title: An evaluation of the NuroChek system for concussion assessment and management

authors: Treacy, Jennifer

abstract: Current methods of concussion assessment are subjective and vulnerable to error, and a missed concussion diagnosis could increase an athlete’s risk of further injury. An objective method of concussion assessment could provide valuable physiological data about injury severity and duration. The NuroChek system uses a flashing light stimulus to evoke electrophysiological activity, which is measured from occipital electrode sites and used to calculate a signal-to-noise ratio (SNR) and determine the magnitude of activity at the target location. Reductions in this activity are proposed to be associated with dysfunction or damage after concussion; in a previous study, the SNR was shown to decrease after concussion, and then return to baseline strength upon recovery.  

To examine the utility of the NuroChek system and SNR output in concussion assessment and management, 157 participants were assessed with the NuroChek system as rugby athletes (n = 121), combat athletes (n = 19), or non-athlete controls (n = 17). All athletes were assessed at multiple time points, while the non-athlete control group was only assessed at one time point. All participants completed two trials of the NuroChek headset and at least one cognitive measure.  

The first study (Chapter 4) examines the acute effects of concussion on the SNR, as well as any SNR changes after injury. Rugby athletes who sustained concussions (n = 21) were tested at multiple time points after their injuries with the NuroChek system and either the King-Devick (K-D) or the Sport Concussion Assessment Tool (SCAT-5). The post-injury and baseline SNR were compared to identify any changes within 3 days of concussion, as well as changes during the follow-up time points that might correspond with concussion recovery (up to 20 days post-injury and mid-season or end-of-season if available). No statistically significant changes were seen after concussion, W = 11.000, p = 0.612, d = -0.099, n = 8. When compared to the non-concussed male rugby athletes, the concussed athletes had significantly lower SNRs than the athletes who sustained regular repetitive impacts by the end-of-season, H(3) = 10.160, p = 0.017, d = 0.135, n = 76.  

The second study (Chapter 5) examines the different effects that concussion history, age, and sex have on the SNR and its trajectory over time in those experiencing repetitive impacts. While the SNR was not affected by concussion history or age, there was a main effect for sex: male athletes demonstrated significantly higher average SNRs than female athletes at all three time points. Additionally, the SNRs from female participants demonstrated a significantly greater proportion of a harmonic artefact (51.8%, compared to 15.1% of data from male participants) that decreased the quality of the female data. Sex and repetitive impacts were examined for any interaction, but the sample sizes were too small in some subgroups for statistical analysis. A main effect of repetitive impacts on the SNR was also seen in rugby and combat athletes.  This could indicate that repetitive impacts lead to higher SNR in athletes over time.  

Overall, the SNR in this study was not sensitive to changes after concussion or during recovery. No evidence was found to support NuroChek’s use in the assessment or management of concussion in rugby athletes. Additionally, the potential effect of repetitive impacts on the SNR confounds the relationship between the SNR and concussion. Future development of electrophysiological assessment methods for concussion should consider the effects of repetitive impacts and sex.

text: An evaluation of the NuroChek system for concussion assessment and management Current methods of concussion assessment are subjective and vulnerable to error, and a missed concussion diagnosis could increase an athlete’s risk of further injury. An objective method of concussion assessment could provide valuable physiological data about injury severity and duration. The NuroChek system uses a flashing light stimulus to evoke electrophysiological activity, which is measured from occipital electrode sites and used to calculate a signal-to-noise ratio (SNR) and determine the magnitude of activity at the target location. Reductions in this activity are proposed to be associated with dysfunction or damage after concussion; in a previous study, the SNR was shown to decrease after concussion, and then return to baseline strength upon recovery.  

To examine the utility of the NuroChek system and SNR output in concussion assessment and management, 157 participants were assessed with the NuroChek system as rugby athletes (n = 121), combat athletes (n = 19), or non-athlete controls (n = 17). All athletes were assessed at multiple time points, while the non-athlete control group was only assessed at one time point. All participants completed two trials of the NuroChek headset and at least one cognitive measure.  

The first study (Chapter 4) examines the acute effects of concussion on the SNR, as well as any SNR changes after injury. Rugby athletes who sustained concussions (n = 21) were tested at multiple time points after their injuries with the NuroChek system and either the King-Devick (K-D) or the Sport Concussion Assessment Tool (SCAT-5). The post-injury and baseline SNR were compared to identify any changes within 3 days of concussion, as well as changes during the follow-up time points that might correspond with concussion recovery (up to 20 days post-injury and mid-season or end-of-season if available). No statistically significant changes were seen after concussion, W = 11.000, p = 0.612, d = -0.099, n = 8. When compared to the non-concussed male rugby athletes, the concussed athletes had significantly lower SNRs than the athletes who sustained regular repetitive impacts by the end-of-season, H(3) = 10.160, p = 0.017, d = 0.135, n = 76.  

