Ilaria Cutica

Neuropragmatics: Extralinguistic pragmatic ability is better preserved in left-hemisphere-damaged patients than in right-hemisphere-damaged patients

The aim of the present study is to compare the pragmatic ability of right- and left-hemisphere-damaged patients excluding the possible interference of linguistic deficits. To this aim, we study extralinguistic communication, that is communication performed only through gestures. The Cognitive Pragmatics Theory provides the theoretical framework: it predicts a gradient of difficulty in the comprehension of different pragmatic phenomena, that should be valid independently of the use of language or gestures as communicative means. An experiment involving 10 healthy individuals, 10 right- and 9 left-hemisphere-damaged patients, shows that pragmatic performance is better preserved in left-hemisphere-damaged (LHD) patients than in right-hemisphere-damaged (RHD) patients.

The Deep Versus the Shallow: Effects of Co-Speech Gestures in Learning From Discourse

This study concerned the role of gestures that accompany discourse in deep learning processes. We assumed that co-speech gestures favor the construction of a complete mental representation of the discourse content, and we tested the predictions that a discourse accompanied by gestures, as compared with a discourse not accompanied by gestures, should result in better recollection of conceptual information, a greater number of discourse-based inferences drawn from the information explicitly stated in the discourse, and poorer recognition of verbatim of the discourse. The results of three experiments confirmed these predictions.

Learning from text benefits from enactment.

Classical studies on enactment have highlighted the beneficial effects of gestures performed in the encoding phase on memory for words and sentences, for both adults and children. In the present investigation, we focused on the role of enactment for learning from scientific texts among primary-school children. We assumed that enactment would favor the construction of a mental model of the text, and we verified the derived predictions that gestures at the time of encoding would result in greater numbers of correct recollections and discourse-based inferences at recall, as compared to no gestures (Exp. 1), and in a bias to confound paraphrases of the original text with the verbatim text in a recognition test (Exp. 2). The predictions were confirmed; hence, we argue in favor of a theoretical framework that accounts for the beneficial effects of enactment on memory for texts.

A Cohort Pilot Study on HIV-Associated Neuropsychological Impairments in Hemophilia Patients.

Despite advances in the management of HIV infection with the introduction of combination antiretroviral therapy, it is well known that HIV can directly infect the central nervous system and, as a result of such infection, neuropsychological impairments can be manifested. In this study, we tried to determine whether seropositivity was associated with a poor neuropsychological performance in patients with hemophilia and HIV. Such a cohort of patients is very often underrepresented and understudied in the HIV literature. To amend such a gap, we carried out an extensive neuropsychological evaluation on these patients, and compared their performance with that of a group of seronegative hemophilia patients. The results revealed that HIV infection in HIV-seropositive (HIV+) hemophilia patients was associated with deficits in attention, short-term memory, abstraction, and visual recognition. Such results are still preliminary and explorative due to the small cohort of patients enrolled. However, the results do seem to have some important implications for day-to-day functioning, as the level of impairment detected may cause difficulties in completing common everyday tasks such as maintaining adherence to complex medication regimens or maintaining social life activities. Continued research into the mechanisms related to HIV and neurocognitive dysfunction may provide targets for interventions that could have meaningful consequences in the real world for HIV hemophilia patients.

Cognitive change in learning from text: Gesturing enhances the construction of the text mental model

The literature on co-speech gestures has revealed a facilitating effect of gestures on both the listeners discourse comprehension and memory, and the speakers discourse production. Bucciarelli (2007) and Cutica and Bucciarelli (2008) advanced a mental model account for the cognitive change produced by gestures: Gestures, whether observed or produced, favour the construction of a mental model of the discourse they accompany. In this paper, we focus on gesturing while studying, assuming that gesturing while reading a text also favours the construction of a mental model of the text. In two experiments we invited adult participants to study two scientific texts and confirmed the predictions deriving from the assumption that gestures favour the construction of a mental model of the text: Gesturing while studying resulted in more correct recollections and text-based inferences (Experiment 1) and loss of verbatim recall (Experiment 2).

Is There Evidence for Neurocognitive Dysfunctions in Patients with Postnatal HIV Infection? A Review on the Cohort of Hemophilia Patients.

