title: Is the Rivermead Post-Concussion Symptoms Questionnaire a reliable and valid measure to assess long-term symptoms in traumatic brain injury and orthopedic injury patients? A novel investigation using Rasch analysis

authors: Balalla, Shivanthi

subjects: brain injuries

abstract: Persistent post-concussion syndrome (PCS) symptoms are known to last years after traumatic brain injury (TBI), and similar symptoms are increasingly being documented among those who have not experienced a TBI. There remains however, a dearth of empirical evidence on the structural composition of symptoms beyond the postacute symptom phase after TBI, and little is known about the potential use of PCS symptom scales to measure PCS-like symptoms in non-TBI individuals. Our objective was therefore to examine the psychometric performance and dimensionality of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) as a measure of long-term PCS symptoms among a TBI and non-TBI sample. A case-control sample of 223 patients with injury, consisting of age- and sex-matched TBI participants (n = 109) and orthopedic participants (n = 114) were recruited from a regional trauma registry in New Zealand (NZ), and assessed at mean 2.5 years post-injury. Results from the Rasch analysis showed that the RPQ achieved fit to the Rasch model, demonstrating very good reliability (Person Separation Index [PSI] = 0.87), thereby indicating that the measure can be used reliably for individual and group assessment of symptoms among both TBI and orthopedic patients. In this study we demonstrated evidence of a unidimensional construct of PCS symptoms in both groups, which helps alleviate previous uncertainty about factor structure, and permits the calculation of a total RPQ score. Conversion of ordinal to interval total scores presented within are recommended for clinicians and researchers, to improve instrument precision, and to facilitate the interpretation of change scores and use of parametric methods in data analysis.

text: Is the Rivermead Post-Concussion Symptoms Questionnaire a reliable and valid measure to assess long-term symptoms in traumatic brain injury and orthopedic injury patients? A novel investigation using Rasch analysis Persistent post-concussion syndrome (PCS) symptoms are known to last years after traumatic brain injury (TBI), and similar symptoms are increasingly being documented among those who have not experienced a TBI. There remains however, a dearth of empirical evidence on the structural composition of symptoms beyond the postacute symptom phase after TBI, and little is known about the potential use of PCS symptom scales to measure PCS-like symptoms in non-TBI individuals. Our objective was therefore to examine the psychometric performance and dimensionality of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) as a measure of long-term PCS symptoms among a TBI and non-TBI sample. A case-control sample of 223 patients with injury, consisting of age- and sex-matched TBI participants (n = 109) and orthopedic participants (n = 114) were recruited from a regional trauma registry in New Zealand (NZ), and assessed at mean 2.5 years post-injury. Results from the Rasch analysis showed that the RPQ achieved fit to the Rasch model, demonstrating very good reliability (Person Separation Index [PSI] = 0.87), thereby indicating that the measure can be used reliably for individual and group assessment of symptoms among both TBI and orthopedic patients. In this study we demonstrated evidence of a unidimensional construct of PCS symptoms in both groups, which helps alleviate previous uncertainty about factor structure, and permits the calculation of a total RPQ score. Conversion of ordinal to interval total scores presented within are recommended for clinicians and researchers, to improve instrument precision, and to facilitate the interpretation of change scores and use of parametric methods in data analysis.

year: 2020

title: Principal Professional Learning in New Zealand:  How does it happen?  Understanding the value of profound professional learning for experienced principals

authors: Graham, Arnna Rosa

subjects: lead learner

abstract: Profound professional learning for principals makes a difference to student achievement.  While indirect, the impact of effective principal practice has a ripple effect throughout the community of learners of a school.  The principal is, and should be, the lead learner of the school.  Authenticity in this action brings credibility.  This credibility establishes the principal as a significant role model.

This qualitative research provides some insight to the understanding and practices of experienced effective principals and their professional learning in a New Zealand context.  The findings suggest that there are measures of effectiveness for New Zealand principals, however ascertaining what to measure is somewhat difficult.  Knowledge of tools to support the identification of learning needs is limited and therefore not significant in the practice of these principals.  