The second study (Chapter 5) examines the different effects that concussion history, age, and sex have on the SNR and its trajectory over time in those experiencing repetitive impacts. While the SNR was not affected by concussion history or age, there was a main effect for sex: male athletes demonstrated significantly higher average SNRs than female athletes at all three time points. Additionally, the SNRs from female participants demonstrated a significantly greater proportion of a harmonic artefact (51.8%, compared to 15.1% of data from male participants) that decreased the quality of the female data. Sex and repetitive impacts were examined for any interaction, but the sample sizes were too small in some subgroups for statistical analysis. A main effect of repetitive impacts on the SNR was also seen in rugby and combat athletes.  This could indicate that repetitive impacts lead to higher SNR in athletes over time.  

Overall, the SNR in this study was not sensitive to changes after concussion or during recovery. No evidence was found to support NuroChek’s use in the assessment or management of concussion in rugby athletes. Additionally, the potential effect of repetitive impacts on the SNR confounds the relationship between the SNR and concussion. Future development of electrophysiological assessment methods for concussion should consider the effects of repetitive impacts and sex.

year: 2024

title: Highly effective school principalship: An investigation of the views of six Solomon Islands' Community High School principals of what constitutes highly effective school principalship and their views on issues that impede their effective practice.

authors: Ruqebatu, Collin Bartholomew

subjects: Solomon Islands

abstract: Batu velakero iri kenaga, loboro mana vakatikili gira vano muzi  (Highly effective leaders are at the front, walk in the middle, and encourage those from behind to catch up) 
My uncle Zorapa said, while I was on a 'pig-hunting' trip with him some twenty odd years ago, that school principals, like all leaders, can only be called leaders if they make a difference. In modern parlance, one frequently encounters this homespun wisdom in the statement that highly effective schools are led by highly effective principals.
This study investigates the perceptions of six practicing principals of the elements of highly effective principalship in Solomon Islands' Community High schools. The study investigates and explores these perceptions and tries to describe the elements of highly effective principalship and the impediments that may prevent principals from becoming effective. The study hopes to contribute towards the possible development of highly effective principalship in the Solomon Islands schools.
The finding of this research reveals that although the participating principals were very experienced, their responses indicate that there appeared to be no theory-driven basis for their practice. Similarly, the perceptions expressed reveal the urgent need for the Solomon Islands to pay more attention to leadership development strategies that will see the creation of national, and personal, leadership philosophies and set the process of ongoing leadership development, enhancement and improvement in the country. The proposed strategies must incorporate current international research and literature on educational leadership theories as well as building on current practice in the Solomon Islands that is nationally and culturally appropriate. In addition, the study suggests that current practitioners should be encouraged to engage in educational leadership research and begin to build a national literature base. 
This study suggests that the process of establishing the notion of highly effective educational leadership in the country's school system should start as soon as possible. Those in policy and decision-making positions must have the courage to implement strategies that will contribute to improved levels of educational leadership in order to raise the quality of education for all learners in the country. The children are the future prosperity of the country.

text: Highly effective school principalship: An investigation of the views of six Solomon Islands' Community High School principals of what constitutes highly effective school principalship and their views on issues that impede their effective practice. Batu velakero iri kenaga, loboro mana vakatikili gira vano muzi  (Highly effective leaders are at the front, walk in the middle, and encourage those from behind to catch up) 
My uncle Zorapa said, while I was on a 'pig-hunting' trip with him some twenty odd years ago, that school principals, like all leaders, can only be called leaders if they make a difference. In modern parlance, one frequently encounters this homespun wisdom in the statement that highly effective schools are led by highly effective principals.
This study investigates the perceptions of six practicing principals of the elements of highly effective principalship in Solomon Islands' Community High schools. The study investigates and explores these perceptions and tries to describe the elements of highly effective principalship and the impediments that may prevent principals from becoming effective. The study hopes to contribute towards the possible development of highly effective principalship in the Solomon Islands schools.
The finding of this research reveals that although the participating principals were very experienced, their responses indicate that there appeared to be no theory-driven basis for their practice. Similarly, the perceptions expressed reveal the urgent need for the Solomon Islands to pay more attention to leadership development strategies that will see the creation of national, and personal, leadership philosophies and set the process of ongoing leadership development, enhancement and improvement in the country. The proposed strategies must incorporate current international research and literature on educational leadership theories as well as building on current practice in the Solomon Islands that is nationally and culturally appropriate. In addition, the study suggests that current practitioners should be encouraged to engage in educational leadership research and begin to build a national literature base. 
This study suggests that the process of establishing the notion of highly effective educational leadership in the country's school system should start as soon as possible. Those in policy and decision-making positions must have the courage to implement strategies that will contribute to improved levels of educational leadership in order to raise the quality of education for all learners in the country. The children are the future prosperity of the country.

year: 2008

title: Handbook of indigenous peoples' rights [Book review]

authors: Te Aho, Linda

abstract: This article reviews the book “Handbook of indigenous peoples' rights”, edited by Corinne Lennox and Damien

text: Handbook of indigenous peoples' rights [Book review] This article reviews the book “Handbook of indigenous peoples' rights”, edited by Corinne Lennox and Damien

year: 2016