The importance of "scaffolding" in clinical approach to deafness across the lifespan

Throughout the present work of thesis, the concept of scaffolding will be used as a fil rouge through the chapters. What I mean for “scaffolding approach”, therefore, is an integrated and multidisciplinary clinical and research methodology to hearing impairments that could take into account persons as a whole; an approach that needs to be continuously adapted and harmonized with the individuals, pursuant to their progress, their limits and resources, in consideration of their audiological, cognitive, emotional, personal, and social characteristics. The following studies of our research group will be presented: A study (2020) designed to assess the effects of parent training (PT) on enhancing children’s communication development (chapter two); Two studies of our research group (2016; 2020) concerning variables influencing comprehension of emotions and nuclear executive functions in deaf children with cochlear implant (chapter three and chapter four) In chapter five a presentation and description of our Mind-Active Communication program, main topics and aims, multidisciplinary organizations of group and individual sessions with a description of used materials and methodology is given. Finally, a preliminary evaluation to explore the use of this multidisciplinary rehabilitative program on quality of life, psychological wellbeing, and hearing abilities in a sample of cochlear implanted elderly persons is reported

Local seismic response studies in the north-western portion of the August 24th, 2016 Mw 6.0 earthquake affected area. The case of Visso village (Central Apennines).

In this work, we investigate the possible causes of the differential damaging observed in Visso village (Central Apennines, about 28 km north from the August 24th, 2016 Mw 6.0 earthquake epicenter). Following insights from the available geological cartography at 1:10.000 scale, a preliminary geophysical survey has been performed in the damaged area in order to constrain geometries and extent of the subsoil lithotypes. Then, these results have been used to retrieve a Vs profile close to the most heavily damaged buildings. This latter has been used as input for a numerical analysis aimed at deriving the motion at the ground level in the study area. In particular, a linear equivalent simulation has been performed by means of EERA code and the waveform has been obtained convolving the time history recorded during the August 24th, 2016 mainshock at Spoleto Monteluco (SPM) site. Our preliminary results indicate a possible correlation of damaging to the thickness and shape of the geological units. Nevertheless, further analyses are necessary to highlight any 2D basin and / non- linear soil behaviour effects in order to compare them to the intrinsic buildings vulnerability, according to the EMS98 guidelines

Neuropsychological functions and audiological findings in elderly cochlear implant users: the role of attention in postoperative performance

Objectives: The present study aimed to investigate in a group of elderly CI users working memory and attention, conventionally considered as predictors of better CI performance and to try to disentangle the effects of these cognitive domains on speech perception, finding potential markers of cognitive decline related to audiometric findings. Methods Thirty postlingually deafened CI users aged >60 underwent an audiological evaluation followed by a cognitive assessment of attention and verbal working memory. A correlation analysis was performed to evaluate the associations between cognitive variables while a simple regression investigated the relationships between cognitive and audiological variables. Comparative analysis was performed to compare variables on the basis of subjects’ attention performance. Results: Attention was found to play a significant role in sound field and speech perception. Univariate analysis found a significant difference between poor and high attention performers, while regression analysis showed that attention significantly predicted recognition of words presented at Signal/Noise +10. Further, the high attention performers showed significantly higher scores than low attentional performers for all working memory tasks. Conclusion: Overall findings confirmed that a better cognitive performance may positively contribute to better speech perception outcomes, especially in complex listening situations. WM may play a crucial role in storage and processing of auditory-verbal stimuli and a robust attention may lead to better performance for speech perception in noise. Implementation of cognitive training in auditory rehabilitation of CI users should be investigated in order to improve cognitive and audiological performance in elderly CI users

Variables influencing executive functioning in preschool hearing-impaired children implanted within 24 months of age: an observational cohort study

Executive Functions (EFs) are fundamental to every aspect of life. The present study was implemented to evaluate factors influencing their development in a group of preschools orally educated profoundly deaf children of hearing parents, who received CI within two years of age. Methods Twenty-five preschool CI children were tested using the Battery for Assessment of Executive Functions (BAFE) to assess their flexibility, inhibition and non-verbal visuo-spatial working memory skills. The percentage of children performing in normal range was reported for each of the EF subtests. Mann-Whitney and Kruskal-Wallis were performed to assess differences between gender, listening mode and degree of parents’ education subgroups. The Spearman Rank Correlation Coefficient was calculated to investigate the relationship between EF scores audiological and linguistic variables. Results Percentages ranging from 76% to 92% of the children reached adequate EF scores at BAFE. Significant relations (p<0.05) were found between EFs and early intervention, listening and linguistic skills. Further, CI children from families with higher education level performed better at the response shifting, inhibitory control and attention flexibility tasks. Economic income correlated significantly with flexibility and inhibitory skills. Females performed better than males only in the attention flexibility task. Conclusions The present study is one of the first to focus attention on the development of EFs in preschool CI children, providing an initial understanding of the characteristics of EFs at the age when these skills emerge. Clinical practice must pay increasing attention to these aspects which are becoming the new emerging challenge of rehabilitation programs

Benefits of parent training in the rehabilitation of deaf or hard of hearing children of hearing parents: a systematic review

The present study is a systematic review on the effectiveness of Parent Training (PT) and coaching in deaf and hard of hearing (DHH) rehabilitation programs which reviews and synthesizes the existing body of evidence to assess the benefits of these programs in enhancing parents’ sensitivity, responsivity and promoting language development in DHH children during the first years after HA fitting or CI activation. Five published studies met the Population, Intervention, Comparison and Outcomes (PICO) inclusion criteria and were eligible to be included, but heterogeneity in terms of the study design, interventions and outcomes did not allow for performing a meta-analysis. All included studies shared the view that a parent’s learning is a circular (rather than frontal) process, and the results appear promising in terms of enhancing parents’ responsiveness and promoting DHH child language development. Nevertheless, the available evidence was judged to not be robust enough due to limitations in the studies’ designs. Further high-quality evidence is needed to evaluate the true degree of clinical value and the cost effectiveness of PT programs aimed at increasing parents’ responsiveness to their DHH childre

