medical case study high school

Health Case Studies

(29 reviews)

Glynda Rees, British Columbia Institute of Technology

Rob Kruger, British Columbia Institute of Technology

Janet Morrison, British Columbia Institute of Technology

Publisher: BCcampus

Language: English

Formats Available

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Reviewed by Jessica Sellars, Medical assistant office instructor, Blue Mountain Community College on 10/11/23

Comprehensiveness rating: 5 see less

This is a book of compiled and very well organized patient case studies. The author has broken it up by disease patient was experiencing and even the healthcare roles that took place in this patients care. There is a well thought out direction and plan. There is an appendix to refer to as well if you are needing to find something specific quickly. I have been looking for something like this to help my students have a base to do their project on. This is the most comprehensive version I have found on the subject.

Content Accuracy rating: 5

This is a book compiled of medical case studies. It is very accurate and can be used to learn from great care and mistakes.

Relevance/Longevity rating: 5

This material is very relevant in this context. It also has plenty of individual case studies to utilize in many ways in all sorts of medical courses. This is a very useful textbook and it will continue to be useful for a very long time as you can still learn from each study even if medicine changes through out the years.

Clarity rating: 5

The author put a lot of thought into the ease of accessibility and reading level of the target audience. There is even a "how to use this resource" section which could be extremely useful to students.

Consistency rating: 5

The text follows a very consistent format throughout the book.

Modularity rating: 5

Each case study is individual broken up and in a group of similar case studies. This makes it extremely easy to utilize.

Organization/Structure/Flow rating: 5

The book is very organized and the appendix is through. It flows seamlessly through each case study.

Interface rating: 5

I had no issues navigating this book, It was clearly labeled and very easy to move around in.

Grammatical Errors rating: 5

I did not catch any grammar errors as I was going through the book

Cultural Relevance rating: 5

This is a challenging question for any medical textbook. It is very culturally relevant to those in medical or medical office degrees.

I have been looking for something like this for years. I am so happy to have finally found it.

Reviewed by Cindy Sun, Assistant Professor, Marshall University on 1/7/23

Interestingly, this is not a case of ‘you get what you pay for’. Instead, not only are the case studies organized in a fashion for ease of use through a detailed table of contents, the authors have included more support for both faculty and students. For faculty, the introduction section titled ‘How to use this resource’ and individual notes to educators before each case study contain application tips. An appendix overview lists key elements as issues / concepts, scenario context, and healthcare roles for each case study. For students, learning objectives are presented at the beginning of each case study to provide a framework of expectations.

The content is presented accurately and realistic.

The case studies read similar to ‘A Day In the Life of…’ with detailed intraprofessional communications similar to what would be overheard in patient care areas. The authors present not only the view of the patient care nurse, but also weave interprofessional vantage points through each case study by including patient interaction with individual professionals such as radiology, physician, etc.

In addition to objective assessment findings, the authors integrate standard orders for each diagnosis including medications, treatments, and tests allowing the student to incorporate pathophysiology components to their assessments.

Each case study is arranged in the same framework for consistency and ease of use.

This compilation of eight healthcare case studies focusing on new onset and exacerbation of prevalent diagnoses, such as heart failure, deep vein thrombosis, cancer, and chronic obstructive pulmonary disease advancing to pneumonia.

Each case study has a photo of the ‘patient’. Simple as this may seem, it gives an immediate mental image for the student to focus.

Interface rating: 4

As noted by previous reviewers, most of the links do not connect active web pages. This may be due to the multiple options for accessing this resource (pdf download, pdf electronic, web view, etc.).

Grammatical Errors rating: 4

A minor weakness that faculty will probably need to address prior to use is regarding specific term usages differences between Commonwealth countries and United States, such as lung sound descriptors as ‘quiet’ in place of ‘diminished’ and ‘puffers’ in place of ‘inhalers’.

The authors have provided a multicultural, multigenerational approach in selection of patient characteristics representing a snapshot of today’s patient population. Additionally, one case study focusing on heart failure is about a middle-aged adult, contrasting to the average aged patient the students would normally see during clinical rotations. This option provides opportunities for students to expand their knowledge on risk factors extending beyond age.

This resource is applicable to nursing students learning to care for patients with the specific disease processes presented in each case study or for the leadership students focusing on intraprofessional communication. Educators can assign as a supplement to clinical experiences or as an in-class application of knowledge.

Reviewed by Stephanie Sideras, Assistant Professor, University of Portland on 8/15/22

The eight case studies included in this text addressed high frequency health alterations that all nurses need to be able to manage competently. While diabetes was not highlighted directly, it was included as a potential comorbidity. The five overarching learning objectives pulled from the Institute of Medicine core competencies will clearly resonate with any faculty familiar with Quality and Safety Education for Nurses curriculum.

The presentation of symptoms, treatments and management of the health alterations was accurate. Dialogue between the the interprofessional team was realistic. At times the formatting of lab results was confusing as they reflected reference ranges specific to the Canadian healthcare system but these occurrences were minimal and could be easily adapted.

The focus for learning from these case studies was communication - patient centered communication and interprofessional team communication. Specific details, such as drug dosing, was minimized, which increases longevity and allows for easy individualization of the case data.

While some vocabulary was specific to the Canadian healthcare system, overall the narrative was extremely engaging and easy to follow. Subjective case data from patient or provider were formatted in italics and identified as 'thoughts'. Objective and behavioral case data were smoothly integrated into the narrative.

The consistency of formatting across the eight cases was remarkable. Specific learning objectives are identified for each case and these remain consistent across the range of cases, varying only in the focus for the goals for each different health alterations. Each case begins with presentation of essential patient background and the progress across the trajectory of illness as the patient moves from location to location encountering different healthcare professionals. Many of the characters (the triage nurse in the Emergency Department, the phlebotomist) are consistent across the case situations. These consistencies facilitate both application of a variety of teaching methods and student engagement with the situated learning approach.

Case data is presented by location and begins with the patient's first encounter with the healthcare system. This allows for an examination of how specific trajectories of illness are manifested and how care management needs to be prioritized at different stages. This approach supports discussions of care transitions and the complexity of the associated interprofessional communication.

The text is well organized. The case that has two levels of complexity is clearly identified

The internal links between the table of contents and case specific locations work consistently. In the EPUB and the Digital PDF the external hyperlinks are inconsistently valid.

The grammatical errors were minimal and did not detract from readability

Cultural diversity is present across the cases in factors including race, ethnicity, socioeconomic status, family dynamics and sexual orientation.

The level of detail included in these cases supports a teaching approach to address all three spectrums of learning - knowledge, skills and attitudes - necessary for the development of competent practice. I also appreciate the inclusion of specific assessment instruments that would facilitate a discussion of evidence based practice. I will enjoy using these case to promote clinical reasoning discussions of data that is noticed and interpreted with the resulting prioritizes that are set followed by reflections that result from learner choices.

Reviewed by Chris Roman, Associate Professor, Butler University on 5/19/22

It would be extremely difficult for a book of clinical cases to comprehensively cover all of medicine, and this text does not try. Rather, it provides cases related to common medical problems and introduces them in a way that allows for various... read more

Comprehensiveness rating: 4 see less

The narrative form of the cases is less subject to issues of accuracy than a more content-based book would be. That said, the cases are realistic and reasonable, avoiding being too mundane or too extreme.

These cases are narrative and do not include many specific mentions of drugs, dosages, or other aspects of clinical care that may grow/evolve as guidelines change. For this reason, the cases should be “evergreen” and can be modified to suit different types of learners.

Clarity rating: 4

The text is written in very accessible language and avoids heavy use of technical language. Depending on the level of learner, this might even be too simplistic and omit some details that would be needed for physicians, pharmacists, and others to make nuanced care decisions.

The format is very consistent with clear labeling at transition points.

The authors point out in the introductory materials that this text is designed to be used in a modular fashion. Further, they have built in opportunities to customize each cases, such as giving dates of birth at “19xx” to allow for adjustments based on instructional objectives, etc.

The organization is very easy to follow.

I did not identify any issues in navigating the text.

The text contains no grammatical errors, though the language is a little stiff/unrealistic in some cases.

Cases involve patients and members of the care team that are of varying ages, genders, and racial/ethnic backgrounds

Reviewed by Trina Larery, Assistant Professor, Pittsburg State University on 4/5/22

The book covers common scenarios, providing allied health students insight into common health issues. The information in the book is thorough and easily modified if needed to include other scenarios not listed. The material was easy to understand... read more

Content Accuracy rating: 4

The treatments were explained and rationales were given, which can be very helpful to facilitate effective learning for a nursing student or novice nurse. The case studies were accurate in explanation. The DVT case study incorrectly identifies the location of the clot in the popliteal artery instead of in the vein.

The content is relevant to a variety of different types of health care providers and due to the general nature of the cases, will remain relevant over time. Updates should be made annually to the hyperlinks and to assure current standard of practice is still being met.

Clear, simple and easy to read.

Consistent with healthcare terminology and framework throughout all eight case studies.

The text is modular. Cases can be used individually within a unit on the given disease process or relevant sections of a case could be used to illustrate a specific point providing great flexibility. The appendix is helpful in locating content specific to a certain diagnosis or a certain type of health care provider.

The book is well organized, presenting in a logical clear fashion. The appendix allows the student to move about the case study without difficulty.

The interface is easy and simple to navigate. Some links to external sources might need to be updated regularly since those links are subject to change based on current guidelines. A few hyperlinks had "page not found".

Few grammatical errors were noted in text.

The case studies include people of different ethnicities, socioeconomic status, ages, and genders to make this a very useful book.

I enjoyed reading the text. It was interesting and relevant to today's nursing student. There are roughly 25 broken online links or "pages not found", care needs to be taken to update at least annually and assure links are valid and utilizing the most up to date information.

Reviewed by Benjamin Silverberg, Associate Professor/Clinician, West Virginia University on 3/24/22

Comprehensiveness rating: 3 see less

The appendix reviews the "key roles" and medical venues found in all 8 cases, but is fairly spartan on medical content. The table of contents at the beginning only lists the cases and locations of care. It can be a little tricky to figure out what is going on where, especially since each case is largely conversation-based. Since this presents 8 cases (really 7 with one being expanded upon), there are many medical topics (and venues) that are not included. It's impossible to include every kind of situation, but I'd love to see inclusion of sexual health, renal pathology, substance abuse, etc.

Though there are differences in how care can be delivered based on personal style, changing guidelines, available supplies, etc, the medical accuracy seems to be high. I did not detect bias or industry influence.

Relevance/Longevity rating: 4

Medications are generally listed as generics, with at least current dosing recommendations. The text gives a picture of what care looks like currently, but will be a little challenging to update based on new guidelines (ie, it can be hard to find the exact page in which a medication is dosed/prescribed). Even if the text were to be a little out of date, an instructor can use that to point out what has changed (and why).

Clear text, usually with definitions of medical slang or higher-tier vocabulary. Minimal jargon and there are instances where the "characters" are sorting out the meaning as well, making it accessible for new learners, too.

Overall, the style is consistent between cases - largely broken up into scenes and driven by conversation rather than descriptions of what is happening.

There are 8 (well, again, 7) cases which can be reviewed in any order. Case #2 builds upon #1, which is intentional and a good idea, though personally I would have preferred one case to have different possible outcomes or even a recurrence of illness. Each scene within a case is reasonably short.

Organization/Structure/Flow rating: 4

These cases are modular and don't really build on concepts throughout. As previously stated, case #2 builds upon #1, but beyond that, there is no progression. (To be sure, the authors suggest using case #1 for newer learners and #2 for more advanced ones.) The text would benefit from thematic grouping, a longer introduction and debriefing for each case (there are learning objectives but no real context in medical education nor questions to reflect on what was just read), and progressively-increasing difficulty in medical complexity, ethics, etc.

I used the PDF version and had no interface issues. There are minimal photographs and charts. Some words are marked in blue but those did not seem to be hyperlinked anywhere.

No noticeable errors in grammar, spelling, or formatting were noted.

I appreciate that some diversity of age and ethnicity were offered, but this could be improved. There were Canadian Indian and First Nations patients, for example, as well as other characters with implied diversity, but there didn't seem to be any mention of gender diverse or non-heterosexual people, or disabilities. The cases tried to paint family scenes (the first patient's dog was fairly prominently mentioned) to humanize them. Including more cases would allow for more opportunities to include sex/gender minorities, (hidden) disabilities, etc.

The text (originally from 2017) could use an update. It could be used in conjunction with other Open Texts, as a compliment to other coursework, or purely by itself. The focus is meant to be on improving communication, but there are only 3 short pages at the beginning of the text considering those issues (which are really just learning objectives). In addition to adding more cases and further diversity, I personally would love to see more discussion before and after the case to guide readers (and/or instructors). I also wonder if some of the ambiguity could be improved by suggesting possible health outcomes - this kind of counterfactual comparison isn't possible in real life and could be really interesting in a text. Addition of comprehension/discussion questions would also be worthwhile.

Reviewed by Danielle Peterson, Assistant Professor, University of Saint Francis on 12/31/21

This text provides readers with 8 case studies which include both chronic and acute healthcare issues. Although not comprehensive in regard to types of healthcare conditions, it provides a thorough look at the communication between healthcare workers in acute hospital settings. The cases are primarily set in the inpatient hospital setting, so the bulk of the clinical information is basic emergency care and inpatient protocol: vitals, breathing, medication management, etc. The text provides a table of contents at opening of the text and a handy appendix at the conclusion of the text that outlines each case’s issue(s), scenario, and healthcare roles. No index or glossary present.

Although easy to update, it should be noted that the cases are taking place in a Canadian healthcare system. Terms may be unfamiliar to some students including “province,” “operating theatre,” “physio/physiotherapy,” and “porter.” Units of measurement used include Celsius and meters. Also, the issue of managed care, health insurance coverage, and length of stay is missing for American students. These are primary issues that dictate much of the healthcare system in the US and a primary job function of social workers, nurse case managers, and medical professionals in general. However, instructors that wish to add this to the case studies could do so easily.

The focus of this text is on healthcare communication which makes it less likely to become obsolete. Much of the clinical information is stable healthcare practice that has been standard of care for quite some time. Nevertheless, given the nature of text, updates would be easy to make. Hyperlinks should be updated to the most relevant and trustworthy sources and checked frequently for effectiveness.

The spacing that was used to note change of speaker made for ease of reading. Although unembellished and plain, I expect students to find this format easy to digest and interesting, especially since the script is appropriately balanced with ‘human’ qualities like the current TV shows and songs, the use of humor, and nonverbal cues.

A welcome characteristic of this text is its consistency. Each case is presented in a similar fashion and the roles of the healthcare team are ‘played’ by the same character in each of the scenarios. This allows students to see how healthcare providers prioritize cases and juggle the needs of multiple patients at once. Across scenarios, there was inconsistency in when clinical terms were hyperlinked.

The text is easily divisible into smaller reading sections. However, since the nature of the text is script-narrative format, if significant reorganization occurs, one will need to make sure that the communication of the script still makes sense.

The text is straightforward and presented in a consistent fashion: learning objectives, case history, a script of what happened before the patient enters the healthcare setting, and a script of what happens once the patient arrives at the healthcare setting. The authors use the term, “ideal interactions,” and I would agree that these cases are in large part, ‘best case scenarios.’ Due to this, the case studies are well organized, clear, logical, and predictable. However, depending on the level of student, instructors may want to introduce complications that are typical in the hospital setting.

The interface is pleasing and straightforward. With exception to the case summary and learning objectives, the cases are in narrative, script format. Each case study supplies a photo of the ‘patient’ and one of the case studies includes a link to a 3-minute video that introduces the reader to the patient/case. One of the highlights of this text is the use of hyperlinks to various clinical practices (ABG, vital signs, transfer of patient). Unfortunately, a majority of the links are broken. However, since this is an open text, instructors can update the links to their preference.

Although not free from grammatical errors, those that were noticed were minimal and did not detract from reading.

Cultural Relevance rating: 4

Cultural diversity is visible throughout the patients used in the case studies and includes factors such as age, race, socioeconomic status, family dynamics, and sexual orientation. A moderate level of diversity is noted in the healthcare team with some stereotypes: social workers being female, doctors primarily male.

As a social work instructor, I was grateful to find a text that incorporates this important healthcare role. I would have liked to have seen more content related to advance directives, mediating decision making between the patient and care team, emotional and practical support related to initial diagnosis and discharge planning, and provision of support to colleagues, all typical roles of a medical social worker. I also found it interesting that even though social work was included in multiple scenarios, the role was only introduced on the learning objectives page for the oncology case.

Reviewed by Crystal Wynn, Associate Professor, Virginia State University on 7/21/21

The text covers a variety of chronic diseases within the cases; however, not all of the common disease states were included within the text. More chronic diseases need to be included such as diabetes, cancer, and renal failure. Not all allied health care team members are represented within the case study. Key terms appear throughout the case study textbook and readers are able to click on a hyperlink which directs them to the definition and an explanation of the key term.

Content is accurate, error-free and unbiased.

The content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement.

The text is written in lucid, accessible prose, and provides adequate context for any jargon/technical terminology used

The text is internally consistent in terms of terminology and framework.

The text is easily and readily divisible into smaller reading sections that can be assigned at different points within the course. Each case can be divided into a chronic disease state unit, which will allow the reader to focus on one section at a time.

Organization/Structure/Flow rating: 3

The topics in the text are presented in a logical manner. Each case provides an excessive amount of language that provides a description of the case. The cases in this text reads more like a novel versus a clinical textbook. The learning objectives listed within each case should be in the form of questions or activities that could be provided as resources for instructors and teachers.

