IntroductionChronic pain is highly prevalent and associated with a large burden of illness; there is a pressing need for safe, home-based, non-pharmacological, interventions. Virtual reality (VR) is a digital therapeutic known to be effective for acute pain, but its role in chronic pain is not yet fully elucidated. Here we present a protocol for the National Institute of Health (NIH) Back Pain Consortium (BACPAC) VR trial that evaluates the effectiveness of three forms of VR for patients with chronic lower back pain (cLBP), a highly prevalent form of chronic pain.Methods and analysisThe NIH BACPAC VR trial will randomise 360 patients with cLBP into one of three arms, each administered through a head-mounted display: 1) skills-based VR, a program incorporating principles of cognitive behavioural therapy, mindful meditation and physiological biofeedback therapy using embedded biometric sensors; 2) distraction-based VR, a program using 360-degree immersive videos designed to distract users from pain; and 3) sham VR, a non-immersive program using two-dimensional videos within a VR headset. Research participants will be monitored for 12 weeks using a combination of patient-reported outcomes administered via REDCap (Research Electronic Data Capture), wearable sensor data collected via Fitbit Charge 4 and electronic health record data. The primary outcome will be the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference scale. Secondary outcomes will include PROMIS Anxiety, PROMIS Sleep Disturbance, opioid prescription data and Pain Catastrophizing Scale Short Form. A subgroup analysis will explore patient level predictors for VR efficacy.Ethics and disseminationEthics approval was obtained from the Institutional Review Board of Cedars-Sinai Health System in April 2020. The results will be disseminated in a peer-reviewed journal.Trial registration numberNCT04409353.

Although there has been much discussion about making psychological research more relevant to social issues, such research has not become prevalent. Why is this the case? What stands in the way of carrying out research that meets traditional standards of quality while bearing upon significant public issues? And what can be done about the situation?The professional training one receives tends to shape what one perceives to be interesting and useful research topics. Topics may be ignored because they do not come within the angle of vision of traditionally trained social scientists rather than because the topics are fundamentally useless or uninteresting. This article.does not merely state such an opinion but proceeds to the more difficult task of what can be done to develop broader research. Important issues regarding the training and experiences of researchers are raised here. These issues can be illuminated by first considering the rationale and data of a research project specifically aimed at being relevant to a social program and policy. Reasons then are discussed why research into this area and similar policy areas has not been developed by academically based social

Four recent articles were examined for their use of resting-state functional magnetic resonance imaging on participants with posttraumatic symptoms. Theory-driven computations were complemented by the novel use of network metrics which revealed reduced global centrality and higher efficiency within the default mode network for participants with posttraumatic symptoms. Data-driven methods from other studies revealed associations between functional networks and PTSD symptoms as well as clusters of functional activation corresponding to different PTSD presentations.

Objective To examine whether girls with attention deficit/hyperactivity disorder (ADHD) demonstrate positive illusory self-perceptions during adolescence and young adulthood. Methods We tested, across a 5-year longitudinal span, whether self-perceptions versus external-source ratings were more strongly predictive of young adulthood impairment and depressive symptoms. Participants included an ethnically diverse sample of 140 girls with ADHD and 88 comparison girls, aged 11–18 years (M = 14.2) at adolescent and 19–24 years (M = 19.6) at young adult assessment. Results Although girls with ADHD rated themselves more positively than indicated by external ratings, their self-reports still did not differ significantly from external ratings in both scholastic competence and social adjustment domains. Comparison girls, on the other hand, rated themselves significantly less positively than indicated by external ratings in social adjustment. Positive discrepancy scores in adolescence did not significantly predict depressive symptoms in young adulthood and vice versa. Crucially, measures of actual competence in adolescence were more strongly associated with young adulthood impairments than were inaccurate self-perceptions for girls with ADHD. Conclusions Our findings continue to challenge the existence of a positive illusory bias among girls with ADHD, including any association of such bias with key indicators of impairment.

Specifically, a significantly greater proportion of the SG had severe/ extreme PRI (67% vs. 18%; G2¼9.220, p¼.005) and was unemployed (68% vs. 30%; G2¼5.207, p¼.032), as compared to the comparison group. Conclusions: Individuals with CLBP and a high pain impact reported higher pain severity, more severe/extreme PRI, decreased LQS, poor GHS, and no work productivity. Study supports the concept of the five cardinal constructs of the PRO core set for CLBP. Future research should be on whether patient's satisfaction with quality of care provided is influenced when these constructs are assessed. Objective: To test the hypothesis that lesion size using cervical water-cooled radiofrequency ablation (RFA) is not affected by different injectates and different volumes of injectate. Design: Basic science -preclinical in vitro study. Setting: Outpatient Interventional Spine Clinic. Participants: Lesions were created in thawed chicken breasts using the water-cooled RFA probes and generator. Interventions: With use of the cervical water-cooled RFA probes and generator, lesions were created in the thawed chicken breasts first with no added injectate. We then used sterile saline, 1% lidociane, 0.25% bupivicaine, and 0.5% bupivicaine at volumes of 0.5cc, 1cc, and 2cc. The lesion was created for 150 seconds at 80 degrees Celcius (60 degrees at the tip of the probe with watercooled technology). After the lesion was created, the chicken breast was cut along the axis of the needle and the diameter of the lesion was measured. Main Outcome Measures: Lesion size. Results or Clinical Course: The diameters of the lesions were consistently between 6 and 7mm, not affected by the injectate or the injectate volumes. Conclusions: The lesions created using the cervical water-cooled RFA probes in chicken breast were not significantly affected by different injectates or their volumes. Unlike traditional RFA where prior studies have noted the lesion size to vary with different injectates and volumes, practitioners using water-cooled RFA can be confident that the lesion size will be consistent.