Valeria Ginex - Academia.edu (original) (raw)

Papers by Valeria Ginex

Neurology, Jul 16, 2008

Objective: Primary progressive aphasia (PPA) is characterized by isolated decline in language fun... more Objective: Primary progressive aphasia (PPA) is characterized by isolated decline in language functions. Semantic dementia and progressive nonfluent aphasia are accepted PPA variants. A "logopenic" variant (LPA) has also been proposed, but its cognitive and anatomic profile is less defined. The aim of this study was to establish the cognitive and anatomic features of LPA. Methods: Six previously unreported LPA cases underwent extensive neuropsychological evaluation and an experimental study of phonological loop functions, including auditory and visual span tasks with digits, letters, and words. For each patient, a voxel-wise, automated analysis of MRI or SPECT data were conducted using SPM2. Results: In LPA, speech rate was slow, with long word-finding pauses. Grammar and articulation were preserved, although phonological paraphasias could be present. Repetition and comprehension were impaired for sentences but preserved for single words, and naming was moderately affected. Investigation of phonological loop functions showed that patients were severely impaired in digit, letter, and word span tasks. Performance did not improve with pointing, was influenced by word length, and did not show the normal phonological similarity effect. Atrophy or decreased blood flow was consistently found in the posterior portion of the left superior and middle temporal gyri and inferior parietal lobule. Conclusions: Logopenic progressive aphasia (LPA) is a distinctive variant of primary progressive aphasia. Cognitive and neuroimaging data indicate that a deficit in phonological loop functions may be the core mechanism underlying the LPA clinical syndrome. Recent studies suggest that Alzheimer disease may be the most common pathology underlying the LPA clinical syndrome.

Neuropsychological Rehabilitation, Jan 4, 2022

JMIR Research Protocols, Nov 16, 2022

Background: The COVID-19 pandemic is negatively impacting the mental health of both patients with... more Background: The COVID-19 pandemic is negatively impacting the mental health of both patients with COVID-19 and the general population. As current guidelines are limiting in-person contacts to reduce the spread of the virus, the development of a digital approach to implement in psychiatric and psychological consultations is needed. In this paper, we present the DigiCOVID protocol, a digital approach to offer remote, personalized psychological and psychiatric support to former or current patients with COVID-19 and their relatives. Objective: The main goal of this project is to evaluate the feasibility, acceptability, and usability of the DigiCOVID protocol. Furthermore, we also aim to assess the impact of the abovementioned protocol by means of pre-post changes in psychological clinical variables. Methods: Participants undergo an initial telephonic screening to ensure inclusion criteria are met. Secondly, participants complete a video-assisted neuropsychological IQ test as well as web-based self-reports of health and general well-being. Participants are then assigned to a psychotherapist who offers 8 teletherapy sessions. At the end of the therapy cycle, the web-based questionnaires are administered for a posttreatment evaluation. Results: As of April 2022, we enrolled a total of 122 participants, of which 94 have completed neuropsychological tests and web-based questionnaires. Conclusions: Our study aims at testing the feasibility and preliminary efficacy of DigiCOVID, a remote telemedicine protocol for the improvement of psychological and psychiatric health in patients with COVID-19 and their relatives. To date, the approach used seems to be feasible and highly customizable to patients' needs, and therefore, the DigiCOVID protocol might pave the way for future telepsychiatry-based interventions.

BMJ Open, Aug 1, 2020

Introduction Engaging family caregivers could be a critical asset to make the 'ageing-in-place' i... more Introduction Engaging family caregivers could be a critical asset to make the 'ageing-in-place' imperative a reality. This is particularly evident in rural and remote areas, where caregivers can fill the gaps that exist due to the fragmentation of the welfare system. However, there is little knowledge about the expectations that family caregivers have from healthcare services in rural and remote areas. Place4Carers (P4C) project aims to co-produce an innovative organisational model of social and healthcare services for family caregivers of older citizens living in Vallecamonica (Italy). The project is expected to facilitate ageing-in-place for older citizens, thus helping caregivers in their daily care activities. Methods and analysis P4C is a community-based participatory research project featuring five work packages (WPs). WP1 consists of a survey of unmet needs of caregivers and older people receiving services in Vallecamonica. WP2 consists of a scoping literature review to map services that provide interventions of support to caregivers living in remote areas and promote engagement. WP3 organises co-creation workshops with caregivers to co-design, co-manage, and co-assess ideas and proposals for shaping caregiver-oriented services and organisational models. WP3 enriches the results of WP1 (survey) and WP2 (scoping literature review), and aims to co-create new ideas for intervention support with and for caregivers in relation to the objectives, features and characteristics of a new service able to address the caregivers' needs and expectations. WP4 tests the service ideas co-created in WP3 through piloting an intervention based on ideas co-created with caregivers. Finally, WP5 assesses the transferability of the intervention to other similar contexts. Ethics and dissemination The study has been approved by the Ethics Committees of the Department of Psychology of Università Cattolica del Sacro Cuore and Politecnico of Milan. Results will be disseminated through peer-reviewed journals, scientific meetings and meetings with the general population.