Drivers and barriers to professional learning are identifiable.  Work/life balance is highlighted as both a measure of effectiveness and a filter for professional learning.  This is one of many filters explored.

Recognition is given to the positioning of New Zealand principalship in a post-modern paradigm and the conflict that arises when measures of neo-liberal accountabilities are employed.  

The significance of school context and culture are highlighted as conditions for profound professional learning.   The culture of traditional learning through principal clusters is challenged. Recommendations and considerations are offered to both principal colleagues and the Ministry of Education as a result of these findings.  These include the need for principal mentoring and secondment to external, national bodies as part of professional learning for all principals.  The value of professional learning is highlighted.  

More significantly principals are challenged to embrace and develop an authentic culture of professional learning.

text: Principal Professional Learning in New Zealand:  How does it happen?  Understanding the value of profound professional learning for experienced principals Profound professional learning for principals makes a difference to student achievement.  While indirect, the impact of effective principal practice has a ripple effect throughout the community of learners of a school.  The principal is, and should be, the lead learner of the school.  Authenticity in this action brings credibility.  This credibility establishes the principal as a significant role model.

This qualitative research provides some insight to the understanding and practices of experienced effective principals and their professional learning in a New Zealand context.  The findings suggest that there are measures of effectiveness for New Zealand principals, however ascertaining what to measure is somewhat difficult.  Knowledge of tools to support the identification of learning needs is limited and therefore not significant in the practice of these principals.  

Drivers and barriers to professional learning are identifiable.  Work/life balance is highlighted as both a measure of effectiveness and a filter for professional learning.  This is one of many filters explored.

Recognition is given to the positioning of New Zealand principalship in a post-modern paradigm and the conflict that arises when measures of neo-liberal accountabilities are employed.  

The significance of school context and culture are highlighted as conditions for profound professional learning.   The culture of traditional learning through principal clusters is challenged. Recommendations and considerations are offered to both principal colleagues and the Ministry of Education as a result of these findings.  These include the need for principal mentoring and secondment to external, national bodies as part of professional learning for all principals.  The value of professional learning is highlighted.  

More significantly principals are challenged to embrace and develop an authentic culture of professional learning.

year: 2010

title: Ascending the Poutama: Culturally responsive diabetes care for Māori communities

authors: Crosswell, Rebekah Jane

subjects: culturally responsive

abstract: Introduction
Type 2 diabetes (T2D) significantly impacts Māori populations in Aotearoa New Zealand (NZ) who experience health disparities including suboptimal disease management.

Aim
To explore culturally responsive approaches to supporting Māori living with T2D from the perspective of healthcare providers.

Methods
Nine semi-structured interviews were conducted with clinicians from various disciplines (general practitioner, podiatrist, exercise physiologist, three kaiāwhina, dietitian, two pharmacists); five clinicians identify as Māori, four as non-Māori. Kaupapa Māori inductive thematic analysis was used.

Results
Four key themes emerged: empowering patient-centred communication, whānau involvement, interprofessional collaboration, and culturally appropriate analogies.

Discussion
The findings underscore the need for holistic, culturally responsive T2D care that prioritises culturally appropriate communication to improve patient engagement, health outcomes and address Māori health disparities.

text: Ascending the Poutama: Culturally responsive diabetes care for Māori communities Introduction
Type 2 diabetes (T2D) significantly impacts Māori populations in Aotearoa New Zealand (NZ) who experience health disparities including suboptimal disease management.

Aim
To explore culturally responsive approaches to supporting Māori living with T2D from the perspective of healthcare providers.

Methods
Nine semi-structured interviews were conducted with clinicians from various disciplines (general practitioner, podiatrist, exercise physiologist, three kaiāwhina, dietitian, two pharmacists); five clinicians identify as Māori, four as non-Māori. Kaupapa Māori inductive thematic analysis was used.

Results
Four key themes emerged: empowering patient-centred communication, whānau involvement, interprofessional collaboration, and culturally appropriate analogies.

Discussion
The findings underscore the need for holistic, culturally responsive T2D care that prioritises culturally appropriate communication to improve patient engagement, health outcomes and address Māori health disparities.

year: 2025