Interface rating: 3

There are several hyperlinks embedded within the textbook that are not functional.

The text contains no grammatical errors.

Cultural Relevance rating: 3

The text is not culturally insensitive or offensive in any way. More examples of cultural inclusiveness is needed throughout the textbook. The cases should be indicative of individuals from a variety of races and ethnicities.

Reviewed by Rebecca Hillary, Biology Instructor, Portland Community College on 6/15/21

This textbook consists of a collection of clinical case studies that can be applicable to a wide range of learning environments from supplementing an undergraduate Anatomy and Physiology Course, to including as part of a Medical or other health care program. I read the textbook in E-reader format and this includes hyperlinks that bring the students to subsequent clinical study if the book is being used in a clinical classroom. This book is significantly more comprehensive in its approach from other case studies I have read because it provides a bird’s eye view of the many clinicians, technicians, and hospital staff working with one patient. The book also provides real time measurements for patients that change as they travel throughout the hospital until time of discharge.

Each case gave an accurate sense of the chaos that would be present in an emergency situation and show how the conditions affect the practitioners as well as the patients. The reader gets an accurate big picture--a feel for each practitioner’s point of view as well as the point of view of the patient and the patient’s family as the clock ticks down and the patients are subjected to a number of procedures. The clinical information contained in this textbook is all in hyperlinks containing references to clinical skills open text sources or medical websites. I did find one broken link on an external medical resource.

The diseases presented are relevant and will remain so. Some of the links are directly related to the Canadian Medical system so they may not be applicable to those living in other regions. Clinical links may change over time but the text itself will remain relevant.

Each case study clearly presents clinical data as is it recorded in real time.

Each case study provides the point of view of several practitioners and the patient over several days. While each of the case studies covers different pathology they all follow this same format, several points of view and data points, over a number of days.

The case studies are divided by days and this was easy to navigate as a reader. It would be easy to assign one case study per body system in an Anatomy and Physiology course, or to divide them up into small segments for small in class teaching moments.

The topics are presented in an organized way showing clinical data over time and each case presents a large number of view points. For example, in the first case study, the patient is experiencing difficulty breathing. We follow her through several days from her entrance to the emergency room. We meet her X Ray Technicians, Doctor, Nurses, Medical Assistant, Porter, Physiotherapist, Respiratory therapist, and the Lab Technicians running her tests during her stay. Each practitioner paints the overall clinical picture to the reader.

I found the text easy to navigate. There were not any figures included in the text, only clinical data organized in charts. The figures were all accessible via hyperlink. Some figures within the textbook illustrating patient scans could have been helpful but I did not have trouble navigating the links to visualize the scans.

I did not see any grammatical errors in the text.

The patients in the text are a variety of ages and have a variety of family arrangements but there is not much diversity among the patients. Our seven patients in the eight case studies are mostly white and all cis gendered.

Some of the case studies, for example the heart failure study, show clinical data before and after drug treatments so the students can get a feel for mechanism in physiological action. I also liked that the case studies included diet and lifestyle advice for the patients rather than solely emphasizing these pharmacological interventions. Overall, I enjoyed reading through these case studies and I plan to utilize them in my Anatomy and Physiology courses.

Reviewed by Richard Tarpey, Assistant Professor, Middle Tennessee State University on 5/11/21

As a case study book, there is no index or glossary. However, medical and technical terms provide a useful link to definitions and explanations that will prove useful to students unfamiliar with the terms. The information provided is appropriate for entry-level health care students. The book includes important health problems, but I would like to see coverage of at least one more chronic/lifestyle issue such as diabetes. The book covers adult issues only.

Content is accurate without bias

The content of the book is relevant and up-to-date. It addresses conditions that are prevalent in today's population among adults. There are no pediatric cases, but this does not significantly detract from the usefulness of the text. The format of the book lends to easy updating of data or information.

The book is written with clarity and is easy to read. The writing style is accessible and technical terminology is explained with links to more information.

Consistency is present. Lack of consistency is typically a problem with case study texts, but this book is consistent with presentation, format, and terminology throughout each of the eight cases.

The book has high modularity. Each of the case studies can be used independently from the others providing flexibility. Additionally, each case study can be partitioned for specific learning objectives based on the learning objectives of the course or module.

The book is well organized, presenting students conceptually with differing patient flow patterns through a hospital. The patient information provided at the beginning of each case is a wonderful mechanism for providing personal context for the students as they consider the issues. Many case studies focus on the problem and the organization without students getting a patient's perspective. The patient perspective is well represented in these cases.

The navigation through the cases is good. There are some terminology and procedure hyperlinks within the cases that do not work when accessed. This is troubling if you intend to use the text for entry-level health care students since many of these links are critical for a full understanding of the case.

There are some non-US variants of spelling and a few grammatical errors, but these do not detract from the content of the messages of each case.

The book is inclusive of differing backgrounds and perspectives. No insensitive or offensive references were found.

I like this text for its application flexibility. The book is useful for non-clinical healthcare management students to introduce various healthcare-related concepts and terminology. The content is also helpful for the identification of healthcare administration managerial issues for students to consider. The book has many applications.

Reviewed by Paula Baldwin, Associate Professor/Communication Studies, Western Oregon University on 5/10/21

The different case studies fall on a range, from crisis care to chronic illness care. read more

The different case studies fall on a range, from crisis care to chronic illness care.

The contents seems to be written as they occurred to represent the most complete picture of each medical event's occurence.

These case studies are from the Canadian medical system, but that does not interfere with it's applicability.

It is written for a medical audience, so the terminology is mostly formal and technical.

Some cases are shorter than others and some go in more depth, but it is not problematic.

The eight separate case studies is the perfect size for a class in the quarter system. You could combine this with other texts, videos or learning modalities, or use it alone.

As this is a case studies book, there is not a need for a logical progression in presentation of topics.

No problems in terms of interface.

I have not seen any grammatical errors.

I did not see anything that was culturally insensitive.

I used this in a Health Communication class and it has been extraordinarily successful. My studies are analyzing the messaging for the good, the bad, and the questionable. The case studies are widely varied and it gives the class insights into hospital experiences, both front and back stage, that they would not normally be able to examine. I believe that because it is based real-life medical incidents, my students are finding the material highly engaging.

Reviewed by Marlena Isaac, Instructor, Aiken Technical College on 4/23/21

This text is great to walk through patient care with entry level healthcare students. The students are able to take in the information, digest it, then provide suggestions to how they would facilitate patient healing. Then when they are faced with... read more

The case studies provided accurate information that relates to the named disease.

It is relevant to health care studies and the development of critical thinking.

Cases are straightforward with great clinical information.

Clinical information is provided concisely.

Appropriate for clinical case study.

Presented to facilitate information gathering.

Takes a while to navigate in the browser.

Cultural Relevance rating: 1

Text lacks adequate representation of minorities.

Reviewed by Kim Garcia, Lecturer III, University of Texas Rio Grande Valley on 11/16/20

The book has 8 case studies, so obviously does not cover the whole of medicine, but the cases provided are descriptive and well developed. Cases are presented at different levels of difficulty, making the cases appropriate for students at different levels of clinical knowledge. The human element of both patient and health care provider is well captured. The cases are presented with a focus on interprofessional interaction and collaboration, more so than teaching medical content.

Content is accurate and un-biased. No errors noted. Most diagnostic and treatment information is general so it will remain relevant over time. The content of these cases is more appropriate for teaching interprofessional collaboration and less so for teaching the medical care for each diagnosis.

The content is relevant to a variety of different types of health care providers (nurses, radiologic technicians, medical laboratory personnel, etc) and due to the general nature of the cases, will remain relevant over time.

Easy to read. Clear headings are provided for sections of each case study and these section headings clearly tell when time has passed or setting has changed. Enough description is provided to help set the scene for each part of the case. Much of the text is written in the form of dialogue involving patient, family and health care providers, making it easy to adapt for role play. Medical jargon is limited and links for medical terms are provided to other resources that expound on medical terms used.

The text is consistent in structure of each case. Learning objectives are provided. Cases generally start with the patient at home and move with the patient through admission, testing and treatment, using a variety of healthcare services and encountering a variety of personnel.

The text is modular. Cases could be used individually within a unit on the given disease process or relevant sections of a case could be used to illustrate a specific point. The appendix is helpful in locating content specific to a certain diagnosis or a certain type of health care provider.

Each case follows a patient in a logical, chronologic fashion. A clear table of contents and appendix are provided which allows the user to quickly locate desired content. It would be helpful if the items in the table of contents and appendix were linked to the corresponding section of the text.

The hyperlinks to content outside this book work, however using the back arrow on your browser returns you to the front page of the book instead of to the point at which you left the text. I would prefer it if the hyperlinks opened in a new window or tab so closing that window or tab would leave you back where you left the text.

No grammatical errors were noted.

The text is culturally inclusive and appropriate. Characters, both patients and care givers are of a variety of races, ethnicities, ages and backgrounds.

I enjoyed reading the cases and reviewing this text. I can think of several ways in which I will use this content.

Reviewed by Raihan Khan, Instructor/Assistant Professor, James Madison University on 11/3/20

The book contains several important health issues, however still missing some chronic health issues that the students should learn before they join the workforce, such as diabetes-related health issues suffered by the patients. read more

The health information contained in the textbook is mostly accurate.

I think the book is written focusing on the current culture and health issues faced by the patients. To keep the book relevant in the future, the contexts especially the culture/lifestyle/health care modalities, etc. would need to be updated regularly.

The language is pretty simple, clear, and easy to read.

There is no complaint about consistency. One of the main issues of writing a book, consistency was well managed by the authors.

The book is easy to explore based on how easy the setup is. Students can browse to the specific section that they want to read without much hassle of finding the correct information.

The organization is simple but effective. The authors organized the book based on what can happen in a patient's life and what possible scenarios students should learn about the disease. From that perspective, the book does a good job.

The interface is easy and simple to navigate. Some links to external sources might need to be updated regularly since those links are subject to change that is beyond the author's control. It's frustrating for the reader when the external link shows no information.

The book is free of any major language and grammatical errors.

The book might do a little better in cultural competency. e.g. Last name Singh is mainly for Sikh people. In the text Harj and Priya Singh are Muslim. the authors can consult colleagues who are more familiar with those cultures and revise some cultural aspects of the cases mentioned in the book.

The book is a nice addition to the open textbook world. Hope to see more health issues covered by the book.

Reviewed by Ryan Sheryl, Assistant Professor, California State University, Dominguez Hills on 7/16/20

This text contains 8 medical case studies that reflect best practices at the time of publication. The text identifies 5 overarching learning objectives: interprofessional collaboration, client centered care, evidence-based practice, quality improvement, and informatics. While the case studies do not cover all medical conditions or bodily systems, the book is thorough in conveying details of various patients and medical team members in a hospital environment. Rather than an index or glossary at the end of the text, it contains links to outside websites for more information on medical tests and terms referenced in the cases.

The content provided is reflective of best practices in patient care, interdisciplinary collaboration, and communication at the time of publication. It is specifically accurate for the context of hospitals in Canada. The links provided throughout the text have the potential to supplement with up-to-date descriptions and definitions, however, many of them are broken (see notes in Interface section).

The content of the case studies reflects the increasingly complex landscape of healthcare, including a variety of conditions, ages, and personal situations of the clients and care providers. The text will require frequent updating due to the rapidly changing landscape of society and best practices in client care. For example, a future version may include inclusive practices with transgender clients, or address ways medical racism implicitly impacts client care (see notes in Cultural Relevance section).

The text is written clearly and presents thorough, realistic details about working and being treated in an acute hospital context.

The text is very straightforward. It is consistent in its structure and flow. It uses consistent terminology and follows a structured framework throughout.

Being a series of 8 separate case studies, this text is easily and readily divisible into smaller sections. The text was designed to be taken apart and used piece by piece in order to serve various learning contexts. The parts of each case study can also be used independently of each other to facilitate problem solving.

The topics in the case studies are presented clearly. The structure of each of the case studies proceeds in a similar fashion. All of the cases are set within the same hospital so the hospital personnel and service providers reappear across the cases, giving a textured portrayal of the experiences of the various service providers. The cases can be used individually, or one service provider can be studied across the various studies.

The text is very straightforward, without complex charts or images that could become distorted. Many of the embedded links are broken and require updating. The links that do work are a very useful way to define and expand upon medical terms used in the case studies.

Grammatical errors are minimal and do not distract from the flow of the text. In one instance the last name Singh is spelled Sing, and one patient named Fred in the text is referred to as Frank in the appendix.

The cases all show examples of health care personnel providing compassionate, client-centered care, and there is no overt discrimination portrayed. Two of the clients are in same-sex marriages and these are shown positively. It is notable, however, that the two cases presenting people of color contain more negative characteristics than the other six cases portraying Caucasian people. The people of color are the only two examples of clients who smoke regularly. In addition, the Indian client drinks and is overweight, while the First Nations client is the only one in the text to have a terminal diagnosis. The Indian client is identified as being Punjabi and attending a mosque, although there are only 2% Muslims in the Punjab province of India. Also, the last name Singh generally indicates a person who is a Hindu or Sikh, not Muslim.

Reviewed by Monica LeJeune, RN Instructor, LSUE on 4/24/20

Has comprehensive unfolding case studies that guide the reader to recognize and manage the scenario presented. Assists in critical thinking process. read more

Has comprehensive unfolding case studies that guide the reader to recognize and manage the scenario presented. Assists in critical thinking process.

Accurately presents health scenarios with real life assessment techniques and patient outcomes.

Relevant to nursing practice.

Clearly written and easily understood.

Consistent with healthcare terminology and framework

Has a good reading flow.

Topics presented in logical fashion

Easy to read.

No grammatical errors noted.

Text is not culturally insensitive or offensive.

Good book to have to teach nursing students.

Reviewed by april jarrell, associate professor, J. Sargeant Reynolds Community College on 1/7/20

The text is a great case study tool that is appropriate for nursing school instructors to use in aiding students to learn the nursing process. read more

The text is a great case study tool that is appropriate for nursing school instructors to use in aiding students to learn the nursing process.

The content is accurate and evidence based. There is no bias noted

The content in the text is relevant, up to date for nursing students. It will be easy to update content as needed because the framework allows for addition to the content.

The text is clear and easy to understand.

Framework and terminology is consistent throughout the text; the case study is a continual and takes the student on a journey with the patient. Great for learning!

The case studies can be easily divided into smaller sections to allow for discussions, and weekly studies.

The text and content progress in a logical, clear fashion allowing for progression of learning.

No interface issues noted with this text.

No grammatical errors noted in the text.

No racial or culture insensitivity were noted in the text.

I would recommend this text be used in nursing schools. The use of case studies are helpful for students to learn and practice the nursing process.

Reviewed by Lisa Underwood, Practical Nursing Instructor, NTCC on 12/3/19

The text provides eight comprehensive case studies that showcase the different viewpoints of the many roles involved in patient care. It encompasses the most common seen diagnoses seen across healthcare today. Each case study comes with its own set of learning objectives that can be tweaked to fit several allied health courses. Although the case studies are designed around the Canadian Healthcare System, they are quite easily adaptable to fit most any modern, developed healthcare system.

Content Accuracy rating: 3

Overall, the text is quite accurate. There is one significant error that needs to be addressed. It is located in the DVT case study. In the study, a popliteal artery clot is mislabeled as a DVT. DVTs are located in veins, not in arteries. That said, the case study on the whole is quite good. This case study could be used as a learning tool in the classroom for discussion purposes or as a way to test student understanding of DVTs, on example might be, "Can they spot the error?"

At this time, all of the case studies within the text are current. Healthcare is an ever evolving field that rests on the best evidence based practice. Keeping that in mind, educators can easily adapt the studies as the newest evidence emerges and changes practice in healthcare.

All of the case studies are well written and easy to understand. The text includes several hyperlinks and it also highlights certain medical terminology to prompt readers as a way to enhance their learning experience.

Across the text, the language, style, and format of the case studies are completely consistent.

The text is divided into eight separate case studies. Each case study may be used independently of the others. All case studies are further broken down as the focus patient passes through each aspect of their healthcare system. The text's modularity makes it possible to use a case study as individual work, group projects, class discussions, homework or in a simulation lab.

The case studies and the diagnoses that they cover are presented in such a way that educators and allied health students can easily follow and comprehend.

The book in itself is free of any image distortion and it prints nicely. The text is offered in a variety of digital formats. As noted in the above reviews, some of the hyperlinks have navigational issues. When the reader attempts to access them, a "page not found" message is received.

There were minimal grammatical errors. Some of which may be traced back to the differences in our spelling.

The text is culturally relevant in that it includes patients from many different backgrounds and ethnicities. This allows educators and students to explore cultural relevance and sensitivity needs across all areas in healthcare. I do not believe that the text was in any way insensitive or offensive to the reader.

By using the case studies, it may be possible to have an open dialogue about the differences noted in healthcare systems. Students will have the ability to compare and contrast the Canadian healthcare system with their own. I also firmly believe that by using these case studies, students can improve their critical thinking skills. These case studies help them to "put it all together".

Reviewed by Melanie McGrath, Associate Professor, TRAILS on 11/29/19

The text covered some of the most common conditions seen by healthcare providers in a hospital setting, which forms a solid general base for the discussions based on each case. read more

The text covered some of the most common conditions seen by healthcare providers in a hospital setting, which forms a solid general base for the discussions based on each case.

I saw no areas of inaccuracy

As in all healthcare texts, treatments and/or tests will change frequently. However, everything is currently up-to-date thus it should be a good reference for several years.

