title: Who should we listen to? Comparing parent and child report of post-concussive symptoms

authors: Liddicoat, Zabé

abstract: A significant proportion of people worldwide are impacted by the effects of traumatic brain injury (TBI). Research into the incidence and severity of TBI demonstrates that the majority of injuries are mild (such as concussion) and are experienced by children and adolescents. Despite the significance of concussion in young people, there is limited research exploring the impact of this injury on this age group. This is compounded by a lack of clarity on how best to assess concussion symptoms with regard to the measure utilised, timing of assessment, and informant reporting. Assessing concussion in children and adolescents is complicated by the child’s ability to report on concussion symptoms and negotiating reporting from parents and children simultaneously. Previous research has identified gaps in the literature including: lack of acute assessment of symptoms, few longitudinal studies into the pattern of symptom reporting over time, and lack of research associating subjective symptom reports with other objective symptom measures. Therefore, the main aims of this study were: 
i)	To assess parent and child concordance when reporting concussion symptoms over time.
ii)	To determine the association between parent and child ratings of concussion symptoms and objective symptom measures. 
This research was part of a wider pilot study, Concussion Recovery and Assessment in New Zealand Adolescents and Children (CRANIAC). It involved 49 pairs of children and their parents or caregivers. Twenty-seven children had sustained a concussion and 22 comprised a comparison group of children with an upper limb injury. The children and their parents completed the Post Concussive Symptom Inventory (PCSI) and Sports Concussion Assessment Tool (SCAT)) on four occasions after injury (one to four days, two weeks, one month, three months). Correlations were used to assess concordance between parent and child ratings at each time point and how the subjective PCSI ratings were associated with the objective symptom assessments from the SCAT. 
Results showed parents and children from both injury groups reported most symptoms acutely after injury and fewer symptoms at every subsequent time point. There were fewer symptoms recorded and lower agreement for parents/children with an upper limb injury than those with concussion. Parents and children appeared to agree least about symptoms during the acute period of injury and agreement generally strengthened over time as symptom number and severity decreased. Additionally, there was more agreement about the presence or absence of symptoms rather than the severity. Finally, the PCSI ratings from parents or children did not relate to objective SCAT domain measures. This suggests that these scales may be measuring different constructs. 
In conclusion, symptom report and parent/child concordance for children with concussion is distinct from another injury. When children have sustained a concussion, it is beneficial to obtain reports from the child and a caregiver, particularly closer to injury. This is because parents and children report similar amounts of symptoms but there are discrepancies in the severity and types of symptoms reported by both raters.  Therefore, it is not a case of asking who we should listen to, but acknowledging both parents and children give complementary information about concussion. It is especially important to obtain parent and child reports in the acute period after concussion. Similarly, subjective symptom report and objective ratings create a more comprehensive assessment. Future research into parent and child symptom reporting with a larger sample would allow analyses by age group, as well as an analysis of differences between reports. In a broader sense, future research into parent and child agreement across general measures of health and wellbeing may also be beneficial.

text: Who should we listen to? Comparing parent and child report of post-concussive symptoms A significant proportion of people worldwide are impacted by the effects of traumatic brain injury (TBI). Research into the incidence and severity of TBI demonstrates that the majority of injuries are mild (such as concussion) and are experienced by children and adolescents. Despite the significance of concussion in young people, there is limited research exploring the impact of this injury on this age group. This is compounded by a lack of clarity on how best to assess concussion symptoms with regard to the measure utilised, timing of assessment, and informant reporting. Assessing concussion in children and adolescents is complicated by the child’s ability to report on concussion symptoms and negotiating reporting from parents and children simultaneously. Previous research has identified gaps in the literature including: lack of acute assessment of symptoms, few longitudinal studies into the pattern of symptom reporting over time, and lack of research associating subjective symptom reports with other objective symptom measures. Therefore, the main aims of this study were: 
i)	To assess parent and child concordance when reporting concussion symptoms over time.
ii)	To determine the association between parent and child ratings of concussion symptoms and objective symptom measures. 
This research was part of a wider pilot study, Concussion Recovery and Assessment in New Zealand Adolescents and Children (CRANIAC). It involved 49 pairs of children and their parents or caregivers. Twenty-seven children had sustained a concussion and 22 comprised a comparison group of children with an upper limb injury. The children and their parents completed the Post Concussive Symptom Inventory (PCSI) and Sports Concussion Assessment Tool (SCAT)) on four occasions after injury (one to four days, two weeks, one month, three months). Correlations were used to assess concordance between parent and child ratings at each time point and how the subjective PCSI ratings were associated with the objective symptom assessments from the SCAT. 
Results showed parents and children from both injury groups reported most symptoms acutely after injury and fewer symptoms at every subsequent time point. There were fewer symptoms recorded and lower agreement for parents/children with an upper limb injury than those with concussion. Parents and children appeared to agree least about symptoms during the acute period of injury and agreement generally strengthened over time as symptom number and severity decreased. Additionally, there was more agreement about the presence or absence of symptoms rather than the severity. Finally, the PCSI ratings from parents or children did not relate to objective SCAT domain measures. This suggests that these scales may be measuring different constructs. 
In conclusion, symptom report and parent/child concordance for children with concussion is distinct from another injury. When children have sustained a concussion, it is beneficial to obtain reports from the child and a caregiver, particularly closer to injury. This is because parents and children report similar amounts of symptoms but there are discrepancies in the severity and types of symptoms reported by both raters.  Therefore, it is not a case of asking who we should listen to, but acknowledging both parents and children give complementary information about concussion. It is especially important to obtain parent and child reports in the acute period after concussion. Similarly, subjective symptom report and objective ratings create a more comprehensive assessment. Future research into parent and child symptom reporting with a larger sample would allow analyses by age group, as well as an analysis of differences between reports. In a broader sense, future research into parent and child agreement across general measures of health and wellbeing may also be beneficial.

