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Background Caregivers of people with eating disorders (EDs) often support refeeding, behavioural monitoring, and co-ordinate therapeutic and medical appointments. Available support is often focused on the person with the ED and rarely on the caregiver. This study examined the impact of caregiving in New Zealand (NZ). Methods Current and previous caregivers completed an online, anonymous survey exploring their experience of caregiving and its psychological impact using the Depression, Anxiety, and Stress Scale (DASS-21), the Eating Disorders Symptom Impact Scale (EDSIS), and questions about the long-term impact of caregiving on caregivers’ mental health. A comparison was made with data on Australian caregivers. Results Current caregivers reported higher levels of depression and stress than those not currently caregiving, as well as higher levels of depressive symptoms than Australian caregivers. The impact of ED symptoms were also generally higher in NZ participants compared with Australian caregivers.The perceived impact of the ED was associated with the psychological distress experienced by caregivers with greater impact being linked to more distress. Of those whose loved ones were in recovery, more than 25% experienced ongoing post-traumatic symptoms related to their caregiving experience. Conclusion NZ caregivers reported ongoing effects related to caregiving even when the person with the ED had recovered. NZ caregivers experience a high level of distress and burden that can persist once recovery is achieved. Comprehensive ED support should include interventions to improve caregivers’ wellbeing. Plain English summary Caring for someone with an eating disorder (ED) can impact all aspects of daily life. We surveyed 153 New Zealand adults who are, or have been, the main caregiver for a loved one with an ED to learn how this role affects them. Most were parents, and about 70% cared for someone with anorexia nervosa. The toughest part was emotional: more than 60% of caregivers described relentless fear, anxiety, and isolation as their biggest challenges. Common mental health tests showed current caregivers had moderate depression and stress and mild anxiety—higher than scores in both the general public and Australian ED caregivers. Roughly one third also reported nightmares, flashbacks, or strong physical reactions when reminded of the caregiving period, pointing to trauma-like stress. Overall, the findings show that ED services need to recognise and actively support caregiver wellbeing during treatment and long after recovery, not just focus on the person with the ED.

There is a profoundly troubling history of research being done on Indigenous peoples without regard for their priorities and accompanying calls to decolonize health research. Storytelling methods can privilege Indigenous voices in research. Indigenous people’s knowledge systems have existed for millennium, where knowledge is produced and shared through stories. Our collaborative team of Indigenous and non-Indigenous researchers, and Indigenous Elders, patients, healthcare providers, and administrators, conducted a participatory, scoping review to examine how storytelling has been used as a method in Indigenous health research on Turtle Island (North America), Australia, and Aotearoa (New Zealand). We searched key databases and online sources for qualitative and mixed-methods studies that involved Indigenous participants and used storytelling as a method in health research. Reviewers screened abstracts/full texts to confirm eligibility. Narrative data were extracted and synthesized. An intensive collaboration was woven throughout and included gatherings incorporating Indigenous protocol, Elders’ teachings on storytelling, and sharing circles. We included 178 articles and found a diverse array of storytelling approaches and adaptations, along with exemplary practices and problematic omissions. Researchers honoured Indigenous ways of knowing, being, and doing through careful preparation and community engagement to do storywork, inclusion of Indigenous languages and protocols, and Indigenous initiation and governance. Storytelling centered Indigenous voices, was a culturally relevant and respectful method, involved a healing process, and reclaimed Indigenous stories. But it could result in several challenges when researchers did not meaningfully engage with Indigenous peoples. These findings can guide respectful storytelling research that bridges divergent Indigenous and Western knowledge systems, to decolonize health research.

