DOCSLIB.ORG

Casaletto Dissertation Defense 05082015 Final

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Casaletto Dissertation Defense 05082015 Final UC San Diego UC San Diego Electronic Theses and Dissertations Title A Metacognition-Based Approach to Improve HIV-associated Neurocognitive Disorders among Substance Users Permalink https://escholarship.org/uc/item/7js8m00h Author Casaletto, Kaitlin Blackstone Publication Date 2015 Peer reviewed|Thesis/dissertation eScholarship.org Powered by the California Digital Library University of California UNIVERSITY OF CALIFORNIA, SAN DIEGO SAN DIEGO STATE UNIVERSITY A Metacognition-Based Approach to Improve HIV-associated Neurocognitive Disorders among Substance Users A dissertation submitted in partial satisfaction of the requirements for the degree of Doctor in Philosophy in Clinical Psychology by Kaitlin Blackstone Casaletto Committee in charge: University of California, San Diego Robert K. Heaton, Co-chair David J. Moore, Co-chair Elizabeth W. Twamley Steven P. Woods San Diego State University Sarah Mattson Claire Murphy 2016 © Kaitlin Blackstone Casaletto All rights reserved, 2016. The Dissertation of Kaitlin Blackstone Casaletto is approved, and it is acceptable in quality and form for publication on microfilm and electronically: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Co-Chair _____________________________________________________________________ Co-Chair University of California, San Diego San Diego State University 2016 iii TABLE OF CONTENTS Signature Page ................................................................................................................. iii List of Figures ................................................................................................................... vi List of Tables ................................................................................................................... vii Acknowledgements ......................................................................................................... viii Vita ................................................................................................................................... ix Abstract of the Dissertation ........................................................................................... xviii Introduction ........................................................................................................................ 1 HIV-1 Infection: Impact on the Brain, Neurocognition, and Everyday Functioning ........ 1 Substance Use: Impact on the Brain, Neurocognition, and Everyday Functioning ....... 3 Comorbid HIV Infection and Substance Use: Impact on the Brain, Neurocognition, and Everyday Functioning .................................................................................................... 6 Metacognition .............................................................................................................. 10 Cognitive Rehabilitation in HIV Infection and Substance Use ..................................... 14 Metacognitive Training as a Neurorehabilitation Approach ......................................... 17 Multitasking ................................................................................................................. 18 Methods ........................................................................................................................... 24 Participants .................................................................................................................. 24 Participant Characterization and Inclusion/Exclusion Criteria ..................................... 25 Design ......................................................................................................................... 26 Procedures .................................................................................................................. 27 Current Neuropsychological Assessment ................................................................... 27 Executive Dysfunction Awareness .............................................................................. 28 Diet, Sleep, and Exercise ............................................................................................ 28 Metacognitive Training plus Goal Management Training strategy (Meta+GMT) Condition ..................................................................................................................... 29 Goal Management Training (GMT) only Condition ...................................................... 31 Active Control Condition .............................................................................................. 31 Assessment of Instrumental Activity of Daily Living (IADL): Everyday Multitasking Test .................................................................................................................................... 31 Assessment of Metacognition: Metacognitive Measures ............................................ 32 Existing Neuromedical and Psychiatric Data ............................................................... 34 Data Analyses ............................................................................................................. 34 Results ............................................................................................................................ 39 Pilot Study ................................................................................................................... 39 Main Study Participants ............................................................................................... 39 Everyday Multitasking Test (Everyday MT) ................................................................. 43 Metacognition .............................................................................................................. 48 Other Moderating Factors ........................................................................................... 52 Study and Training Feedback ..................................................................................... 54 Discussion ....................................................................................................................... 56 Training Benefits ......................................................................................................... 56 Other Moderating Factors for Goal Management Training (GMT) Benefits ................ 