Technological aids for the rehabilitation of memory and executive functioning in children and adolescents with acquired brain injury (Review).

Background The use of technology in healthcare settings is on the increase and may represent a cost-effective means of delivering rehabilitation. Reductions in treatment time, and delivery in the home, are also thought to be benefits of this approach. Children and adolescents with brain injury often experience deficits in memory and executive functioning that can negatively affect their school work, social lives, and future occupations. Effective interventions that can be delivered at home, without the need for high-cost clinical involvement, could provide a means to address a current lack of provision. We have systematically reviewed studies examining the effects of technology-based interventions for the rehabilitation of deficits in memory and executive functioning in children and adolescents with acquired brain injury. Objectives To assess the effects of technology-based interventions compared to placebo intervention, no treatment, or other types of intervention, on the executive functioning and memory of children and adolescents with acquired brain injury. Search methods We ran the search on the 30 September 2015. We searched the Cochrane Injuries Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic + EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED, SSCI, CPCI-S, and CPSI-SSH), CINAHL Plus (EBSCO), two other databases, and clinical trials registers. We also searched the internet, screened reference lists, and contacted authors of included studies. Selection criteria Randomised controlled trials comparing the use of a technological aid for the rehabilitation of children and adolescents with memory or executive-functioning deficits with placebo, no treatment, or another intervention. Data collection and analysis Two review authors independently reviewed titles and abstracts identified by the search strategy. Following retrieval of full-text manuscripts, two review authors independently performed data extraction and assessed the risk of bias. Main results Four studies (involving 206 participants) met the inclusion criteria for this review. Three studies, involving 194 participants, assessed the effects of online interventions to target executive functioning (that is monitoring and changing behaviour, problem solving, planning, etc.). These studies, which were all conducted by the same research team, compared online interventions against a 'placebo' (participants were given internet resources on brain injury). The interventions were delivered in the family home with additional support or training, or both, from a psychologist or doctoral student. The fourth study investigated the use of a computer program to target memory in addition to components of executive functioning (that is attention, organisation, and problem solving). No information on the study setting was provided, however a speech-language pathologist, teacher, or occupational therapist accompanied participants. Two studies assessed adolescents and young adults with mild to severe traumatic brain injury (TBI), while the remaining two studies assessed children and adolescents with moderate to severe TBI. Risk of bias We assessed the risk of selection bias as low for three studies and unclear for one study. Allocation bias was high in two studies, unclear in one study, and low in one study. Only one study (n = 120) was able to conceal allocation from participants, therefore overall selection bias was assessed as high. One study took steps to conceal assessors from allocation (low risk of detection bias), while the other three did not do so (high risk of detection bias). Primary outcome 1: Executive functioning: Technology-based intervention versus placebo Results from meta-analysis of three studies (n = 194) comparing online interventions with a placebo for children and adolescents with TBI, favoured the intervention immediately post-treatment (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.66 to -0.09; P = 0.62; I2 = 0%). (As there is no 'gold standard' measure in the field, we have not translated the SMD back to any particular scale.) This result is thought to represent only a small to medium effect size (using Cohen’s rule of thumb, where 0.2 is a small effect, 0.5 a medium one, and 0.8 or above is a large effect); this is unlikely to have a clinically important effect on the participant. The fourth study (n = 12) reported differences between the intervention and control groups on problem solving (an important component of executive functioning). No means or standard deviations were presented for this outcome, therefore an effect size could not be calculated. The quality of evidence for this outcome according to GRADE was very low. This means future research is highly likely to change the estimate of effect. Primary outcome 2: Memory One small study (n = 12) reported a statistically significant difference in improvement in sentence recall between the intervention and control group following an eight-week remediation programme. No means or standard deviations were presented for this outcome, therefore an effect size could not be calculated. Secondary outcomes Two studies (n = 158) reported on anxiety/depression as measured by the Child Behavior Checklist (CBCL) and were included in a meta-analysis. We found no evidence of an effect with the intervention (mean difference -5.59, 95% CI -11.46 to 0.28; I2 = 53%). The GRADE quality of evidence for this outcome was very low, meaning future research is likely to change the estimate of effect. A single study sought to record adverse events and reported none. Two studies reported on use of the intervention (range 0 to 13 and 1 to 24 sessions). One study reported on social functioning/social competence and found no effect. The included studies reported no data for other secondary outcomes (that is quality of life and academic achievement). Authors' conclusions This review provides low-quality evidence for the use of technology-based interventions in the rehabilitation of executive functions and memory for children and adolescents with TBI. As all of the included studies contained relatively small numbers of participants (12 to 120), our findings should be interpreted with caution. The involvement of a clinician or therapist, rather than use of the technology, may have led to the success of these interventions. Future research should seek to replicate these findings with larger samples, in other regions, using ecologically valid outcome measures, and reduced clinician involvement.

