Lived Experience of Health and Wellbeing Among Young People with Early Psychosis in Aotearoa New Zealand.

First episode psychosis (FEP) can disrupt a young person's life and future health. Those with lived experience of FEP can inform effective support. This study investigated how young people with FEP experience good health and wellbeing living in Aotearoa New Zealand. Recent clients of early intervention services (n = 12) shared their stories across varying traditional and creative platforms. Thematic analysis revealed seven themes important for living well with FEP: whanaungatanga (relationships), addressing stigma, finding out who I am with psychosis, getting the basics right, collaborative healthcare, understanding psychosis, and access to resources. The themes informed five supporting processes: whakawhanuangatanga (relationship-building), using holistic approaches, creating space for young people, reframing, and improving access to appropriate resources. These findings deepen our understanding of how we can support young people to live well with FEP. This study highlights the value of creative methods and partnering with lived experience experts to conduct meaningful health research.This trial was registered at Australian New Zealand Clinical Trials Registry (ANZCTR) CTRN12622001323718 on 12/10/2022 "retrospectively registered"; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384775&isReview=true .

Developing a System of Health Support for Young People Experiencing First-Episode Psychosis: Protocol for a Co-design Process.

BACKGROUND: People living with psychosis face a substantially increased risk of poor psychological well-being and physical health and premature mortality. Encouraging positive health behaviors from an early stage is crucial to the health and well-being of this population but is often overshadowed by symptom management within early intervention services. OBJECTIVE: Experience-based co-design is a participant-centered approach that aims to combine service user narratives with service design methods to design systems of support for health and well-being. This study aims to use experience-based co-design principles to co-design a system that supports the health and well-being of young people experiencing first-episode psychosis (FEP), which considers the lived experience of these people within the context of early intervention services. We also aim to develop a set of principles to guide future systems to support the health and well-being of young people experiencing FEP. METHODS: Up to 15 young people living with FEP aged 16 to 24 years who are service users of early intervention services in psychosis, their immediate support networks (family or friends), and health professionals involved with early intervention services in psychosis will be invited to participate in a series of co-design workshops. Data will be collected in various forms, including expressive forms (eg, art and spoken word) and traditional methods (interview transcription and surveys), with phenomenographic and thematic analyses being used to understand these data. Furthermore, the co-design process will draw upon indigenous (Maori) knowledge and the lived experience of mental health services from the perspectives of the members of the research team. The co-design process will be evaluated in terms of acceptability from the perspective of service users via rating scales and interviews. The study will be conducted within the Lower North Island in Aotearoa New Zealand. RESULTS: Data collection will be performed between August 2022 and February 2023. Drawing from extended consultations with service users and service providers, we have developed a robust co-design process with which we intend to collect rich qualitative and quantitative data. The results of this process will be used to create a system of support that can be immediately applied and as preliminary evidence for funding and resource applications to deliver and evaluate a "full" version of the co-designed system of support. CONCLUSIONS: The co-designed system of support and accompanying set of principles will offer a potentially impactful health and well-being intervention for young people experiencing FEP in Aotearoa New Zealand. Furthermore, making the co-design process transparent will further the field in terms of providing a blueprint for this form of participant-focused research. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622001323718; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384775&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44980.

Empowering Women in the Face of Body Ideals: A Scoping Review of Health Promotion Programs.

Achieving women's health equity and empowerment is a global priority. In a Western context, women are often disempowered by the value society places on body size, shape or weight, which can create a barrier to health. Health promotion programs can exacerbate women's preoccupations with their bodies by focusing outcomes toward achieving an "ideal" body size. Women's health promotion activities should be empowering if the desired outcomes are to improve their health and well-being long-term. This review sought to identify key elements from health promotion programs that aimed to empower women. A search was conducted in PubMed, MEDLINE, Web of Science, Scopus, CINAHL complete, and Academic Search Premiere databases. The search yielded 27 articles that collectively reported on 10 different programs. Through thematic synthesis, each article was analyzed for (1) key program features employed to empower women and (2) how such programs evaluated women's health. Seven themes resulted, of which five describe key empowering features (active participation, social support, sustainable change, holistic health perspective, strength-based approach) and two evaluation characteristics (assessment across multiple health domains and a mixed-method design). The findings from this review can assist health promoters to design and improve initiatives that aim to empower women.

Identification of potential 'lifestyle-responsive' epigenomic biomarkers in healthy women aged 18-40.

