Codesigning a systemic discharge intervention for inpatient mental health settings (MINDS): a protocol for integrating realist evaluation and an engineering-based systems approach.

INTRODUCTION: Transition following discharge from mental health hospital is high risk in terms of relapse, readmission and suicide. Discharge planning supports transition and reduces risk. It is a complex activity involving interacting systemic elements. The codesigning a systemic discharge intervention for inpatient mental health settings (MINDS) study aims to improve the process for people being discharged, their carers/supporters and staff who work in mental health services, by understanding, co-designing and evaluating implementation of a systemic approach to discharge planning. METHODS AND ANALYSIS: The MINDS study integrates realist research and an engineering-informed systems approach across three stages. Stage 1 applies realist review and evaluation using a systems approach to develop programme theories of discharge planning. Stage 2 uses an Engineering Better Care framework to codesign a novel systemic discharge intervention, which will be subjected to process and economic evaluation in stage 3. The programme theories and resulting care planning approach will be refined throughout the study ready for a future clinical trial. MINDS is co-led by an expert by experience, with researchers with lived experience co-leading each stage. ETHICS AND DISSEMINATION: MINDS stage 1 has received ethical approval from Yorkshire & The Humber-Bradford Leeds (Research Ethics Committee (22/YH/0122). Findings from MINDS will be disseminated via high-impact journal publications and conference presentations, including those with service user and mental health professional audiences. We will establish routes to engage with public and service user communities and National Health Service professionals including blogs, podcasts and short videos. TRIAL REGISTRATION NUMBER: MINDS is funded by the National Institute of Health Research (NIHR 133013) https://fundingawards.nihr.ac.uk/award/NIHR133013. The realist review protocol is registered on PROSPERO. PROSPERO REGISTRATION NUMBER: CRD42021293255.

Transcriptome Profiling of Wheat Seedlings following Treatment with Ultrahigh Diluted Arsenic Trioxide.

Plant systems are useful research tools to address basic questions in homeopathy as they make it possible to overcome some of the drawbacks encountered in clinical trials (placebo effect, ethical issues, duration of the experiment, and high costs). The objective of the present study was to test the hypothesis whether 7-day-old wheat seedlings, grown from seeds either poisoned with a sublethal dose of As2O3 or unpoisoned, showed different significant gene expression profiles after the application of ultrahigh diluted As2O3 (beyond Avogadro's limit) compared to water (control). The results provided evidence for a strong gene modulating effect of ultrahigh diluted As2O3 in seedlings grown from poisoned seeds: a massive reduction of gene expression levels to values comparable to those of the control group was observed for several functional classes of genes. A plausible hypothesis is that ultrahigh diluted As2O3 treatment induced a reequilibration of those genes that were upregulated during the oxidative stress by bringing the expression levels closer to the basal levels normally occurring in the control plants.

Extremely low doses of arsenic affect in vitro pollen germination.

INTRODUCTION: This study deals with the effects of extremely low doses or high dilutions of pharmacological compounds on in vitro pollen germination of kiwifruit (Actinidia deliciosa). MATERIAL AND METHODS: The biological efficacy of As2O3 at the 5th and 45th decimal dilution/succussion level (As 5x and As 45x) was tested on pollen previously stressed with As2O3 150 or 200 µM. The outcome variable was the pollen germination rate, as detected blind after 3 h 30 min by an Axioplan microscope. RESULTS: A directionally consistent recovery of germination percentage was observed in both As 5x and As 45x after stressing with As2O3 150 µM. When pollen was stressed with As2O3 200 µM only as 45x induced a general and significant germination increase. CONCLUSIONS: Our results suggest that both treatments might partially remove the inhibitory effect caused by the stressor. Similar effects were observed on the same model using weak extremely low frequency magnetic fields (ELF-MFs) mediated through water. Although preliminary, the findings seem to indicate the in vitro pollen performance as adequate to study the effects of physicochemical subthreshold stimuli (extremely low doses or high dilutions of pharmacological compounds, weak ELF-MFs), mediated through water.