63 Metacognitive Training Null Effects: Informing Future Directions ................................ 65 iv Clinical Implications ..................................................................................................... 70 Training Feasibility and Acceptability .......................................................................... 73 Limitations ................................................................................................................... 74 Summary and Other Future Directions ........................................................................ 77 Appendix ......................................................................................................................... 80 References ...................................................................................................................... 83 v LIST OF FIGURES Figure 1. Adapted version of Toglia and Kirk’s (2000) Model of Metacognition subdivided into the hypothesized domains…………………………………………………..30 Figure 2. Conceptual impact of HIV infection and substance use disorders (SUD) on metacognition and executive functions and the relative benefit of Goal Management Training and Metacognitive Training for Everyday Multitasking Test performance……..43 Figure 3. HIV/SUD participants’ performances on the Everyday Multitasking Test following study training condition.…………………………………………………………….63 Figure 4. Performances on the Everyday Multitasking Test comparing HIV/SUD participants who completed the active control and those who completed the Goal Management Training (as part of the Metacognitive Training or alone)………………….64 Figure 5. HIV/SUD individuals with poor dual tasking abilities benefitted most from Goal Management Training on Everyday Multitasking Test performances…………………….66 Figure 6. Major domains of in-vivo metacognitive performances by study condition; Online Awareness demonstrates a significant increasing positive trend across study arms……………………………………………………………………………………………...67 Figure 7. Among the measuring comprising metacognition, Task Appraisal demonstrates a trend for increasing elaboration across study conditions……………….68 Figure 8. Goal Management Training (GMT; as part of the Metacognitive Training or not) demonstrates a small-to-medium benefit for Online Awareness among HIV/SUD individuals compared to those who received the control condition……….......................69 Figure 9. Goal Management Training (GMT; as part of the Metacognitive Training or not) resulted in more elaborate Task Appraisals among HIV/SUD individuals than those in the control condition…………………………………………………………………………70 Figure 10. Feedback regarding trainings and participation by study arm………………..73 Figure 11. Flowchart illustrating the five stages of Goal Management Training as reproduced from Levine et al. (2000)………………………………………………………...98 vi LIST OF TABLES Table 1. Application of Goal Management Training to the Multitasking Test……………50 Table
Load more

Recommended publications
  • Uila Supported Apps
    Uila Supported Applications and Protocols updated Oct 2020 Application/Protocol Name Full Description 01net.com 01net website, a French high-tech news site. 050 plus is a Japanese embedded smartphone application dedicated to 050 plus audio-conferencing. 0zz0.com 0zz0 is an online solution to store, send and share files 10050.net China Railcom group web portal. This protocol plug-in classifies the http traffic to the host 10086.cn. It also 10086.cn classifies the ssl traffic to the Common Name 10086.cn. 104.com Web site dedicated to job research. 1111.com.tw Website dedicated to job research in Taiwan. 114la.com Chinese web portal operated by YLMF Computer Technology Co. Chinese cloud storing system of the 115 website. It is operated by YLMF 115.com Computer Technology Co. 118114.cn Chinese booking and reservation portal. 11st.co.kr Korean shopping website 11st. It is operated by SK Planet Co. 1337x.org Bittorrent tracker search engine 139mail 139mail is a chinese webmail powered by China Mobile. 15min.lt Lithuanian news portal Chinese web portal 163. It is operated by NetEase, a company which 163.com pioneered the development of Internet in China. 17173.com Website distributing Chinese games. 17u.com Chinese online travel booking website. 20 minutes is a free, daily newspaper available in France, Spain and 20minutes Switzerland. This plugin classifies websites. 24h.com.vn Vietnamese news portal 24ora.com Aruban news portal 24sata.hr Croatian news portal 24SevenOffice 24SevenOffice is a web-based Enterprise resource planning (ERP) systems. 24ur.com Slovenian news portal 2ch.net Japanese adult videos web site 2Shared 2shared is an online space for sharing and storage.
    [Show full text]
  • OTT and Related On-Line Services in Arab Region
    OTT and related on-line services in Arab Region Release 1.1 31/01/2017 Reality of OTTs in Arab Region The objective of the study is: 1- to have a global view on OTT and on-line services worldwide with the impact and trends of these services on national players and economies, 2- to have an overview on associated practices and relevant public policies worldwide and in the Region, 3- to propose recommendations on methods and approaches for preparation of associated policies and frameworks. _____________________________ The present document is the first release of the report. A draft questionnaire is proposed with this release and is intended to be submittedfor a survey to Regulators/policy Makers and Operators in the Region. The outcome of the survey with the related findings will be commented and included in a next version of this report. It is to note that, as the subject of OTT is being regularly debated in almost all regions with potential move and change in the related positions and decisions, some information reported in the present report may become outdated. __________________________________________________________________ OTT and related on-line services in Arab Region Executive Summary With the increase of global mobile broadband penetration, as well as the rapid adoption of connected devices, consumers have been provided with an access to a wide variety of on-line services which go beyond the traditional voice and messaging services provided by telecom operators (alias telcos *). These on-line services are reshaping the entire telecommunication eco-system, and are of great benefit to consumers worldwide, to the global economy and ubiquitous connectivity.
