INTRODUCTION: After treatment with chemotherapy, many patients with breast cancer experience cognitive problems. While limited interventions are available to improve cognitive functioning, physical exercise showed positive effects in healthy older adults and people with mild cognitive impairment. The Physical Activity and Memory study aims to investigate the effect of physical exercise on cognitive functioning and brain measures in chemotherapy-exposed patients with breast cancer with cognitive problems.METHODS AND ANALYTICS: One hundred and eighty patients with breast cancer with cognitive problems 2-4 years after diagnosis are randomised (1:1) into an exercise intervention or a control group. The 6-month exercise intervention consists of twice a week 1-hour aerobic and strength exercises supervised by a physiotherapist and twice a week 1-hour Nordic or power walking. The control group is asked to maintain their habitual activity pattern during 6 months. The primary outcome (verbal learning) is measured at baseline and 6 months. Further measurements include online neuropsychological tests, self-reported cognitive complaints, a 3-tesla brain MRI, patient-reported outcomes (quality of life, fatigue, depression, anxiety, work performance), blood sampling and physical fitness. The MRI scans and blood sampling will be used to gain insight into underlying mechanisms. At 18 months online neuropsychological tests, self-reported cognitive complaints and patient-reported outcomes will be repeated.ETHICS AND DISSEMINATION: Study results may impact usual care if physical exercise improves cognitive functioning for breast cancer survivors.TRIAL REGISTRATION NUMBER: NTR6104.
In this chapter it is argued that self-direction is currently well above the head of the majority of youngsters and even of many adults. Evidence for this conclusion stems from developmental and brain research. However, for various reasons it is important that people develop the competences that are necessary for self-direction. To what degree is it possible to develop these competences? Are they 'learnable'? What can education contribute?
Since the emergence of modern man some 200,000 years ago, people and technologyhave been inextricably linked to each other. However, unlike traditional technology -such as leverage (and derivative applications such as hammers, wheels and crankshafts),and control of fire - smart technology is equipped with adaptive capacity. Whereas intraditional technology people have to think and handle in terms of technology in orderto apply technology successfully and purposefully, technology with, for example, itsown learning ability adapts to humans. This means that smart technology influencesdevelopment in a different way than traditional technology. Changes in the relationship between human development (brain) and smarttechnology - technology with its own learning capacity and adaptability - have led tothe articulation of 4 requirements technology should meet: 1. it must be sustainable, 2. it must not block development and if it does it must be clear how, 3. there must bea logical argument why the technique can be used and how it can be explained, also in terms of psychological development and, finally, 4. the social and ethical discoursemust be stated in a transparent way. At a fast pace, futurologists and management gurus are presenting “theories” abouthow smart technology will change us permanently as individuals. Requirements 1(sustainability) and 2 (technology influencing human development) are at stake here.However, these ideas cannot be substantiated by scientific research. Psychology(and the other social and human sciences) have not yet been able to generate a convincing interpretation of what is going on in the area of brain and technology (living technology). In fact, there is a need for argumentation. In order to arrive at an argument-based psychology, insight into the non-linearityof processes is indispensable. The Brain & Technology research group is exploring the great possibilities to bridge the distance between people and their limitations by using smart technology, or possibilities, especially when it comes to argument based applied psychology! In this document, mainly the argument requirement is considered, because in the rapidly changing technological processes, the argument often does not sufficiently develop and the argument lies pre-eminently at the level of applied psychology, brain and technology.
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