Occupational stress and burnout are prevalent among special education teachers and are associated with a range of professional, organisational and systemic challenges within educational settings. These challenges can adversely affect teachers’ mental health, well-being and professional functioning, highlighting the need for effective interventions to support their workforce.

This scoping review aimed to identify the available mental health interventions to manage occupational stress and burnout among special education teachers, with a focus on mental health and well-being outcomes.

Scoping review.

This scoping review was compiled using the Arksey and O’Malley methodological framework and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Searches were systematically conducted across six databases, namely CINAHL, Web of Science, Scopus, PUBMED (NCBI), EMBASE and Cochrane from January 1995 to February 2026.

We systematically searched for peer-reviewed original intervention studies published in English that examine mental health interventions to manage occupational stress and burnout among special education teachers in the school setting.

The identified studies were screened using Rayyan Software and data extraction was performed using a data extraction sheet. Of the 447 studies obtained through electronic databases, 12 were eligible after full-text screening and 6 studies were obtained via other methods. In total, 18 studies were finally considered in the review. The screening and data extraction were performed independently by two reviewers. The discrepancies were resolved through discussion between the reviewers; if unresolved, a third reviewer was consulted.

The review included studies involving 834 participants, of whom the majority were females (74.5%). Participants’ ages ranged from 21 to 65 years. 12 intervention approaches were identified, most commonly mindfulness-based interventions, yoga and Rational Emotive Behaviour Therapy. The findings suggest that these interventions may be associated with reductions in occupational stress and burnout, as well as improvements in mental health outcomes.

Using evidence-based interventions to manage stress and burnout among special education teachers can help to improve their mental health and overall well-being. This review highlights practical interventions that can be implemented in the workplace. Integrating scalable strategies into occupational health initiatives is essential to support the workforce’s well-being and sustainability.

Proactive deprescribing is the process of stopping a medicine and comprises four steps: (1) identify a patient for potential stop of a medicine, (2) evaluate a patient for potential stop of a medicine, (3) stop a medicine and (4) monitor after stopping.

The CHARMER (CompreHensive geriAtRician-led MEdication Review) trial is a stepped-wedge design to evaluate the effectiveness and cost-effectiveness of a behaviour change intervention to increase proactive deprescribing in hospitals. The CHARMER intervention comprises a deprescribing action plan, deprescribing briefings, videos of successful deprescribing consultations, deprescribing case studies workshop and a deprescribing performance dashboard. The process evaluation will explore trial processes, CHARMER intervention implementation, CHARMER behavioural mechanisms of action and contextual factors influencing these aspects.

The convergent parallel design process evaluation will follow the UK Medical Research Council guidance. We will interview: staff involved in CHARMER implementation, geriatricians and pharmacists who receive the intervention and research delivery staff involved in patient/carer recruitment and data collection. We will also interview patients/carers and primary care practitioners. Interviews will be supplemented with recordings of implementation activities and completed implementation manuals. Questionnaires will capture the extent to which the four proactive deprescribing steps are enacted by intervention recipients, measure the behavioural mechanisms by which the CHARMER intervention operates and capture the patient experience of proactive deprescribing. Qualitative data will be analysed thematically and then mapped to Normalisation Process Theory to explore implementation and the Theoretical Domains Framework to explore behaviour change. Most quantitative data will be analysed descriptively; however, changes in staff questionnaire responses preintervention and postintervention will be analysed using a Mann-Whitney test. We will triangulate qualitative and quantitative findings to explain intervention effects.

Ethical and governance approvals have been obtained by the Wales 2 Research Ethics Committee and the Health Research Authority, respectively. The dissemination strategy will be underpinned by the evidence-based Guide to Disseminating Research (GuiDiR) targeting healthcare practitioners, policy makers and patient-facing organisations.

ISRCTN13248281.

To investigate how patients with sarcoma present prior to diagnosis—through a general practitioner (GP) or another healthcare professional (HCP)—and describe presenting symptoms.

International observational cohort study.

Data were obtained from the longitudinal ‘QUality of life and Experiences of Sarcoma Trajectories’ (QUEST) cohort study, conducted across the Netherlands, the United Kingdom (UK), Australia and New Zealand.

Among 572 patients, 487 (85.1%) started their diagnostic trajectory at the GP (subcohort 1) and 85 (14.9%) with another HCP (subcohort 2)—mainly medical specialists treating unrelated conditions (36/85; 42.4%). Soft tissue sarcoma patients most often reported swelling, whereas bone sarcoma patients reported unexplained pain. Notably, 31/85 (36.5%) of subcohort 2 were asymptomatic. Reasons for delaying GP visits included assuming symptoms were minor and expecting them to resolve. Patients sought care when, among others, symptoms persisted and worsened.

Most patients first consulted a GP, underlining the role of primary care in sarcoma diagnosis internationally. Due to rarity and nonspecific symptoms, faster diagnosis remains challenging, requiring improvements in both primary and specialist care.

NCT03441906; Results.