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Burgio, Francesca (2016) Numerical Activities of Daily Living (NADL) and Numerical Activities of Daily Living - Financial (NADL-F) in Neurological Diseases. [Ph.D. thesis]

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Abstract (english)

What is the impact of acalculia upon an individual’s everyday life? In clinical practice, a few measures of Activities of Daily Living are available. In these batteries, however, numerical abilities were not distinguished from other abilities. As a consequence, no instrument has been made available so far to measure the nature and the extent of damage to everyday life specifically brought by acalculia in a given individual. The first aim of this series of studies was to build and validate an instrument, the Numerical Activities of Daily Living (NADL), designed to measure this impact. The first section of the thesis describes the psychometric properties of the newly created NADL and the specific profiles observed among patients suffering of several neurological diseases (a specific study was devoted to neurofibromatosis type 1) by using this instrument; patients with a right hemisphere focal lesion were also the object of a specific study). A further development of NADL (NADL-Children) was built for the assessment of numerical activities of daily living in children: it helped to predict math school performance after the first year of primary school.
In the second section we deepened one particular aspect of daily living activities requiring numbers (i.e. dealing with finances) found to be critical in our studies employing NADL. Indeed, the loss of financial capacity can have serious legal, economical, and personal consequences on an individual. Therefore, we additionally created a tool (Numerical Activities of Daily Living - Financial; NADL-F) that was also successfully validated in clinical populations in Italy as the second scope of this thesis. We also explored the differences in financial and numerical domains between MCI and healthy controls by means of NADL and NADL-F. The cognitive domains found to be involved in the deficit may be appropriate targets for future intervention studies aimed at preserving functional independence in individuals with MCI. Finally we also correlated the performance in the NADL and NADL-F test with anatomical brain changes. The investigation of the neural correlates of financial and other daily numerical abilities will help us to better define the knowledge of this high-level functions; moreover the neuroimaging studies will shed light on the brain areas related to the performance in financial tasks, and will be useful to find out the predictors of the time-course of decline in financial capacities.

Abstract (italian)

Qual'è l'impatto dell'acalculia sulla vita quotidiana? Nella pratica clinica, solo pochi strumenti sono disponibili. In queste batterie, oltretutto, le abilità numeriche non vengono distinte dalle altre abilità della vita quotidiana. Di conseguenza non vi è alcuno strumento che possa misurare l'impatto della acalculia nella vita quotidiana. Il primo obiettivo di questa serie di studi è stato dunque quello di costruire e validare uno strumento, il Numerical Activities of Daily Living (NADL), per misurare questo impatto. La prima sezione della tesi descrive le proprietà psicometriche del test NADL ed in particolar modo, vengono esplorati diversi profili di errori specifici per ogni singola patologia neurologica considerata ad esempio nei pazienti con neurofibromatosi e nei pazienti con lesione emisferica destra. Un ulteriore sviluppo del NADL (NADL-Children) è stato costruito al fine di valutare le abilità numeriche della vita quotidiana nei bambini.
Nella seconda sezione viene approfondito un particolare aspetto delle attività di vita quotidiana in cui l'uso dei numeri è essenziale, l'uso del denaro. La perdita della capacità finanziaria può avere delle serie implicazioni sul piano legale ed economico oltre che personale. Abbiamo dunque creato uno strumento specificatamente pensato per questo fine (Numerical Activities of Daily Living - Financial; NADL-F). Il secondo obiettivo della tesi è stato quello di validare lo strumento per poterlo rendere diponibile in Italia e applicarlo a differenti popolazioni cliniche. Abbiamo inoltre esplorato le differenze nei domini numerici e finanziari sia in soggetti di controllo sani che in pazienti con deterioramento cognitivo lieve utilizzando sia il NADL che il NADL-F. I domini cognitivi che sono risultati essere implicati nel deficit potrebbero essere l'obiettivo di futuri interventi riabilitativi di studi successivi che hanno come obiettivo quello di preservare l'indipendenza funzionale e l'autonomia dei pazienti con deterioramento cognitivo lieve. Infine, abbiamo correlato la performance sia al NADL che al NADL-F con le differenze volumetriche cerebrali associate sia nei pazienti che nei controlli. Lo studio dei correlati neurali delle abilità numeriche e finanziarie ci aiuterà a fare maggiore chiarezza nello studio di queste funzioni di alto livello. Inoltre gli studi di neuroimmagine potranno chiarire le aree cerebrali legate alla performance in questi compiti che saranno utili per trovare dei predittori del declino nel corso del tempo di queste capacità.

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EPrint type:Ph.D. thesis
Tutor:Semenza, Carlo
Ph.D. course:Ciclo 29 > Corsi 29 > SCIENZE MEDICHE, CLINICHE E SPERIMENTALI
Data di deposito della tesi:21 January 2017
Anno di Pubblicazione:15 November 2016
Key Words:Number Cognition, Activities of Daily Living, Financial Capacity, Neurological Diseases, Children
Settori scientifico-disciplinari MIUR:Area 11 - Scienze storiche, filosofiche, pedagogiche e psicologiche > M-PSI/03 Psicometria
Area 11 - Scienze storiche, filosofiche, pedagogiche e psicologiche > M-PSI/02 Psicobiologia e psicologia fisiologica
Area 11 - Scienze storiche, filosofiche, pedagogiche e psicologiche > M-PSI/01 Psicologia generale
Area 11 - Scienze storiche, filosofiche, pedagogiche e psicologiche > M-PSI/08 Psicologia clinica
Area 11 - Scienze storiche, filosofiche, pedagogiche e psicologiche > M-PSI/04 Psicologia dello sviluppo e psicologia dell'educazione
Struttura di riferimento:Dipartimenti > Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari
Codice ID:9888
Depositato il:17 Nov 2017 09:28
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