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In this directed case study students follow a nurse practitioner and work with a diagnostics team to determine what is wrong with Tristan, an infant who comes to the clinic with multiple bruises. Students are given background and patient history, and are then given results of various blood tests ordered by the diagnostics team. The exercise emphasizes the physiological process of coagulation and the importance of various clotting factors, especially factor VIII. Students will be introduced to results from several blood tests, including: complete blood count, partial thromboplastin time, prothrombin time, metabolic panel, and factor VIII assay. The patient is ultimately diagnosed with severe hemophilia A and the case then introduces students to this disorder, the genetic determinants, the incidence, and ways to manage the disease. The data in this case are real and the story represents the medical history of an actual patient. Originally developed for pre-nursing students, this activity would also be suitable for majors in physiology or pre-medical students; it could also be used in an introductory genetics or biology course.

We recently asked school nurses, "What's the most important thing teachers can do to help keep students healthy during the school year?"

Was the "Brooklyn Butcher" of 1926 a cold-blooded killer or was something less sinister at play? This interrupted case study introduces students to hemoglobin binding and carbon monoxide poisoning by working through the details of a fictionalized account of a true-crime story. Topics covered include molecule conformational states, binding affinity, deoxyhemoglobin, oxyhemoglobin, carboxyhemoglobin, and oxygen transport. Students also design an experiment to determine the cause of death of the victim. Prior to beginning the activity students should have some knowledge of the respiratory and circulatory systems and be familiar with oxygen binding curves. Detailed understanding of hemoglobin conformational changes is not necessary since this information is covered in the case. Students will also learn briefly about the electromagnetic spectrum and visible light. Originally developed for a non-majors, pre-nursing anatomy and physiology course, the case is also appropriate for use in any of the following courses: introductory biochemistry, introductory biology, introductory chemistry, nursing, exercise physiology, or possibly even introductory physics.

This PowerPoint-driven case study follows the progress of three undergraduate students as they attempt to model the rapid spread of an influenza outbreak to determine whether their local newspaper's claim that "40% of the campus has the flu" is accurate. The case introduces epidemiological modeling using a base model for a seasonal influenza outbreak written in the NetLogo programmable modeling environment. In class, students develop tests for the various parameters of the model, run simulations, and evaluate the output. The students then explore the impact of influenza control strategies (vaccination, isolation, and antiviral medications), and finish with the question of whether the continuing outbreak on campus could be a pandemic. The case is written at a basic level for a lower-level undergraduate lecture-style class, but can be adapted to upper-level courses as well. The case was piloted in four different microbiology courses. The simulations stimulated active discussion and the content worked well, whether it was used in a pre-nursing microbiology or upper-level immunology class.

In this interrupted case study, students shadow an endocrinologist as she tries to determine what is wrong with Angela Barber. Angela is a middle-aged woman presenting with symptoms suggestive of a thyroid issue. Students are given background information, patient history, and results from thyroid-specific blood tests. The exercise emphasizes the hypothalamic-pituitary-thyroid axis and particularly highlights the role of negative feedback. Students will use results from serum thyrotropin and thyroid hormone level tests, as well as patient symptoms, to come up with a diagnosis. In preparation for the diagnosis, students are asked to compare the endocrine profiles of patients with Graves' disease, Hashimoto's disease, iodine deficiency (primary hypothyroidism), and various tumors. The case was developed for college-level biology majors in a physiology course, but also has been used successfully for pre-nursing students in a non-majors anatomy and physiology course. Thus, this activity would be suitable for majors in physiology or pre-medical students, as well as allied health majors.

Signaling at the neuromuscular junction (NMJ) is a complex process that is required for many actions that sustain life within humans. Toxins that act upon the NMJ, both natural and synthetic, act in a variety of ways to inhibit this function. This case study examines how a variety of toxins can act to disrupt the normal mechanism of function of the NMJ  by placing a protagonist ("Unlucky Chucky") at an eco-spa in Colombia with his good friend Melody. Unfortunately, during their time at the eco-spa, things don't always turn out well for Chucky. A variety of neuromuscular toxins are discussed including curare (d-tubocurarine), Botox (botulinum toxin A), physostigmine and sarin gas (GB). This case was designed to be used in a variety of classrooms ranging from an undergraduate introduction to biology course in a module focused on neuromuscular functioning, to an introduction to physiology course as an introduction to the NMJ; it could also potentially be used in a nursing course that is examining NMJ physiology.

An elderly woman living independently with some help from her family is brought to the local emergency room because she is confused and vomiting. While her son suspects a stroke, a quick battery of laboratory tests indicates that her current problems are the result of impaired kidney function, an old-fashioned home remedy for ulcers, and her prescribed blood pressure medication. The combination of patient- and drug-related factors produces an acid-base disorder responsible for her confusion. This disorder further disrupts her kidney function. The case illustrates secretion and reabsorption processes in the kidney tubule which regulate plasma and urinary electrolytes (including calcium) and pH. The role of bicarbonate in maintaining systemic pH is emphasized. Interactions among the renal, respiratory and nervous systems in the regulation of systemic pH are also illustrated. Further, basic principles of pharmacotherapy and issues related to the appropriate use of medications are introduced. The case was developed for use in a physiology or human anatomy and physiology course, but it might be used in undergraduate nursing courses as well (e.g., pharmacology, pathophysiology).

 For my research project with the USHMM, I focused on the ethical and moral deficiencies exhibited and practiced by scientists, doctors, nurses, and anthropologists during the Holocaust. As part of that research, I also focused on the American Eugenics movement,and specifically what happened in North Carolina.       The website contains videos, testimonies, articles, timelines, and specific activities associated with the specific Nazi plans of euthanasia through extermination. There is also a site that deals specifically with American and NC eugenics.

This case study tells the story of a group of ten men, recently released from federal penitentiaries, who are housed in a residential reentry center for the remainder of their sentences. Their stay is intended to bridge the gap between incarceration and return to life in the community. Due to the length of time served, the men are poorly skilled in healthy behaviors and self-reliance in the areas of food and activity. Although a work of fiction, the narrative realistically portrays a variety of challenges that the men face including a chronic health issue, menu planning, tight budgets, hunger, boredom, lack of cooking skills, and life without a local supermarket. Innovation, trial and error, and collaboration result in a story of resilience and health behavior change in a sparsely populated area of Northern Michigan. The case was originally developed for a college-level nutrition course, but could also be used in social work, community health, and health education, nursing, and dietetics classes.

The physical connection between mother and fetus is provided by the placenta, an organ, built of cells from both the mother and fetus, which serves as a conduit for the exchange of nutrients, gasses, and wastes. Cells may migrate through the placenta between the mother and the fetus, taking up residence in many organs of the body including the lung, thyroid, muscle, liver, heart, kidney and skin. These may have a broad range of impacts, from tissue repair and cancer prevention to sparking immune disorders.