Each case is written so that any level of healthcare student would understand. Hyperlinks in the text is also very helpful.

All of the cases are written in a similar fashion.

Although not structured as a typical text, each case is easily assigned as a stand-alone.

Each case is organized clearly in an appropriate manner.

I did not see any issues.

I did not see any grammatical errors

The text seemed appropriately inclusive. There are no pediatric cases and no cases of intellectually-impaired patients, but those types of cases introduce more advanced problem-solving which perhaps exceed the scope of the text. May be a good addition to the text.

I found this text to be an excellent resource for healthcare students in a variety of fields. It would be best utilized in inter professional courses to help guide discussion.

Reviewed by Lynne Umbarger, Clinical Assistant Professor, Occupational Therapy, Emory and Henry College on 11/26/19

While the book does not cover every scenario, the ones in the book are quite common and troublesome for inexperienced allied health students. The information in the book is thorough enough, and I have found the cases easy to modify for educational purposes. The material was easily understood by the students but challenging enough for classroom discussion. There are no mentions in the book about occupational therapy, but it is easy enough to add a couple words and make inclusion simple.

Very nice lab values are provided in the case study, making it more realistic for students.

These case studies focus on commonly encountered diagnoses for allied health and nursing students. They are comprehensive, realistic, and easily understood. The only difference is that the hospital in one case allows the patient's dog to visit in the room (highly unusual in US hospitals).

The material is easily understood by allied health students. The cases have links to additional learning materials for concepts that may be less familiar or should be explored further in a particular health field.

The language used in the book is consistent between cases. The framework is the same with each case which makes it easier to locate areas that would be of interest to a particular allied health profession.

The case studies are comprehensive but well-organized. They are short enough to be useful for class discussion or a full-blown assignment. The students seem to understand the material and have not expressed that any concepts or details were missing.

Each case is set up like the other cases. There are learning objectives at the beginning of each case to facilitate using the case, and it is easy enough to pull out material to develop useful activities and assignments.

There is a quick chart in the Appendix to allow the reader to determine the professions involved in each case as well as the pertinent settings and diagnoses for each case study. The contents are easy to access even while reading the book.

As a person who attends carefully to grammar, I found no errors in all of the material I read in this book.

There are a greater number of people of different ethnicities, socioeconomic status, ages, and genders to make this a very useful book. With each case, I could easily picture the person in the case. This book appears to be Canadian and more inclusive than most American books.

I was able to use this book the first time I accessed it to develop a classroom activity for first-year occupational therapy students and a more comprehensive activity for second-year students. I really appreciate the links to a multitude of terminology and medical lab values/issues for each case. I will keep using this book.

Reviewed by Cindy Krentz, Assistant Professor, Metropolitan State University of Denver on 6/15/19

The book covers eight case studies of common inpatient or emergency department scenarios. I appreciated that they had written out the learning objectives. I liked that the patient was described before the case was started, giving some understanding of the patient's background. I think it could benefit from having a glossary. I liked how the authors included the vital signs in an easily readable bar. I would have liked to see the labs also highlighted like this. I also felt that it would have been good written in a 'what would you do next?' type of case study.

The book is very accurate in language, what tests would be prudent to run and in the day in the life of the hospital in all cases. One inaccuracy is that the authors called a popliteal artery clot a DVT. The rest of the DVT case study was great, though, but the one mistake should be changed.

The book is up to date for now, but as tests become obsolete and new equipment is routinely used, the book ( like any other health textbook) will need to be updated. It would be easy to change, however. All that would have to happen is that the authors go in and change out the test to whatever newer, evidence-based test is being utilized.

The text is written clearly and easy to understand from a student's perspective. There is not too much technical jargon, and it is pretty universal when used- for example DVT for Deep Vein Thrombosis.

The book is consistent in language and how it is broken down into case studies. The same format is used for highlighting vital signs throughout the different case studies. It's great that the reader does not have to read the book in a linear fashion. Each case study can be read without needing to read the others.

The text is broken down into eight case studies, and within the case studies is broken down into days. It is consistent and shows how the patient can pass through the different hospital departments (from the ER to the unit, to surgery, to home) in a realistic manner. The instructor could use one or more of the case studies as (s)he sees fit.

The topics are eight different case studies- and are presented very clearly and organized well. Each one is broken down into how the patient goes through the system. The text is easy to follow and logical.

The interface has some problems with the highlighted blue links. Some of them did not work and I got a 'page not found' message. That can be frustrating for the reader. I'm wondering if a glossary could be utilized (instead of the links) to explain what some of these links are supposed to explain.

I found two or three typos, I don't think they were grammatical errors. In one case I think the Canadian spelling and the United States spelling of the word are just different.

This is a very culturally competent book. In today's world, however, one more type of background that would merit delving into is the trans-gender, GLBTQI person. I was glad that there were no stereotypes.

I enjoyed reading the text. It was interesting and relevant to today's nursing student. Since we are becoming more interprofessional, I liked that we saw what the phlebotomist and other ancillary personnel (mostly different technicians) did. I think that it could become even more interdisciplinary so colleges and universities could have more interprofessional education- courses or simulations- with the addition of the nurse using social work, nutrition, or other professional health care majors.

Reviewed by Catherine J. Grott, Interim Director, Health Administration Program, TRAILS on 5/5/19

The book is comprehensive but is specifically written for healthcare workers practicing in Canada. The title of the book should reflect this. read more

The book is comprehensive but is specifically written for healthcare workers practicing in Canada. The title of the book should reflect this.

The book is accurate, however it has numerous broken online links.

Relevance/Longevity rating: 3

The content is very relevant, but some links are out-dated. For example, WHO Guidelines for Safe Surgery 2009 (p. 186) should be updated.

The book is written in clear and concise language. The side stories about the healthcare workers make the text interesting.

The book is consistent in terms of terminology and framework. Some terms that are emphasized in one case study are not emphasized (with online links) in the other case studies. All of the case studies should have the same words linked to online definitions.

Modularity rating: 3

The book can easily be parsed out if necessary. However, the way the case studies have been written, it's evident that different authors contributed singularly to each case study.

The organization and flow are good.

Interface rating: 1

There are numerous broken online links and "pages not found."

The grammar and punctuation are correct. There are two errors detected: p. 120 a space between the word "heart" and the comma; also a period is needed after Dr (p. 113).

I'm not quite sure that the social worker (p. 119) should comment that the patient and partner are "very normal people."

There are roughly 25 broken online links or "pages not found." The BC & Canadian Guidelines (p. 198) could also include a link to US guidelines to make the text more universal . The basilar crackles (p. 166) is very good. Text could be used compare US and Canadian healthcare. Text could be enhanced to teach "soft skills" and interdepartmental communication skills in healthcare.

Reviewed by Lindsey Henry, Practical Nursing Instructor, Fletcher on 5/1/19

I really appreciated how in the introduction, five learning objectives were identified for students. These objectives are paramount in nursing care and they are each spelled out for the learner. Each Case study also has its own learning... read more

As a seasoned nurse, I believe that the content regarding pathophysiology and treatments used in the case studies were accurate. I really appreciated how many of the treatments were also explained and rationales were given, which can be very helpful to facilitate effective learning for a nursing student or novice nurse.

The case studies are up to date and correlate with the current time period. They are easily understood.

I really loved how several important medical terms, including specific treatments were highlighted to alert the reader. Many interventions performed were also explained further, which is great to enhance learning for the nursing student or novice nurse. Also, with each scenario, a background and history of the patient is depicted, as well as the perspectives of the patient, patients family member, and the primary nurse. This really helps to give the reader a full picture of the day in the life of a nurse or a patient, and also better facilitates the learning process of the reader.

These case studies are consistent. They begin with report, the patient background or updates on subsequent days, and follow the patients all the way through discharge. Once again, I really appreciate how this book describes most if not all aspects of patient care on a day to day basis.

Each case study is separated into days. While they can be divided to be assigned at different points within the course, they also build on each other. They show trends in vital signs, what happens when a patient deteriorates, what happens when they get better and go home. Showing the entire process from ER admit to discharge is really helpful to enhance the students learning experience.

The topics are all presented very similarly and very clearly. The way that the scenarios are explained could even be understood by a non-nursing student as well. The case studies are very clear and very thorough.

The book is very easy to navigate, prints well on paper, and is not distorted or confusing.

I did not see any grammatical errors.

Each case study involves a different type of patient. These differences include race, gender, sexual orientation and medical backgrounds. I do not feel the text was offensive to the reader.

I teach practical nursing students and after reading this book, I am looking forward to implementing it in my classroom. Great read for nursing students!

Reviewed by Leah Jolly, Instructor, Clinical Coordinator, Oregon Institute of Technology on 4/10/19

Good variety of cases and pathologies covered. read more

Good variety of cases and pathologies covered.

Content Accuracy rating: 2

Some examples and scenarios are not completely accurate. For example in the DVT case, the sonographer found thrombus in the "popliteal artery", which according to the book indicated presence of DVT. However in DVT, thrombus is located in the vein, not the artery. The patient would also have much different symptoms if located in the artery. Perhaps some of these inaccuracies are just typos, but in real-life situations this simple mistake can make a world of difference in the patient's course of treatment and outcomes.

Good examples of interprofessional collaboration. If only it worked this way on an every day basis!

Clear and easy to read for those with knowledge of medical terminology.

Good consistency overall.

Broken up well.

Topics are clear and logical.

Would be nice to simply click through to the next page, rather than going through the table of contents each time.

Minor typos/grammatical errors.

No offensive or insensitive materials observed.

Reviewed by Alex Sargsyan, Doctor of Nursing Practice/Assistant Professor , East Tennessee State University on 10/8/18

Because of the case study character of the book it does not have index or glossary. However it has summary for each health case study outlining key elements discussed in each case study. read more

Because of the case study character of the book it does not have index or glossary. However it has summary for each health case study outlining key elements discussed in each case study.

Overall the book is accurately depicting the clinical environment. There are numerous references to external sites. While most of them are correct, some of them are not working. For example Homan’s test link is not working "404 error"

Book is relevant in its current version and can be used in undergraduate and graduate classes. That said, the longevity of the book may be limited because of the character of the clinical education. Clinical guidelines change constantly and it may require a major update of the content.

Cases are written very clearly and have realistic description of an inpatient setting.

The book is easy to read and consistent in the language in all eight cases.

The cases are very well written. Each case is subdivided into logical segments. The segments reflect different setting where the patient is being seen. There is a flow and transition between the settings.

Book has eight distinct cases. This is a great format for a book that presents distinct clinical issues. This will allow the students to have immersive experiences and gain better understanding of the healthcare environment.

Book is offered in many different formats. Besides the issues with the links mentioned above, overall navigation of the book content is very smooth.

Book is very well written and has no grammatical errors.

Book is culturally relevant. Patients in the case studies come different cultures and represent diverse ethnicities.

Reviewed by Justin Berry, Physical Therapist Assistant Program Director, Northland Community and Technical College, East Grand Forks, MN on 8/2/18

This text provides eight patient case studies from a variety of diagnoses, which can be utilized by healthcare students from multiple disciplines. The cases are comprehensive and can be helpful for students to determine professional roles, interprofessional roles, when to initiate communication with other healthcare practitioners due to a change in patient status, and treatment ideas. Some additional patient information, such as lab values, would have been beneficial to include.

Case study information is accurate and unbiased.

Content is up to date. The case studies are written in a way so that they will not be obsolete soon, even with changes in healthcare.

The case studies are well written, and can be utilized for a variety of classroom assignments, discussions, and projects. Some additional lab value information for each patient would have been a nice addition.

The case studies are consistently organized to make it easy for the reader to determine the framework.

The text is broken up into eight different case studies for various patient diagnoses. This design makes it highly modular, and would be easy to assign at different points of a course.

The flow of the topics are presented consistently in a logical manner. Each case study follows a patient chronologically, making it easy to determine changes in patient status and treatment options.

The text is free of interface issues, with no distortion of images or charts.

The text is not culturally insensitive or offensive in any way. Patients are represented from a variety of races, ethnicities, and backgrounds

This book would be a good addition for many different health programs.

Reviewed by Ann Bell-Pfeifer, Instructor/Program Director, Minnesota State Community and Technical College on 5/21/18

The book gives a comprehensive overview of many types of cases for patient conditions. Emergency Room patients may arrive with COPD, heart failure, sepsis, pneumonia, or as motor vehicle accident victims. It is directed towards nurses, medical laboratory technologists, medical radiology technologists, and respiratory therapists and their roles in caring for patients. Most of the overview is accurate. One suggestion is to provide an embedded radiologist interpretation of the exams which are performed which lead to the patients diagnosis.

Overall the book is accurate. Would like to see updates related to the addition of direct radiography technology which is commonly used in the hospital setting.

Many aspects of medicine will remain constant. The case studies seem fairly accurate and may be relevant for up to 3 years. Since technology changes so quickly in medicine, the CT and x-ray components may need minor updates within a few years.

The book clarity is excellent.

The case stories are consistent with each scenario. It is easy to follow the structure and learn from the content.

The book is quite modular. It is easy to break it up into cases and utilize them individually and sequentially.

The cases are listed by disease process and follow a logical flow through each condition. They are easy to follow as they have the same format from the beginning to the end of each case.

The interface seems seamless. Hyperlinks are inserted which provide descriptions and references to medical procedures and in depth definitions.

The book is free of most grammatical errors. There is a place where a few words do not fit the sentence structure and could be a typo.

The book included all types of relationships and ethnic backgrounds. One type which could be added is a transgender patient.

I think the book was quite useful for a variety of health care professionals. The authors did an excellent job of integrating patient cases which could be applied to the health care setting. The stories seemed real and relevant. This book could be used to teach health care professionals about integrated care within the emergency department.

Reviewed by Shelley Wolfe, Assistant Professor, Winona State University on 5/21/18

This text is comprised of comprehensive, detailed case studies that provide the reader with multiple character views throughout a patient’s encounter with the health care system. The Table of Contents accurately reflected the content. It should be noted that the authors include a statement that conveys that this text is not like traditional textbooks and is not meant to be read in a linear fashion. This allows the educator more flexibility to use the text as a supplement to enhance learning opportunities.

The content of the text appears accurate and unbiased. The “five overarching learning objectives” provide a clear aim of the text and the educator is able to glean how these objectives are captured into each of the case studies. While written for the Canadian healthcare system, this text is easily adaptable to the American healthcare system.

Overall, the content is up-to-date and the case studies provide a variety of uses that promote longevity of the text. However, not all of the blue font links (if using the digital PDF version) were still in working order. I encountered links that led to error pages or outdated “page not found” websites. While the links can be helpful, continued maintenance of these links could prove time-consuming.

I found the text easy to read and understand. I enjoyed that the viewpoints of all the different roles (patient, nurse, lab personnel, etc.) were articulated well and allowed the reader to connect and gain appreciation of the entire healthcare team. Medical jargon was noted to be appropriate for the intended audience of this text.

The terminology and organization of this text is consistent.

The text is divided into 8 case studies that follow a similar organizational structure. The case studies can further be divided to focus on individual learning objectives. For example, the case studies could be looked at as a whole for discussing communication or could be broken down into segments to focus on disease risk factors.

The case studies in this text follow a similar organizational structure and are consistent in their presentation. The flow of individual case studies is excellent and sets the reader on a clear path. As noted previously, this text is not meant to be read in a linear fashion.

This text is available in many different forms. I chose to review the text in the digital PDF version in order to use the embedded links. I did not encounter significant interface issues and did not find any images or features that would distract or confuse a reader.

No significant grammatical errors were noted.

The case studies in this text included patients and healthcare workers from a variety of backgrounds. Educators and students will benefit from expanding the case studies to include discussions and other learning opportunities to help develop culturally-sensitive healthcare providers.

I found the case studies to be very detailed, yet written in a way in which they could be used in various manners. The authors note a variety of ways in which the case studies could be employed with students; however, I feel the authors could also include that the case studies could be used as a basis for simulated clinical experiences. The case studies in this text would be an excellent tool for developing interprofessional communication and collaboration skills in a variety healthcare students.

Reviewed by Darline Foltz, Assistant Professor, University of Cincinnati - Clermont College on 3/27/18

This book covers all areas listed in the Table of Contents. In addition to the detailed patient case studies, there is a helpful section of "How to Use this Resource". I would like to note that this resource "aligns with the open textbooks... read more

The book appears to be accurate. Although one of the learning outcomes is as follows: "Demonstrate an understanding of the Canadian healthcare delivery system.", I did not find anything that is ONLY specific to the Canadian healthcare delivery system other than some of the terminology, i.e. "porter" instead of "transporter" and a few french words. I found this to make the book more interesting for students rather than deter from it. These are patient case studies that are relevant in any country.

The content is up-to-date. Changes in medical science may occur, i.e. a different test, to treat a diagnosis that is included in one or more of the case studies, however, it would be easy and straightforward to implement these changes.

This book is written in lucid, accessible prose. The technical/medical terminology that is used is appropriate for medical and allied health professionals. Something that would improve this text would to provide a glossary of terms for the terms in blue font.

This book is consistent with current medical terminology

This text is easily divided into each of the 6 case studies. The case studies can be used singly according to the body system being addressed or studied.

Because this text is a collection of case studies, flow doesn't pertain, however the organization and structure of the case studies are excellent as they are clear and easy to read.

There are no distractions in this text that would distract or confuse the reader.

I did not identify any grammatical errors.

This text is not culturally insensitive or offensive in any way and uses patients and healthcare workers that are of a variety of races, ethnicities and backgrounds.

I believe that this text would not only be useful to students enrolled in healthcare professions involved in direct patient care but would also be useful to students in supporting healthcare disciplines such as health information technology and management, medical billing and coding, etc.

