***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Motor vehicle accidents ( MVAs ) are the main cause of Posttraumatic stress disorder ( PTSD ) in industrialized countries . This includes the frequently occurring but understudied situation of parents learning that their children were injured . However , unlike in other types of trauma survivors , little is known about the predictors of PTSD symptoms in mothers whose child has suffered an MVA . METHODS A group of 72 mothers and 28 fathers were prospect ively assessed for peritraumatic distress , peritraumatic dissociation , and PTSD symptoms 1 and 5 weeks after their child had suffered an MVA . RESULTS Levels of peritraumatic distress and dissociation were comparable to other trauma victims , 18 % of the mothers were considered to be suffering from probable PTSD . In mothers , significant positive correlations were found between PTSD symptoms and peritraumatic distress ( r=.34 ) and dissociation ( r=.37 ) , whereas mothers ' PTSD symptoms were associated with decreased peritraumatic dissociation in fathers ( r=-.37 ) . Even after controlling for covictim/witness status , peritraumatic distress was a predictor of mothers ' PTSD symptoms , explaining 14 % of the variance . CONCLUSIONS Peritraumatic response and PTSD symptoms should be routinely assessed among parents whose child has experienced a traumatic event OBJECTIVE To evaluate prospect ively the association between parental anxiety during treatment for childhood leukemia and posttraumatic stress symptoms ( PTSS ) after treatment ends . A secondary goal is to explore concurrent variables associated with parental avoidance after treatment ends . METHODS This is a longitudinal follow-up study of 113 parents of children treated for leukemia who previously participated in a study of procedural distress during treatment .  Data included parental self-report question naires completed during treatment and after treatment . RESULTS Using hierarchical multiple regression , we found anxiety during treatment to be a significant predictor of later PTSS for mothers , but not fathers . Anxiety , self-efficacy , posttraumatic growth and length of time since treatment ended were associated with parental avoidance . CONCLUSIONS Highly anxious parents are at risk for PTSS and may benefit from approaches that decrease anxiety during treatment and afterward . Enhancing self-efficacy related to follow-up care and identifying positive aspects of the traumatic experiences are suggested as treatment approaches for families after cancer treatment OBJECTIVE The American Academy of Pediatrics highlights the important role of pediatricians in recognizing adverse child responses to tragic events , such as traffic crashes . One challenge in effectively identifying children and their parents with troubling psychological responses to trauma is that little is known about the normal range of acute psychological responses in children and their parents in the immediate aftermath of traumatic events , making identification of adverse child responses difficult . Within the first month after a traumatic event , individuals may display reexperiencing , avoidance , and hyperarousal symptoms as well as dissociation ( eg , feelings of unreality or emotional numbing ) . The presence of these responses , collectively known as acute stress disorder ( ASD ) , alerts providers to those who may be at risk for ongoing difficulties . For beginning to develop an evidence base to guide pediatric care providers in addressing acute traumatic responses , the aim of the current investigation was to describe systematic ally the range and type of symptoms of ASD in children and their parents after pediatric traffic injury . METHODS A prospect i ve cohort study was conducted of traffic-injured children , who were 5 to 17 years of age and admitted to the hospital for treatment of injuries from traffic crashes , and their parents . All children who met eligibility criteria between July 1999 and May 2000 were invited to participate in the study . After consent/assent was obtained , children and their custodial parents ( or guardians ) were interviewed within 1 month after injury via a structured assessment to determine the circumstances of the crash and the presence of ASD symptoms . Relevant demographic and clinical information ( eg , age , race , gender , date of injury ) was abstract ed from the medical records of subjects . A survey instrument to assess the presence of ASD symptoms was completed by both the child and his or her guardian . All children completed the  Child Acute Stress Question naire , and all parents completed the  Stanford Acute Stress Reaction Question naire . Responses were scored for the presence of dissociation , reexperiencing , avoidance , and /or hyperarousal symptoms as well as broad distress ( symptoms present in every category ) . RESULTS Symptoms of ASD were commonly observed in the children and parents . Eighty-eight percent of children and 83 % of parents reported having at least 1 clinical ly significant symptom ; this affected 90 % of the families . Broad distress was observed for