Chronic pain is a prevalent and persistent problem in middle childhood and adolescence. The biopsychosocial model of pain, which accounts for the complex interplay of the biological, psychological, social, and environmental factors that contribute to and maintain pain symptoms and related disability has guided our understanding and treatment of pediatric pain. Consequently, many interventions for chronic pain are within the realm of rehabilitation, based on the premise that behavior has a broad and central role in pain management. These treatments are typically delivered by one or more providers in medicine, nursing, psychology, physical therapy, and/or occupational therapy. Current data suggest that multidisciplinary treatment is important, with intensive interdisciplinary pain rehabilitation (IIPT) being effective at reducing disability for patients with high levels of functional disability. The following review describes the current state of the art of rehabilitation approaches to treat persistent pain in children and adolescents. Several emerging areas of interventions are also highlighted to guide future research and clinical practice.

In recent years, a literature has emerged describing contributions fathers make to the development of very young children. Scholars suggest that active play may...

Objectives: Valid and efficient assessment of patient-reported outcomes remains a priority to guide pain treatment and research. PROMIS pediatric self-report and parent proxy measures offer feasible and rigorous evaluation of functioning in children with chronic conditions, including pain. A key challenge is determining the usefulness of multisource information from children and caregivers for understanding pain and function. Our primary aim examined child-caregiver agreement across child functioning domains. Our secondary aim examined child and caregiver factors associated with the child-caregiver agreement. Materials and Methods: A sample of 806 children with chronic pain (M _age=14.50 y; 72% female individuals) and a caregiver (M _age=45.82 y; 85% mothers) completed PROMIS pediatric self-report and parent proxy measures of anxiety, depression, fatigue, pain interference, and mobility before intake in an interdisciplinary outpatient pediatric chronic pain program. Results: The agreement was poor to good depending on the evaluation method (effect size, intraclass correlation, and clinical significance interpretation). Caregivers generally reported worse child symptoms across domains compared with child self-report. The greatest discrepancy was observed for child anxiety, pain interference, and peer relations, with the greatest agreement for child mobility. The greater caregiver-child discrepancy was found for younger children, girls, with a higher child or caregiver pain catastrophizing, and poorer caregiver physical or mental health. Discussion: Findings are discussed within the interpersonal context of pain and indicate the relevance of both child and caregiver perspectives to personalize chronic pain assessment and treatment. Findings can be used by clinicians and researchers to guide whether and how to integrate multi-informant reports about child chronic pain functioning.

Oomycetes attack a huge variety of economically and ecologically important plants. These pathogens release, detect and respond to signal molecules to coordinate their communal behaviors including the infection process. When signal molecules are present at or above threshold level, single zoospores can infect plants. However, at the beginning of a growing season population densities of individual species are likely below those required to reach a quorum and produce threshold levels of signal molecules to trigger infection. It is unclear whether these molecules are shared among related species and what their chemistries are.

Routines in the family are a potential source of resilience for at-risk children and support children's emerging emotion regulation. Meanwhile, inadequate sleep has been linked with deficits in cognitive processes to attend to environmental stimuli and with poor emotion regulation for children. The detrimental effects of poor sleep are potentially worse in low-income children. The aim of the current study was to examine the moderating role of sleep in the association between family routines and emotion regulation in toddlers in poverty. We analyzed data of 130 toddlers (24-31 months; 58% boys) from low-income, primarily African American families. Mothers completed questionnaires about child routines (Child Routines Questionnaire; CRQ; Wittig, 2005).To measure emotion regulation, toddlers completed an observed behavioral task meant to elicit frustration (Lab-TAB-Locomotor Version; Goldsmith & Rothbart, 1991). As hypothesized, adequate sleep (> 11 hr) fully moderated the association between routines and observed emotion regulation. There was no effect of routines on emotion regulation for toddlers with inadequate amounts of sleep. Analyses controlled for toddler respiratory sinus arrhythmia (RSA) as well as maternal emotion dysregulation (the Emotional Dysregulation Scale; EDS; Westen, Muderrisoglu, Fowler, Shedler, & Koren, 1997). These results emphasize the importance of sufficient sleep in at-risk toddlers. Furthermore, the results suggest that the effectiveness of family interventions focusing on family health to increase toddler emotion regulation could be improved by incorporating sleep interventions/routines. (PsycINFO Database Record (c) 2018 APA, all rights reserved).