Topics in Stroke Rehabilitation, Mar 21, 2017

Background: Aphasia is a serious consequence of stroke but aphasics patients have been routinely ... more Background: Aphasia is a serious consequence of stroke but aphasics patients have been routinely excluded from participation in some areas of stroke research. Objective: To assess the role of specific linguistic and non-verbal cognitive abilities on the short-term motor recovery of patients with aphasia due to first-ever stroke to the left hemisphere after an intensive rehabilitation treatment. Methods: 48 post-acute aphasic patients, who underwent physiotherapy and speech language therapy, were enrolled for this retrospective cohort-study. Four types of possible predictive factors were taken into account: clinical variables, functional status, language and non-verbal cognitive abilities. The motor FIM at discharge was used as the main dependent variable. Results: Patients were classified as follows: 6 amnestic, 9 Broca's, 7 Wernicke's, and 26 global aphasics. Motor FIM at admission (p = 0.003) and at discharge (p = 0.042), all linguistic subtests of Aachener AphasieTest (p = 0.001), and non-verbal reasoning abilities (Raven's CPM, p = 0.006) resulted significantly different across different types of aphasia. Post-hoc analyses showed differences only between global aphasia and the other groups. A Multiple Linear Regression shows that admission motor FIM (p = 0.001) and Token test (p = 0.040), adjusted for clinical, language, and non-verbal reasoning variables, resulted as independent predictors of motor FIM scores at discharge, while Raven's CPM resulted close to statistical significance. Conclusions: Motor function at admission resulted as the variable that most affects the motor recovery of post-stroke patients with aphasia after rehabilitation. A linguistic test requiring also non-linguistic abilities, including attention and working memory (i.e. Token test) is an independent predictor as well.

Neuropsychologia, 2007

Introduction: While sentence comprehension has been reported to be defective in frontotemporal de... more Introduction: While sentence comprehension has been reported to be defective in frontotemporal dementia (FTD), it is still unclear if this disorder reflects the presence of syntactic impairment, or may be attributed to other factors, such as executive or working memory dysfunction. In order to assess the status of syntactic knowledge in a group of patients belonging to the FTD spectrum, we investigated their ability to detect violations of Universal Grammar principles in a sentence judgement task. Methods: The group included four semantic dementia patients (SD), nine frontal variant of FTD patients (FvFTD), 15 progressive supranuclear palsy (PSP) patients, and 11 corticobasal degeneration syndrome (CBDS) patients. Their performance was compared to a group of 10 patients with mild probable Alzheimer disease (AD) and to 10 healthy volunteers. The patients underwent a standard aphasia test and a sentence comprehension test. The experimental study included five kinds of violations: semantic coherence (SC), verb-subject agreement (VSAgr), pronominalization involving clitic movement (ClM), interrogatives (WhS) and contrastive focus constructions (CFC). Results: The FTD patients performed within normal range in the aphasia test, and in the sentence comprehension test. Within the FTD subgroups, only patients with CBDS were significantly impaired in detecting three of the five kinds of violations. AD patients were also impaired in the detection of WhS and SC anomalies and in sentence comprehension. Discussion: The present findings indicate that, within the FTD spectrum, an impairment of syntactic knowledge can be found only in CBDS patients, even in the absence of clinical evidence of aphasia.

