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Abstract Background Anorexia nervosa (AN) has amongst the highest mortality rates and the highest treatment costs of any psychiatric disorder. Recently, interest in non-invasive brain stimulation as a novel treatment for AN has grown. These include repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). Methods This double-blind, randomised sham-controlled trial will compare the relative acceptability and efficacy of tDCS and rTMS in people with AN. 70 participants will be randomised to active or sham tDCS, or active or sham rTMS treatment (2:1:2:1 ratio) over an 8-week treatment period. Participants will receive treatment as usual across the study duration. The primary outcomes are change on the Eating Disorder Examination Questionnaire and treatment acceptability. Secondary outcomes will include change in weight, cognition, mood, interpersonal functioning, and quality of life. Following the 8-week assessment, all participants will have the option of receiving an additional 12 weeks of at-home tDCS. A follow-up assessment will be conducted at 20 weeks post treatment. Discussion Research into non-invasive brain stimulation as treatments for AN has potential to improve clinical outcomes for patients by comparing the relative efficacy and acceptability of both treatment modalities in the inpatient and at-home setting (i.e., for at-home tDCS) results from this study will provide important information for informing future larger clinical trials of these treatments for AN. Trial registration ClinicalTrials.gov Identifier: NCT05788042.

Destruction wrought by hurricanes can physically impact schools, houses, and businesses, all of which can delay or prevent recovery within communities. This study investigated the awareness among five private K-12 Christian administrators of the United States Department of Education (USDOE) guidelines for developing emergency operation plans (EOPs) for effective response and recovery. The five administrators were selected from a pool of 12 whose schools sustained on-site damage during the 2017 hurricane season. Their interview responses supported evidence of general knowledge of USDOE guidelines. Notably, veteran administrators reported that their previous hurricane response experience was more useful than their knowledge of government EOP guidelines.

The study investigated the difficulties encountered by Grade 11 teachers in teaching Senior High School General Mathematics, the reasons for the problems, and the strategies employed by teachers in overcoming the challenges with an end view of developing training design. The sequential explanatory mixed methods design was used in the study with the aid of a questionnaire checklist and an interview to validate the answers generated by the questionnaires. The study revealed that the challenges in teaching emerged due to time constraints and mastery issues of contents. Though teachers were pedagogically and technologically equipped to teach the course, however, some have poor time management and link to peers to share the best strategies to cope with the problems. Hence, training, as well as seminars and workshops for the unmastered competencies/contents and the competencies with no strategies applied to deal with the difficulties in teaching, are to be provided to Grade 11 General Mathematics teachers by implementing the training design developed by the researchers.

BackgroundMost people with mental health problems do not seek help, with delays of even decades in seeking professional help. Lack of engagement with professional mental health services can lead to poor outcomes and functional impairment. However, few effective interventions have been identified to improve help-seeking in adults, and those that exist are not widely implemented to deliver public health impact. Co-designing interventions with people with lived experience of mental ill-health and other relevant stakeholders is critical to increase the likelihood of uptake and engagement with these programs. ObjectiveThis study aims to (1) test the effectiveness of a co-designed help-seeking program on increasing professional help-seeking intentions in employees in a workplace setting; (2) determine whether the program reduces mental illness stigma and improves help-seeking intentions and behavior, mental health literacy, mental health symptoms, and work and activity functioning relative to the control condition; (3) explore factors that facilitate broader implementation of the co-designed program; and (4) explore the cost-effectiveness of the co-designed program compared to the control condition over 6 months. MethodsA 2-arm cluster randomized controlled trial will be conducted (target sample: N=900 from 30 to 36 workplaces, with n=25 to 35 participants per workplace). The trial will compare the relative effectiveness of an enhanced interactive program (intervention condition) with a standard psychoeducation-alone program (active control condition) on the primary outcome of professional help-seeking intentions as measured by the General Help-Seeking Questionnaire. Secondary outcomes include the impact on mental illness stigma; mental health literacy; help-seeking attitudes and behavior; work and activity functioning; quality of life; and symptoms of mental ill-health including depression, anxiety, and general psychological distress. ResultsFacilitators of and risks to the trial are identified and addressed in this protocol. Recruitment of workplaces is scheduled to commence in the first quarter of 2024. ConclusionsIf effective, the program has the potential to be ready for rapid dissemination throughout Australia, with the potential to increase appropriate and efficient service use across the spectrum of evidence-based services. Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000270617p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385376 International Registered Report Identifier (IRRID)PRR1-10.2196/55529

The Canadian academy is dominated by Western epistemologies that devalue Indigenous ways of knowing and marginalize Indigenous communities, cultures, and histories (Louie et al., 2017). This paper draws on a cross-disciplinary, interprofessional collaboration between a School of Public Health Sciences and School of Social Work to develop an online graduate course that sought to advance knowledge and practice in Indigenous wellbeing and health through a social justice lens. We explore key considerations, strategies, and challenges undertaken by an interdisciplinary group of non-Indigenous professors to create a learning experience for students that challenges colonial ways of seeing, being, knowing, and doing in the professional practice fields of public health and social work and that serves to elevate and sustain Indigenous voices, knowledges, sciences, and practices within the academy. In doing so, we centre the process of course development, including working with an Indigenous Advisory Circle and Indigenous contributors of content, guest lecture videos, and artwork. The paper describes the creation of a relational teaching and learning community, while raising concerns about the institutionalization of this approach to Indigenous-focused course development in the absence of the structural changes needed to enhance the presence of Indigenous faculty and Elders in academic institutions.

There are more than 70 distinct sarcomas, and this diversity complicates the development of precision-based therapeutics for these cancers. Prospective comprehensive genomic profiling could overcome this challenge by providing insight into sarcomas' molecular drivers. Through targeted panel sequencing of 7494 sarcomas representing 44 histologies, we identify highly recurrent and type-specific alterations that aid in diagnosis and treatment decisions. Sequencing could lead to refinement or reassignment of 10.5% of diagnoses. Nearly one-third of patients (31.7%) harbor potentially actionable alterations, including a significant proportion (2.6%) with kinase gene rearrangements; 3.9% have a tumor mutational burden ≥10 mut/Mb. We describe low frequencies of microsatellite instability (