CONTEXT: Human health is complex and multifaceted; there is a need for biomarkers that reflect the multidimensional nature of health. OBJECTIVE: To identify potential epigenomic biomarkers of health in women aged 18-40 participating in a six-month lifestyle intervention, next level health. MATERIALS AND METHODS: Methylation data were obtained by reduced representation bisulphite sequencing of 21 female intervention participants as well as three non-participants. The Differential Methylation Analysis Package (DMAP) was used to investigate inter- and intra-individual variability and to identify potential targets of transient epigenetic control in the population studied. RESULTS: Eleven genes were identified as significantly differentially methylated post- intervention in all 21 participants. 1884 genomic locations were found to be differentially methylated amongst the total female population studied representing potential epigenomic biomarkers. CONCLUSIONS: The ability to demonstrate epigenetic changes arising from a lifestyle intervention can provide key information on the relationship between gene regulation, human behaviour and health.

Reliability of Central Adiposity Assessments Using B-Mode Ultrasound: A Comparison of Linear and Curved Array Transducers.

Recently, it was reported that intra-abdominal thickness (IAT) assessments using ultrasound are most reliable if measured from the linea alba to the anterior vertebral column. These 2 anatomical sites can be simultaneously visualized using a linear array transducer. Linear array transducers have different operational characteristics when compared with conventional curved array transducers and are more reliable for some ultrasound-derived measures such as abdominal subcutaneous fat thickness. However, it is unknown whether linear array transducers facilitate more reliable IAT measurements than curved array transducers. The purpose of the current study was to (1) compare the reliability of linear and curved array transducer assessments of IAT and maximal abdominal ratio (MAR) and (2) use the findings to update central adiposity measurement guidelines. Fifteen healthy adults (mean [SD], 27 [10] years; 60% female) with a range of somatotypes (body mass index: mean [SD], 24 [4]; range, 19-33 kg/m; waist circumference: mean [SD], 75 [11]; range, 61-96 cm) were tested on 3 mornings under standardized conditions. Intra-abdominal thickness was assessed 2 cm above the umbilicus (transverse plane), measuring from linea alba to the anterior vertebral column. Maximal abdominal ratio was defined as the ratio of IAT to abdominal subcutaneous fat thickness. The IAT range was 25 to 87 mm, and the MAR range was 0.15 to 0.77. Between-day intraclass correlation coefficient values for IAT measurements made were comparable (0.96-0.97) for both transducers, as were MAR values (0.95). In conclusion, while both transducers provided equally reliable measurement of IAT, the use of a single linear array transducer simplifies the assessment of central adiposity.

Reliability tests and guidelines for B-mode ultrasound assessment of central adiposity.

INTRODUCTION: Ultrasound represents a validated and relatively inexpensive diagnostic device for assessing central adiposity; however, widespread adoption has been impeded by the lack of reliable standard operating procedures. PURPOSE: To examine the reliability of, and describe guidelines for, ultrasound-derived recording of intra-abdominal fat thickness (IAT) and maximal preperitoneal fat thickness (PFT). METHODS: Ultrasound scans were obtained from 20 adults (50% female, 26 ± 7 years, 24·5 kg/m(2) ) on three different mornings. IAT was assessed 2 cm above the umbilicus (transverse plane) measuring from linea alba to: (i) anterior aorta, (ii) posterior aorta and (iii) anterior aspect of the vertebral column. PFT was measured from linea alba to visceral peritoneum in (i) sagittal and (ii) transverse planes, immediately over and inferior to the xiphi-sternum, respectively. RESULTS: For IAT, the criterion intraclass correlation coefficient (ICC) of 0·75 was exceeded for measurements to anterior aorta (0·95), posterior aorta (0·94) and vertebra (0·96). The reliability coefficient expressed as a percentage of the mean (RC%) was lowest (better) for measurement to vertebrae (9·8%). For PFT, mean thickness was comparable for sagittal (1·74 cm) and transverse (1·76 cm) planes; ICC values were also comparable for both planes (0·98 vs. 0·98, respectively), as were RC% (7·5% vs. 7·1%, respectively). CONCLUSIONS: IAT assessments to the vertebra were marginally more reliable than those to other structures. While PFT assessments were equally reliable for both measurements planes, precise probe placement was easier for the sagittal plane. Based on these findings, guidelines for the reliable measurement of central adiposity using ultrasound are presented.