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For adolescents living with higher body weight, changing lifestyle behaviours can be met with challenges due to psychosocial factors, such as mental health and emotional challenges. Few behavioural interventions have included skill development to manage these mental health and emotional challenges.
The feasibility of a dialectical behavioural therapy (DBT)–enhanced lifestyle intervention will be evaluated through a pilot randomised controlled trial. We will recruit 90 adolescents aged 14–17 years with a body mass index Z-score >1.4 and mild-to-moderate depressive symptoms to participate with a caregiver in the trial. Adolescents will be randomised 2:2:1 to one of the three study arms: (A) behavioural lifestyle intervention with DBT skills training, (B) behavioural lifestyle intervention alone (ie, without DBT skills training) or (C) control. The interventions will include two sessions weekly for 16 weeks that include (1) one modified DBT skills training with two facilitators, supervised by a clinical psychologist, combined with one behavioural lifestyle session delivered by a dietitian and/or a kinesiologist and (2) two behavioural lifestyle sessions alone. DBT skills training will consist of teaching mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness and walking the middle path modules. Behavioural sessions will be guided by evidence-based practices for goal setting, dietary counselling, improving sleep, reducing screen time and structured physical activity. The main outcomes are enrolment rates, adherence to the intervention and retention rates for follow-up measurements. The secondary outcome will be changes in the quality of life (Pediatric Quality of Life Inventory) and daily physical activity levels between baseline and immediately post-intervention. Adolescents will participate in a focus group incorporating photo elicitation to explore satisfaction, acceptability and perceived benefits of the study arms.
This study has received ethical approval from the University of Manitoba’s Biomedical Research Ethics Committee (HS24295-H2020:427), Hamilton Health Sciences & McMaster University (HiREB 18159) and The Conjoint Health Research Ethics Board (CHREB), University of Calgary (REB24-1084). Results will be disseminated through publication in peer-reviewed journals and be relevant to researchers and clinicians involved in paediatrics and paediatric weight management.
This discussion paper explores the group experience of a cohort of eight nurses completing our university's first professional nursing doctorate programme.
This paper aims to make sense of our shared experience and to contribute to what is known about doctoral study by sharing our insights.
Discursive paper.
Through individual and group reflections on our experience, we address the questions ‘why did we stay’? and ‘how do we make sense of the fact that we all, as a group, successfully completed the programme’? We drew on principles of collaborative and collective auto-ethnography to guide our group reflexivity in response to these questions.
The main reasons we gave for staying were: (i) commitment, which had three strands - ‘proving’, ‘obligation’ and ‘self-determination’ - and (ii) shared-identity and common humanity. The two further elements that helped us make sense of our cohort's completion were (i) the joy of learning together and (ii) professional friendship and Socratic inquiry.
As the first programme cohort for the nursing doctorate in our area, we became a close and supportive group, which we argue contributed to our success. We ascribed this to our characteristics as doctoral students and the creation of a sisterhood reminiscent of a community of practice. We also acknowledged the importance of the WhatsApp platform in facilitating group cohesion, and the sense of reflexive closure brought by the process of reflection at the end of our programme.
We recommend that doctoral cohorts, supervisors, and teaching teams systematically plan opportunities into programmes for organic relationship development and consider how the literature on communities of practice and academic persistence might support academic development. Academic staff could also encourage students to set up an online communication channel such as WhatsApp or similar at an early stage in their programmes and give particular consideration to closure and transition to post-doctoral practice on completion of professional doctorates.
Postpartum psychosis is a psychiatric emergency that occurs following childbirth. Women are often cared for in general psychiatric units or in psychiatric Mother and Baby units. Postpartum psychosis is associated with a significant risk of relapse. There is a need to explore how women perceive care to understand what works well or needs further improvement.
This review aimed to explore women's experiences of care and support for postpartum psychosis.
A systematic review using meta-ethnographic methods was conducted.
Comprehensive searches were conducted between 4 March 2024 and 4 March 2025 on five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Web of Science). Backward and forward chain searching was also undertaken.
Critical appraisal was conducted following screening. Reciprocal and refutational translation were used to form the synthesis, and a line of argument was developed. The eMERGe reporting guidelines were used.
Fifteen studies were included within this synthesis. All the studies were conducted in high income countries and included 235 women. Three main themes were developed. ‘Navigating the unknown’ explored women's perceptions of postpartum psychosis as a less well-known condition, and their informational needs. ‘The double-edged sword of care’ found that there were helpful elements of formal mental health care, but that accessing care was sometimes traumatic, stigmatising and conflicting to women's identities. ‘Seeking consolation and recovery’ explored women's need for psychological support and experiences of peer support.
The findings of this review highlighted women's needs in respect to informational support, medication support, psychological support and in-patient care settings. Mother and baby units were strongly preferred by women.
The findings highlighted a need for specialised care for postpartum psychosis.
There were no patient or public contributions.
Prospero (CRD42024515712)
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