instrucionais como organizadores prévios para uma aprendizagem mais significativa na disciplina de língua estrangeira moderna – LEM – Inglês. Essa proposta representa a inserção das TDICs, especificamente, na implementação de um ambiente digital de aprendizagem, na mediação contextual do material didático (EJA – Mundo do Trabalho), diante das dificuldades percebidas em observações em sala de aula (de um CEEJA no interior paulista) e dos inúmeros fatores dificultadores que os educandos da EJA enfrentam ao retomarem os estudos. Daí a pertinência de uma reflexão sobre a prática pedagógica em suas relações históricas para o desenvolvimento de novas estratégias perante as demandas e premências de um mundo em constante mudança. Assim, considerando o princípio da filosofia freireana no que concerne ao respeito dos saberes dos educandos, bem como os conceitos de Ausubel sobre aprendizagem significativa em relação àquilo que o aprendiz já sabe, dá-se ênfase à aprendizagem como processo dialógico de significação e autonomia que compreende a aquisição de um repertório de signos, na articulação de múltiplas linguagens (verbais, não verbais, audíveis), por meio de videoaulas para a constituição da consciência e autonomia do educando. Ao educador cabe o papel de mediador desse processo, com a consciência de suas ações como construtor de conhecimentos, atento às necessidades dos educandos e reflexivo sobre suas práticas pedagógicas. It seems no longer possible to think of the Youth and Adult Education without contemplating the use of Digital Information and Communication Technologies (DICT), an area where new teaching-learning situations can be explored to provide new and effective situations of teaching and learning. Bearing in mind the importance of assisting such a diverse audience as the students at a CEEJA, a Youth and Adult Education program in Brazil, in semi-distance learning mode, the objective of this dissertation is to develop instructional video lessons as previous organizers for a more meaningful learning of the discipline English as a foreign language, and the insertion of DICT through the implementation of a digital learning environment, on contextual mediation of learning material (EJA -Mundo do Trabalho - EJA World of Work), in face of the difficulties detected by observations in the classroom (at a CEEJA in São Paulo state) and for numerous complicating factors that students from EJA face when they resume their studies. Hence the relevance of a reflection on teaching practice in its historical relationship to the development of new strategies to meet the demands and exigencies of a world that is constantly changing. Therefore, considering the principle of Freire's philosophy regarding the respect for knowledge as well as the concepts of Ausubel about meaningful learning with respect to the learner already knows, this dissertation focuses on learning as a dialogic process of signification and autonomy, which includes the acquisition of a repertoire of signs, the articulation of multiple languages (verbal, nonverbal, audible), through video classes for the development of consciousness and autonomy of the learners. The educator’s role is being a mediator of this process, being aware of actions as a builder of knowledge, watching out the needs of learners and being reflective about their own teaching practices.

This study deals with the continuous education of teachers in special education, offered by the platform of Sao Paulo Network Program of teacher’s formation (REDEFOR), as well as the evaluation of the results of a study conducted by 38 in-course teachers regarding accessibility of 29 schools in the State of Sao Paulo. The objective, therefore, is to describe the results of the data collected by the in-course teachers about the accessibility conditions in their schools, through the protocol of routes. Evaluating 870 items, 19% were considered accessible, 18% were inaccessible, and 68% were not found adapted elements or accessible. It should be noted, as well, that a high percentage of elements not found, especially the fundamental as ramps (security), signs (communication) and elevators. Considering that the concomitance of accessible and inaccessible elements at the same amount where adapting an environmental requirement in rush in order to obey the legislation.

The aim of this study consists in the measurement of psychological health and adaptation in mothers of children during the first 12 months of treatment for leukaemia and in the identification of possible early predictors. Ninety-four mothers were followed longitudinally at one week (T1), one month (T2), six months (T3) and 12 months (T4) post-diagnosis. The instruments used were: PTSD symptom checklist, BSI-18, Problem Scale, Ladder of life and an in-depth interview (EFI-C). Couple connectedness, family routine reorganisation, parental communication around the child's illness and trust in the medical care significantly increased from T1 to T4. Two models are proposed concerning possible predictors of mothers' PTSS at T2 and at T3. Clinical suggestions are proposed on the basis of our empirical findings in order to plan informative, clinical and practical interventions for mothers of children under treatment for leukaemia.