Introduction

Case Study #1: Chronic Obstructive Pulmonary Disease (COPD)

Learning Objectives
Patient: Erin Johns
Emergency Room

Case Study #2: Pneumonia

Day 0: Emergency Room
Day 1: Emergency Room
Day 1: Medical Ward
Day 2: Medical Ward
Day 3: Medical Ward
Day 4: Medical Ward

Case Study #3: Unstable Angina (UA)

Patient: Harj Singh

Case Study #4: Heart Failure (HF)

Patient: Meryl Smith
In the Supermarket
Day 0: Medical Ward

Case Study #5: Motor Vehicle Collision (MVC)

Patient: Aaron Knoll
Crash Scene
Operating Room
Post Anaesthesia Care Unit (PACU)
Surgical Ward

Case Study #6: Sepsis

Patient: George Thomas
Sleepy Hollow Care Facility

Case Study #7: Colon Cancer

Patient: Fred Johnson
Two Months Ago
Pre-Surgery Admission

Case Study #8: Deep Vein Thrombosis (DVT)

Patient: Jamie Douglas

Appendix: Overview About the Authors

Ancillary Material

About the book.

Health Case Studies is composed of eight separate health case studies. Each case study includes the patient narrative or story that models the best practice (at the time of publishing) in healthcare settings. Associated with each case is a set of specific learning objectives to support learning and facilitate educational strategies and evaluation.

The case studies can be used online in a learning management system, in a classroom discussion, in a printed course pack or as part of a textbook created by the instructor. This flexibility is intentional and allows the educator to choose how best to convey the concepts presented in each case to the learner.

Because these case studies were primarily developed for an electronic healthcare system, they are based predominantly in an acute healthcare setting. Educators can augment each case study to include primary healthcare settings, outpatient clinics, assisted living environments, and other contexts as relevant.

About the Contributors

Glynda Rees teaches at the British Columbia Institute of Technology (BCIT) in Vancouver, British Columbia. She completed her MSN at the University of British Columbia with a focus on education and health informatics, and her BSN at the University of Cape Town in South Africa. Glynda has many years of national and international clinical experience in critical care units in South Africa, the UK, and the USA. Her teaching background has focused on clinical education, problem-based learning, clinical techniques, and pharmacology.

Glynda‘s interests include the integration of health informatics in undergraduate education, open accessible education, and the impact of educational technologies on nursing students’ clinical judgment and decision making at the point of care to improve patient safety and quality of care.

Faculty member in the critical care nursing program at the British Columbia Institute of Technology (BCIT) since 2003, Rob has been a critical care nurse for over 25 years with 17 years practicing in a quaternary care intensive care unit. Rob is an experienced educator and supports student learning in the classroom, online, and in clinical areas. Rob’s Master of Education from Simon Fraser University is in educational technology and learning design. He is passionate about using technology to support learning for both faculty and students.

Part of Rob’s faculty position is dedicated to providing high fidelity simulation support for BCIT’s nursing specialties program along with championing innovative teaching and best practices for educational technology. He has championed the use of digital publishing and was the tech lead for Critical Care Nursing’s iPad Project which resulted in over 40 multi-touch interactive textbooks being created using Apple and other technologies.

Rob has successfully completed a number of specialist certifications in computer and network technologies. In 2015, he was awarded Apple Distinguished Educator for his innovation and passionate use of technology to support learning. In the past five years, he has presented and published abstracts on virtual simulation, high fidelity simulation, creating engaging classroom environments, and what the future holds for healthcare and education.

Janet Morrison is the Program Head of Occupational Health Nursing at the British Columbia Institute of Technology (BCIT) in Burnaby, British Columbia. She completed a PhD at Simon Fraser University, Faculty of Communication, Art and Technology, with a focus on health information technology. Her dissertation examined the effects of telehealth implementation in an occupational health nursing service. She has an MA in Adult Education from St. Francis Xavier University and an MA in Library and Information Studies from the University of British Columbia.

Janet’s research interests concern the intended and unintended impacts of health information technologies on healthcare students, faculty, and the healthcare workforce.

She is currently working with BCIT colleagues to study how an educational clinical information system can foster healthcare students’ perceptions of interprofessional roles.

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85 Medical Case Studies for High School Students!

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Description

In my quest to find medical case studies appropriate for my high school students, I found little to nothing. I knew, however, that they provide an amazing learning experience that would encourage critical thinking while learning anatomy, physiology, medical terms and pathophysiology. After an exhausting amount of research and development using textbooks, reliable internet sources, my medical background and actual cases, I was able to create 85 medical case studies that I believe will be challenging, yet attainable for high school students. Each case is 4-8 sentences in length and provides enough vital information to make an educated guess of the diagnosis. This download could be used in an A&P, Health Science or any Medical-based class.

This download includes the following:

PDF with 85 cases listed (75 that are considered "common" with 10 "unusual" diagnoses)
Fillable PDF with the 85 cases listed that can be completed electronically
PDF Quick Answer Key
PDF with an explanation and defense for each of the cases
PDF listing of all the diagnoses
PDF of Common Terminology used with the definition
Excel Spreadsheet of the Cases sorted by number and system that is involved
PowerPoint with each case on its own slide
Video Instructions that will walk you through the documents as well as give ideas of how to vary for difficulty

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Healthcare Science

Posted by Catherine Douylliez on Jan 17th 2023

Great product!

Great Activity

Posted by Janelle Deutsch on May 17th 2021

The case studies were perfect for our class!

Health Science

Posted by Amy on Feb 17th 2021

This is great! My kids love doing the case studies as we discuss the different body systems.

Posted by Unknown on Oct 13th 2020

Love these!! Saves a lot of time from me having to come up with my own!!

Grey's Pathology

Posted by Allison Loftin on Oct 7th 2020

I love this activity! I use it with my Med Term students. It is challenging for them. There are so many ways this can be used. Well worth it!!

Greys Pathology

Posted by Annalee Dunbar on Sep 24th 2020

Using this in Medical Therapeutics, so helpful!

Very useful

Posted by Ronda Manninen on Sep 23rd 2020

The Grey's Pathology medical case studies is user friendly and very useful. I use them as bellringers to get the class started. Some of my students have not had Anatomy or Medical Terminology and they can still participate. You are missing out if you don't have these. :)

Good value, students found a trick.

Posted by Angie Fetsko on Sep 11th 2020

It only took my students about 5 case studies to figure out that they answers are in order on the Disease List compared to the case studies, so #1 is the first choice on the list, #2 is the second choice, so on and so on. Other than that, they are pretty interesting.

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The Biology Corner

Biology Teaching Resources

Student Designed Case Studies for Anatomy

Instead of a final exam, give your students a final project for their anatomy class – Design Your Own Case Study

Students in my anatomy class complete many case studies throughout the year focused on body system units. Case studies are a way to add a personal story to (sometimes) technical information about physiology. For my high school students, I try to find cases that are about younger people or even children, cases like “ A Tiny Heart ,” which tells the story of a baby born with a heart defect. Students seem to be more engaged when the cases about about people closer to their age or very young.

As a final project, the honors anatomy students make their own case study. They get to choose their topic, though I recommend they choose something they have a personal stake in. For example, one student chose to do her case on Lupus, because her mother has that condition.

The instructions outline how to write the case based on a simple flow chart.

Start with an introduction of a person by telling a story or narrating an event. Next, describe the tests needed to make a diagnosis. Tests can include X-rays, blood tests, urine tests, or other physical exams.

Students should include specific details here and images if appropriate. Following the diagnosis section, they should focus on the specific anatomy and physiology of the disease. Because homeostasis is a major theme of the class, students should focus on how the disorder causes an imbalance in the system

The last section will include how the disorder can be treated. In some cases, there will not be a cure, but the symptoms can be managed. Each section should contain 2-3 questions, similar to how cases we’ve done in class are organized.

While it may be better to assign this as a group project, during the 2021 pandemic, this was an individual assignment, due to the difficulties with working together. I think it would work very well as a project that 2-3 individuals could work on together.

Shannan Muskopf

Using Case Studies for Anatomy and Physiology

Integrating case studies for anatomy and physiology students can be a great way to encourage solving problems while giving them a taste of the medical profession. The analysis required to make a diagnosis is a real-world application of the Claim- Evidence- Reasoning format designated in the Next Generation Science Standards*. Certainly wet labs and experiments can also require the same skills in solving problems and writing conclusions, but case studies are an easy extension of these skills. And certainly, there is no course in which case studies are easier to integrate than Anatomy and Physiology.

Teaching Anatomy and Physiology with Medical Case Studies

Human Anatomy and Physiology is usually taught by dividing body systems and teaching one system at a time, which is the way I teach my Anatomy & Physiology course . It makes for an organized approach that is easier for teachers to plan and students to study. It diminishes, however, the interconnection between the body systems and can prevent students from seeing the human body as a whole.

Case studes are a great way to use problem-solving strategies while bringing attention to multiple body systems at one time.

Case studies are a great way to use problem-solving strategies while bringing attention to multiple body systems at one time. For example, my case study about hypercalcemia discusses hormones from the endocrine system and how they relate to the circulatory and skeletal systems.

I started incorporating case studies into my A&P course this year and students were immediately receptive. Rather than using obscure medical conditions and disorders, I tried to use ones that my students may encounter throughout their lives. In fact, one of my students learned about Bell’s Palsy just a few months before his aunt was diagnosed with it.

As my A&P course is an introduction for high school students and most of them are not necessarily planning to be medical professionals, I kept the case studies relatively simple and assigned them to my Honors students as extended homework assignments. I created guided reading and research options for each case study. At the beginning of the year, students were simply asked to read the case study assignment and answer questions about the particular diagnosis. This was the first time these students had ever seen an assignment about medical conditions and I felt it was necessary to lead them with baby steps. After 2 or 3 case studies of this type, I switched to the research-based case studies. In this type, students are given the symptoms and a diagnosis, then asked to research how the condition causes those symptoms.

In future years, however, I’d love to be able to offer a more interactive approach by providing my class with a few symptoms, allowing them to decide which diagnostic tests to use, and then reporting imaginary results to lead them toward an accurate diagnosis. I did provide my students with a list of common diagnostic tests to help them understand the terminology as they came across it.

Interactive case studies may provide a more collaborative approach to learning and encourage students to evaluate the best course of action based on a set of results. This technique is recommended in nursing education programs to “ bridge the gap between theory and practice .”

If you’ve been considering using case studies in your classroom, please check out the bundle of 12 that I have created. You can also download my Common Diagnostic Tests list for FREE !

**Please note: NGSS is a registered trademark of WestEd. Neither WestEd nor the lead states and partners that developed the Next Generation Science Standards were involved in the production of these lessons, and do not endorse it.

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Harvard T.H. Chan School of Public Health Case-Based Teaching & Learning Initiative

Teaching cases & active learning resources for public health education, case library.

The Harvard Chan Case Library is a collection of teaching cases with a public health focus, written by Harvard Chan faculty, case writers, and students, or in collaboration with other institutions and initiatives.

Use the filters at right to search the case library by subject, geography, health condition, and representation of diversity and identity to find cases to fit your teaching needs. Or browse the case collections below for our newest cases, cases available for free download, or cases with a focus on diversity.

Using our case library

Access to cases.

Many of our cases are available for sale through Harvard Business Publishing in the Harvard T.H. Chan case collection . Others are free to download through this website .

Cases in this collection may be used free of charge by Harvard Chan course instructors in their teaching. Contact Allison Bodznick , Harvard Chan Case Library administrator, for access.

Access to teaching notes

Teaching notes are available as supporting material to many of the cases in the Harvard Chan Case Library. Teaching notes provide an overview of the case and suggested discussion questions, as well as a roadmap for using the case in the classroom.

Access to teaching notes is limited to course instructors only.

Teaching notes for cases available through Harvard Business Publishing may be downloaded after registering for an Educator account .
To request teaching notes for cases that are available for free through this website, look for the "Teaching note available for faculty/instructors " link accompanying the abstract for the case you are interested in; you'll be asked to complete a brief survey verifying your affiliation as an instructor.

Using the Harvard Business Publishing site

Faculty and instructors with university affiliations can register for Educator access on the Harvard Business Publishing website, where many of our cases are available . An Educator account provides access to teaching notes, full-text review copies of cases, articles, simulations, course planning tools, and discounted pricing for your students.

What's New

Atkinson, M.K. , 2023. Organizational Resilience and Change at UMass Memorial , Harvard Business Publishing: Harvard T.H. Chan School of Public Health. Available from Harvard Business Publishing Abstract The UMass Memorial Health Care (UMMHC or UMass) case is an examination of the impact of crisis or high uncertainty events on organizations. As a global pandemic unfolds, the case examines the ways in which UMMHC manages crisis and poses questions around organizational change and opportunity for growth after such major events. The case begins with a background of UMMHC, including problems the organization was up against before the pandemic, then transitions to the impact of crisis on UMMHC operations and its subsequent response, and concludes with challenges that the organization must grapple with in the months and years ahead. A crisis event can occur at any time for any organization. Organizational leaders must learn to manage stakeholders both inside and outside the organization throughout the duration of crisis and beyond. Additionally, organizational decision-makers must learn how to deal with existing weaknesses and problems the organization had before crisis took center stage, balancing those challenges with the need to respond to an emergency all the while not neglecting major existing problem points. This case is well-suited for courses on strategy determination and implementation, organizational behavior, and leadership.

The case describes the challenges facing Shlomit Schaal, MD, PhD, the newly appointed Chair of UMass Memorial Health Care’s Department of Ophthalmology. Dr. Schaal had come to UMass in Worcester, Massachusetts, in the summer of 2016 from the University of Louisville (KY) where she had a thriving clinical practice and active research lab, and was Director of the Retina Service. Before applying for the Chair position at UMass she had some initial concerns about the position but became fascinated by the opportunities it offered to grow a service that had historically been among the smallest and weakest programs in the UMass system and had experienced a rapid turnover in Chairs over the past few years. She also was excited to become one of a very small number of female Chairs of ophthalmology programs in the country.

Dr. Schaal began her new position with ambitious plans and her usual high level of energy, but immediately ran into resistance from the faculty and staff of the department. The case explores the steps she took, including implementing a LEAN approach in the department, and the leadership approaches she used to overcome that resistance and build support for the changes needed to grow and improve ophthalmology services at the medical center.

This case describes efforts to promote racial equity in healthcare financing from the perspective of one public health organization, Community Care Cooperative (C3). C3 is a Medicaid Accountable Care Organization–i.e., an organization set up to manage payment from Medicaid, a public health insurance option for low-income people. The case describes C3’s approach to addressing racial equity from two vantage points: first, its programmatic efforts to channel financing into community health centers that serve large proportions of Black, Indigenous, People of Color (BIPOC), and second, its efforts to address racial equity within its own internal operations (e.g., through altering hiring and promotion processes). The case can be used to help students understand structural issues pertaining to race in healthcare delivery and financing, to introduce students to the basics of payment systems in healthcare, and/or to highlight how organizations can work internally to address racial equity.

Kerrissey, M.J. & Kuznetsova, M. , 2022. Killing the Pager at ZSFG , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract This case is about organizational change and technology. It follows the efforts of one physician as they try to move their department past using the pager, a device that persisted in American medicine despite having long been outdated by superior communication technology. The case reveals the complex organizational factors that have made this persistence possible, such as differing interdepartmental priorities, the perceived benefits of simple technology, and the potential drawbacks of applying typical continuous improvement approaches to technology change. Ultimately the physician in the case is not able to rid their department of the pager, despite pursuing a thorough continuous improvement effort and piloting a viable alternative; the case ends with the physician having an opportunity to try again and asks students to assess whether doing so is wise. The case can be used in class to help students apply the general concepts of organizational change to the particular context of technology, discuss the forces of stasis and change in medicine, and to familiarize students with the uses and limits of continuous improvement methods.

Yatsko, P. & Koh, H. , 2021. Dr. Joan Reede and the Embedding of Diversity, Equity, and Inclusion at Harvard Medical School , Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract For more than 30 years, Dr. Joan Reede worked to increase the diversity of voices and viewpoints heard at Harvard Medical School (HMS) and at its affiliate teaching hospitals and institutes. Reede, HMS’s inaugural dean for Diversity and Community Partnership, as well as a professor and physician, conceived and launched more than 20 programs to improve the recruitment, retention, and promotion of individuals from racial and ethnic groups historically underrepresented in medicine (UiMs). These efforts have substantially diversified physician faculty at HMS and built pipelines for UiM talent into academic medicine and biosciences. Reede helped embed the promotion of diversity, equity, and inclusion (DEI) not only into Harvard Medical School’s mission and community values, but also into the DEI agenda in academic medicine nationally. To do so, she found allies and formed enduring coalitions based on shared ownership. She bootstrapped and hustled for resources when few readily existed. And she persuaded skeptics by building programs using data-driven approaches. She also overcame discriminatory behaviors and other obstacles synonymous with being Black and female in American society. Strong core values and sense of purpose were keys to her resilience, as well as to her leadership in the ongoing effort to give historically marginalized groups greater voice in medicine and science.

Cases Available for Free Download

This case summarizes the toxic water crisis in Flint, Michigan between 2011 and the end of 2016, which followed the decision to switch the city’s public water supply from Lake Huron to the more corrosive Flint River. It outlines the factors that led to the initial government decision, and the social, economic, health, and policy consequences that followed. The case highlights the role of citizens, scientists, and activists in raising public awareness of the crisis and the toxic long-term effects of lead poisoning on affected children. It also illustrates the challenges and questions such a crisis poses for other communities in the United States and globally.

