The objective of this study was to examine combination speed of processing (SOP) cognitive remediation therapy (CRT) and transcranial direct stimulation (tDCS) as neurorehabilitation in older HIV+ adults. Thirty-three HIV+ adults aged 50+ completed neurocognitive testing and were randomized to either active (n = 17) or sham (n = 16) tDCS. Both conditions received 10 1-hour sessions of SOP CRT, with either active or sham tDCS for the first 20 minutes. Participants then completed a posttest assessment. Repeated measures analysis of variance examining Time X Condition showed small-to-medium effects in the expected direction for an executive (d = 0.36), and SOP measure (d = 0.49), while medium-to-large effects were observed for an executive/attention (d = 0.60) and oral reading measure (d = 0.75). The only statistically significant interaction was the oral reading measure. Small-to-medium and medium-to-large effects (ds = 0.32, 0.58) were found for two SOP measures in the opposite direction (sham group showing greater improvements). Further trials of CRT and tDCS in this population are needed, including larger samples and a nonactive control and tDCS only condition, as is determination of which parameters of each technique (e.g., tDCS montage, timing of tDCS, domain targeted in CRT, number of sessions) are most effective in improving cognitive outcomes, durability of training gains, and translation to everyday functioning.

Performing secondary tasks, such as texting while driving, is associated with an increased risk of motor vehicle collisions (MVCs). While cognitive processes, such as executive function, are involved in driving, little is known about the relationship between executive control and willingness to engage in distracted driving. This study investigated the relationship between age, behavioral manifestations of executive function, and self-reported distracted driving behaviors. Executive difficulty (assessed with the BRIEF-A) as well as demographics (age and gender) was considered as possible predictors of engagement in distracted driving behaviors. Fifty-nine young, middle, and older adults self-reported executive difficulty and weekly engagement in distracted driving behaviors. Results revealed that while partially accounted for by age, global executive difficulty was uniquely related to engagement in distracted driving behaviors. Older age was associated with fewer weekly self-reported distracted driving behaviors while higher self-reported executive difficulty was associated with more frequent weekly engagement in distracted behavior. No significant differences were found between young and middle-aged adults on distracted driving behaviors. Findings conclude that distracted driving is a ubiquitous phenomenon evident in drivers of all ages. Possible mechanisms underlying distracted driving behavior could potentially be related to deficits in executive function.

This article examined the impact of mobile technology on young pedestrians, bicyclists, and drivers. A systematic search yielded 41 articles meeting inclusion criteria: peer-reviewed, published before February 1, 2016, behavioral outcome related to pedestrian, bicycling, or driving in the presence of mobile technology use, youth sample. Eleven studies were meta-analyzed to evaluate increased risk for crash/near-crash while distracted. Risk of bias and quality of research were assessed. Across methodologies, developmental stages, and type of distracting task, mobile technology use impairs youth safety on the road. Quality of evidence was low (pedestrian) to moderate (driving). Findings are discussed from the perspective of cognitive and visual distractions. Policy and behavioral efforts should continue to reduce mobile technology use in transportation settings.

Objective Motor vehicle collisions (MVCs) are one of the leading causes of injury and death for adolescents. Driving is a complex activity that is highly reliant on executive function to safely navigate through the environment. Little research has examined the efficacy of using self-reported executive function measures for assessing adolescent driving risk. This study examined the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire and performance based-executive function tasks as potential predictors of problematic driving outcomes in adolescents. Methods Forty-six adolescent drivers completed the (1) BRIEF, (2) Trail Making Test (TMT), (3) Backwards Digit Span, and (4) self-report on three problematic driving outcomes: the number of times of having been pulled over by a police officer, the number of tickets issued, and the number of MVCs. Results Greater self-reported difficulty with planning and organization was associated with greater odds of having a MVC, while inhibition difficulties were associated with greater odds of receiving a ticket. Greater self-reported difficulty across multiple BRIEF subscales was associated with greater odds of being pulled over. Conclusion Overall findings indicated that the BRIEF, an ecological measure of executive function, showed significant association with self-reported problematic driving outcomes in adolescents. No relationship was found between performance-based executive function measures and self-reported driving outcomes. The BRIEF could offer unique and quick insight into problematic driving behavior and potentially be an indicator of driving risk in adolescent drivers during clinical evaluations.

Cognitive impairments seen in people living with HIV (PLWH) are associated with difficulties in everyday functioning, specifically driving. This study utilized speed of processing cognitive remediation therapy (SOP-CRT) with transcranial direct current stimulation (tDCS) to gauge the feasibility and impact on simulated driving. Thirty PLWH (Mage = 54.53, SD = 3.33) were randomly assigned to either: sham tDCS SOP-CRT or active tDCS SOP-CRT. Seven indicators of simulated driving performance and safety were obtained. Repeated measures ANOVAs controlling for driver’s license status (valid and current license or expired/no license) revealed a large training effect on average driving speed. Participants who received active tDCS SOP-CRT showed a slower average driving speed (p = 0.020, d = 0.972) than those who received sham tDCS SOP-CRT. Non-significant small-to-medium effects were seen for driving violations, collisions, variability in lane positioning, and lane deviations. Combination tDCS SOP-CRT was found to increase indices of cautionary simulated driving behavior. Findings reveal a potential avenue of intervention and rehabilitation for improving driving safety among vulnerable at-risk populations, such as those aging with chronic disease.

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Objective: Walking is integral to transportation and physical activity, but safety is a primary concern for pedestrians due to the increasing amount of injuries and deaths per year. To address the need for avenues of pedestrian safety improvements, this study's objective was to determine the association among driver and pedestrian characteristics and behavior, environmental characteristics, and the presence of injury resulting from a pedestrian-vehicle crash.