Study protocol for an adaptive, multi-arm, multi-stage (MAMS) randomised controlled trial of brief remotely delivered psychosocial interventions for people with serious mental health problems who have experienced a recent suicidal crisis: Remote Approaches to Psychosocial Intervention Delivery (RAPID).

BACKGROUND: People with serious mental health problems (SMHP) are more likely to be admitted to psychiatric hospital following contact with crisis services. Admissions can have significant personal costs, be traumatic and are the most expensive form of mental health care. There is an urgent need for treatments to reduce suicidal thoughts and behaviours and reduce avoidable psychiatric admissions. METHODS: A multi-stage, multi-arm (MAMS) randomised controlled trial (RCT) with four arms conducted over two stages to determine the clinical and cost effectiveness of three psychosocial treatments, compared to treatment as usual (TAU), for people with SMHP who have had recent suicidal crisis. Primary outcome is any psychiatric hospital admissions over a 6-month period. We will assess the impact on suicidal thoughts and behaviour, hope, recovery, anxiety and depression. The remote treatments delivered over 3 months are structured peer support (PREVAIL); a safety planning approach (SAFETEL) delivered by assistant psychologists; and a CBT-based suicide prevention app accessed via a smartphone (BrighterSide). Recruitment is at five UK sites. Stage 1 includes an internal pilot with a priori progression criteria. In stage 1, the randomisation ratio was 1:1:1:2 in favour of TAU. This has been amended to 2:2:3 in favour of TAU following an unplanned change to remove the BrighterSide arm following the release of efficacy data from an independent RCT. Randomisation is via an independent remote web-based randomisation system using randomly permuted blocks, stratified by site. An interim analysis will be performed using data from the first 385 participants from PREVAIL, SAFETEL and TAU with outcome data at 6 months. If one arm is dropped for lack of benefit in stage 2, the allocation ratio of future participants will be 1:1. The expected total sample size is 1064 participants (1118 inclusive of BrighterSide participants). DISCUSSION: There is a need for evidence-based interventions to reduce psychiatric admissions, via reduction of suicidality. Our focus on remote delivery of established brief psychosocial interventions, utilisation of different modalities of delivery that can provide sustainable and scalable solutions, which are also suitable for a pandemic or national crisis context, will significantly advance treatment options. TRIAL REGISTRATION: ISRCTN33079589. Registered on June 20, 2022.

Determining Barriers to Use of Edible School Gardens in Illinois.

OBJECTIVE: The objective of this study was to gather data regarding the awareness, perceived benefits, interest in, and barriers to establishment of edible school gardens in Illinois public schools. METHOD: Setting/Design: This study used an online survey design. PARTICIPANTS: Participants included Illinois public elementary school principals and superintendents. VARIABLES MEASURED: Region and community population, current edible garden use, perception (Likert scale) of garden benefits, interest in establishment of a school edible garden, and barriers to establishment of a school edible garden were the variables of interest. ANALYSES: Logit regression and Kruskal-Wallis with follow-up where p < 0.05 were performed. RESULTS: Elementary school principals and superintendents are aware of gardens and their potential benefits to students, but many barriers exist that make their use challenging. Funding, staff and volunteer support, and class time were identified as the major barriers. Region affected likelihood of garden use, and community population size also affected the odds of having an edible school garden. CONCLUSION AND IMPLICATIONS: Data suggest that edible garden use would increase with provision of resources and organization of dedicated supporters.

Producing biodiesel using whole-cell biocatalysts in separate hydrolysis and methanolysis reactions.

This research examined the effect of using separate hydrolysis and methanolysis reactions for biodiesel production using a whole-cell biocatalysts derived from Rhizopus Oryzae (ATCC 10260). Biodiesel yield from separate hydrolysis and methanolysis was compared to transesterification reactions where both hydrolysis and methanolysis reactions occur in the same reactor. All reactions were conducted at room temperature. The effect of substituting ethanol for methanol was also studied. Separating the hydrolysis and methanolysis reactions did not significantly increase biodiesel yields; however, this approach successfully converted about 99% of triglycerides into fatty acid methyl esters (FAME) and free fatty acids (FFA). Use of ethanol in place of methanol did not significantly improve the biodiesel yield. However, there is evidence that ethanol may either esterify FFA more quickly than methanol, or result in a more stable ester. The best biodiesel yield was about 90% when a transesterification reaction using methanol was followed by one hydrolysis and one ethanolysis reaction; however, this is only slightly higher than the 88% biodiesel yield of two transesterification reactions in series (using methanol as alcohol).