    [Show full text]
  • A Scoping Review of AHP Interventions for People Living with Dementia, Their Families, Partners and Carers
    Dementia A scoping review of AHP interventions for people living with dementia, their families, partners and carers Prepared for: Alzheimer Scotland: Action on Dementia 22 Drumsheugh Gardens Edinburgh Scotland EH3 7RN Prepared by: The Division of Occupational Therapy and Arts Therapies Queen Margaret University School of Health Sciences Edinburgh EH21 6UU Investigator: Duncan Pentland, D. Health Soc Sci Published: 03-December-2015 CONTENTS Contents ................................................................................................................................................... i List of figures and tables ........................................................................................................................ iv List of abbreviations, acronyms and symbols ......................................................................................... v 1. Introduction .................................................................................................................................... 1 1.1. Purpose ................................................................................................................................... 1 1.2. Approach ................................................................................................................................. 1 1.3. Methods .................................................................................................................................. 1 2. Cognitive interventions ..................................................................................................................
    [Show full text]
  • Time-Resolved Terahertz Spectroscopy Of
    TIME-RESOLVED TERAHERTZ SPECTROSCOPY OF SEMICONDUCTOR QUANTUM DOTS by GEORGI DAKOVSKI Submitted in partial fulfillment of the requirements For the degree of Doctor of Philosophy Thesis advisor: Dr. Jie Shan Department of Physics Case Western Reserve University January, 2008 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the dissertation of ______________________________________________________ candidate for the Ph.D. degree *. (signed)_______________________________________________ (chair of the committee) ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ (date) _______________________ *We also certify that written approval has been obtained for any proprietary material contained therein. Table of Contents List of figures……………………………………………………………………5 Abstract………………………………………………………………………..10 1. Introduction to optical pump/terahertz probe spectroscopy………………12 1.1 Generation and detection of THz radiation……………………….13 1.2 Applications of THz-TDS…………………………………………...19 1.3 Outline of the thesis………………………………………………...20 2. Localized THz generation via optical rectification in ZnTe………………..22 2.1 Difference-frequency generation…………………………………..24 2.2 Experimental setup………………………………………………….26 2.3 Results………………………………………………………………..27 2.4 Numerical simulation and discussion……………………………..30 2.5 Conclusions………………………………………………………….39 1 3.
    [Show full text]
  • Annual Report 2006
    ANNUAL TOWN REPORT OF THE YEAR 2006 MARBLEHEAD, MASSACHUSETTS MARBLEHEAD TOWN REPORT Table of Contents Board of Selectmen 4 Warrant for Annual Town Meeting 7 May 1, 2006 and Annual Town Election May 8, 2006 Results of Annual Town Election 23 May 8, 2006 Results of Annual Town Meeting 27 May 1 & 2, 2006 Warrant for State Primary 66 September 19, 2006 Results of State Primary 68 September 19, 2006 Warrant for State Election 74 November 7, 2006 Results of State Election 79 November 7, 2006 Officials Elected 83 Officials Appointed 86 Vital Records of 2006 98 Number of births, marriages, deaths and causes of death recorded Department Reports: Abbot Public Library 101 Board of Assessors 105 Board of Health 107 Building Commissioner and Inspectional 120 Services Cable TV Oversight Committee 122 Cemetery Department 123 Conservation Commission 125 Council on Aging 127 Department of Public