A Literature Review of Similarities Between and Among Patients With Autism Spectrum Disorder and Epilepsy.

Autism spectrum disorder (ASD) has been shown to be associated with various other conditions, and most commonly, ASD has been demonstrated to be linked to epilepsy. ASD and epilepsy have been observed to exhibit high rates of comorbidity, even when compared to the co-occurrence of other disorders with similar pathologies. At present, nearly one-half of the individuals diagnosed with ASD also have been diagnosed with comorbid epilepsy. Research suggests that both conditions likely share similarities in their underlying disease pathophysiology, possibly associated with disturbances in the central nervous system (CNS), and may be linked to an imbalance between excitation and inhibition in the brain. Meanwhile, it remains unclear whether one condition is the consequence of the other, as the pathologies of both disorders are commonly linked to many different underlying signal transduction mechanisms. In this review, we aim to investigate the co-occurrence of ASD and epilepsy, with the intent of gaining insights into the similarities in pathophysiology that both conditions present with. Elucidating the underlying disease pathophysiology as a result of both disorders could lead to a better understanding of the underlying mechanism of disease activity that drives co-occurrence, as well as provide insight into the underlying mechanisms of each condition individually.

Implementation of Learning Communities at Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates.

Learning community programs have been widely implemented in higher education institutions, including many accredited medical schools in North America. Learning communities have been shown to create a sense of belonging, enhance teaching and learning, and promote an inclusive educational environment that reinforces collaboration, professionalism, and wellbeing. Based on their demonstrated success, a learning community program was included in the development of Khalifa University College of Medicine and Health Sciences (KU CMHS), the first medical school in the capital city of Abu Dhabi and the first to offer a postbaccalaureate, Doctor of Medicine (MD) degree in the United Arab Emirates (UAE). Named the Falcon Learning Communities (FLCs), the program adopted the core values of the Learning Communities Institute and integrated them into curricular, co-curricular, and extra-curricular programming. This paper presents an overview on the development of the FLC program, its implication for both students and faculty, preliminary feedback from teachers and learners, and considerations for future work.

Critical and Ictal Phases in Simulated EEG Signals on a Small-World Network.

Healthy brain function is marked by neuronal network dynamics at or near the critical phase, which separates regimes of instability and stasis. A failure to remain at this critical point can lead to neurological disorders such as epilepsy, which is associated with pathological synchronization of neuronal oscillations. Using full Hodgkin-Huxley (HH) simulations on a Small-World Network, we are able to generate synthetic electroencephalogram (EEG) signals with intervals corresponding to seizure (ictal) or non-seizure (interictal) states that can occur based on the hyperexcitability of the artificial neurons and the strength and topology of the synaptic connections between them. These interictal simulations can be further classified into scale-free critical phases and disjoint subcritical exponential phases. By changing the HH parameters, we can model seizures due to a variety of causes, including traumatic brain injury (TBI), congenital channelopathies, and idiopathic etiologies, as well as the effects of anticonvulsant drugs. The results of this work may be used to help identify parameters from actual patient EEG or electrocorticographic (ECoG) data associated with ictogenesis, as well as generating simulated data for training machine-learning seizure prediction algorithms.

A systematic review of eHealth interventions to improve health literacy.

Implementation of eHealth is now considered an effective way to address concerns about the health status of health care consumers. The purpose of this study was to review empirically based eHealth intervention strategies designed to improve health literacy among consumers in a variety of settings. A computerized search of 16 databases of abstracts (e.g. Biomedical Reference Collection, Cochrane Central Register of Controlled Trials, Computers & Applied Sciences Complete, Health Technology Assessments, MEDLINE) were explored in a systematic fashion to assess the presence of eHealth applications targeting health literacy. Compared to control interventions, the interventions using technology reported significant outcomes or showed promise for future positive outcomes regarding health literacy in a variety of settings, for different diseases, and with diverse samples. This review has indicated that it is feasible to deliver eHealth interventions specifically designed to improve health literacy skills for people with different health conditions, risk factors, and socioeconomic backgrounds.

Evaluation of nursing-specific drug information PDA databases used as clinical decision support tools.

BACKGROUND: Nursing is arguably the most organizationally diverse healthcare profession. Educational backgrounds may vary, even among similarly credentialed nurses. Drug information databases used as clinical decision support tools can improve access to pharmacologic information at point-of-care when housed on personal digital assistants. They may also help address the disparity in drug information and pharmacology education between nurses. OBJECTIVES: To evaluate nursing-specific drug information database content on personal digital assistants (PDAs). METHODS: Seven nursing-specific PDA databases were evaluated for scope (absence or presence of an answer) and completeness (three-point scale) via the use of 80 general category and 80 subspecialty drug information questions. Erroneous information was also tracked. Individual scope and completeness scores were delineated by rank order and chi square was performed to determine differences in scope and completeness scores between the databases. RESULTS: Davis's Drug Guide for Nurses (DDGN) and Nursing Lexi-Drugs (NLD) tied for the highest scores for scope, including each answering 72.5% of the 160 evaluation questions. No significant differences existed between their scores and those earned by Nursing2008 Drug Handbook (p<0.05). The highest scores for completeness were earned by NLD with 58.1% and DDGN at 57.1%. Saunders Nursing Drug Handbook was the only database that showed a significantly lower score in completeness as compared to the other six databases (p<0.05). A 4.2% overall error rate was found among database answers. DISCUSSION: Significant differences were found among the performances in the databases evaluated in this study for their ability to answer commonly encountered drug information issues in nursing practice. All databases contained some erroneous information and even the top performers failed to provide answers to more than one-fourth of the questions posed. The availability of accurate and timely drug information at point-of-care can play a vital role in patient management and outcomes, but current resources that are available need to be improved.