Background There is a complicated and exploitative history of research with Indigenous peoples and accompanying calls to meaningfully and respectfully include Indigenous knowledge in healthcare. Storytelling approaches that privilege Indigenous voices can be a useful tool to break the hold that Western worldviews have within the research. Our collaborative team of Indigenous and non-Indigenous researchers, and Indigenous patients, Elders, healthcare providers, and administrators, will conduct a critical participatory, scoping review to identify and examine how storytelling has been used as a method in Indigenous health research. Methods Guided by two-eyed seeing, we will use Bassett and McGibbon’s adaption of Arksey and O’Malley’s scoping review methodology. Relevant articles will be identified through a systematic search of the gray literature, core Indigenous health journals, and online databases including Scopus, MEDLINE, Embase, CINAHL, AgeLine, Academic Search Complete, Bibliography of Native North Americans, Canadian Reference Centre, and PsycINFO. Qualitative and mixed-methods research articles will be included if the researchers involved Indigenous participants or their healthcare professionals living in Turtle Island (i.e., Canada and the USA), Australia, or Aotearoa (New Zealand); use storytelling as a research method; focus on healthcare phenomena; and are written in English. Two reviewers will independently screen titles/abstracts and full-text articles. We will extract data, identify the array of storytelling approaches, and critically examine how storytelling was valued and used. An intensive collaboration will be woven throughout all review stages as academic researchers co-create this work with Indigenous patients, Elders, healthcare professionals, and administrators. Participatory strategies will include four relational gatherings throughout the project. Based on our findings, we will co-create a framework to guide the respectful use of storytelling as a method in Indigenous health research involving Indigenous and non-Indigenous peoples. Discussion This work will enable us to elucidate the extent, range, and nature of storytelling within Indigenous health research, to critically reflect on how it has been and could be used, and to develop guidance for the respectful use of this method within research that involves Indigenous peoples and settlers. Our findings will enable the advancement of storytelling methods which meaningfully include Indigenous perspectives, practices, and priorities to benefit the health and wellbeing of Indigenous communities. Systematic review protocol registration Open Science Framework ( https://osf.io/rvf7q )

The Four R principles (4Rs) of respect, responsibility, relevance, and reciprocity were developed in the field of education by Kirkness and Barnhardt and have guided respectful approaches in research. Our purpose was to adapt the 4Rs for storytelling methods in Indigenous health research and identify associated exemplary research practices. Indigenous team members drew on their traditional Cree and Anishinaabemowin languages to formulate revised 4R definitions tailored to storytelling in health research and our location on Turtle Island, Treaty One territory. We used this adapted 4R framework to identify and analyze patterns of exemplary practices in studies (N=178) using storytelling methods. Our findings can guide respectful storytelling research to meaningfully incorporate Indigenous perspectives for the well-being and benefit of Indigenous communities.

Parents' use of discipline is thought to maintain children's misbehavior and is thus often a target of interventions. Although many parents benefit from treatment, some parents do not and less is known about factors that hinder parents' ability to benefit from treatment. Research on parental ADHD suggests that parents' executive functioning skills may influence their use of ineffective discipline. Additionally, although discipline is thought to be motivated by negative emotion, little attention has been paid to the influence that emotion has on the executive functioning skills used to execute discipline responses. This study used a dual-systems perspective to examine how both the cool and hot system of executive functioning would influence lax and overreactive discipline and if there were any interactions between the two systems. Fifty-nine parents of children between the ages of 2 and 5 years participated in the study. Results indicated that cool executive functioning related to increased overreactive discipline, but not lax discipline. Hot executive functioning was not related to either ineffective discipline. Subsequent analysis revealed that inhibitory skills specifically contributed to the predictive power of cool executive functioning on overreactive discipline. These findings emphasize the importance of inhibitory skills' influence on overreactive discipline and suggest that parent-based interventions should consider a parent's inhibitory abilities within the treatment.