Works 131 Engineering Department 133 Financial Services 134 Fire Department 136 2 TABLE OF CONTENTS Fort Sewall Oversight Committee 148 Harbors and Waters 149 Marblehead Cultural Council 151 Marblehead Historical Commission 153 Marblehead Housing Authority 155 Metropolitan Area Planning Council 162 Municipal Light Department 169 Old and Historic Districts Commission 177 Planning Board 178 Police Department 180 Recreation, Parks & Forestry 186 Sealer of Weights & Measures 199 Shellfish Constables 200 Veterans’ Agent 201 Water and Sewer Commission 203 Zoning Board of Appeals 211 School Reports Marblehead School Committee members 212 organization and meetings Marblehead
    [Show full text]
  • Clinic Showcase Book TABLE of CONTENTS
    2020 Clinic Showcase Book TABLE OF CONTENTS Message from the Dean .............................................................................................................. 4 Message from the Junior/Senior Clinic Coordinator .................................................................... 5 Biomedical Engineering....................................................................................................... 6-23 A Clinical Path to Cartilage Biopsy Procurement .............................................................. 6 Aligned Nanofiber Embedded Composite Thin Films and Layer-by-layer Structures ...... 7 Chemotherapeutic and Analgesic Drug Delivery Systems ................................................ 7 Crystallinity, Reversibility, and Injectability of PVA/PEG Hydrogels .................................. 8 Developing Biosensors for Studying the Tumor Microenvironment .................................. 8 Dexamethasone and Lidocaine hydrogel to lessen inflammation at insulin pump site ..... 9 Dimension Adjustable Power Chair ................................................................................... 9 DNA Nanogels for Targeted Delivery of Chemotherapeutics .......................................... 10 Early Detection of Implant Loosening to Prevent Total Implant Failure .......................... 10 Effects of Genipin Crosslinking on the Mechanical Properties of Hydrogels Derived from Decellularized Bovine Tendon .................................................................................11 Gelatin-Based
    [Show full text]
  • Think: Inferring Cognitive Status from Subtle Behaviors
    Proceedings of the Twenty-Sixth Annual Conference on Innovative Applications of Artificial Intelligence THink: Inferring Cognitive Status from Subtle Behaviors Randall Davis David J. Libon Rhoda Au David Pitman Dana L. Penney MIT CSAIL Neurology Department Neurology Department MIT CSAIL Department of Neurology Cambridge, MA Drexel College of Med. Boston Univ Sch of Med Cambridge, MA Lahey Health [email protected] [email protected] [email protected] dpitman@ mit.edu [email protected] Abstract The Digital Clock Drawing Test is a fielded application that The Task provides a major advance over existing neuropsychological testing technology. It captures and analyzes high precision information about both outcome and process, opening up For more than 50 years clinicians have been giving the the possibility of detecting subtle cognitive impairment even Clock Drawing Test, a deceptively simple, yet widely when test results appear superficially normal. We describe accepted cognitive screening test able to detect altered the design and development of the test, document the role of AI in its capabilities, and report on its use over the past cognition in a wide range of neurological disorders, seven years. We outline its potential implications for earlier including dementias (e.g., Alzheimer’s), stroke, detection and treatment of neurological disorders. We also Parkinson’s, and others (Freedman 1994) (Grande 2013). set the work in the larger context of the THink project, The test instructs the subject to draw on a blank page a which is exploring multiple approaches to determining clock showing 10 minutes after 11 (called the “command” cognitive status through the detection and analysis of subtle behaviors.