Site response analyses for complex geological and morphological conditions: relevant case-histories from 3rd level seismic microzonation in Central Italy

The paper presents the results of 5 case studies on complex site e ects selected within the project for the level 3 seismic microzonation of several municipalities of Central Italy dam- aged by the 2016 seismic sequence. The case studies are characterized by di erent geo- logical and morphological con gurations: Monte San Martino is located along a hill slope, Montedinove and Arquata del Tronto villages are located at ridge top whereas Capitignano and Norcia lie in correspondence of sediment- lled valleys. Peculiarities of the sites are constituted by the presence of weathered/jointed rock mass, fault zone, shear wave veloc- ity inversion, complex surface and buried morphologies. These factors make the de ni- tion of the subsoil model and the evaluation of the local response particularly complex and di cult to ascertain. For each site, after the discussion of the subsoil model, the results of site response numerical analyses are presented in terms of ampli cation factors and acceleration response spectra in selected points. The physical phenomena governing the site response have also been investigated at each site by comparing 1D and 2D numerical analyses. Implications are deduced for seismic microzonation studies in similar geological and morphological conditions.Published5741–57775T. Sismologia, geofisica e geologia per l'ingegneria sismicaJCR Journa

Physical stratigraphy and geotechnical properties controlling the local seismic response in explosive volcanic settings: the Stracciacappa maar (central Italy)

Nowadays, policies addressed to prevention and mitigation of seismic risk need a consolidated methodology finalised to the assessment of local seismic response in explosive volcanic settings. The quantitative reconstruction of the subsoil model provides a key instrument to understand how the geometry and the internal architecture of outcropping and buried geological units have influence on the propagation of seismic waves. On this regard, we present a multidisciplinary approach in the test area of the Stracciacappa maar (Sabatini Volcanic District, central Italy), with the aim to reconstruct its physical stratigraphy and to discuss how subsoil heterogeneities control the 1D and 2D local seismic response in such a volcanic setting. We first introduce a new multidisciplinary dataset, including geological (fieldwork and log from a 45-m-thick continuous coring borehole), geophysical (electrical resistivity tomographies, single station noise measurements, and 2D passive seismic arrays), and geotechnical (simple shear tests performed on undisturbed samples) approaches. Then, we reconstruct the subsoil model for the Stracciacappa maar in terms of vertical setting and distribution of its mechanical lithotypes, which we investigate for 1D and 2D finite element site response analyses through the application of two different seismic scenarios: a volcanic event and a tectonic event. The numerical modelling documents a significant ground motion amplification (in the 1–1.5 Hz range) revealed for both seismic scenarios, with a maximum within the centre of the maar. The ground motion amplification is related to both 1D and 2D phenomena including lithological heterogeneity within the upper part of the maar section and interaction of direct S-waves with Rayleigh waves generated at edges of the most superficial lithotypes. Finally, we use these insights to associate the expected distribution of ground motion amplification with the physical stratigraphy of an explosive volcanic setting, with insights for seismic microzonation studies and local seismic response assessment in populated environments

Engineering reconnaissance following the August 24, 2016 M6.0 Central Italy earthquake

An earthquake with a moment magnitude reported as 6.0 from INGV (Istituto Nazionale di Geofisica e Vulcanologia); occurred at 03:36 AM (local time) on 24 August 2016 in the central part of Italy. The epicenter was located at the borders of the Lazio, Abruzzi, Marche and Umbria regions, about 2.5 km north-east of the village of Accumoli and about 100 km from Rome. The hypocentral depth was about 8 km (INGV). We summarize preliminary findings of the Italy-US GEER (Geotechnical Extreme Events Reconnaissance) team, on damage distribution, causative faults, earthquake-induced landslides and rockfalls, building and bridge performance, and ground motion characterization. Our reconnaissance team used multidisciplinary approaches, combining expertise in geology, seismology, geomatics, geotechnical engineering, and structural engineering. Our approach was to combine traditional reconnaissance activities of on-ground recording and mapping of field conditions, with advanced imaging and damage detection routines enabled by state-of-the-art geomatics technology. We anticipate that results from this study, will be useful for future post-earthquake reconnaissance efforts, and improved emergency respons

PERL: a dataset of geotechnical, geophysical, and hydrogeological parameters for earthquake-induced hazards assessment in Terre del Reno (Emilia-Romagna, Italy)

In 2012, the Emilia-Romagna region (Italy) was struck by a seismic crisis characterized by two main shocks (ML 5.9 and 5.8) which triggered relevant liquefaction events. Terre del Reno is one of the municipalities that experienced the most extensive liquefaction effects due to its complex geostratigraphic and geomorphological setting. This area is indeed located in a floodplain characterized by lenticular fluvial channel bodies associated with crevasse and levee clay–sand alternations, related to the paleo-Reno River. Therefore, it was chosen as a case study for the PERL project, which aims to define a new integrated methodology to assess the liquefaction susceptibility in complex stratigraphic conditions through a multi-level approach. To this aim, about 1800 geotechnical, geophysical, and hydrogeological investigations from previous studies and new realization surveys were collected and stored in the PERL dataset. This dataset is here publicly disclosed, and some possible applications are reported to highlight its potential.</p