year: 2020

title: Using keyphrases as search result surrogates on small screen devices

authors: Jones, Steve

subjects: computer science

abstract: This paper investigates user interpretation of search result displays on small screen devices. Such devices present interesting design challenges given their limited display capabilities, particularly in relation to screen size. Our aim is to provide users with succinct yet useful representations of search results that allow rapid and accurate decisions to be made about the utility of result documents, yet minimize user actions (such as scrolling), the use of device resources, and the volume of data to be downloaded. Our hypothesis is that keyphrases that are automatically extracted from documents can support this aim. We report on a user study that compared how accurately users categorized result documents on small screens when the document surrogates consisted of either keyphrases only, or document titles. We found no significant performance differences between the two conditions. In addition to these encouraging results, keyphrases have the benefit that they can be extracted and presented when no other document metadata can be identified.

text: Using keyphrases as search result surrogates on small screen devices This paper investigates user interpretation of search result displays on small screen devices. Such devices present interesting design challenges given their limited display capabilities, particularly in relation to screen size. Our aim is to provide users with succinct yet useful representations of search results that allow rapid and accurate decisions to be made about the utility of result documents, yet minimize user actions (such as scrolling), the use of device resources, and the volume of data to be downloaded. Our hypothesis is that keyphrases that are automatically extracted from documents can support this aim. We report on a user study that compared how accurately users categorized result documents on small screens when the document surrogates consisted of either keyphrases only, or document titles. We found no significant performance differences between the two conditions. In addition to these encouraging results, keyphrases have the benefit that they can be extracted and presented when no other document metadata can be identified.

year: 2003-09

title: Treaty People Recognising and Marking Pākehā Culture in Aotearoa New Zealand

authors: Black, Rosanne Marjory

subjects: Pakeha culture

abstract: The suggestion that all people are cultural and live in cultural worlds acts to challenge members of culturally dominant groups as they tend to see their way of life as normal rather than cultural. Dominant group members usually talk about themselves in relation to their national identity (New Zealander, Australian, or American) rather than name being part of a cultural group within their nation state. This study, located in Aotearoa New Zealand, explores with a particular group of New Zealanders, how Pākehā who are members of the dominant group, may come to recognise themselves as being cultural, to name themselves culturally, and to mark aspects of their culture. The contribution that recognising culture makes to a decolonisation agenda is also explored. This study of Pākehā culture is approached from both a realist and a social constructionist perspective. Culture, an abstract concept, is largely theorised as a constructed notion in a historically structured location. How culture is recognised, and the ways it is produced and enacted, through relationships and interactions in the broader structures of New Zealand society were explored using realist thematic methods of analysis. Treaty people are a network of mostly Pākehā activist educators who have engaged in promoting knowledge of and support for Māori claims for justice under Te Tiriti o Waitangi (the Treaty of Waitangi was the document signed by Settlers and Māori leaders in 1840 to establish settlement arrangements). Treaty people are practised in talking about cultural issues largely through their engagement with Māori - Pākehā relationships. The research focused on the situations and processes that stimulated a group of thirty four ‘Treaty people’ to start thinking about themselves as cultural; about what it meant to have a cultural identity; and what they recognised as markers of their culture. I have been a member of this Treaty People network for many years and carry the dual positioning of being the researcher, and a participant, both as a member of the group and as a Pākehā. Data was collected over an eighteen month period from two focus groups in 2003 and 2005. These sessions were video and audio-recorded and later transcribed. I meet with available participants in their own locations early in 2005 and audio-recorded the conversations. The transcriptions and notes form the data for this study. My findings from this study include: • Culture was often first recognised through encounters with different cultural groups and usually when a person is in a situation where they are in a minority. Although, dominant group members do not always see their own daily practices and values as cultural they often name as cultural the practices and values of people different from them. • Recognising and naming ourselves as cultural and marking our culture were difficult tasks that go against the grain of dominance. • Pākehā culture was recognised in a number of ways. Treaty people recognised that there were other forms of knowing about the world and that dominant group members valued being ‘right’ and in control of knowledge. Coming to recognise themselves as cultural unsettled a sense of certainty about their position in the world, and opened up possibilities for new ways to engage in intercultural relationships where participation rather than being in control was valued. • Accepting the name Pākehā implied having a position of responsibility to tangata whenua and to the land. In turn those who have accepted being Pākehā receive a sense of belonging to Aotearoa and a place to stand in justice alongside Māori and other people who are culturally different from them. • While this thesis does not make explicit links between ‘being cultural’ and a decolonisation agenda the Treaty People participants named strategies to support decolonisation and challenge Pākehā dominance which include: recognising practices and values that are perpetuated through colonisation, in particular egalitarianism, assimilation and superiority; recognising Māori as tangata whenua (first people of the land) and Te Tiriti o Waitangi relationships; taking up the challenge to seek justice through striving to deal with past wrongs and to engage in equitable relationships with Māori. This thesis contributes to the psychology and social science literature as it serves to address the question “We don’t have a culture … do we?” I posit that all psychologists do have a culture and provide some rich descriptions, for those who are Pākehā, of how their culture may be recognised, how it might be described and talked about. This is a core cultural competency requirement for psychologists. My thesis also contribute to a growing body of literature from members of dominant groups, who are developing a discourse to explore and make visible their cultural or raced (whiteness) positions of power and privilege.