The case is accompanied by an instructor’s note, role play exercise, and discussion guide with an accompanying teaching graphic.

Teaching note available for faculty/instructors .

Gordon, R., Rottingen, J.-A. & Hoffman, S. , 2014. The Meningitis Vaccine Project , Harvard University: Global Health Education and Learning Incubator. Access online Abstract This case follows the vaccine development for Meningitis A, a disease that routinely caused deadly epidemics in Sub-Saharan Africa. The case explores why such a vaccine had not been developed previously and how the creation of the Meningitis Vaccine Project (MVP) - a partnership between the World Health Organization (WHO) and PATH, a non-governmental organization - enabled the vaccine to be successfully developed over 10 years by creating a novel product development partnership. Students examine why the public/private partnership was successful and how such a model could be applied to the development of other vaccines and health technologies. Additionally, the case explores the strategies applied by Marc LaForce, the MVP’s director and veteran public health advocate, to make the MVP a success. In particular, the case examines the management skills LaForce exercised during his tenure to develop a vaccine that affected African countries could afford through their own health budgets.

This module will present two unfolding case studies based on real-world, actual events. The cases will require participants to review videos embedded into three modules and a summary module: Introduction to Concepts of Social Determinant of Health and Seeking Racial Equity Case Study on Health and Healthcare Context - Greensboro Health Disparities Collaborative (GHDC) Case Study on Social and Community Context - Renaissance Community Cooperative (RCC) Summary (Optional)

The learning objectives for the modules are related to achieving the Healthy People 2020 Social Determinants of Health Objectives – specifically the (1) Health and Healthcare Context, and (2) Social and Community Context.

Chaumont, C. & Anyona, M. , 2020. Caught in a Storm: The World Health Organization and the 2014 Ebola Outbreak , Harvard T.H. Chan School of Public Health, Harvard Kennedy School. Access online Abstract The case recounts the events of the 2014-2016 West Africa Ebola Outbreak, starting with the death of patient zero, a young Guinean boy named Emile Ouamouno in December 2013 and ending in August 2014 when the World Health Organization declared the outbreak a Public Health Emergency of International Concern (PHEIC), an international legal tool aimed to draw additional attention and resources to particular health events which present a global risk. In doing so, the case particularly examines the role of the World Health Organization, a key actor in the epidemic, and provides further context into the strategy, finances, and organizational design of the organization. Additional information related to the Ebola Virus Disease (EVD), infectious disease epidemics, and the socioeconomic and political context of the three countries most affected by the outbreak (Sierra Leone, Liberia, and Guinea) is also provided. The case study draws upon interviews with key experts involved in both the management of the epidemic and its aftermath, including Dr. Suerie Moon, Study Director of the Independent Panel on the Global Response to Ebola, Amb. Jimmy Kolker, then Assistant Secretary for Global Affairs in the United States Department of Health and Human Services, and Dr. Bruce Aylward, Special Representative of the Director-General for the Ebola Response from September 2014 to July 2016. The case is accompanied by an epilogue which retraces events after the PHEIC was declared in August 2014, and provides several quotes from key stakeholders involved in the outbreak, providing further context into how the epidemic was eventually contained, and which lessons could be learned from it.

Focus on Diversity, Equity, and Inclusion

This case describes and explores the development of the first medical transitions clinic in Louisiana by a group of community members, health professionals, and students at Tulane Medical School in 2015. The context surrounding health in metro New Orleans, the social and structural determinants of health, and mass incarceration and correctional health care are described in detail. The case elucidates why and how the Formerly Incarcerated Transitions (FIT) clinic was established, including the operationalization of the clinic and the challenges to providing healthcare to this population. The case describes the central role of medical students as case managers at the FIT clinic, and how community organizations were engaged in care provision and the development of the model. The case concludes with a discussion of the importance of advocacy amongst health care professionals.

Yatsko, P. & Koh, H. , 2017. Dr. Jonathan Woodson, Military Health System Reform, and National Digital Health Strategy , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract Dr. Jonathan Woodson faced more formidable challenges than most in his storied medical, public health, and military career, starting with multiple rotations in combat zones around the world. He subsequently took on ever more complicated assignments, including reforming the country’s bloated Military Health System (MHS) in his role as assistant secretary of defense for health affairs at the U.S. Department of Defense from 2010 to 2016. As the director of Boston University’s Institute for Health System Innovation and Policy starting in 2016, he devised a National Digital Health Strategy (NDHS) to harness the myriad disparate health care innovations taking place around the country, with the goal of making the U.S. health care system more efficient, patient-centered, safe, and equitable for all Americans. How did Woodson—who was also a major general in the U.S. Army Reserves and a skilled vascular surgeon—approach such complicated problems? In-depth research and analysis, careful stakeholder review, strategic coalition building, and clear, insightful communication were some of the critical leadership skills Woodson employed to achieve his missions.

This teaching case study examines psychological trauma in a community context and the relevance, both positive and negative, of social determinants of health. Healthy People 2020 views people residing in communities with large-scale psychological trauma as an emerging issue in mental health and mental health disorders (Healthy People, 2016). The case study, which focuses on Newark, New Jersey, addresses three of the five key determinants of health: social and community context, health and health care, and neighborhood and built environment. The three key determinants are addressed using psychological trauma as an exemplar in the context of trauma-informed systems. The social and community context is addressed using concepts of social cohesion, civic participation, and discrimination. Access to health and health care are addressed with discussion of access to mental health and primary care services, health literacy, and the medical home model. Neighborhood and built environment are viewed through the lens of available government and NGO programs and resources to improve the physical environment with a focus on quality of housing, crime and violence, and environmental conditions. Upstream interventions designed to improve mental health and well-being that support trauma-informed systems are analyzed. The use of Newark as the case study setting allows a real-life exploration of each of these three key determinants of health.

This case study has four sections – introduction, case study, side bar, and vignettes. Learners should work through the case, access appropriate resources, and work in a team for successful completion.

Al Kasir, A., Coles, E. & Siegrist, R. , 2019. Anchoring Health beyond Clinical Care: UMass Memorial Health Care’s Anchor Mission Project , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract As the Chief Administrative Officer of UMass Memorial Health Care (UMMHC) and president of UMass Memorial (UMM) Community Hospitals, Douglas Brown had just received unanimous and enthusiastic approval to pursue his "Anchor Mission" project at UMMHC in Worcester, Massachusetts. He was extremely excited by the board's support, but also quite apprehensive about how to make the Anchor Mission a reality. Doug had spearheaded the Anchor Mission from its earliest exploratory efforts. The goal of the health system's Anchor Mission-an idea developed by the Democracy Collaborative, an economic think tank-was to address the social determinants of health in its community beyond the traditional approach of providing excellent clinical care. He had argued that UMMHC had an obligation as the largest employer and economic force in Central Massachusetts to consider the broader development of the community and to address non-clinical factors, like homelessness and social inequality that made people unhealthy. To achieve this goal, UMMHC's Anchor Mission would undertake three types of interventions: local hiring, local sourcing/purchasing, and place-based community investment projects. While the board's enthusiasm was palpable and inspiring, Doug knew that sustaining it would require concrete accomplishments and a positive return on any investments the health system made in the project. The approval was just the first step. Innovation and new ways of thinking would be necessary. The bureaucracy behind a multi-billion-dollar healthcare organization would need to change. Even the doctors and nurses would need to change! He knew that the project had enormous potential but would become even more daunting from here.

Weinberger, E. , 2017. Coloring the Narrative: How to Use Storytelling to Create Social Change in Skin Tone Ideals , Harvard T.H. Chan School of Public Health: Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED). Download free of charge Abstract Many millions of people around the world experience the pervasive, and often painful, societal messages of colorism, where lighter skin tones are asserted to be more attractive and to reflect greater affluence, power, education, and social status. Even in places where the destructive effects of colorism are fairly well understood, far less is known about the problem of skin-lightening (really, it’s “skin bleaching”) creams and lotions, and the health risks that consumers assume with these products. In this teaching case, the protagonists are two women who have recently immigrated to the United States from Nigeria and Thailand, both with a life-time of experience with these products like many of the women of their home countries. As the story unfolds, they struggle along with the rest of the characters to copy with the push and pull of community norms vs. commercial influences and the challenge of promoting community health in the face of many societal and corporate obstacles. How can the deeply ingrained messages of colorism be effectively confronted and transformed to advance social change without alienating the community members we may most want to reach? Teaching note and supplemental slides available for faculty/instructors .

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Browse our case library

Wang, M. & Kane, N.M. , 2011. The Green and Healthy Homes Initiative (GHHI) , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract Ruth Ann Norton, executive director of the National Coalition to End Childhood Lead Poisoning (CECLP), founded the Green & Healthy Homes Initiative (GHHI) in order to leverage newly available federal funds from the American Recovery and Reinvestment Act of 2009 (ARRA) for weatherizing low-income housing. Unfortunately, by June 2011, the ARRA funding was winding down, and Norton was looking for other, sustainable sources of financing to keep the GHHI program alive.

Kane, N.M. & Alidina, S. , 2008. Attacking Heart Disease in Suffolk County , Harvard T.H. Chan School of Public Health case collection. Download free of charge Abstract “Suffolk County is experiencing elevated cardiovascular disease mortality relative to New York State,” explained Dr. Humayun Chaudhry, Commissioner for the Department of Health Services of Suffolk County. Given the general affluence of the area, he finds the CVD mortality rates "a paradoxical situation. We need to determine strategies to address this high priority health issue for our county." Teaching note available for faculty/instructors .

Quelch, J.A. & Rodriguez, M. , 2014. Cancer Screening in Japan: Market Research and Segmentation , Harvard Business Publishing. Available from Harvard Business Publishing Abstract Since founding CancerScan in 2008, Jun Fukuyoshi and Yoshiki Ishikawa had helped to improve cancer screening rates in Japan. Between 2005 and 2007, awareness of breast cancer in Japan rose from 55% to 70%, but the incidence of breast cancer screenings remained constant. Jun and Yoshiki applied marketing research techniques to increase the screening rate for breast cancer, a disease which killed over 12,000 Japanese women in 2011. Cancer screening initiatives accounted for 60% of the company's 2013 sales of $2.5 million.

Kane, N.M. & Madden, S.L. , 2013. Implementing a Patient-Centered Medical Home on Mount Desert Island , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract This case presents organizational challenges facing a physician champion of the Patient-Centered Medical Home (PCMH). Dr. Julian Kuffler, working with his employer, the Mount Desert Island Hospital System (MDI), hoped to persuade the primary care physicians in the system to embrace the PCMH care model. Physician resistance was strongly opposed to some of the key principles of PCMH, such as managing the health of a defined population, standardizing chronic care management protocols, delegating patient care tasks to non-physician members of a care team, and to having strong physician leadership at the system level. At the same time, MDI was a small rural “critical access hospital” with declining admissions, predominantly outpatient-based revenues, and deteriorating finances. MDI leadership viewed high quality primary care to be essential for MDI to be able to attract the best health system partner with which it could affiliate to become part of a larger, more financially viable organization. MDI leadership also hoped to find a partner that could also support its participation in new population health arrangements such as accountable care organizations.

Milstein, D., Madden, S.L. & MacCracken, L. , 2015. Integrating Private Practice and Hospital-Based Breast Services at Baystate Health (Parts A & B) , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract Dr. Laurie Gianturco (“Dr. G.”), Chief of Radiology at Baystate Health and President of the private imaging practice Radiology & Imaging, Inc. (“R&I”), and her partner for this project, Suzanne Hendery, VP of Marketing & Communications at Baystate Health, considered their new assignment. With Baystate leadership’s full executive sponsorship and support, but no additional budget, they were tasked with consolidating two competing practices—one operated by R&I, the other by Baystate Medical Center—to form a new breast services center under the Baystate umbrella. The consolidation would simplify redundant Baystate-affiliated breast services offerings, making the system less confusing for patients and providers while giving Baystate the opportunity to offer more patient-centered services as well as reducing its operating costs and boosting revenues. They knew it would be a complicated project, involving two competing physician practice cultures, three clinical specialty orientations, the potential disruption of existing referral networks, and the merger of imaging services for healthy women along with treatment for women with breast cancer. Despite these challenges, they banded together to define a patient-driven culture, create an integrated program, and build a strong brand anchored by the new facility. Their goal was to gain a competitive advantage by developing a relationship-based approach that would exceed customer (patients and referring physicians) expectations for service. “The financial argument was the easy part,” Dr. G reflected. “How to actually design a model of care is where we came to an impasse.”

Weinberger, E. , 2015. Full of Surprises: Dietary Supplements and the Gym, or, a Tale of Corporate Social Responsibility , Harvard T.H. Chan School of Public Health: Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED). Download free of charge Abstract Working out at the gym is a healthy endeavor, but many gyms endorse unhealthful practices. They may advertise or sell dietary supplements for weight loss or muscle building that not only fail to do what they promise, but contain potentially dangerous ingredients. Callie Guertin is a primary care physician in Hamilton, in the fictitious U.S. state of Columbia, and a daily gym-goer who is slowly awakening to the fact that her chosen new gym, MuscleTone, sells weight-loss supplements at its welcome desk. She wants them to stop; but what can she do on her own? With some guidance from a young activist, Stacie Lubin, and her sympathetic personal trainer, Rudi, Guertin learns skills of coalition building to pressure the MuscleTone chain to change its practices. Perhaps, using principles of corporate social responsibility, or CSR, MuscleTone can be made to realize that abandoning sales and advertising of supplements can produce a good result for everybody—healthier customers, of course, but also a new marketing campaign touting MuscleTone as the gym for “healthy living”? Guertin and her allies are working on MuscleTone to make just this case. Teaching note available for faculty/instructors .

Solomon, C. & Kane, N.M. , 2016. Strategic Change at Whitman-Walker Health , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract In the seven years since Don Blanchon was hired as the Chief Executive Officer of Whitman-Walker Health, it had transitioned into a primary care-based community health center and a patient-centered medical home serving a diverse population in a rapidly changing area of Washington, DC. The Affordable Care Act of 2010 would, in Blanchon’s view, increase access to providers for WWH’s patient population, thereby increasing the competition. The implications of this change left senior management with unresolved strategic questions. Should WWH pursue a “hybrid FQHC model,” a new location, new services, or a future strategic partnership with a large health system? What should the next direction be for WWH, and how should it get there?

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Article Contents

Answer to part 1, answer to part 2, answer to part 3, answer to part 4, answer to part 5.

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Educational Case: A 57-year-old man with chest pain

Contributed equally.

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Nikhil Aggarwal, Subothini Selvendran, Vassilios Vassiliou, Educational Case: A 57-year-old man with chest pain, Oxford Medical Case Reports , Volume 2016, Issue 4, April 2016, Pages 62–65, https://doi.org/10.1093/omcr/omw008

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This is an educational case report including multiple choice questions and their answers. For the best educational experience we recommend the interactive web version of the exercise which is available via the following link: http://www.oxfordjournals.org/our_journals/omcr/ec01p1.html

A 57 year-old male lorry driver, presented to his local emergency department with a 20-minute episode of diaphoresis and chest pain. The chest pain was central, radiating to the left arm and crushing in nature. The pain settled promptly following 300 mg aspirin orally and 800 mcg glyceryl trinitrate (GTN) spray sublingually administered by paramedics in the community. He smoked 20 cigarettes daily (38 pack years) but was not aware of any other cardiovascular risk factors. On examination he appeared comfortable and was able to complete sentences fully. There were no heart murmurs present on cardiac auscultation. Blood pressure was 180/105 mmHg, heart rate was 83 bpm and regular, oxygen saturation was 97%.

What is the most likely diagnosis?

An ECG was requested and is shown in figure 1.

How would you manage the patient? (The patient has already received 300 mg aspirin).

30 minutes later the patient's chest pain returned with greater intensity whilst waiting in the emergency department. Now, he described the pain as though “an elephant is sitting on his chest”. The nurse has already done an ECG by the time you were called to see him. This is shown in figure 2.

ECG on admission.

ECG 30 minutes after admission.

What would be the optimal management for this patient?

He was taken to the catheterization lab where the left anterior descending coronary artery (LAD) was shown to be completely occluded. Following successful percutaneous intervention and one drug eluding stent implantation in the LAD normal flow is restored (Thrombosis in myocardial infarction, TIMI = 3). 72 hours later, he is ready to be discharged home. The patient is keen to return to work and asks when he could do so.

When would you advise him that he could return to work?

One week later, he receives a letter informing him that he is required to attend cardiac rehabilitation. The patient is confused as to what cardiac rehabilitation entails, although he does remember a nurse discussing this with him briefly before he was discharged. He phones the hospital in order to get some more information.

Which of the following can be addressed during cardiac rehabilitation?

A - Acute coronary syndrome

Although the presentation could be attributable to any of the above differential diagnoses, the most likely etiology given the clinical picture and risk factors is one of cardiac ischemia. Risk factors include gender, smoking status and age making the diagnosis of acute coronary syndrome the most likely one. The broad differential diagnosis in patients presenting with chest pain has been discussed extensively in the medical literature. An old but relevant review can be found freely available 1 as well as more recent reviews. 2 , 3

C - Atorvastatin 80 mg, Clopidogrel 300 mcg, GTN 500 mcg, Ramipril 2.5 mg,

In patients with ACS, medications can be tailored to the individual patient. Some medications have symptomatic benefit but some also have prognostic benefit. Aspirin 4 , Clopidogrel 5 , Atenolol 6 and Atorvastatin 7 have been found to improve prognosis significantly. ACE inhibitors have also been found to improve left ventricular modeling and function after an MI. 8 , 9 Furthermore, GTN 10 and morphine 11 have been found to be of only significant symptomatic benefit.