Microbicide Vaginal Rings: Technological Challenges and Clinical Development

Vaginal rings (VRs) are flexible, torus-shaped, polymeric devices designed to sustain delivery of pharmaceutical drugs to the vagina for clinical benefit. Following first report in a 1970 patent application, several steroid-releasing VR products have since been marketed for use in hormone replacement therapy and contraception. Since 2002, there has been growing interest in the use of VR technology for delivery of drugs that can reduce the risk of sexual acquisition of human immunodeficiency virus type 1 (HIV-1), the causative agent of acquired immunodeficiency syndrome (AIDS). Although no vaginally-administered product has yet been approved for HIV reduction/prevention, extensive research efforts are continuing and a number of VR devices offering sustained release of so-called ‘HIV microbicide’ compounds are currently being evaluated in late-stage clinical studies. This review article provides an overview of the published scientific literature within this important field of research, focusing primarily on articles published within peer-reviewed journal publications. Many important aspects of microbicide-releasing VR technology are discussed, with a particular emphasis on the technological, manufacturing and clinical challenges that have emerged in recent years.

The effect of redundancy and neutrality in genetic search

An experimental study aimed at assessing the influence of redundancy and neutrality on the performance of an (1+1)-ES evolution strategy modeled using Markov chains and applied to NK fitness landscapes is presented. For the study, two families of redundant binary representations, one non-neutral family which is based on linear transformations and that allows the phenotypic neighborhoods to be designed in a simple and effective way, and the neutral family based on the mathematical formulation of error control codes are used. The results indicate whether redundancy or neutrality affects more strongly the behavior of the algorithm used.

Eco-cities: technological showcases or public spaces?

A growing body of critical literature seeks to identify conceptual and practical problems accompanying the realisation of mainstream ‘eco-city’ initiatives around the world. However, little attention has been paid to the status of the ‘city’ itself within the broader discourse. If eco-cities are to be more than experimental ‘technological showcases’, and aim to transform urban life more generally, the question of what types of ‘cityness’ will ensue is of considerable importance. To effect a more significant sustainability transition, eco-city plans and policies may need somehow to encompass a more nuanced conceptualisation of cities as complex, unpredictable, and emergent spaces. The incompatibility of such a conceptualisation with liberal-modernist modes of planning means that radically innovative new approaches to eco-city development may need to be found. This thesis considers whether the eco-city, theorised as a multiple process of real-world experimentation, may shed some light on how ‘cityness’ might better be planned for in future. To do so, it conceptualises cityness through the lens of ‘publicness’. It makes an original contribution to knowledge by developing a new theoretical model of publicness as an ‘assemblage’ of space and behaviour, with an ‘emergent’ and ‘civic’ modality. It thereby extends recent debates over the idea of ‘urban assemblage’, and makes innovative links between theories of planning and of the public. This model informs the analysis of original empirical research, investigating the conceptualisation of the public in an international sample of official eco-city documents, and exploring the publicness of two implemented initiatives, in Portland, Oregon (US) and newly built Sejong City (South Korea). The research finds that publicness tends to be poorly articulated in mainstream eco-city plans and policies, with potentially negative implications for sustainability in the ‘urban age’. However, it also argues that state institution-led planning – even when experimental ‘governance’ approaches are adopted – may inevitably be limited in its ability to encompass the emergent public life of the city. The thesis concludes by considering the prospects for overcoming or more productively acknowledging these limits in future.

Educational characteristics of adult students in portuguese technological schools

Despite a massive expansion of education in Portugal, since the 1970’s, educational attainment of the adult population in the country remains low. The numbers of working-age people in some form of continuing education are among the lowest, according to the OECD and EU-27 statistics. Technological Schools(TS), initially created in the 1990’s, under the umbrella of the Ministry of Economy in partnership with industry and industrial associations, aimed to prepare qualified staff for industries and services in the country, particularly in the engineering sector, through the provision of post secondary non-university programmes of studies, the CET (Technological Specialization Courses). Successful CET students are awarded a DET(Diploma of Technological Specialization), which corresponds to Vocational Qualification level IV of the EU, according to the latest alteration (2005) of the Education Systems Act (introduced in 1986). In this, CET’s are also clearly defined as one of the routes for access to Higher Education (HE), in Portugal. The PRILHE (Promoting Reflective and Independent Learning in Higher Education) multinational project, funded by the European Socrates Grundtvig Programme, aimed to identify the learning processes which enable adult students in higher education to become autonomous reflective learners and search best practices to support these learning processes. During this research, both quantitative and qualitative methods were used to determine how students organise their studies and develop their learning skills. The Portuguese partner in the project’ consortium used a two case studies approach, one with students of Higher Education Institutions and other with students of TS. This paper only applies to students of TS, as these have a predominant bias towards engineering. Results show that student motivation and professional teaching support contribute equally to the development of an autonomous and reflective approach to learning in adult students; this is essential for success in a knowledge economy, where lifelong learning is the key to continuous employment.