The debate regarding neurocognitive functions in the early stages of HIV infection is still ongoing; different studies have reached contrasting conclusions, probably because many of them take into account different cohorts of patients. A main distinction is between HIV seropositive patients infected perinatally, and those infected postnatally. The aim of this paper is to review results on neurocognitive dysfunctions and other types of neurological involvement in a specific cohort of HIV+ patients infected postnatally: hemophilia patients. Such a review is relevant, as HIV seropositive patients infected postnatally are understudied with respect to patients infected perinatally, and as the results of the few studies aiming at comparing them are contrasting. Taken together, the 11 studies reviewed suggest the presence of both long-term neurocognitive dysfunctions and neurological alterations, such as the presence of atrophic changes and lesions in the white matter. The current review may offer new research insights into the neurocognitive dysfunctions in HIV-patients, and on the nature of such dysfunctions.

Health orientation, knowledge, and attitudes toward genetic testing and personalized genomic services: Preliminary data from an Italian sample

Objective. The study aims at assessing personality tendencies and orientations that could be closely correlated with knowledge, awareness, and interest toward undergoing genetic testing. Methods. A sample of 145 subjects in Italy completed an online survey, investigating demographic data, health orientation, level of perceived knowledge about genetic risk, genetic screening, and personal attitudes toward direct to consumer genetic testing (DTCGT). Results. Results showed that respondents considered genetic assessment to be helpful for disease prevention, but they were concerned that results could affect their life planning with little clinical utility. Furthermore, a very high percentage of respondents (67%) had never heard about genetic testing directly available to the public. Data showed that personality tendencies, such as personal health consciousness, health internal control, health esteem, and confidence, motivation to avoid unhealthiness and motivation for healthiness affected the uptake of genetic information and the interest in undergoing genetic testing. Conclusions. Public knowledge and attitudes toward genetic risk and genetic testing among European countries, along with individual personality and psychological tendencies that could affect these attitudes, remain unexplored. The present study constitutes one of the first attempts to investigate how such personality tendencies could motivation to undergo genetic testing and engagement in lifestyle changes.

Timing of Gestures: Gestures Anticipating or Simultaneous With Speech as Indexes of Text Comprehension in Children and Adults

The deep comprehension of a text is tantamount to the construction of an articulated mental model of that text. The number of correct recollections is an index of a learners mental model of a text. We assume that another index of comprehension is the timing of the gestures produced during text recall; gestures are simultaneous with speech when the learner has built an articulated mental model of the text, whereas they anticipate the speech when the learner has built a less articulated mental model. The results of four experiments confirm the predictions deriving from our assumptions for both children and adults. Provided that the recollections are correct, the timing of gestures can differ and can be considered a further measure of the quality of the mental model, beyond the number of correct recollections.

Clinical Trials, Data Protection and Patient Empowerment in the Era of the New EU Regulations

Cancer clinical trials and, in general, cancer clinical research by definition need a multi-modality approach. It is not enough to discover and register new drugs. To get cancer under control requires us to perform complex clinical studies that integrate drugs, companion diagnostics, new or improved surgical procedures and new radiotherapy approaches as well as, most importantly, to integrate all available information. This includes biological material and, of increasing importance, large amounts of data using big data technologies. To personalise treatment, genetic data are more and more frequently used. Therefore, the general approach is holistic. Legislators, on the other hand, work in a silo mentality; the needs of clinical research are poorly understood, and legislation focuses on either health care or the commercialisation of a product, and not on clinical research. In the last 2 years the EU has drafted several major regulations touching on clinical trials, in vitro diagnostics, medical devices and data protection, all of which will impact clinical research, although the silo mentality makes the overall framework inconsistent and potentially highly damaging to the EUs capacity to make rapid progress in the field of personalised medicine.

Decisions and involvement of cancer patient survivors: a moral imperative

Purpose The aim of this study was to review the experiences of direct involvement in patient survivorship for treatment and research. Methods This is a narrative-focused review of the following two recent experiences of patient involvement: the Chordoma Foundation and the Triple Negative Breast Cancer Foundation. Results These two examples represent concrete experiences that patients have built to favor a real involvement in the care and treatment of tumors. These experiences are profoundly modifying how cancer research is conducted and draw attention to the psychosocial dimensions of health care. Conclusion These examples represent the new scenario in which modern medicine faces completely new challenges, copes with new needs, and cooperates with new health care professionals. Implications Involving patients in a new perspective raises practical and ethical challenges for organizations to work together, for health providers to be professionally skilled and for the government to promote safeguarding policies.