Oxygen should only to be used when saturations <95% and at the lowest concentration required to keep saturations >95%. 12

There is no evidence that diltiazem, a calcium channel blocker, is of benefit. 13

His ECG in figure 1 does not fulfil ST elevation myocardial infarction (STEMI) criteria and he should therefore be managed as a Non-STEMI. He would benefit prognostically from beta-blockade however his heart rate is only 42 bpm and therefore this is contraindicated. He should receive a loading dose of clopidogrel (300 mg) followed by daily maintenance dose (75 mg). 14 , 15 He might not require GTN if he is pain-free but out of the available answers 3 is the most correct.

D - Proceed to coronary angiography

The ECG shows ST elevation in leads V2-V6 and confirms an anterolateral STEMI, which suggests a completely occluded LAD. This ECG fulfils the criteria to initiate reperfusion therapy which traditionally require one of the three to be present: According to guidance, if the patient can undergo coronary angiography within 120 minutes from the onset of chest pain, then this represents the optimal management. If it is not possible to undergo coronary angiography and potentially percutaneous intervention within 2 hours, then thrombolysis is considered an acceptable alternative. 12 , 16

≥ 1 mm of ST change in at least two contiguous limb leads (II, III, AVF, I, AVL).

≥ 2 mm of ST change in at least two contiguous chest leads (V1-V6).

New left bundle branch block.

GTN and morphine administration can be considered in parallel but they do not have a prognostic benefit.

E - Not before an exercise test

This patient is a lorry driver and therefore has a professional heavy vehicle driving license. The regulation for driving initiation in a lorry driver following a NSTEMI/ STEMI may be different in various countries and therefore the local regulations should be followed.

In the UK, a lorry driver holds a category 2 driving license. He should therefore refrain from driving a lorry for at least 6 weeks and can only return to driving if he completes successfully an exercise evaluation. An exercise evaluation is performed on a bicycle or treadmill. Drivers should be able to complete 3 stages of the standard Bruce protocol 17 or equivalent (e.g. Myocardial perfusion scan) safely, having refrained from taking anti-anginal medication for 48 hours and should remain free from signs of cardiovascular dysfunction during the test, notably: angina pectoris, syncope, hypotension, sustained ventricular tachycardia, and/or electrocardiographic ST segment shift which is considered as being indicative of myocardial ischemia (usually >2 mm horizontal or down-sloping) during exercise or the recovery period. 18

For a standard car driving license (category 1), driving can resume one week after successful intervention providing that no other revascularization is planned within 4 weeks; left ventricular ejection fraction (LVEF) is at least 40% prior to hospital discharge and there is no other disqualifying condition.

Therefore if this patent was in the UK, he could restart driving a normal car one week later assuming an echocardiogram confirmed an EF > 40%. However, he could only continue lorry driving once he has passed the required tests. 18

E - All of the above

Cardiac rehabilitation bridges the gap between hospitals and patients' homes. The cardiac rehabilitation team consists of various healthcare professions and the programme is started during hospital admission or after diagnosis. Its aim is to educate patients about their cardiac condition in order to help them adopt a healthier lifestyle. This includes educating patients' about their diet, exercise, risk factors associated with their condition such as smoking and alcohol intake and finally, about the medication recommended. There is good evidence that adherence to cardiac rehabilitation programmes improves survival and leads to a reduction in future cardiovascular events. 19 , 20

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Yusuf S , Zhao F , Mehta S , Chrolavicius S , Tognoni G , Fox K . Clopidogrel in unstable angina to prevent recurrent events trail investigators . effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation . N Engl J Med . 2001 ; 345 (7) : 494 – 502 . http://www.nejm.org/doi/full/10.1056/NEJMoa010746#t=articleTop .

Yusuf S , Peto R , Lewis J , Collins R , Sleight P . Beta blockade during and after myocardial infarction: An overview of the randomized trials . Prog Cardiovasc Dis . 1985 ; 27 (5) : 335 – 371 . http://www.sciencedirect.com/science/article/pii/S0033062085800037 .

Schwartz GG , Olsson AG , Ezekowitz MD et al. . Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: The MIRACL study: A randomized controlled trial . JAMA . 2001 ; 285 (13) : 1711 – 1718 . http://jama.jamanetwork.com/article.aspx?articleid=193709 .

Pfeffer MA , Lamas GA , Vaughan DE , Parisi AF , Braunwald E . Effect of captopril on progressive ventricular dilatation after anterior myocardial infarction . N Engl J Med . 1988 ; 319 (2) : 80 – 86 . http://content.onlinejacc.org/article.aspx?articleid=1118054 .

Sharpe N , Smith H , Murphy J , Hannan S . Treatment of patients with symptomless left ventricular dysfunction after myocardial infarction . The Lancet . 1988 ; 331 (8580) : 255 – 259 . http://www.sciencedirect.com/science/article/pii/S0140673688903479 .

Ferreira JC , Mochly-Rosen D . Nitroglycerin use in myocardial infarction patients . Circ J . 2012 ; 76 (1) : 15 – 21 . http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527093/ .

Herlitz J , Hjalmarson A , Waagstein F . Treatment of pain in acute myocardial infarction . Br Heart J . 1989 ; 61 (1) : 9 – 13 . http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1216614/ .

Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, et al . ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation . Eur Heart J . 2012 ; 33 (20) : 2569 – 2619 . http://eurheartj.oxfordjournals.org/content/33/20/2569 .

The effect of diltiazem on mortality and reinfarction after myocardial infarction . the multicenter diltiazem postinfarction trial research group . N Engl J Med . 1988 ; 319 (7) : 385 – 392 . http://www.nejm.org/doi/full/10.1056/NEJM198808183190701 .

Jneid H , Anderson JL , Wright RS et al. . 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/Non–ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 focused update) A report of the american college of cardiology foundation/american heart association task force on practice guidelines . J Am Coll Cardiol . 2012 ; 60 (7) : 645 – 681 . http://circ.ahajournals.org/content/123/18/2022.full .

Hamm CW , Bassand JP , Agewall S et al. . ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The task force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the european society of cardiology (ESC) . Eur Heart J . 2011 ; 32 (23) : 2999 – 3054 . http://eurheartj.oxfordjournals.org/content/32/23/2999.long .

O'Gara PT , Kushner FG , Ascheim DD et al. . 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: Executive summary: A report of the american college of cardiology foundation/american heart association task force on practice guidelines . J Am Coll Cardiol . 2013 ; 61 (4) : 485 – 510 . http://content.onlinejacc.org/article.aspx?articleid=1486115 .

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Objectives and standards, materials and setup, procedure and extensions, handouts and downloads.

Many different microorganisms can infect the human respiratory system, causing symptoms such as fever, runny nose or sore throat. Even the common cold, which may range from mild to serious, can be caused by any of more than 200 viruses! Colds are among the leading causes of visits to physicians in the United States, and the Centers for Disease Control and Prevention (CDC) report that 22 million school days are lost in the U.S. each year due to the common cold. Usually, cold symptoms appear within two to three days of infection and include: mucus buildup in the nose, swelling of sinuses, cough, headache, sore throat, sneezing and mild fever (particularly in infants and young children). The body’s immune system, which protects against disease-causing microbes, almost always is able to eliminate the viruses responsible for a cold.

Flu (or influenza) often is more serious than the common cold. Caused by one of three types of closely related viruses, flu can come on quickly, with chills, fatigue, headache and body aches. A high fever and severe cough may develop. Flu may be prevented in some cases through a vaccine. However, since the viruses that cause flu change slightly from year to year, a new vaccine is required each flu season. Influenza was responsible for three pandemics (worldwide spread of disease) in the 20th Century alone.

Antibiotics do not kill viruses, and therefore, are not helpful in fighting the common cold or flu. But these diseases can make a person more susceptible to bacterial infections, such as strep throat, a common infection by a Streptococcus bacterium . Symptoms of “strep” infections include sore throat, high fever, coughing, and swollen lymph nodes and tonsils. Diagnosis should be based on the results of a throat swab, which is cultured, and/or a rapid antigen test, which detects foreign substances, known as antigens, in the throat. Strep infections usually can be treated effectively with antibiotics. Without treatment, strep throat can lead to other serious illnesses, such as scarlet fever and rheumatic fever.

Symptoms similar to those of a cold can be caused by allergens in the air. Health experts estimate that 35 million Americans suffer from respiratory allergies, such as hay fever (pollen allergy). An allergy is a reaction of an individual’s disease defense system (immune system) to a substance that does not bother most people. Allergies are not contagious.

Develop descriptions, explanations, predictions and models using evidence.

Think critically and logically to make the relationships between evidence and explanations.

Recognize and analyze alternative explanations and predictions.

Life Science

Disease is a breakdown in structures or functions of an organism. Some diseases are the result of infection by other organisms.

Teacher Materials (see Setup)

90 letter-size plain envelopes

6 sheets of white, self-stick folder labels, 3-7/16 in. x 2/3 in., 30 labels per sheet (Avery™ #5366, 5378 or 8366)

Overhead projector

Overhead transparency of the "Disorders and Symptoms" student sheet

Materials per Group of Students

Set of prepared envelopes (15 envelopes per set)

Copy of "What is Wrong with Allison?" and "Disorders and Symptoms" student sheets (see Lesson pdf)

Group concept map (ongoing)

Photocopy the "What is Wrong with Allison?" and "Disorders and Symptoms" student sheets (one copy of each per student), to be distributed in order (see Procedure).

Photocopy the label template sheet onto six sheets of white, self-stick labels, such as Avery™ #5366, 5378 or 8366, which contain 30 labels per sheet.

Use one page of photocopied labels to create each set of envelopes. Place a "Question" label on the outside of one envelope and stick the corresponding "Clue" label on the inside flap of the same envelope. Close the flap, but do not seal the envelope. Make six sets of 15 envelopes (one set per group).

Make an overhead transparency of the "Disorders and Symptoms" sheet. Have students work in groups of four.

Optional: Instead of using self-stick labels, copy the label template page onto plain paper and cut out each question and clue. Tape one question to the outside of an envelope and the corresponding clue to the inside flap of the envelope.

Begin a class discussion of disease by asking questions such as, How do you know when you are sick? What are some common diseases? Are all diseases alike? Are all diseases caused by a kind of microbe? Do some diseases have similar symptoms?

Tell your students that in this class session, they will be acting as medical personnel trying to diagnose a patient. Give each group a copy of the "What is Wrong with Allison?" sheet. Have one student read the case to the group, and then have groups discuss it. The reporter should record each group’s ideas about what might be wrong with Allison.

Have each student group list four possible questions that a doctor might ask a patient like Allison. Write these questions on the board and discuss with the class.

Have groups identify three possible diseases that Allison may have, based on the story, class discussion and their own experiences.

Give each student a copy of the "Disorders and Symptoms" sheet and briefly introduce the four illnesses to the entire class. Compare these illnesses to the ones that students suggested. Ask, Are there any similarities? Have students follow the instructions on the sheet to complete the exercise.

Give each group of students a set of envelopes. Warn students not to open the envelopes until they are instructed to do so. Tell students that each envelope contains information that a medical doctor might need about a patient. All information is important to the diagnosis, but only certain information will help to distinguish among the four possible respiratory disorders. Instruct students that their task is to decide which envelopes contain information that will help them determine Allison’s illness. Once a group has agreed on question choices, it may open as many envelopes—one at a time—as needed. The challenge is to use as few envelopes as possible to diagnose Allison’s illness. Each group should keep a tally of the number of envelopes opened. Remind students that in real life, a physician would conduct a complete examination and gather all possible information before making a diagnosis.

Allow time for groups to work. Provide assistance to students who may not understand the information contained in the envelopes. If the medicine and body temperature envelopes have been opened, make sure students understand that some medications, like Tylenol™, will mask the presence of mild fevers.

Have each group present its diagnosis and the reasoning used to arrive at its decision. (Allison’s disease is a common cold. If students have arrived at other conclusions, discuss the evidence they used. Mention the challenges of diagnosing respiratory diseases.)

Expand the discussion to address the importance of not taking antibiotics for viral diseases. Ask, Since Allison has a cold, should her doctor prescribe antibiotics? Would it be okay to take leftover antibiotics? Help students understand that antibiotics are effective for bacterial infections, but do not help against viral infections like colds. Also, mention that if antibiotics are prescribed for a bacterial infection, it is important to follow the doctor’s instructions and to take all the medication, even if symptoms start to improve before the medicine is gone. Otherwise, the disease may reoccur. Taking antibiotics incorrectly, or using them inappropriately (such as taking leftover medicine without a doctor’s guidance) can contribute to the development of antibiotic resistant forms of bacteria, which cannot be killed by existing antibiotics.

Have student groups add information to their concept maps.

X-Times: Career Options

Student magazine: Special issue featuring healthcare professionals who discuss why each chose his or her career, educational requirements needed to obtain the job, and day-to-day responsibilities.

X-Times: Microbes

Student magazine: articles focusing on microbes, both helpful and harmful. Includes a special report, "HIV/AIDS: The Virus and the Epidemic."

Science Education Partnership Award, NIH

MicroMatters Grant Number: 5R25RR018605

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Routes to Medical School for the High School Student

You can take the traditional path or opt for a combined undergraduate-M.D. program that lasts seven or eight years.

Paths to Med School for High Schoolers

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Students considering combined programs should note that they have a very limited number of spots and many qualified applicants.

For high school students who know they want to become doctors, applying to college may also involve thinking about when and how they want to matriculate into medical school .

Though many students now take a year or two off after college graduation before beginning their medical education, many other students are interested in becoming physicians on the shortest timeline available.

Here's some information about two broad paths toward med school – the traditional route and combined programs – that future doctors who are still in high school may consider as they apply to college .

The Traditional Route

Despite the presence of other routes to med school, the majority of prospective med students follow a typical academic path. They matriculate at an undergraduate institution, complete their premedical requirements by junior or senior year, take the MCAT and apply to medical schools within the general application pool.

Because students who take this route aren’t enrolled in a special program, they have the flexibility to structure their schedules as they wish and to take courses beyond those geared toward their major or premed requirements. For high school students who want to become doctors but who are thinking about a nonscience major or who want a typical undergraduate academic experience, pursuing the tried-and-true traditional path toward medicine might fit best.

Combined Programs

Unlike the traditional path toward medicine, combined programs such as baccalaureate-M.D. programs offer early but typically conditional acceptance into medical school at the time of college acceptance. Whereas students charting a typical premed course will have to face the uncertainty of the medical school admissions process, students in combined programs have the luxury of knowing that if they are able to uphold certain academic standards, they will continue on into the med school affiliated with their program.

Students considering applying to combined programs should note that most of these programs have a very limited number of spots and many qualified applicants. For example, the eight-year combined BA/BS-MD Program at the University of Colorado accommodates no more than 10 in-state students each year.

Acceptance to these programs is far from guaranteed, and prospective applicants should be prepared to submit standard applications alongside their applications to combined programs during their college admissions cycle.

8-year combined programs

In eight-year combined programs, students complete four years of undergraduate study before transitioning into med school. While some of these programs stipulate that students major in STEM, others allow students to select any major since they will have a full four years to complete both their premed and major requirements.

Though students in eight-year programs do not obtain their M.D. degree quicker than students who go straight through undergrad to med school, eight-year programs allow students to avoid the expense and pressure associated with the med school application cycle.

Additionally, in some eight-year programs – such as the Pre-Professional Scholars Program in Medicine at Case Western Reserve University in Ohio – students do not have to take the MCAT, alleviating the stress associated with having to perform well on that test.

7-year combined programs

The path to becoming a fully licensed physician is lengthy, requiring an undergraduate degree, a medical degree, completion of postgraduate residency and sometimes fellowship training.

For high school students motivated to jump-start their medical education, seven-year combined programs may be an attractive way to reach the finish line sooner. These programs offer many of the same perks as eight-year programs: conditional acceptance into med school, skipping the normal application process and often forgoing the MCAT.

Students in seven-year programs complete their undergraduate requirements in three years before proceeding to the standard four years of med school.

While saving a year for those dead set on medicine may make sense, students have limited academic flexibility due to the abbreviated undergraduate experience required of these programs. For example, students in the CUNY School of Medicine 's seven-year Sophie Davis Biomedical Education Program do not have the option to major in non-STEM subjects, as they – like most students in seven-year programs – must complete both their premed and undergraduate requirements in three years.

Before applying to these types of programs, be sure to weigh your desire for medicine with your desire to have a “normal” undergraduate experience, complete with the academic opportunities that experience typically entails.

Should You Become a Doctor?

Tags: medical school , graduate schools , education , students , high school

About Medical School Admissions Doctor

Need a guide through the murky medical school admissions process? Medical School Admissions Doctor offers a roundup of expert and student voices in the field to guide prospective students in their pursuit of a medical education. The blog is currently authored by Dr. Ali Loftizadeh, Dr. Azadeh Salek and Zach Grimmett at Admissions Helpers , a provider of medical school application services; Dr. Renee Marinelli at MedSchoolCoach , a premed and med school admissions consultancy; Dr. Rachel Rizal, co-founder and CEO of the Cracking Med School Admissions consultancy; Dr. Cassie Kosarec at Varsity Tutors , an advertiser with U.S. News & World Report; Dr. Kathleen Franco, a med school emeritus professor and psychiatrist; and Liana Meffert, a fourth-year medical student at the University of Iowa's Carver College of Medicine and a writer for Admissions Helpers. Got a question? Email [email protected] .

