An experimental investigation of the automatic/voluntary dissociation in limb apraxia

The ability of apraxic patients to perform gestures in everyday life is a controversial issue. In this paper, we aimed to evaluate the automatic/voluntary dissociation (AVD) in four patients affected by clinically relevant limb apraxia. For this purpose, we sampled different kinds of gestures belonging to patients' motor repertoire and then assessed their production in a testing session. Our experimental procedure consisted of two steps: in the first phase, we recorded gestures produced by patients in two natural conditions; in the second phase, we assessed production of correctly produced tool-actions, and of spontaneous non tool-actions and meaningless conversational (cohesive and beats) gestures under different modalities. AVD was observed for all types of gestures, albeit to different degree in single patients. The present findings demonstrate that the context provides strong bottom-up cues for the retrieval of motor patterns, while artificial testing conditions impose an additional cognitive load.     

On the ethics of facial transplantation research

Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet all the ethical requirements usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase.     

Motion and color processing in school-age children and adults: an ERP study

Stimuli designed to selectively elicit motion or color processing were used in a developmental event-related potential study with adults and children aged 6, 7 and 8. A positivity at posterior site INZ (P-INZ) was greater to motion stimuli only in adults. The P1 and N1 were larger to color stimuli in both adults and children, but earlier to motion stimuli only in adults. Finally, the P2 was larger to color stimuli in adults but larger to motion stimuli in children, and earlier to motion stimuli only in children. The findings across components indicate development from middle childhood to adulthood in aspects of both the motion and color processing systems indexed by this paradigm, but are consistent with an hypothesis of a more protracted time course of development for the motion as compared to the color processing system.     

Role of motor imitation in traversability of surfaces by walking infants.

The ecological approach by Gibson stressed the role of visual cues in toddlers' locomotor activities. In particular, a rigid surface offers more traversability "affordances" to walkers (13-16 mo. old) than a deformable surface. On the other hand, imitation plays a relevant role in human behaviors. In our study a group of 17 walking infants (12-19 mo.) were asked to choose between locomoting on a rigid versus a deformable surface after having seen an older child walking on the deformable surface. A control group of 19 infants were asked to do the same task without having seen a model. The task was repeated three times. No relevant differences appeared between the two groups as to the choice of surfaces: the rigid surface was preferred by both groups. Some slight differences in the behavior of the experimental group were seen as a result of observing the model. Clearly, however, social stimulus. such as the sight of an older child performing a specific task, does not overcome the affordances which induce infants not to walk on the deformable surface.     

Stress‐related exhaustion disorder – clinical manifestation of burnout? A review of assessment methods,sleep impairments,cognitive disturbances,and neuro‐biological and physiological changes in clinical burnout

The aim of this paper was to provide an overview of the literature on clinically significant burnout, focusing on its assessment, associations with sleep disturbances, cognitive impairments, as well as neurobiological and physiological correlates. Fifty‐nine English language articles and six book chapters were included. The results indicate that exhaustion disorder (ED), as described in the Swedish version of the International Classification of Diseases, seems to be the most valid clinical equivalent of burnout. The data supports the notion that sleep impairments are causative and maintaining factors for this condition. Patients with clinical burnout/ED suffer from cognitive impairments in the areas of memory and executive functioning. The studies on neuro‐biological mechanisms have reported functional uncoupling of networks relating the limbic system to the pre‐frontal cortex, and decreased volumes of structures within the basal ganglia. Although there is a growing body of literature on the physiological correlates of clinical burnout/ED, there is to date no biomarker for this condition. More studies on the role of sleep disturbances, cognitive impairments, and neurobiological and physiological correlates in clinical burnout/ED are warranted.     

Stress-Induced Cardiomyopathy and Psychological Wellbeing 1 Year After an Acute Event

Stress cardiomyopathy (SCM) typically presents similar symptoms to acute myocardial infarction (AMI). However, these symptoms differ when it comes to a transient and completely reversible myocardial dysfunction, which is frequently precipitated by acute stressful events, occurring in the absence of plaque rupture and coronary thrombosis. The purpose of this study was to investigate health-related quality of life (HRQL) and emotional burden subsequent to cardiac events in SCM patients. Thirty-seven SCM patients were compared with 37 matched AMI patients. All selected patients were assessed for HRQL and psychological distress at baseline and 1-year after the acute event. After controlling for covariates, scores on the Psychological General Well Being Index indicated that depressed mood had increased in both groups, but the increase for SCM patients was greater than for AMI patients. The AMI group displayed greater decreases than the SCM in physical quality of life and in total cardiac-related health quality of life. The percentage of patients with psychological distress increased significantly more in the SCM group than in the AMI group, and it made no difference whether the triggering event was emotional or physical. Our results suggest that, despite the more favorable medical prognosis of SCM patients, their cardiac condition being transient and resolving completely in few weeks, the psychological impact associated with their condition is more negative 1 year later than in the case of AMI patients whose medical prognosis is less favorable, and this difference is independent of type of trigger event.     

