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.

In this article, we have identified some of the ethical considerations related to evidence-based practice and surrounding issues as they bear on occupational therapy and rehabilitation. We acknowledge that practitioners are professionally and morally obligated to ensure that their decisions are informed and reflect best practices. Further, we recognize the value of encouraging practitioners to assume responsibility for searching and appraising available evidence so that informed options can be shared with patients. Table 1 summarizes the ethical considerations in evidence-based practice. Ethical dilemmas are a natural part of the health care enterprise. They existed before evidence-based practice became an everyday term, and they present themselves whether or not evidence-based practice is introduced into a clinical decision. From a moral and professional standpoint, the dangers of not attending to evidence are just as significant as the ethical issues attending to its application. Evidence-based practice has clear limitations in occupational therapy and rehabilitation. Currently, these limitations loom as major obstacles to practice behaviors that are better informed and influenced by research. In the United States, the implementation of a prospective payment system in rehabilitation will provide increased impetus for research and for attention to the results of that research. As we consider and apply this research to practice, we must do so judiciously, mindful that evidence-based practice is a gift that comes to health care in ethical wrappings.

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.

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.

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.

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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.

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.