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Medical Coverage and Repatriation for Injured Student on School Trip

Case Studies
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Unbeknownst to him, a Singaporean patient had found himself to have sustained cuts to his lower limbs because of falling broken glass in Bangkok, Thailand during a school trip. The patient had sleepwalked from his hotel room to the lobby and in an attempt to open the door, but having failed, resorted to kick the glass at the lobby, and in the process, had injured himself. International SOS assistance was requested by the patient’s school for medical expenses coverage and the patient’s safe return to Singapore.

Upon receiving the call, the patient had been admitted to the hospital with the help of a bystander. To quickly gain a thorough understanding of the extent of his injury, International SOS’s Assistance Centre in Bangkok was contacted to monitor the patient’s condition and to facilitate consistent communication between the hospital, the school, and the insurer. As a result of International SOS network capabilities, International SOS was able to quickly obtain the necessary information for the approval of the patient’s medical expenses from the insurer. This was immediately followed by placing a guarantee of payment (GOP).

To overcome the problem, International SOS recommended repatriation back to Singapore to further his medical care. The International SOS Assistance Centre in Singapore effectively coordinated the flights, quotation, directions on the coverage for the patient’s mother’s air ticket, and coverage approval from the insurer. Receiving the approval from the insurer on repatriation, the Assistance Centre in Singapore submitted the Passenger Medical Clearance (MEDA) clearance form to the airline, coordinated the logistics and ground movements, and arranged for the patient’s stay with the receiving hospital in Singapore. Considering the patient’s medical condition, the evacuation was executed via a commercial stretcher and a medical team, which consisted of an International SOS general practitioner (GP) doctor and a nurse.

Following the quick response of both our Assistance Centres, the patient was safely repatriated back to Singapore alongside his mother at the preferred hospital for the patient to continue his medical treatments. The operation, which commenced upon receiving the call, to the patient’s safe arrival at the hospital was achieved within four days. The patient’s safe arrival was also communicated to all relevant stakeholders.

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About Adverse Childhood Experiences
Risk and Protective Factors
Program: Essentials for Childhood: Preventing Adverse Childhood Experiences through Data to Action
Adverse childhood experiences can have long-term impacts on health, opportunity and well-being.
Adverse childhood experiences are common and some groups experience them more than others.

diverse group of children lying on each other in a park

What are adverse childhood experiences?

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). Examples include: 1

Experiencing violence, abuse, or neglect.
Witnessing violence in the home or community.
Having a family member attempt or die by suicide.

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding. Examples can include growing up in a household with: 1

Substance use problems.
Mental health problems.
Instability due to parental separation.
Instability due to household members being in jail or prison.

The examples above are not a complete list of adverse experiences. Many other traumatic experiences could impact health and well-being. This can include not having enough food to eat, experiencing homelessness or unstable housing, or experiencing discrimination. 2 3 4 5 6

Quick facts and stats

ACEs are common. About 64% of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six (17.3%) adults reported they had experienced four or more types of ACEs. 7

Preventing ACEs could potentially reduce many health conditions. Estimates show up to 1.9 million heart disease cases and 21 million depression cases potentially could have been avoided by preventing ACEs. 1

Some people are at greater risk of experiencing one or more ACEs than others. While all children are at risk of ACEs, numerous studies show inequities in such experiences. These inequalities are linked to the historical, social, and economic environments in which some families live. 5 6 ACEs were highest among females, non-Hispanic American Indian or Alaska Native adults, and adults who are unemployed or unable to work. 7

ACEs are costly. ACEs-related health consequences cost an estimated economic burden of $748 billion annually in Bermuda, Canada, and the United States. 8

ACEs can have lasting effects on health and well-being in childhood and life opportunities well into adulthood. 9 Life opportunities include things like education and job potential. These experiences can increase the risks of injury, sexually transmitted infections, and involvement in sex trafficking. They can also increase risks for maternal and child health problems including teen pregnancy, pregnancy complications, and fetal death. Also included are a range of chronic diseases and leading causes of death, such as cancer, diabetes, heart disease, and suicide. 1 10 11 12 13 14 15 16 17

ACEs and associated social determinants of health, such as living in under-resourced or racially segregated neighborhoods, can cause toxic stress. Toxic stress, or extended or prolonged stress, from ACEs can negatively affect children’s brain development, immune systems, and stress-response systems. These changes can affect children’s attention, decision-making, and learning. 18

Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. 18 These effects can also be passed on to their own children. 19 20 21 Some children may face further exposure to toxic stress from historical and ongoing traumas. These historical and ongoing traumas refer to experiences of racial discrimination or the impacts of poverty resulting from limited educational and economic opportunities. 1 6

Adverse childhood experiences can be prevented. Certain factors may increase or decrease the risk of experiencing adverse childhood experiences.

Preventing adverse childhood experiences requires understanding and addressing the factors that put people at risk for or protect them from violence.

Creating safe, stable, nurturing relationships and environments for all children can prevent ACEs and help all children reach their full potential. We all have a role to play.

Merrick MT, Ford DC, Ports KA, et al. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017. MMWR Morb Mortal Wkly Rep 2019;68:999-1005. DOI: http://dx.doi.org/10.15585/mmwr.mm6844e1 .
Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Science Direct. 2022; 22:7; 1105-1114. DOI: https://doi.org/10.1016/j.acap.2022.04.010 .
Smith-Grant J, Kilmer G, Brener N, Robin L, Underwood M. Risk Behaviors and Experiences Among Youth Experiencing Homelessness—Youth Risk Behavior Survey, 23 U.S. States and 11 Local School Districts. Journal of Community Health. 2022; 47: 324-333.
Experiencing discrimination: Early Childhood Adversity, Toxic Stress, and the Impacts of Racism on the Foundations of Health | Annual Review of Public Health https://doi.org/10.1146/annurev-publhealth-090419-101940 .
Sedlak A, Mettenburg J, Basena M, et al. Fourth national incidence study of child abuse and neglect (NIS-4): Report to Congress. Executive Summary. Washington, DC: U.S. Department of Health an Human Services, Administration for Children and Families.; 2010.
Font S, Maguire-Jack K. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions. Child Abuse Negl. 2016;51:390-399.
Swedo EA, Aslam MV, Dahlberg LL, et al. Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR Morb Mortal Wkly Rep 2023;72:707–715. DOI: http://dx.doi.org/10.15585/mmwr.mm7226a2 .
Bellis, MA, et al. Life Course Health Consequences and Associated Annual Costs of Adverse Childhood Experiences Across Europe and North America: A Systematic Review and Meta-Analysis. Lancet Public Health 2019.
Adverse Childhood Experiences During the COVID-19 Pandemic and Associations with Poor Mental Health and Suicidal Behaviors Among High School Students — Adolescent Behaviors and Experiences Survey, United States, January–June 2021 | MMWR
Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics. 2004 Feb;113(2):320-7.
Miller ES, Fleming O, Ekpe EE, Grobman WA, Heard-Garris N. Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes. Obstetrics & Gynecology . 2021;138(5):770-776. https://doi.org/10.1097/AOG.0000000000004570 .
Sulaiman S, Premji SS, Tavangar F, et al. Total Adverse Childhood Experiences and Preterm Birth: A Systematic Review. Matern Child Health J . 2021;25(10):1581-1594. https://doi.org/10.1007/s10995-021-03176-6 .
Ciciolla L, Shreffler KM, Tiemeyer S. Maternal Childhood Adversity as a Risk for Perinatal Complications and NICU Hospitalization. Journal of Pediatric Psychology . 2021;46(7):801-813. https://doi.org/10.1093/jpepsy/jsab027 .
Mersky JP, Lee CP. Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample. BMC pregnancy and childbirth. 2019;19(1). https://doi.org/10.1186/s12884-019-2560-8 .
Reid JA, Baglivio MT, Piquero AR, Greenwald MA, Epps N. No youth left behind to human trafficking: Exploring profiles of risk. American journal of orthopsychiatry. 2019;89(6):704.
Diamond-Welch B, Kosloski AE. Adverse childhood experiences and propensity to participate in the commercialized sex market. Child Abuse & Neglect. 2020 Jun 1;104:104468.
Shonkoff, J. P., Garner, A. S., Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, & Section on Developmental and Behavioral Pediatrics (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663
Narayan AJ, Kalstabakken AW, Labella MH, Nerenberg LS, Monn AR, Masten AS. Intergenerational continuity of adverse childhood experiences in homeless families: unpacking exposure to maltreatment versus family dysfunction. Am J Orthopsych. 2017;87(1):3. https://doi.org/10.1037/ort0000133 .
Schofield TJ, Donnellan MB, Merrick MT, Ports KA, Klevens J, Leeb R. Intergenerational continuity in adverse childhood experiences and rural community environments. Am J Public Health. 2018;108(9):1148-1152. https://doi.org/10.2105/AJPH.2018.304598 .
Schofield TJ, Lee RD, Merrick MT. Safe, stable, nurturing relationships as a moderator of intergenerational continuity of child maltreatment: a meta-analysis. J Adolesc Health. 2013;53(4 Suppl):S32-38. https://doi.org/10.1016/j.jadohealth.2013.05.004 .

Adverse Childhood Experiences (ACEs)

ACEs can have a tremendous impact on lifelong health and opportunity. CDC works to understand ACEs and prevent them.

Straight Talk About Soy

a variety of soy foods, including: soybeans, edamame, soy sauce, tofu, tempeh, soy milk

The Takeaway: Soy is a unique food that is widely studied for its estrogenic and anti-estrogenic effects on the body. Studies may seem to present conflicting conclusions about soy, but this is largely due to the wide variation in how soy is studied. Results of recent population studies suggest that soy has either a beneficial or neutral effect on various health conditions. Soy is a nutrient-dense source of protein that can safely be consumed several times a week, and probably more often, and is likely to provide health benefits—especially when eaten as an alternative to red and processed meat.

Soy is exalted as a health food by some, with claims of taming hot flashes, warding off osteoporosis, and protecting against hormonal cancers like breast and prostate.

At the same time, soy is shunned by others for fear that it may cause breast cancer, thyroid problems, and dementia, though these claims have not been substantiated.

Whether published in a popular press article or a well-designed clinical study, some debate about soy remains. As a species within the legume family , nutrition scientists often label soy as a food with potential for significant health benefits. However, due to contrary research that suggests possible negative effects of soy in certain situations, there has been a hesitancy to wholeheartedly promote soy.

Part of the uncertainty is due to the intricacy of soy’s effects on the body. Soy is unique in that it contains a high concentration of isoflavones, a type of plant estrogen (phytoestrogen) that is similar in function to human estrogen but with much weaker effects. Soy isoflavones can bind to estrogen receptors in the body and cause either weak estrogenic or anti-estrogenic activity. The two major soy isoflavones are called genistein and daidzein. Soy isoflavones and soy protein appear to have different actions in the body based on the following factors:

Type of study . Is it being examined in a study with animals or humans? Soy may be metabolized differently in animals, so the outcomes of animal studies may not be applicable to humans.
Hormone levels . Because soy can have estrogenic properties, its effects can vary depending on the existing level of hormones in the body. Premenopausal women have much higher circulating levels of estradiol—the major form of estrogen in the human body—than postmenopausal women. In this context soy may act like an anti-estrogen, but among postmenopausal women soy may act more like an estrogen. Also, women with breast cancer are classified into hormone type—either hormone positive (ER+/PR+) or hormone negative (ER-/PR-) breast cancer—and these tumors respond differently to estrogens.
Type of soy . What type of soy is being studied: Whole soy foods such as tofu and soybeans, processed versions like soy protein powders, or soy-based veggie burgers? Fermented or unfermented soy foods? If supplements are used, do they contain isoflavones or soy protein?

Thus, there are many factors that make it difficult to construct blanket statements about the health effects of soy.

Aside from their isoflavone content, soy foods are rich in nutrients including B vitamins , fiber , potassium , magnesium , and high-quality protein . Unlike some plant proteins, soy protein is considered a complete protein, containing all nine essential amino acids that the body cannot make which must be obtained from the diet. Soy foods are also classified as fermented or unfermented (see table with examples, below). Fermented means that the soy food has been cultured with beneficial bacteria , yeast, or mold. Some believe that fermenting soy improves its digestibility and absorption in the body, as this process partially breaks down soy’s sugar and protein molecules.

Research on Soy and Disease

Learn more about the research on soy and specific diseases or other conditions:

Soy protein took center stage after research showed that it might lower levels of harmful cholesterol. A 1995 meta-analysis of 38 controlled clinical trials showed that eating approximately 50 grams of soy protein a day (no small amount as this translates to 1½ pounds of tofu or eight 8-ounce glasses of soy milk!) in place of animal protein reduced harmful LDL cholesterol by 12.9 percent. [1] Such reductions, if sustained over time, could mean a greater than 20% lower risk of heart attack, stroke, or other forms of cardiovascular disease. In response to this finding, in 1999 the Food and Drug Administration (FDA) allowed companies to claim that diets low in saturated fat and cholesterol that also contain soy “may reduce the risk of heart disease.” [2]

However, a number of studies since have tempered that finding. [3] According to a comprehensive update of soy research by the nutrition committee of the American Heart Association (AHA) published in 2000, eating 50 grams of soy per day lowered LDL by only about 3%. [3] In October 2017, after review of additional scientific studies since the health claim was authorized, the FDA proposed a rule to revoke the claim because numerous studies presented inconsistent findings on the relationship between soy protein and heart disease. [4] Some of these inconsistencies may have resulted because soy was compared with a variety of alternative foods.

Even though soy protein may have only a small direct effect on cholesterol, soy may still benefit the heart in other ways. An epidemiological study following three large cohorts of American men and women who did not have cardiovascular disease at the start of the study found that those who ate the highest amounts of tofu and isoflavones from soy foods, compared with those who ate the least, had an 18% and 13% lower risk, respectively, of developing heart disease. [5] The benefit of tofu was stronger in premenopausal women and postmenopausal women not using hormone therapy.

Soy foods are generally good for the heart and blood vessels because they provide polyunsaturated fat, fiber, vitamins, and minerals, and are low in saturated fat. Replacing red meat with plant proteins including soy foods, beans, and nuts was associated with a 14% lower risk of heart disease, as found in the Health Professionals Follow-up Study, a large long-term epidemiological study of more than 43,000 men. [6] Another large cohort of more than 500,000 Chinese adults with no previous cardiovascular disease found that those with the highest intakes of soy (4+ days a week) compared with those who never ate soy had a 25% lower risk of deaths from heart attack. [7]

Hormone replacement therapy has traditionally been used as an effective treatment for hot flashes and other unpleasant symptoms that accompany menopause, but its long-term use has raised concerns of an increased risk of some diseases including breast cancer and stroke. Soy has been a popular alternative treatment but not clearly supported by research; in theory the potential estrogenic effects of soy isoflavones could help to tame hot flashes by giving an estrogen-like boost during a time of dwindling estrogen levels.

In many Far East Asian countries where soy is eaten daily, women have lower rates of menopausal symptoms, although research is conflicting as to whether soy is a primary contributor. [8] Reports suggest that about 70–80% of U.S. women of menopausal and perimenopausal age experience hot flashes, in comparison with 10–20% of Far Eastern Asian women. [9] Further, the average blood concentration of the isoflavone genistein in Asian women who regularly consume soy is about 12 times higher than that of U.S. women. [9]

Yet several meta-analyses and carefully controlled clinical studies have not found strong evidence of a link. [10,11] An AHA review in 2006 concluded that it was unlikely that soy isoflavones exert enough estrogenic activity to have an important impact on hot flashes and other symptoms of menopause. [3] A JAMA review the same year found highly conflicting results with soy isoflavone extracts and stated that the overall evidence did not support its benefit in relieving hot flashes. [12]

In another review of 43 randomized controlled trials have examined the effects of phytoestrogens on hot flashes and night sweats in perimenopausal and postmenopausal women. Four trials found that extracts of 30 mg or greater of genistein consistently reduced the frequency of hot flashes. Other trials that used dietary soy or soy extracts suggested a reduced frequency and severity of hot flashes and night sweats when compared with placebo, but these trials were small with a possible strong placebo effect. [8] No adverse effects were noted from the soy treatments when followed for up to two years, but the authors did not feel overall there was strong and consistent evidence for a benefit of soy.

Another meta-analysis of 16 studies found that soy isoflavone supplements had a small and gradual effect in weakening menopausal hot flashes compared with estradiol (human estrogen). However, authors noted weaknesses in the analysis due to a small number of participants and high variability in study design. [9]

A more recent review of randomized trials found that some studies showed benefit of soy supplements on hot flashes; the therapeutic dosage ranged from 40-70 mg of isoflavones daily. [13] The authors also observed that the presence of equol (a protective substance made from the breakdown of isoflavones that only some women can produce) may be needed for isoflavones to effectively reduce hot flashes. Despite these results, the study authors did not offer a confident conclusion on the use of isoflavone supplements due to variations in study design and length; differences in the types and dosages of supplements; and the small sample sizes and high drop-out rates.

This area needs further research as questions remain about a possible benefit of soy. Results are conflicting, potentially due to variation in the types of soy preparations used, the quantities given, and for how long they are used.

Phytoestrogens don’t always mimic estrogen. In some tissues and in some people, they may block the action of estrogen. If soy’s estrogen-blocking action occurs in the breast, then eating soy could, in theory, reduce the risk of breast cancer because estrogen stimulates the growth and multiplication of breast and breast cancer cells. Studies so far have not provided a clear answer. Some have shown a benefit with soy consumption and breast cancer while others show no association. [14-17] It appears that the effects of soy may vary depending on menopausal status, the age at which soy is consumed, and type of breast cancer.