    [Show full text]
  • Local Innovation for Better Outcomes for Neonates (LIBON) Project PLAN Nepal Child Survival Project XXII Sunsari, Parsa, and Bara Districts in Nepal
    Local Innovation for Better Outcomes for Neonates (LIBON) Project PLAN Nepal Child Survival Project XXII Sunsari, Parsa, and Bara Districts in Nepal Final Evaluation Report 30th September 2007 to 29th September 2011 Cooperative Agreement No. GHN-A-00-07-0006-00 1 Report Prepared By Mahesh K. Maskey – Lead Evaluator, Final Evaluation Team Bhagawan Das Shrestha – Field Program Manager – LIBON Dipak Dahal - Monitoring and Evaluation Officer – LIBON Sher Bahadur Rana – Health Coordinator – Plan Nepal Harpreet Anand – Program Manager -- Plan USA Submitted: December 23, 2011 Plan International USA HARPREET ANAND, PROGRAM MANAGER, FIELD PROGRAM SUPPORT Plan International USA, Inc. 1730 Rhode Island Avenue, NW, Suite 1100 Washington, DC 20036 Tel. (202) 223-8325 [email protected] Plan International NEPAL BHAGWAN DAS SHRESTHA, FIELD PROGRAM MANAGER Plan International NEPAL Shree Durbar, Pulchowk-3 P. O. Box: 8980 COUNTRY, ZIP CODE: 44700 Tel. + 977 1 5535 560 extensión 135 [email protected] 2 ACRONYMS and ABBREVIATIONS AHW Auxiliary Health Worker ANC Antenatal Care ANM Auxiliary Nurse Midwife BCC Behavior Change Communication BPP Birth Preparedness Package CB-IMCI Community-based Integrated Management of Childhood Illness CB-NCP Community-based Neonatal Care Program CBO Community-based Organization CDK Clean Delivery Kit CDP Community Drug Program CHD Child Health Division (MoHP) CHW Community Health Worker CHX Chlorhexidine CS Child Survival CSHGP Child Survival and Health Grants Program CSSA Child Survival
    [Show full text]
  • Regulamin Korzystania Z Biz Multipak W Orange Dla Firm Obowiązuje Od Dnia 23 Stycznia 2014 Roku Do Odwołania
    Regulamin korzystania z Biz MultiPak w Orange dla Firm obowiązuje od dnia 23 stycznia 2014 roku do odwołania § 1 DEFINICJE 1. Na potrzeby niniejszego Regulaminu zostają przyjęte następujące definicje pisane wielką literą: a) Abonent – przedsiębiorca (w rozumieniu ustawy z dnia 2 lipca 2004 r. o swobodzie działalności gospodarczej, Dz. U. Nr 173, poz. 1807 ze zm.) lub inny podmiot zarejestrowany w rejestrze REGON; b) Aneks do Umowy – zawarty w formie pisemnej aneks do Umowy; c) Cennik Usług – cennik usług w ofercie Biz Plany w Orange dla Firm; d) Mobilna Sieć Orange – ruchoma publiczna sieć telekomunikacyjna, wykorzystująca między innymi takie standardy, jak GSM 900/1800 lub UMTS, obsługiwana przez Operatora; e) Numer - numer telefonu komórkowego MSISDN przyznany Abonentowi w wyniku zawarcia Umowy; f) Operator – Orange Polska Spółka Akcyjna z siedzibą i adresem w Warszawie (02-326) przy Al. Jerozolimskich 160, wpisana do Rejestru Przedsiębiorców prowadzonego przez Sąd Rejonowy dla m.st. Warszawy w Warszawie, XII Wydział Gospodarczy Krajowego Rejestru Sądowego, pod numerem 0000010681; REGON 012100784, NIP 526- 02-50-995; g) OWU - Ogólne warunki grupowego ubezpieczenia „Bezpieczny Telefon dla Firm” dla Abonentów sieci Orange Polska S.A. – segment BIZNES, ustalone przez Powszechny Zakład Ubezpieczeń Spółka Akcyjna; h) Pakiet 100 MB – pakiet 100 MB dostępny w ramach usługi Internet 100 MB UE; i) Punkt Sprzedaży OrangeOrange- salon Orange, salon partner Orange; j) Plany Taryfowe – następujące plany taryfowe, dla których dostępny jest MultiPak: Biz 40; Biz 60; Biz 90; Biz 125; k) Regulamin – niniejszy regulamin korzystania z Biz MultiPak w Orange dla Firm; l) Regulamin Świadczenia Usług Telekomunikacyjnych - Regulamin świadczenia usług telekomunikacyjnych w sieci telekomunikacyjnej GSM 900/1800 i UMTS przez Spółkę pod firmą Orange Polska S.A.