a large minority : 28 % of children and 23 % of parents . No statistically significant association was found between child broad distress and either child age ( r = -0.12 ) or child injury severity score ( r = -0.05 ) . chi(2 ) analyses revealed no significant association between broad distress and child gender , child race , or mechanism of injury . No statistically significant association was found between parent broad distress and child age ( r = -0.06 ) or child injury severity score ( r = 0.09 ) . chi(2 ) analyses revealed no significant association between parent broad distress and child gender or parent presence at the crash scene . Associations were found between parent broad distress and race in that fewer white parents reported broad distress . In addition , mechanism of injury was associated with parent broad distress : more parents reported broad distress when their children were involved in pedestrian-motor vehicle crashes , and fewer parents reported broad distress when their children were injured in a bicycle fall . CONCLUSIONS Pediatric care providers can expect to see some ASD symptoms in most children and parents in the immediate aftermath of traffic-related injury . Brief education is appropriate to explain that these symptoms are normal reactions that are likely to resolve . If symptoms persist for > 1 month or are particularly distressing in their intensity , then referral for psychological care may be necessary for treatment of posttraumatic stress disorder . Given the high prevalence of pediatric traffic crashes and the underdiagnosis of posttraumatic stress disorder , probing for recent crash exposure might be appropriate during routine child health maintenance . The following are recommendations for pediatricians : 1 ) routinely call the family several days and 1 to 2 weeks after a traffic injury and ask about behavioral symptoms and family function ; 2 ) make use of the ongoing physician-patient relationship to explore symptom presence and intensity and any functional impairment in the injured child ; a brief office visit with the child and parents could serve this purpose ; 3 ) be sure to explore the effect that the child 's injury has had on the family ; remember that the parent 's experience posttraumatic stress symptoms after pediatric traffic-related injuries and these symptoms may limit the parent 's ability to support the child ; 4 ) provide supportive care and give families the opportunity to discuss the crash and their current feelings ; do not force families to talk about the crash ; 5 ) although any child in a traffic crash or his or her parent is at risk for posttraumatic symptomatology , regardless of injury severity , particular attention should be paid to the parents of child pedestrians who are struck by motor vehicles . These parents experience posttraumatic symptoms more commonly than parents of children in other traffic crashes OBJECTIVE To report acceptability , feasibility , and outcome data from a r and omized clinical trial ( RCT ) of a brief intervention for caregivers of children newly diagnosed with cancer . METHOD Eighty-one families were r and omly assigned following collection of baseline data to Intervention or Treatment as Usual ( TAU ) . Recruitment and retention rates and progression through the protocol were tracked . Measures of state anxiety and posttraumatic stress symptoms served as outcomes . RESULTS Difficulties enrolling participants included a high percentage of newly diagnosed families failing to meet inclusion criteria ( 40 % ) and an unexpectedly low participation rate ( 23 % ) . However , movement through the protocol was generally completed in a timely manner and those completing the intervention provided positive feedback . Outcome data showed no significant differences between the arms of the RCT . CONCLUSIONS There are many challenges inherent in conducting a RCT shortly after cancer diagnosis . Consideration of alternative research design s and optimal timing for interventions are essential next steps Objectives : To examine children 's reports of their health-related quality of life ( HRQoL )  following paediatric traffic injury , to explore child and parental post-traumatic stress , and to identify children and parents with adverse outcomes . Design : Prospect i ve cohort study . Assessment s : shortly after the injury , three months and six months post injury . Setting : Department of Traumatology , University Hospital . Subjects : Fifty-one young traffic injury victims aged 8 - 15 years . Main measures : TNO-AZL  Children 's Quality of Life question naire and the Impact of Event Scale . Results : Short-term adverse changes in the child 's HRQoL were observed for the child 's motor functioning and autonomy . At three months , 12 % of the children and 16 % of the parents reported serious post-traumatic stress symptoms . Increased stress at three months , or across follow-up , was observed among hospitalized children , children with head injuries , and children injured in a motor vehicle accident . Parental stress was related to low socioeconomic status and the seriousness of the child 