text: Treaty People Recognising and Marking Pākehā Culture in Aotearoa New Zealand The suggestion that all people are cultural and live in cultural worlds acts to challenge members of culturally dominant groups as they tend to see their way of life as normal rather than cultural. Dominant group members usually talk about themselves in relation to their national identity (New Zealander, Australian, or American) rather than name being part of a cultural group within their nation state. This study, located in Aotearoa New Zealand, explores with a particular group of New Zealanders, how Pākehā who are members of the dominant group, may come to recognise themselves as being cultural, to name themselves culturally, and to mark aspects of their culture. The contribution that recognising culture makes to a decolonisation agenda is also explored. This study of Pākehā culture is approached from both a realist and a social constructionist perspective. Culture, an abstract concept, is largely theorised as a constructed notion in a historically structured location. How culture is recognised, and the ways it is produced and enacted, through relationships and interactions in the broader structures of New Zealand society were explored using realist thematic methods of analysis. Treaty people are a network of mostly Pākehā activist educators who have engaged in promoting knowledge of and support for Māori claims for justice under Te Tiriti o Waitangi (the Treaty of Waitangi was the document signed by Settlers and Māori leaders in 1840 to establish settlement arrangements). Treaty people are practised in talking about cultural issues largely through their engagement with Māori - Pākehā relationships. The research focused on the situations and processes that stimulated a group of thirty four ‘Treaty people’ to start thinking about themselves as cultural; about what it meant to have a cultural identity; and what they recognised as markers of their culture. I have been a member of this Treaty People network for many years and carry the dual positioning of being the researcher, and a participant, both as a member of the group and as a Pākehā. Data was collected over an eighteen month period from two focus groups in 2003 and 2005. These sessions were video and audio-recorded and later transcribed. I meet with available participants in their own locations early in 2005 and audio-recorded the conversations. The transcriptions and notes form the data for this study. My findings from this study include: • Culture was often first recognised through encounters with different cultural groups and usually when a person is in a situation where they are in a minority. Although, dominant group members do not always see their own daily practices and values as cultural they often name as cultural the practices and values of people different from them. • Recognising and naming ourselves as cultural and marking our culture were difficult tasks that go against the grain of dominance. • Pākehā culture was recognised in a number of ways. Treaty people recognised that there were other forms of knowing about the world and that dominant group members valued being ‘right’ and in control of knowledge. Coming to recognise themselves as cultural unsettled a sense of certainty about their position in the world, and opened up possibilities for new ways to engage in intercultural relationships where participation rather than being in control was valued. • Accepting the name Pākehā implied having a position of responsibility to tangata whenua and to the land. In turn those who have accepted being Pākehā receive a sense of belonging to Aotearoa and a place to stand in justice alongside Māori and other people who are culturally different from them. • While this thesis does not make explicit links between ‘being cultural’ and a decolonisation agenda the Treaty People participants named strategies to support decolonisation and challenge Pākehā dominance which include: recognising practices and values that are perpetuated through colonisation, in particular egalitarianism, assimilation and superiority; recognising Māori as tangata whenua (first people of the land) and Te Tiriti o Waitangi relationships; taking up the challenge to seek justice through striving to deal with past wrongs and to engage in equitable relationships with Māori. This thesis contributes to the psychology and social science literature as it serves to address the question “We don’t have a culture … do we?” I posit that all psychologists do have a culture and provide some rich descriptions, for those who are Pākehā, of how their culture may be recognised, how it might be described and talked about. This is a core cultural competency requirement for psychologists. My thesis also contribute to a growing body of literature from members of dominant groups, who are developing a discourse to explore and make visible their cultural or raced (whiteness) positions of power and privilege.

year: 2010