    [Show full text]
  • Mike Hess",California,United States
    Downloaded from: justpaste.it/1bvk7 Myredbook.com, now providingsupport.com non graduate of San Jose State University Maxim Integrated Products "Mike Hess",California,United States *****(Part 1)***** you are IMMEDIATELY UNDER CITIZENS ARREST (09/30/2017) for colluding with Narc, rapist, stalker, drug dealer (ecstasy,cocaine, meth, heroin,pcp,lsd), drug user (ecstasy,cocaine, meth, heroin,pcp,lsd),hacker, alcoholic, cyber stalker, libel writer, slander(er) http://lpw.cdph.ca.gov/SearchPage.aspx License Details Licensee: DAVID CIPRIANO License Number: CPT 00055744 License Title: CERTIFIED PHLEBOTOMY TECHNICIAN I Status: Inactive Approve Date: 5/7/2012 12:00:00 AM Last Renewal Date: 5/27/2014 12:00:00 AM Expiration Date: 5/6/2016 12:00:00 AM Grace Period Ends: 5/6/2016 12:00:00 AM End of License Details Return to Search lived on Latham, in Mtn.View (94040), in Palo Alto(94036), at 1837 Clarke Ave #21. East Palo Alto, CA 94303 (deadhook.yuku.com/topic/2879/OFFICIAL-MAILBOMB-LIST?page=4 - "Apr 6, 2004 - More. My Recent Posts. David Cipriano 1837 Clarke Ave #21. East Palo Alto, CA 94303 don't be shy about asking me for a trade or a b&p :9l .." ) Case Number Style / Defendant File Date Type Status CLJ192275 EVA SALAS VS. DAVID CIPRIANO 12/07/2005 (32) Limited Residential Unlawful Detainer - under 10,000 Closed https://odyportal-ext.sanmateocourt.org/Portal-External/Home/WorkspaceMode?p=0 "worked" at Chilis & "worked" Palo Alto Olive Garden (2515 El Camino Real Palo Alto, CA 94306 ) lived with John in Palo Alto NEVER worked at Honda Palo Alto,
    [Show full text]
  • Image Enhancement in Digital X-Ray Angiography
    Image Enhancement in Digital X-Ray Angiography Erik Meijering Colophon This book was typeset by the author using LATEX2ε. The main body of the text was set using a 10-points Computer Modern Roman font. All graphics and images were included formatted as Encapsulated PostScript (TM Adobe Systems Incorporated). The final PostScript output was converted to Portable Document Format (PDF) and transferred to film for printing. Cover design by the author using CorelDRAW (TM Corel Corporation) version 8. The background is a colored fragment of a slice taken from a clinical 3DRA dataset. The graphics on the front cover symbolically represent the contents of the different chap- ters: the vector field (in red) refers to the problem of patient motion registration and correction in DSA, addressed in Chapters 2, 3, and 4; the circles and arrows (in green) represent the tasks of visualization and subsequent quantification of blood vessels and their anomalies in 3DRA images, which constitute the subject of Chapter 5; finally, the plot (in blue) portrays the realization of the sinc-like kernel implicitly used in cu- bic spline interpolation, which according to the results of the comparative evaluation study described in Chapter 6 is the method of choice for geometrical transformation of medical image data. Copyright c 2000 by Erik Meijering. All rights reserved. No part of this publica- tion may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the author. ISBN 90-393-2500-6 Printed by Ponsen & Looijen, Wageningen.
    [Show full text]
  • Samena Trends
    SAMENA TRENDS EXCLUSIVELY FOR SAMENA TELECOMMUNICATIONS COUNCIL'S MEMBERS Volume 04 Issue 04 BUILDING DIGITAL ECONOMIES April 2013 A SAMENA Telecommunications Council Newsletter The Future of Telecom and Broadcasting: Forging New Synergies and Cooperation Franco Bernabe Chairman & CEO Telecom Italia EDITORIAL The Future of Telecom and Broadcasting Both telecommunications operators and work together—the more synergistically it broadcasters have similarities in what their can be done, the better results it may yield. core business aspires to achieve in the future. That is, both groups want to ensure better Technologically speaking, cooperation- content and multimedia service delivery building can be realized through the amidst the influx of alternative competition, implementation of next-generation network and both want to efficiently make use of the technologies and strategies, which allow for spectrum available to them—be it for legacy effectively dealing with complex network service offerings in their respective domains traffic patterns. Clearly, from a network or for creating innovative services and point of view, should telecom operators and applications in the telecom-media converged broadcasters decide to strategically combine domain. In any case, both require growth and their tangible and intangible assets, various sustainability. challenges will be faced. However, combined experience and expertise in creatively As associated network costs, declining profit attending to customer demands could help per user, and the entry of new players into the manage such challenges. Moreover, the telecoms and content value-chains become presence of enabling regulatory and legal more pronounced, the need for creating new frameworks is highly critical, as this should business models to protect core business enable smooth and seamless exchange and interests becomes even greater.
    [Show full text]