BMC Health Services Research, Jun 21, 2021

Background: Family caregivers are key actors in the ageing society. They are mediators between pr... more Background: Family caregivers are key actors in the ageing society. They are mediators between practitioners and patients and usually provide also essential daily services for the elders. However, till now, few services have been deployed to help caregivers in their care tasks as in improving their mental health which can experience sever burden due to caregiving duties. The purpose of the study is to implement a community-based participatory research project to co-design an innovative organizational model of social services for family caregivers of elderly health consumers living in remote rural areas in Italy. Methods: This is a community-based participatory research project in the remote area of Vallecamonica involving four main phases. These included a quantitative analysis of caregiver needs, a scoping review on existing services for caregivers, co-design workshops with local stakeholders and caregivers to create a novel service the piloting and a first implementation of the service and the assessment of project transferability to other contexts. Results: As the hours dedicated to elder care increases, both objective and developmental caregiver's burden significantly increases. Conversely, higher levels of engagement were associated with lower physical and emotional burden, and caregiver engagement was positively correlated with their perceived self-efficacy in managing disruptive patient behaviours. Based on these preliminary results, four co-design workshops with caregivers were conducted and led to the definition of the SOS caregivers service, built on four pillars structured upon the previous need analysis: a citizens' management board, training courses, peer-to-peer meetings, and project and service information. We found that co-design is an effective means of creating new services for family caregivers, whose experiential knowledge proved to be a key resource for the project team in delivering and managing services. Less positively, the transferability analysis indicated that local municipalities remain reluctant to acknowledge caregivers' pivotal role.

Cortex, Sep 1, 2014

programming of exploratory movements. The cross-modal transfer of information via visual percepti... more programming of exploratory movements. The cross-modal transfer of information via visual perception permits the activation of a partially degraded image, which alone does not allow the proper recognition of the initial tactile stimulus.

Neurological Sciences, Sep 9, 2012

We report the construction and standardization of a new comprehensive battery of tests for the as... more We report the construction and standardization of a new comprehensive battery of tests for the assessment of semantic memory disorders. The battery is constructed on a common set of 48 stimuli, belonging to both living and non-living categories, rigidly controlled for several confounding variables, and is based on an empirically derived corpus of semantic features. It includes six tasks, in order to assess semantic memory through different modalities of input and output: two naming tasks, one with colored pictures and the other in response to an oral description, a word-picture matching task, a picture sorting task, a free generation of features task and a sentence verification task. Normative data on 106 Italian subjects pooled across homogenous subgroups for age, sex and education are reported. The new battery allows an in-depth investigation of category-specific disorders and of progressive semantic memory deficits at features level, overcoming some of the limitations of existing tests.

European journal of public health, Sep 1, 2020

BACKGROUND The COVID-19 pandemic is negatively impacting the mental health of both COVID-19 patie... more BACKGROUND The COVID-19 pandemic is negatively impacting the mental health of both COVID-19 patients and the general population. Given the current guidelines limiting in person contact to reduce the spread of the virus, a digital approach is needed to tackle the psychological aftermath of the pandemic. Here, we present DigiCOVID, a digital mental health approach to offer remote, personalized support to former or current COVID-19 patients and/or their relatives. OBJECTIVE The main goal of this project is to evaluate the feasibility, acceptability and usability of DigiCOVID. Furthermore, as we have designed DigiCOVID in order to improve mental wellbeing, we also aim to assess the impact of the abovementioned intervention by means of pre-post changes in psychological clinical variables. METHODS Participants undergo an initial phone-based screening to ensure inclusion criteria are met. Then, they complete a neuropsychological test over video to assess IQ, and fill out online self-reports of health and wellbeing. Participants are then assigned to psychotherapist who offers 8 tele-therapy sessions. At the end of the therapy cycle, the online questionnaires are filled out again. RESULTS As of April 2022, we enrolled a total of 122 subjects, of which 94 have completed neuropsychological tests and online questionnaires. CONCLUSIONS Our study aims at testing the feasibility and preliminary efficacy of DigiCOVID, a remote tele-psychiatry approach to tackle the COVID-19 pandemic psychological aftermaths. To date, the approach used seems to be feasible and highly customizable to patients’ needs, and thus DigiCOVID could provide a blueprint for future tele-psychiatry-based interventions. CLINICALTRIAL This study was approved by our local Ethics Committee (IRCCS Ca’ Granda Ospedale Maggiore Policlinico) on 28.10.2020. The trial is registered on clinicaltrials.gov with the following ID: NCT05231018.

Behavioural Neurology, 2007

The corticobasal degeneration syndrome has been suggested to be part of a complex of conditions (... more The corticobasal degeneration syndrome has been suggested to be part of a complex of conditions (including the different subtypes of frontotemporal dementia and progressive supranuclear palsy), which reflect a spectrum of pathological substrates. This concept is supported by the frequent clinical overlap that can be observed among patients diagnosed with these conditions. We report three clinical cases, characterized by the overlap of the clinical features of corticobasal degeneration syndrome with, respectively, nonfluent progressive aphasia, progressive supranuclear palsy and semantic dementia. Current diagnostic criteria emphasize differences in clinical presentation, which probably reflect the preferential location of pathology in the early stages of disease. However, with disease progression, a considerable clinical overlap can be expected among the different syndromes. This concept should be extended not only to the cognitive and behavioural features of the frontotemporal dementia subtypes, but also to the movement disorders of corticobasal degeneration and supranuclear palsy.