Objective To assess post-traumatic stress symptoms (PTSS) in mothers of children over 2 years of leukemia treatment, to identify possible early family and child predictors of this symptomatology and to indicate the temporal trajectory of PTSS. Methods Participants were 76 Italian mothers (mean age = 37.30 years; SD = 6.07) of children receiving treatment for acute lymphoblastic (n = 69) or myeloid (n = 7) leukemia. Mothers had 12.05 years of education (SD = 3.87), and their incomes were average (52.1%), high (26%) and low (21.9%) for Italian norms, never in poverty. The pediatric patients with leukemia were equally distributed by gender with their mean age of 7.10 years (SD = 4.18). Post-traumatic stress symptoms were measured by a 17-item checklist. Scales assessing anxiety, depression, physical (Brief Symptom Inventory 18) and cognitive functioning (Problem Scale), and life evaluation were also used. There were five assessment points: 1 week (T1), 1 month (T2), 6 months (T3), 12 months (T4) and 24 months post-diagnosis (T5). Results The main results indicated moderate presence of clinical PTSS (≥9 symptoms: 24% at T2, 18% at T3, 16% at T4 and 19% at T5) that remained stable across time points, whereas Brief Symptom Inventory 18 Global score decreased and life evaluation improved. A series of hierarchical regression models identified cognitive functioning early after the diagnosis as the best predictive factor of PTSS across time points. Conclusion Specific psychological interventions could be devised for mothers at risk for short and long-term PTSS just after the diagnosis. Copyright © 2012 John Wiley & Sons, Ltd.

To assess post-traumatic stress symptoms (PTSS) in mothers of children over 2 years of leukemia treatment, to identify possible early family and child predictors of this symptomatology and to indicate the temporal trajectory of PTSS.Participants were 76 Italian mothers (mean age = 37.30 years; SD = 6.07) of children receiving treatment for acute lymphoblastic (n = 69) or myeloid (n = 7) leukemia. Mothers had 12.05 years of education (SD = 3.87), and their incomes were average (52.1%), high (26%) and low (21.9%) for Italian norms, never in poverty. The pediatric patients with leukemia were equally distributed by gender with their mean age of 7.10 years (SD = 4.18). Post-traumatic stress symptoms were measured by a 17-item checklist. Scales assessing anxiety, depression, physical (Brief Symptom Inventory 18) and cognitive functioning (Problem Scale), and life evaluation were also used. There were five assessment points: 1 week (T1), 1 month (T2), 6 months (T3), 12 months (T4) and 24 months post-diagnosis (T5).The main results indicated moderate presence of clinical PTSS (≥9 symptoms: 24% at T2, 18% at T3, 16% at T4 and 19% at T5) that remained stable across time points, whereas Brief Symptom Inventory 18 Global score decreased and life evaluation improved. A series of hierarchical regression models identified cognitive functioning early after the diagnosis as the best predictive factor of PTSS across time points.Specific psychological interventions could be devised for mothers at risk for short and long-term PTSS just after the diagnosis.

Clinician-parent communication may often be difficult, especially soon after the diagnosis. The aims of this article are to identify the communication strategies associated with expressions of adaptive emotions in parents and to explore the effect of the type of leukemia and of parent's gender on parents' expressions of emotions. The data are obtained from 4.622 conversational turns of 20 videotaped interviews with 10 mothers and 10 fathers of children at their first hospitalization for leukemia. A coding scheme for parent emotional expressions was reliably applied by two independent judges. An original self-report questionnaire on parents' emotional states was used before and after the interview. Positive politeness of interviewer elicits adaptive emotional expressions in parents. Mothers of children with acute myeloid leukemia and fathers of children with acute lymphoblastic leukaemia appear more distressed during the interview. This interview can be identified as an innovative technique of communication with parents of children with cancer.