's injury and accident ( hospitalization , head injury , serious injury , motor vehicle involved , others injured ) . Conclusions : The children reported only temporary effects in their motor functioning and autonomy . Post-traumatic stress symptoms following paediatric traffic injury were not only experienced by the children , but also by their parents OBJECTIVE To report initial feasibility and outcome from a pilot study of a new three-session intervention for caregivers of children newly diagnosed with cancer , Surviving Cancer Competently Intervention Program-Newly Diagnosed ( SCCIP-ND ) . METHOD Nineteen families ( 38 caregivers ) were r and omly assigned to  SCCIP-ND  or treatment as usual subsequent to learning of their child 's illness . The study design included pre- and 2-month postintervention assessment s , with state anxiety and posttraumatic stress symptoms as outcomes . Feasibility was based on therapist feedback and supervision , program evaluations , and data from study -tracking procedures . RESULTS SCCIP-ND appears to be an acceptable intervention that can be used successfully with caregivers over the first few months after diagnosis . Recruitment and retention data document feasibility but also highlight challenges . Preliminary outcome data show changes in the desired direction [ e.g. , reduced anxiety and parental posttraumatic stress symptoms ( PTSS ) ] . CONCLUSIONS The pilot data are supportive of the value and challenges of developing evidence -based family interventions in pediatric psychology OBJECTIVE To determine if maternal distress predicts child adjustment outcomes or if child adjustment outcomes predict maternal distress among children newly diagnosed with cancer , and if a parent-focused intervention has downstream effects on child adjustment . METHODS Mothers ( n = 52 ) were r and omly assigned to a clinic-based , interdisciplinary intervention for parents of children newly diagnosed with cancer .  Measures of maternal distress and child adjustment were collected at baseline , posttreatment , and follow-up . RESULTS A lagged relationship was identified between maternal distress and child internalizing symptoms , but not externalizing symptoms . The parent intervention  reduced child internalizing and externalizing symptoms at follow-up . Only the child internalizing symptoms effect was mediated by reduced maternal distress . The child externalizing symptoms effect was mediated by unobserved parent factors . CONCLUSIONS This study provides support for illness adjustment and coping models that emphasize the role of parent factors in driving child adjustment outcomes and is encouraging for future parent-focused intervention research Objective : To assess short-term changes in child and parent psychiatric status following meningococcal disease . Design : Prospect i ve cohort study ; 3-month follow-up using parent , teacher , and child question naires . Setting : Hospital admissions to three pediatric intensive care units and 19 general pediatric wards . Patients : Sixty children aged 3–6 yrs , 60 mothers , and 45 fathers . Interventions : We administered measures of illness severity ( Glasgow Meningococcal Septicaemia Prognostic Score , days in hospital ) and psychiatric morbidity ( Strengths and Difficulties Question naires , parent and teacher versions ;  Impact of Event  scales ; General Health Question naire-28 ) . Measurements and Main Results : In children admitted to pediatric intensive care units , parental reports at 3-month follow-up showed a significant increase in emotional and hyperactivity symptoms and in related impairment ; symptoms of posttraumatic stress disorder were present in four of 26 ( 15 % ) children > 8 yrs old . Regarding the parents , 26 of 60 ( 43 % ) mothers in the total sample had question naire scores indicative of high risk for psychiatric disorder and 22 of 58 ( 48 % ) for posttraumatic stress disorder . In fathers there was high risk for psychiatric disorder in 11 of 45 ( 24 % ) and for posttraumatic stress disorder in 8 of 43 ( 19 % ) . Severity of the child 's physical condition on admission was significantly associated with hyperactivity and conduct symptoms at follow-up . Length of hospital admission was associated with psychiatric symptoms in the child and posttraumatic stress disorder symptoms in parents . There were also significant associations between psychiatric symptoms in children and parents . Conclusions : Admission of children to pediatric intensive care units for meningococcal disease is associated with an increase in and high levels of psychiatric and posttraumatic stress disorder symptoms in children and parents . Length of admission is associated with psychiatric symptoms in children and posttraumatic stress disorder symptoms in parents . Pediatric follow-up should explore psychiatric as well as physical sequelae in children and parents BACKGROUND Traffic crashes are the leading health threat to children in the United States , result ing in nearly 1 million injuries annually 
    Output:
    
Findings suggest a high prevalence of acute and posttraumatic stress symptoms in parents .