Research Square (Research Square), Feb 24, 2021

Background Family caregivers are key actors in the ageing society. They play a pivotal role in en... more Background Family caregivers are key actors in the ageing society. They play a pivotal role in enabling the possibility of elders to age in place, so to live at home for as long as possible. They also are mediators between practitioners and patients and usually provide also essential daily services for the elders. However, till now, few services have been deployed to help caregivers in their care tasks as in improving their mental health which can experience sever burden due to

Objectives. A growing amount of evidences suggests that nature elements can increase health quali... more Objectives. A growing amount of evidences suggests that nature elements can increase health quality of hospitalized patients (1). The aim of the study is to investigate the relationship between the characteristics of an intensive rehabilitation hospital environment and the recovery processes of patients in a post-acute phase. Methods. The present study involves two phases. In the first one, now concluded, we attempted to determine the characteristics of the exterior spaces that best fits with needs of our patients: a group of landscape architects visited the site, met the hospital staff, and realized the project of the garden. At the same time, we collected data from 95 neurologic, orthopedic, and pneumologic patients who were hospitalized before the construction of the garden. This group will be considered as a control group for the second phase of the study, in which we will compare patients who did not use garden and patients who will have access to it. The outcome measures are: level of disability, quality of life (QOL) and depression symptoms. Results. Some characteristics of the garden that are thought to be salient for our clinical population have been identified. We are able to show some master plans of the project. Moreover, we found a significant difference in QOL and depression between the three groups of patients. Discussion. The benefits from a garden should be considered to reducing the disability in post-acute patients in an intensive rehabilitation hospital

Journal of Affective Disorders

$Research paper thumbnail of Cognitive impairment is a negative short-term and long-term prognostic factor in elderly patients with hip fracture$

European journal of physical and rehabilitation medicine, 2015

BACKGROUND Subjects with severe cognitive impairment (CI) have a high-risk of hip fractures with ... more BACKGROUND Subjects with severe cognitive impairment (CI) have a high-risk of hip fractures with increased rate of adverse postoperative functional outcomes and mortality. AIM To evaluate the impact of different degrees of CI on functional recovery and mortality after hip fracture. DESIGN Prospective observational study. SETTING Two orthopedic surgery units. POPULATION Two hundred twenty-eight consecutive patients after a hip surgery. METHODS Patients were assessed at baseline through the Short Portable Mental Status Questionnaire (SPMSQ), an instrument that allows to categorize subjects as follows: cognitively intact (SPMSQ≥8) or with mild (SPMSQ=6-7), moderate (SPMSQ=3-5) and severe CI (SPMSQ<3). Barthel Index (BI) was used to assess functional disability. All patients underwent rehabilitation from the day after surgery to discharge (mean length of stay =10.2±3.4). Outcome measures were: (1) overall mortality up to 12 months after surgery; (2) motor ability achieved at discharg...

European Journal of Public Health, 2020

Background ”Ageing-in-place” may improve elderly citizens' quality of life and the sustainabi... more Background ”Ageing-in-place” may improve elderly citizens' quality of life and the sustainability of welfare systems. In this process engaging family caregivers is crucial. Methods A community-based participatory research in the remote area of Vallecamonica was enacted. First, we surveyed unmet needs of family caregivers. Then, a scoping literature review on existing interventions for engaging family caregivers was performed. Third, 4 co-design workshops were conducted to co-generate a new service. Finally, the service was piloted for a period of 6 months and evaluated. Results 51 caregivers participated in the survey: they were mainly females, mean 60 y.o and with medium-low level of education. The scoping review resulted in only 14 interventions targeted to elderly's caregivers in remote areas. The workshops involved 27 caregivers and co-designed a new psycho-social service (SOSCargivers) articulated into: 1) a structured informative platform to facilitate health literacy ...

Lean Construction, 1997

Later, on the next job, a lead pipe fitter explained to a visitor why he was installing the parti... more Later, on the next job, a lead pipe fitter explained to a visitor why he was installing the particular spool just rigged. He replied that it was the longest they could find. Pressed to explain the decision he said,&amp;amp;amp;amp;amp;#x27;Look�I&amp;amp;amp;amp;amp;#x27;m getting beat up for productivity and long pieces make me look good&amp;amp;amp;amp;amp;#x27;.