Tower of London test: a comparison between conventional statistic approach and modelling based on artificial neural network in differentiating fronto-temporal dementia from Alzheimer's disease

The early differentiation of Alzheimer's disease (AD) from frontotemporal dementia (FTD) may be difficult. The Tower of London (ToL), thought to assess executive functions such as planning and visuo-spatial working memory, could help in this purpose. Twentytwo Dementia Centers consecutively recruited patients with early FTD or AD. ToL performances of these groups were analyzed using both the conventional statistical approaches and the Artificial Neural Networks (ANNs) modelling. Ninety-four non aphasic FTD and 160 AD patients were recruited. ToL Accuracy Score (AS) significantly (p < 0.05) differentiated FTD from AD patients. However, the discriminant validity of AS checked by ROC curve analysis, yielded no significant results in terms of sensitivity and specificity (AUC 0.63). The performances of the 12 Success Subscores (SS) together with age, gender and schooling years were entered into advanced ANNs developed by Semeion Institute. The best ANNs were selected and submitted to ROC curves. The non-linear model was able to discriminate FTD from AD with an average AUC for 7 independent trials of 0.82. The use of hidden information contained in the different items of ToL and the non linear processing of the data through ANNs allows a high discrimination between FTD and AD in individual patients.     

The Impact of Culture on the Individual Subjective Well-Being of the Italian Population: An Exploratory Study

The aim of this study is to explore the relationship between cultural access and individual psychological well-being, in order to provide a possible estimation of the impact of cultural participation upon subjective perceptions of well being. Our exploratory research was based on a cross-sectional survey undertook on a medium-large sample (n = 1500) of Italian residents in fall 2008. We refer to the Psychological General Well-Being Index–PGWBI, a tool that has been validated through 30 years of research, as an index of measurement. Moreover, we have administered to the sample an additional questionnaire inquiring about access to 15 distinct culturally related activities. Data are processed by means of a specific methodology based on ANN and Called TWIST. TWIST has been developed by the Semeion Research Center, Rome. Our analysis suggests that culture has a relevant role as a determinant of individual psychological well-being, in that a selected subset of cultural variables turn out to perform among the best predictors of individual PGWB levels. Our results also allow some preliminary considerations about innovative, well-being focused public health policies leveraging upon the human and social developmental role of culture.     

The Interaction Between Culture, Health and Psychological Well-Being: Data Mining from the Italian Culture and Well-Being Project

The purpose of this study is to understand the impact of health status and cultural participation upon psychological well-being, with special attention to the interaction between patterns of cultural access and other factors known to affect psychological well-being. Data for this report were collected from a sample of 1,500 Italian citizens. A multi-step random sampling method was adopted to draw a large representative sample from the Italian population. Subjects underwent a standard questionnaire for psychological well-being [the Italian short form of the Psychological General Well Being Index (PGWBI)], and a questionnaire related to the frequency of participation to 15 different kinds of cultural activities during the previous year. The results show that, among the various potential factors considered, cultural access unexpectedly rankes as the second most important determinant of psychological well-being, immediately after the absence or presence of diseases, and outperforming factors such as job, age, income, civil status, education, place of living and other important factors. According to a semantic map generated by a powerful data mining algorithm, it turns out that different factors (among which cultural access and health status in particular) may be viewed as concurrent elements of a complex multi-causal scheme that seems to play a primary role in determining psychological distress or well-being. In particular, distress seems to be tightly connected with: living in the Southern part of Italy, average income level, living in semi-urban and urban areas, age group 46–60, presence of more than two concomitant diseases and a low level of cultural access. Well being, on the other hand, is tightly connected with: male gender, high cultural access, and absence of diseases. Some of these associations are confirmed by Principal Component Analysis.     

The Opinions of GP's Patients About Suicide,Assisted Suicide,Euthanasia, and Suicide Prevention: An Italian Survey

A survey about opinions on end‐of‐life issues of a population represented by 1,171 people in the waiting room of general practitioners' surgeries was conducted in a province of northern Italy. Most subjects did not consider suicide as a reasonable option even in cases of a serious and incurable disease. Moreover, subjects did not consider euthanasia as a possible option either; however, they did express an opposite attitude when considering euthanasia in a third‐person perspective. People with a personal history of suicidal behavior appear to present as a different population, overall expressing more open attitudes.