Corporate brand identity management in a technological faculty – how brand relationships influence students and companies reputations

Identity is traditionally defined as an emission concept [1]. Yet, some research points out that there are external factors that can influence it [2]; [3]; [4]. This subject is even more relevant if one considers corporate brands. According to Aaker [5] the number, the power and the credibility of corporate associations are bigger in the case of corporate brands. Literature recognizes the influence of relationships between companies in identity management. Yet, given the increasingly important role of corporate brands, it is surprising that to date no attempt to evaluate that influence has been made in the management of corporate brand identity. Also Keller and Lehman [6] highlight relationships and costumer experience as two areas requiring more investigation. In line with this, the authors intend to develop an empirical research in order to evaluate the influence of relationships between brands in the identity of corporate brand from an internal perspective by interviewing internal stakeholders (brand managers and internal clients). This paper is organized by main contents: theoretical background, research methodology, data analysis and conclusions and finally cues to future investigation.

Data analysis applied to the evaluation of a technological nature teaching model as a regional development tool

This paper presents the creation and development of technological schools directly linked to the business community and to higher public education. Establishing themselves as the key interface between the two sectors they make a signigicant contribution by having a greater competitive edge when faced with increasing competition in the tradional markets. The development of new business strategies supported by references of excellence, quality and competitiveness also provides a good link between the estalishment of partnerships aiming at the qualification of education boards at a medium level between the technological school and higher education with a technological foundation. We present a case study as an example depicting the success of Escola Tecnológica de Vale de Cambra.

Building a knowledge and learning society in Portugal - Adult students in technological schools and higher education institutions

Chapter in Merrill, Barbara (ed.) (2009) Learning to Change? The Role of Identity and Learning Careers in Adult Education. Hamburg: Peter Lang Publishers. URL: http://www.peterlang.com/ index.cfm?vID=58279&vLang=E&vHR=1&vUR=2&vUUR=1

A technological innovation plan for enterprises in the Azores

The INOTEC-Empresa – the Technological Innovation Plan for Enterprises in the Autonomous Region of the Azores (RAA) - was developed in 2006-2007, at the request of the Regional Government, with the main aim of promoting innovation within small and medium enterprises. The methodological approach used in the development of the INOTEC – Empresa Plan was designed to obtain a comprehensive view of regional actors and included a document review, participation of the various actors through interviews, a collection of statements from RAA – Região Autónoma dos Açores – entrepreneurs, academics, public leaders and other key players, together with an analysis of their views and a survey of the innovation dynamics of the most relevant Azorean enterprises. The INOTEC-Empresa – the Technological Innovation Plan for Enterprises – comprises seven programmes aimed at promoting innovation in the Region. This paper focuses on the Programmes for Qualification of Human Resources and the Development of Scientific and Technological Capacities for Innovation. Some socio-economic data and the metrics selected to assess and benchmark the implementation of the Plan will als

Two Technological Dystopias: Le monde tel que'il sera and Alpha Ralpha Boulevard

The aim of this paper is to corn pare two technological dystopias: Emile Souvestre's Le Monde tel qu'il sera (1846) and Cordwainer Smith's "Alpha Ralpha Boulevard" (1961). Both texts present dystopian societies experienced by many of its inhabitants as being the best of possible worlds. The above authors question the massive use of technology, worry about what technology can do to human beings, how it can dehumanize them. They reveal serious social and moral concerns regarding the less privileged. These are excluded from the benefits of"Utopia" while making it possible. Both authors are childs of.. their time: they live in a period of national pride, they can see the shadows behind the luminous, the dangers resulting from human beings playing God with nature and humanity. Also, they are innovators: Souvestre announces dystopian science fiction and Smith renews with the genre announcing the New Wave movement in Anglo-American science fiction.

Technological evolution

The evolution of a technology and the understanding of the moment in its life cycle is of the utmost importance to the entry strategy devised by any company. Having the entry of EDP Brazil on the micro-generation market as background, the present workproject attempts to summarize the most important topics in management literature concerning the theory of technology life-cycles and the updated literature on developments of photovoltaic technology to infer the current positioning of this technology in the theoretical models. The need for this type of work stems from the very common lack of bridging between the academic research of economic aspects relevant to the evolution of technologies and the agents of research on specific technological issues. When this occurs, namely due to the external nature of research to companies, thereby escaping the harsh economic controls of a profit seeking enterprise, the evolution many times lacks the appropriate framework to be studied on a more forward looking manner and to allow for management decisions to be based on.