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Generic self-management programs aim to facilitate behavioural adjustment and therefore have considerable potential for patients with chronic musculoskeletal pain. Our main objective was to collect and synthesize all data on the effectiveness of generic self-management interventions for patients with chronic musculoskeletal pain in terms of physical function, self-efficacy, pain intensity and physical activity. Our secondary objective was to describe the content of these interventions, by means of classification according to the Behaviour Change Technique Taxonomy. We searched PubMed, CENTRAL, Embase and Psycinfo for eligible studies. Study selection, data extraction and risk of bias were assessed by two researchers independently. Meta-analyses were only performed if the studies were sufficiently homogeneous and GRADE was used to determine the quality of evidence. We identified 20 randomized controlled trials that compared a self-management intervention to any type of control group. For post-intervention results, there was moderate quality evidence of a statistically significant but clinically unimportant effect for physical function and pain intensity, both favouring the self-management group. At follow-up, there was moderate quality evidence of a small clinically insignificant effect for self-efficacy, favouring the self-management group. All other comparisons did not indicate an effect. Classification of the behaviour change techniques showed large heterogeneity across studies. These results indicate that generic self-management interventions have a marginal benefit for patients with chronic musculoskeletal pain in the short-term for physical function and pain intensity and for self-efficacy in the long-term, and vary considerably with respect to intervention content.Significance: This study contributes to a growing body of evidence that generic self-management interventions have limited effectiveness for patients with chronic musculoskeletal pain. Furthermore, this study has identified substantial differences in both content and delivery mode across self-management interventions. [ABSTRACT FROM AUTHOR]

Introduction: Despite the importance of a biopsychosocial approach in chronic pain, many physiotherapists still adhere to a biomedical framework.1 To facilitate the adoption of a biopsychosocial view, more insight into barriers and facilitators for using this approach is required. The aim for this study is to map these barriers and facilitators. Methods: A scoping review was performed.2 Eligible studies present data on barriers and facilitators, chronic pain, primary care physiotherapy and a biopsychosocial perspective. Extracted data on barriers and facilitators was discussed and sub grouped in themes following a qualitative content analysis approach, using the Theoretical Domains Framework3 and a micro-meso-macro layout to organise and map the different themes. Results: Twenty-three studies were included. Although analyses are ongoing preliminary results show that on a micro-level barriers and facilitators concern the therapist (knowledge, skills, attitudes, confidence, role clarity, patient perception, etc.), the patient (expectations, etc.) and the patient-therapist relationship. On a meso-level barriers relating to the environmental context (time, treatment-fee, etc.) were identified. Discussion: It appears that a level of saturation was reached, suggesting a complete picture of known barriers and facilitators. There is, however, a large variety in used terminology and unclarity of what a biopsychosocial model entails. The presented overview can be used to inform professionals, researchers and policy-makers when designing strategies for implementation. Process evaluation: The focus in the search strategy was on studies mentioning the biopsychosocial model. This might have resulted in missing studies that implicitly adopted this approach. [ABSTRACT FROM AUTHOR]

Introduction: Despite the importance of a biopsychosocial approach in chronic pain, many physiotherapists still adhere to a biomedical framework. Designing a teaching program that supports obtaining adequate competencies in the participant's context is challenging.1 This study describes the development of a program for learning primary care physiotherapists to use the biopsychosocial model in chronic pain. Methods: Participatory Action Research methodology, including experts in chronic pain, education and co-design as well as the target audience, was used. Information gathered from literature and curricula of EFIC and IASP was combined with interviews and focusgroups with stakeholders. Co-design methods structured by several design-sprints were used to create, iterate and pilot-test choices of content, and design-and educational solutions.2 Data were summarized in a Plan of Requirements. Results: Based on the Plan of Requirements a three-month program was developed containing three days of face-to-face learning, online learning and facilitated learning in the workspace.3 The program challenges participants to move out of their comfort zone, with room for active personal learning and respect for the dynamic nature of skills needed for working with chronic pain. Discussion: The use of a broad range of stakeholders strengthens the consistency, content and validity of the program. Co-design as a method for development is, though rich, difficult to replicate and present in a transparent manner. Next a feasibility study is needed to evaluate the program. Process evaluation: Because of COVID the design-process had to take place online hindering the interaction. However, it also facilitated the possibility for stakeholders to join for a brief consultation. [ABSTRACT FROM AUTHOR]

We present a case of presumed arachnoid cyst that was diagnosed at 18.5 weeks' gestation, developed a hematoma at 28 weeks and had virtually resolved by 32 weeks. Expectant management of antenatally diagnosed cases is suggested. [ABSTRACT FROM AUTHOR]

Provides information on the diagnosis of arachnoid cyst. Details of arachnoid cyst; Process of screening tumors in the central nervous system; Information on cyst growth.