Relationship between physician supply and breast cancer survival: a geographic approach.

Breast cancer is the most common cancer in women, accounting for nearly 30% of all female cancers. Breast cancer is the second leading cause of cancer mortality in women in the US. During the last two decades, the benefits of early detection, early intervention, and postoperative treatment have resulted in decreased breast cancer mortality in the US general population. However, the distribution of breast cancer mortality varies among geographic regions of the US. The reasons for this variation remain largely unknown. We choose to look for a possible association between the numbers of physicians in each city within the State of Florida and breast cancer survival among women aged 40+ residing in that particular city. Using Cox Proportionate Hazard Modeling, we found a direct association between the number of physicians practicing in a particular city and breast cancer survival in that particular city (P=0.0153), while controlling for other known risk factors affecting survival. To our knowledge, this is the first study to report an association between physician supply and cancer survival within defined geographic areas. This association shows as physician density consistently dropped in a defined geographic area so did time of survival among women with breast cancer.

Open-access publishing for pharmacy-focused journals.

PURPOSE: Pharmacy-focused journals that are available in open-access (OA), freely accessible, hybrid, or traditional formats were identified. METHODS: Relevant journals were accessed from PubMed, International Pharmaceutical Abstracts, EMBASE, and the Pharmacology and Pharmacy category of Thomson Scientific Journal Citation Reports. Criteria were established to select journals that satisfied the definition of pharmacy focused. Journals were assessed based on accessibility, copyright transfer requirements, and restrictions. If tracked, the journal's impact factor (IF) was identified according to classification, and medians were calculated for each journal category. RESULTS: A total of 317 pharmacy-focused journals were identified. The majority of pharmacy-focused journals identified were traditional/non-OA (n = 240). A smaller number of journals were freely accessible/ non-OA (n = 37), freely accessible/non-OA with content restrictions (n = 20), or freely available/non-OA with date restrictions (n = 18). The fewest number of journals were completely OA (n = 2). The median IF for the 185 journals whose IF was tracked was 2.029. The median IF for freely accessible and hybrid journals (n = 42) was 2.550, whereas the median IF for traditional journals (n = 143) was 1.900. CONCLUSION: A very small number of pharmacy-focused journals adhere to the OA paradigm of access. However, journals that adopt some elements of the OA model, chiefly free accessibility, may be more likely to be cited than traditional journals. Pharmacy practitioners, educators, and researchers could benefit from the advantages that OA offers but should understand its financial disadvantages.

The effectiveness of low vision rehabilitation on quality of life: an evidence-based practice approach to answer clinical questions.

The goal of this article is to demonstrate to occupational therapy practitioners how an evidence-based approach to practice can assist them in providing high-quality client-centered care. A case scenario of a client with low vision was utilized to outline the steps of evidence-based practice to answer clinical questions. A critical appraisal of the literature regarding the effectiveness of low vision rehabilitation on quality of life was conducted. The appraisal included 5 quantitative studies and 2 literature reviews. Mixed results were found. A variety of low vision rehabilitation models exist. Informing the client of the current evidence and local services will allow the client to make educated decisions regarding their health care options.

Genetics, human genome project and occupational therapy practice.

The Human Genome Project (HGP) has enabled rapid advances in healthcare practice. Medical genetics, once largely confined to relatively rare diseases seen by only a few specialists, is now becoming a central component in our understanding of most major diseases. Occupational therapy practice, without a doubt, will be changed significantly by the explosion of genetic knowledge. This article provides the basic concepts of genes and their relationship to our health. Four types of genetic disorders are introduced. The HGP and its expected gains and limitations are described. Ethical, legal and social implications (ELSI) of advances in genetics are discussed with an example of an ethical dilemma. Finally, this article also provides information on genetic counseling to assist occupational therapists in identifying the need for a referral to genetic counseling.

Duchenne muscular dystrophy in females: a rare genetic disorder and occupational therapy perspectives.

As genetic technology rapidly advances, its effects on healthcare will inevitably change the way occupational therapists serve their clients. This change will include how the needs and goals of clients are met and achieved. It is, therefore, necessary that occupational therapists become educated and remain current in the field of genetics. Duchenne muscular dystrophy (DMD) is an X-linked genetic disorder known as the most common form of muscular dystrophy in males. The majority of the available literature on DMD focuses on males, as the disorder is clinically very rare in females. This article reviews the basics of genetics and explains the etiology of DMD in females. A case example of a young girl with DMD is provided to illustratethe occupational therapy implications of this rare genetic disorder.