The development of clinical reasoning in new graduate nurses is an essential component of nursing education. A lack of clinical reasoning in a new nurse can lead to poor patient outcomes and increased budget concerns for health care facilities. Limited studies were present regarding the use of the flipped classroom teaching method to promote development of clinical reasoning in the classroom setting. The question guiding the research was as follows: Is there a significant difference in the clinical reasoning skills of associate degree nursing students who have been instructed using the flipped classroom teaching method compared to those who have received instruction in a traditional lecture setting? A quasi experimental pretest/posttest design was utilized to answer the research question. Data produced from the Health Science Reasoning Test was analyzed using an analysis of covariance with the identified covariate of the pretest score to control for past developed clinical reasoning skills. The sample was consistent with national statistics related to gender and age of an associate degree nursing student. The intervention group had a large percentage of participants with previous experience as a health care worker. The career of a licensed practical nurse was the most represented health care career. Data analysis of the intervention group revealed a p 0.01; thereby indicating the flipped classroom teaching method had a positive effect on the development of clinical reasoning in associate degree nursing students. Results demonstrated the intervention was effective, however the resulted effect size was decreased due to the length of the intervention. Future recommendations for research included a longitudinal study of the flipped classroom to develop clinical reasoning, with the use of the intervention over multiple courses. Nurse educators and administrators should consider the length of the course instruction and the students’ previous experiences for maximum effectiveness of the method.

The micromechanical behaviour of model composites containing alpha-alumina fibres in epoxy has been studied using fluorescence spectroscopy. Using calibration constants determined for fibre strain versus alumina fluorescence peak position, strain and stress distributions in the embedded fibres were measured in-situ as the composites were loaded.Three types of alumina fibre, Nextel 610, PRD-166 and Saphikon, were characterised using scanning electron microscopy, x-ray diffraction and fluorescence spectroscopy. The fibre diameters range from 12 to 130 μm. PRD-166 has a significantly rougher surface than the others. This fibre has a randomly oriented polycrystalline structure, while Nextel 610 has a degree of texture. Saphikon is a single crystal with the long axis of the unit cell oriented parallel to the fibre axis. The fluorescence spectrum of all three fibres is composed of two intense peaks at about 14400 and 14431 cm-1, which shift to higher wavenumbers in approximately linear relationships with axial strain and stress.The fragmentation test, in which dumbbells containing single alumina fibres, fully embedded in epoxy resin were subjected to tensile stress, was performed whilst simultaneously measuring fluorescence spectra in a distribution along the embedded fibre length. This enabled the evaluation of the alumina epoxy interface. The interfacial shear strengths of the fibre-epoxy interfaces were found to be 40 MPa for Nextel 610, 38 MPa for PRD-166 and 18 MPa for Saphikon. The predictions of shear lag models were found to fit the data well. It was necessary to deduce certain parameters of the models from the measured data. Therefore the models are of limited use as predictive tools.In addition the axial and radial stress distributions were derived for Saphikon using stress- bandshift rates for the different crystallographic directions of ruby crystals. The axial stress scaled approximately linearly with strain, while the radial stress distributions provided a new insight into interfacial behaviour. The radial stress increased with applied load until interfacial debonding occurred, and then become zero for debonded parts of the interface.The push-in test, in which compressive stress is applied to the end of single, partially embedded fibres, was also performed using fluorescence spectra to measure strain and stress distributions in the embedded fibres. A protruding section of the fibre was used as a ‘push rod’ for the application of stress to the embedded fibre. A shear lag model was used to fit the data. The strain in Saphikon was found to be affected by a compressive radial component. When the axial strain was calculated this was found to fit the model better.The Broutman test, in which modified dumbbells containing single, fully embedded fibres are subjected to compressive load, was performed using fluorescence spectroscopy to evaluate the fibre strain distributions for the first time. The nucleation of debonding due to radial tension across the interface was detected using the radial stress distribution before it became visible using optical methods.The multiple fibre fragmentation test, in which a dumbbell containing several fully embedded parallel fibres is subjected to tensile stress, was performed for Saphikon in epoxy resin. The large diameter of the Saphikon fibre enabled fluorescence spectra to be obtained as a transverse distribution, and therefore strain, axial stress and radial stress variations were obtained across the width of the embedded fibre. The radial stress was found to be relieved on the side nearer to a broken fibre due to the stress field surrounding a damage site.