Objective: A systematic review aiming to identify and critically appraise evidence for the validity and reliability of the Strengths and Difficulties Questionnaire in pre-school children (aged 3-5). Method:The review followed the Preferred Reporting Items for Systematic Reviews and Meta- Results: 41 studies were included (56 manuscripts). Two qualitative studies examined content and cultural validity, revealing issues with some questions. Six studies discussed language validations and recommended some changes to the wording. Evidence for discriminative validity was good (Area Under the Curve ≥ 0.80) as was evidence for convergent validity (weighted average correlation coefficients ≥0.50), except for the Pro-social scale. There was limited support for discriminant validity but good evidence for the 5-factor structural validity of the tool. One study demonstrated measurement invariance across ethnicity. Sensitivity was below 70% and specificity above 70% in most studies that examined this. One study showed that caseness indicators varied between countries. Internal consistency of the total difficulty scale was good (weighted average Cronbach's alpha parents' and teachers' version 0.79 and 0.82) but weaker for other subscales (weighted average parents' and teachers' range 0.49-0.69 and 0.69-0.83). Inter-rater reliability between parents was moderate (correlation coefficients range 0.42-0.64) and between teachers strong (range 0.59-0.81). Cross-informant consistency was weak to moderate (weighted average correlation coefficients range 0.25-0.45).Test-retest reliability was mostly inadequate. One study demonstrated moderate size effect sizes.Conclusions: Evidence for a number of psychometric properties is strong. However, the lack of evidence for test-retest reliability, cultural validity and criterion validity should be addressed given the wide-spread implementation of the tool in routine clinical practice, including in New Zealand. Furthermore, the moderate level of consistency between different informants indicate that an assessment of a pre-schooler should not rely on a single informant.

On-line programmes designed to improve sleep are feasible for use for adults following mild-to-moderate TBI. Based on the effect size identified in this pilot study, 128 people (64 per group) would be needed to determine clinical effectiveness.

Whilst significant improvements were noted across measures over time, a significant proportion of individuals still perform poorly on neuropsychological measures 12-months after mild TBI; and these were linked to post-concussion symptoms, mood and self-reported cognitive outcomes. This implies a longer trajectory for recovery than has previously been suggested, which has implications for provision of assessment and rehabilitation services for more extended periods.

Aim: The aim of this study is to investigate Māori (Indigenous peoples of Aotearoa New Zealand) understandings of dementia ( mate wareware) and develop a framework to inform assessment of cognitive impairment. Method: Qualitative, kaupapa Māori (M āori approach) research with 241 older Māori ( kaumātua) involving 17 focus groups across Aotearoa New Zealand (NZ) and eight families ( whānau) from one region. We thematically analyzed transcribed data from audio-recorded interviews. Results: Two overarching themes, namely, connection ( Tūhononga) and self ( Whaiaro), and eight subthemes in particular mind ( hinengaro), spirit ( wairua), body ( tinana), family ( whānau), social connection ( whanaungatanga), identity and role ( tuakiri), place ( wāhi), and ancestors ( tūpuna) emerged. Māori language ( Te Reo Māori) was important for cognitive health. Conclusion: The findings embedded in cultural values improve understanding of dementia ( mate wareware) in Māori. These themes can inform the assessment of older Māori with cognitive impairment. For those without cognitive impairment, the Tūhononga Whaiaro framework suggests factors potentially crucial for healthy aging in Māori.

BackgroundScreening children for behavioural difficulties requires the use of a tool that is culturally valid. We explored the cross-cultural acceptability and utility of the Strengths and Difficulties Questionnaire for pre-school children (aged 3–5) as perceived by families in New Zealand.MethodsA qualitative interpretive descriptive study (focus groups and interviews) in which 65 participants from five key ethnic groups (New Zealand European, Māori, Pacific, Asian and other immigrant parents) took part. Thematic analysis using an inductive approach, in which the themes identified are strongly linked to the data, was employed.ResultsMany parents reported they were unclear about the purpose of the tool, affecting its perceived value. Participants reported not understanding the context in which they should consider the questions and had difficulty understanding some questions and response options. Māori parents generally did not support the questionnaire based approach, preferring face to face interaction. Parents from Māori, Pacific Island, Asian, and new immigrant groups reported the tool lacked explicit consideration of children in their cultural context. Parents discussed the importance of timing and multiple perspectives when interpreting scores from the tool.ConclusionsIn summary, this study posed a number of challenges to the use of the Strengths and Difficulties Questionnaire in New Zealand. Further work is required to develop a tool that is culturally appropriate with good content validity.