The Role of Moderators and Mediators in Implementing and Evaluating Intellectual and Developmental Disabilities-Related Policies and Practices
This article describes a comprehensive framework for incorporating moderator and mediator variables in program logic models and theory development as a useful way to better implement and evaluate policies and practices in the field of intellectual and developmental disabilities related (IDD). Firstly, an overview of [program] logic models in the field of IDD is provided. Secondly, we present the role of moderator and mediator variables in program logics models. Thirdly, the role of moderators and mediators is explained in relation to outcomes through a systematic review in the Web of Science. Fourthly, a discussion about the role that moderator and mediator variables play in theory development is presented. Fifthly, a comprehensive framework for incorporating moderator and mediator variables into program logic models is proposed. This comprehensive framework involves testing specific relations between well-defined and operatized moderator and/or mediator variables that may influence and impacts policies and practices ’ outcomes. When mediators and moderators are considered and included in program logic models, the effect of interventions, practices and policies can be better understood and therefore enhanced.
Low back pain and neck pain are the first and fourth leading causes, respectively, of years lived with disability. The treatment of intervertebral disk degeneration remains a significant challenge. While there are still many obstacles to overcome, the use of stem cells for the treatment of disk degeneration has emerged as one of the most promising and exciting techniques to restore the structure and function of the degenerated disk. The use of stem cells in treating intervertebral disk disease as well as the obstacles that remain are reviewed here in an evidence-based manner.
Partial capitate shortening is a decompression procedure for the treatment of positive or neutral ulnar variance Kienbock disease. In 45% to 73% of population, the lunate has a separate hamate facet which is also known as a type II lunate. We hypothesized that capitate shortening alone may not ensure adequate decompression of type II lunate, therefore, an added hamate shortening was performed aiming at a better distal unloading in these situations. Thirty Kienbock patients, stage II, type II lunate, and ulna positive or neutral variance, were recruited in this study, Half of which underwent an isolated partial capitate ost...
Study Design. Retrospective study. Objective. To describe the treatment results of patients with severe ankylosing spondylitis (AS) kyphosis who underwent two-level osteotomy and correction surgery. Summary of Background Data. The best solution for the fixed kyphotic deformity of AS is corrective osteotomy. Many osteotomy options are available: pedicle subtraction osteotomy (PSO), Smith-Peterson osteotomy (SPO), and vertical column resection (VCR). These procedures all provide multiplanar deformity correction. Nevertheless, when the AS deformity is severe, an additional osteotomy site to get more correction, achiev...
Conclusion. The DASH is a valid and responsive PRO measure to evaluate disabling upper extremity involvement in patients undergoing cervical spine surgery. Level of Evidence: 3
CONCLUSIONS: In this review, biological and chemical knowledge of melatonin, its experimental effects, and the clinical impact on patients with neurological disorders were described. According to all of the beneficial results obtained from experimental and clinical trials, melatonin may have a prophylactic and therapeutic effect on neurological diseases. Strong collaboration between neurologists and health service policy makers is needed to encourage use of melatonin in the patients suffering from neurological diseases. Melatonin may be the solution we have been looking for. PMID: 31718830 [PubMed - as supplied by publisher]
Conclusions: Hearing impairment in MPS patients is common and is aggravated as the disease progresses. Thus, adequate intervention and hearing rehabilitation might play an important role in managing hearing disabilities in MPS patients.
We report here the derivation of familial iPSC lines from two controls and three ASD patients carrying NRXN1α+/−, using a non-integrating Sendai viral kit. The genotype and karyotype of the resulting iPSCs were validated by whole genome SNP array. All iPSC lines expressed comparable levels of pluripotency markers and could be differentiated into three germ layers.
CONCLUSIONS Patients in the chronic phase of CHIK present functional disability, thus alerting healthcare professionals to the importance of implementing actions aimed at an adequate treatment in all phases of the disease, mainly related to pain treatment and motor rehabilitation.
Authors: Santarelli V, Marucci C, Collazzoni A, Rossetti MC, Pizziconi G, Pacitti F, Stratta P, Rossi A, Rossi R Abstract The relationship between subjective appraisal of cognitive deficits and symptom severity in schizophrenia is unclear. Insight reportedly affects both factors. Our aim is to further asses the relationship between subjective perception of cognitive deficits, symptom severity and lack of insight as a mediator variable. 109 subjects with schizophrenia were evaluated. Positive and Negative Syndrome Scale (PANSS) was modelled as independent variable, Subjective Scale to Investigate Cognition in Schizo...
ConclusionsPrevention efforts to reduce ED utilization, especially for those with ID and ASD with co-occurring psychiatric conditions, is warranted. Primary care providers and case managers should develop care plans to reduce the likelihood for emergency psychiatric utilization and ensure alternative care pathways. ED clinicians may require additional training to address the needs of this population when they present to the ED in crisis.