In animal and cell studies, high dosages of isoflavone or isolated soy protein extracts tend to stimulate breast cancer growth. [18,19] However, studies that observe people consuming soy foods over time show either a protective or neutral effect. Women from Asian countries appear to receive greater protective benefit from breast cancer with high soy intakes than American and European women, but this may simply be a difference in the amount of soy consumed. [20,21] Asian women may have higher levels of equol, a substance metabolized from the isoflavone daidzein by bacterial flora in the intestines. [22] Equol is believed to block potentially negative effects of human estrogen, but not all women possess the bacteria needed to create equol. [23] It is estimated that 30-50% of all humans are able to produce equol. [24] Eating soy foods starting at an early age (such as those found in many traditional Far East Asian diets) may be why women from some countries find greater benefit from soy foods than others. [19] However, the overall evidence on equol and cancer risk is unsettled. [25]

The Shanghai Women’s Health Study which followed 73,223 Chinese women for more than 7 years has been the largest and most detailed study of soy and breast cancer risk in a population with high soy consumption. [26] In this study, women who ate the most soy had a 59% lower risk of premenopausal breast cancer compared with those who ate the lowest amounts of soy. There was no association with postmenopausal breast cancer. Risk was 43% lower when soy was eaten during adolescence. Seven years later, the study authors published a follow-up analysis from the same cohort over 13 years to evaluate any association between soy foods and specific types of breast cancer defined by hormone receptors and by menopausal status (Estrogen [ER] +/-; Progesterone [PR] +/-). [27] Key highlights of the study:

A 22% lower risk of breast cancer when comparing the highest to lowest intakes of soy during adulthood.
A 28% lower risk of hormone positive (ER+, PR+) breast cancer in postmenopausal women.
A 54% lower risk of hormone negative (ER-, PR-) breast cancer in premenopausal women.
A 47% lower risk of premenopausal breast cancer when comparing high to low intakes of soy during adolescence and adulthood.

The Breast Cancer Family Registry was a prospective study following 6,235 women for 9 years diagnosed with breast cancer and living in the U.S. and Canada; intake of soy isoflavones was examined in relation to deaths from all causes. [28] Key highlights of the study:

Women who ate the highest amounts of soy isoflavones had a 21% lower risk of death compared with women with the lowest intakes.
Women who had ER-/PR- tumors and who were not receiving tamoxifen appeared to receive greatest benefit from the higher soy isoflavone intakes. However, isoflavone intake did not have a negative impact on women who were receiving tamoxifen or who had ER+/PR+ tumors.
Of all ethnicities, Asian American women tended to have the highest isoflavone intakes at about 6 mg daily, but this amount was still much lower than women living in Asian countries who eat closer to 46 mg daily. The authors noted that American women appeared to benefit from eating smaller amounts of soy.

Another prospective study followed 1,954 American women who were breast cancer survivors for six years. [29] Key highlights of the study:

Among postmenopausal women treated with tamoxifen, breast cancer recurrence was 60% lower when comparing the highest to the lowest daidzein (a specific type of soy isoflavone) No benefit was observed in women who had never used tamoxifen.
Recurrence was lower with increasing isoflavone intake among women with tumors that were ER+/PR+ but not ER-/PR-.
The most frequent sources of soy foods were not whole or minimally processed soy foods, but rather soy sauce, breakfast or diet drinks, tofu, diet bars, and soy protein isolate powder. The mean amount of isoflavones in the “high” category was about 19 mg daidzein and 27 mg genistein daily—a modest amount compared with Asian populations.
The authors concluded that soy isoflavones eaten at levels comparable to those in Asian populations may reduce the risk of cancer recurrence in women receiving tamoxifen therapy and does not appear to interfere with tamoxifen efficacy. However, the findings need to be confirmed because they were mainly in subgroups and could be due to chance.

Prospective studies also find soy foods to be protective from breast cancer deaths:

A cohort study of 1,460 Chinese women who were early-stage breast cancer survivors looked at dietary soy isoflavone intakes at baseline and after the breast cancer diagnosis, over a four-year period. [30] Higher soy intakes at baseline were associated with a 66% lower risk of deaths from any cause and a 64% lower risk of deaths from breast cancer. Higher soy intakes after diagnosis were associated with a 64% and 51% lower risk of deaths, from any cause and from breast cancer, respectively. The effects were greater in women who were premenopausal, had ER-/PR- tumors, and were taking tamoxifen.
A meta-analysis of prospective cohort studies found a 12% reduction in breast cancer deaths with each 5 gram per day increase in soy protein intake. [31]

However, randomized controlled trials do not show an effect of soy foods on risk factors for breast cancer:

A review of randomized controlled trials (RCTs) looked at isoflavone intakes ranging from 36-235 mg/day from food or supplements, taken from 1 month to 3 years, and breast cancer risk (as measured by breast density, changes in estrogen, and bloodwork) in healthy women. [32] The eighteen RCTs included both pre- and postmenopausal participants. No changes in breast cancer risk factors were found with isoflavone intakes. The authors noted limitations in their analysis in that there were wide variations in numbers of participants and the doses and duration of treatments, which made drawing firm conclusions difficult. Most importantly, these studies did not examine actual incidence of breast cancer.

The incidence of prostate cancer is highest in Western countries and lowest in Asian countries, where soy foods are a regular part of the daily diet. In addition, observational studies have found an increased risk of prostate cancer in Chinese and Japanese men who move to Western countries and adopt a Western diet, but not in those who continue eating a traditional diet. [33] Soy isoflavones, specifically genistein and daidzein, are incorporated in prostate tissue and may act as weak estrogens and inhibit the development of prostate cancer. [34]

In a meta-analysis of 30 case-control and cohort studies from the U.S., Europe, Japan, and China, intakes of total soy foods, genistein, daidzein, and unfermented soy foods were associated with a lower risk of prostate cancer. [34]

A review of eight randomized controlled trials examined the effects of soy in men with or at risk of developing prostate cancer. Two of these studies found that isoflavone supplements or dietary soy protein reduced the risk of prostate cancer in men at high risk of developing the disease. However, none of the studies found a significant effect on prostate specific antigen (PSA) levels, a protein produced by the prostate gland that is used to detect prostate cancer. There were no adverse effects reported with soy supplementation. The authors discussed limitations of the review including the small number of participants, the short duration of studies (less than one year), and variation in dosages and types of soy given. [33]

A small randomized controlled trial in 2021 examined if soy protein supplements could slow down or reverse rising PSA levels in men who had previously been diagnosed and treated for prostate cancer, but who had a recurrence (as evidenced by rising PSA levels). The study found that even though the soy protein supplements increased blood levels of genistein, there was no effect of the supplement versus placebo on PSA levels when given for 6-8 months. [35]

Fermented soy foods commonly eaten in East Asian diets, including natto, tempeh, soy paste, and soy sauce, contain isoflavones and also bacteria that might have benefits for neurological disorders including cognitive decline, Alzheimer’s disease (AD), and Parkinson’s disease (PD). Soy’s antioxidant and anti-inflammatory effects may reduce the oxidative stresses associated with AD and PD. [36] Animal studies have suggest that soy compounds can weaken the progression of AD and prevent nerve cell death. They also find that soy can reduce inflammation and excess free radical production in the brain. AD has been associated with decreased levels of beneficial anti-inflammatory bacteria while harboring increased levels of proinflammatory bacteria. Fermented soy foods are produced with beneficial bacteria like Lactobacilli, Bifidobacteria, and Bacillus species that produce butyrate, a short-chain fatty acid that regulates immune function and is being investigated for its protective effects on the brain.

Long-term low levels of estrogen the occur in menopausal women can reduce the number of estrogen receptors in the brain that are necessary for specific cognitive functions like memory and learning. [37] The soy isoflavone, daidzein, has been hypothesized to reduce decline in cognitive function or disease processes related to cognition and behavior. Thus, the possibility has been raised that eating soy foods might help prevent age-related memory loss or decline in thinking skills. [38]

Studies in humans, however, are not conclusive on soy’s effects on the brain:

Trials have yielded contradictory results, with some showing a benefit with soy isoflavone supplementation [39, 40] and others showing no benefit. [41-43] A review of 13 randomized controlled trials found that in about half of the studies, isoflavone supplementation had a beneficial effect on cognition in older men and women compared with controls, including improvements in attention, information-processing speed, and memory. However the results overall were mixed, with other studies not demonstrating a benefit. This may have been due to differing dosages given or the types of cognition tests used. [37]

One large study in men found a detrimental effect on cognitive function. In a prospective cohort study of more than 3,700 Japanese-American men living in Hawaii, those with the highest intakes of tofu (eaten almost daily) at midlife ages had greater cognitive impairment and brain atrophy in late life compared with men with the lowest tofu intakes (almost never eaten). [44] However, the actual number of men eating very high amounts of tofu was small, and past dietary information was collected by relying on the participants’ memory, some of whom may have already experienced cognitive decline. Because of this, the researchers stated that the findings were too preliminary to make recommendations. [45]

A meta-analysis of 18 randomized controlled trials found that although soy supplements raised thyroid stimulating hormone levels slightly, they did not have any effect on actual thyroid hormone production. [46] However, another study found that soy may interfere with thyroid hormone medication used to treat hypothyroidism. In one randomized double-blinded trial, 60 patients with a mild form of hypothyroidism (called subclinical hypothyroidism) were given low or high-dose phytoestrogen supplements (both also contained 30 grams of soy protein), the amount that might be obtained from a vegetarian diet. [47] Risk of developing clinical hypothyroidism was increased in the higher phytoestrogen group (no effect in the lower phytoestrogen group). The authors suggested that female vegetarian patients with subclinical hypothyroidism may need more careful monitoring of thyroid function. However, the authors also found a benefit on of reduced cardiovascular risk factors in the high phytoestrogen group, with a significant reduction in insulin resistance, inflammatory markers, and blood pressure. The effect of soy on thyroid function needs further examination.

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Last reviewed January 2022

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https://educationhub.blog.gov.uk/2024/05/16/new-rshe-guidance-what-it-means-for-sex-education-lessons-in-schools/

New RSHE guidance: What it means for sex education lessons in schools

R elationships, Sex and Health Education (RSHE) is a subject taught at both primary and secondary school.

In 2020, Relationships and Sex Education was made compulsory for all secondary school pupils in England and Health Education compulsory for all pupils in state-funded schools.

Last year, the Prime Minister and Education Secretary brought forward the first review of the curriculum following reports of pupils being taught inappropriate content in RSHE in some schools.

The review was informed by the advice of an independent panel of experts. The results of the review and updated guidance for consultation has now been published.

We are now asking for views from parents, schools and others before the guidance is finalised. You can find the consultation here .

What is new in the updated curriculum?

Following the panel’s advice, w e’re introducing age limits, to ensure children aren’t being taught about sensitive and complex subjects before they are ready to fully understand them. 

We are also making clear that the concept of gender identity – the sense a person may have of their own gender, whether male, female or a number of other categories – is highly contested and should not be taught. This is in line with the cautious approach taken in our gu idance on gender questioning children.

Along with other factors, teaching this theory in the classroom could prompt some children to start to question their gender when they may not have done so otherwise, and is a complex theory for children to understand.

The facts about biological sex and gender reassignment will still be taught.

The guidance for schools also contains a new section on transparency with parents, making it absolutely clear that parents have a legal right to know what their children are being taught in RSHE and can request to see teaching materials.

In addition, we’re seeking views on adding several new subjects to the curriculum, and more detail on others. These include:

Suicide prevention
Sexual harassment and sexual violence
L oneliness
The prevalence of 'deepfakes’
Healthy behaviours during pregnancy, as well as miscarriage
Illegal online behaviours including drug and knife supply
The dangers of vaping 
Menstrual and gynaecological health including endometriosis, polycystic ovary syndrome (PCOS) and heavy menstrual bleeding.

What are the age limits?

In primary school, we’ve set out that subjects such as the risks about online gaming, social media and scams should not be taught before year 3.

Puberty shouldn’t be taught before year 4, whilst sex education shouldn’t be taught before year 5, in line with what pupils learn about conception and birth as part of the national curriculum for science.

In secondary school, issues regarding sexual harassment shouldn’t be taught before year 7, direct references to suicide before year 8 and any explicit discussion of sexual activity before year 9.

Do schools have to follow the guidance?

Following the consultation, the guidance will be statutory, which means schools must follow it unless there are exceptional circumstances. 

There is some flexibility w ithin the age ratings, as schools will sometimes need to respond to questions from pupils about age-restricted content, if they come up earlier within their school community.

In these circumstances, schools are instructed to make sure that teaching is limited to the essential facts without going into unnecessary details, and parents should be informed.

When will schools start teaching this?

School s will be able to use the guidance as soon as we publish the final version later this year.

However, schools will need time to make changes to their curriculum, so we will allow an implementation period before the guidance comes into force.   

What can parents do with these resources once they have been shared?

This guidance has openness with parents at its heart. Parents are not able to veto curriculum content, but they should be able to see what their children are being taught, which gives them the opportunity to raise issues or concerns through the school’s own processes, if they want to.

Parents can also share copyrighted materials they have received from their school more widely under certain circumstances.

If they are not able to understand materials without assistance, parents can share the materials with translators to help them understand the content, on the basis that the material is not shared further.

Copyrighted material can also be shared under the law for so-called ‘fair dealing’ - for the purposes of quotation, criticism or review, which could include sharing for the purpose of making a complaint about the material.

This could consist of sharing with friends, families, faith leaders, lawyers, school organisations, governing bodies and trustees, local authorities, Ofsted and the media. In each case, the sharing of the material must be proportionate and accompanied by an acknowledgment of the author and its ownership.

Under the same principle, parents can also share relevant extracts of materials with the general public, but except in cases where the material is very small, it is unlikely that it would be lawful to share the entirety of the material.

These principles would apply to any material which is being made available for teaching in schools, even if that material was provided subject to confidentiality restrictions.

Do all children have to learn RSHE?

Parents still have the right to withdraw their child from sex education, but not from the essential content covered in relationships educatio n.

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Prosecutors suddenly drop case against high school principal charged with murdering wife after medical examiner's 'position changed'

A manda Dodson (left) in an obituary photo, Rocky Dodson (right) in a Boone County Sheriff’s Office mug shot after his 2022 arrest.

An Arkansas high school principal and basketball coach resigned after he was charged in March 2022 with murdering his wife, but he maintained his innocence. Now prosecutors have moved to dismiss the case against Rocky Dodson after a medical examiner was confronted with information that 36-year-old Amanda Dodson’s death might been caused by a fall.

The reversal by officials in Boone County comes two months before Dodson was set to stand trial and a matter of weeks after his defense attorney Shane Wilkinson argued that investigators simply assumed his client must have caused a “blunt force” throat injury his wife suffered in the early hours of March 6, 2022, at the couple’s Omaha home.

“The only facts provided are that Amanda Dodson was a chronic alcoholic who was discovered with an unexplained throat injury,” Wilkinson said, KTLO reported , before quoting the relevant portion of the affidavit: “This affiant believes that Rocky Brian Dodson was the only person present and who had the ability to inflict the blow on Amanda Dodson that caused her death.”

Wilkinson accused the state of ignoring that Amanda Dodson’s death was “most likely” explained by a fall while “extremely intoxicated,” whereby she “struck her throat on some object such as a countertop,” the report said. The lawyer said the deceased’s blood alcohol content (BAC) was .468.

When the second-degree murder case first came to light, the Boone County Sheriff’s Office said that Amanda Dodson died from a “severe injury,” vaguely citing investigative and “medical examiner findings” in support of the charge.

At the time , Rocky Dodson was the principal of Omaha High School coached the boys basketball team. The news stunned the school district superintendent, not just because of Rocky Dodson’s arrest. Amanda Dodson had worked as a secretary in the Omaha and Cotter school districts, as her obituary noted .

KY3 reported an even more stunning development on Friday, namely that the Fourteenth Judicial District Prosecuting Attorney’s Office decided to dismiss the case, believing it could not be proven beyond a reasonable doubt, as the cause of death is and has been “undetermined.”

“It was told at that time this could not have been an accident. Based on that conversation and several subsequent conversations, it was determined we could move forward with a charge of second-degree murder against the defendant in this matter,” Prosecuting Attorney David Ethredge explained. “Recently we received information from defense lawyers involved in this case.”

“Subsequent to that information being provided, myself and my deputy prosecutor visited with Dr. Cunningham, who is the ME responsible for this case,” he said. “Dr. Cunningham’s position changed from what we had been told initially, that this could not have been have been an accident, it could not resulted from an accidental fall.”

“That course of conduct made it very different for us to look at,” Ethredge added.

The investigation began after Rocky called 911 to report that he woke up on March 6, 2022, to find that Amanda had died overnight. He reportedly said let her in the house when she came home drunk after 2 a.m. and that he went back to sleep.

In a statement to Law&Crime, defense attorney Wilkinson said his client was arrested “before a single witness was interviewed” and “before the toxicology results were available.”

He said the medical examiner and the sheriff’s office “should have both known that was an issue.”

“The autopsy report came out in May of 2022 and listed the cause of death as ‘undetermined,'” Wilkinson said. “That much has been known for 736 days. This is not an 11th hour change of circumstance. The trial is set in July, so the facts finally had to be acknowledged.”

The post Prosecutors suddenly drop case against high school principal charged with murdering wife after medical examiner’s ‘position changed’ first appeared on Law & Crime .

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7 Medical Case Study Templates And Examples Examples
Clinical Case Studies For Medical Students
Write An Effective Case Study On A Patient In Just 4 Easy Steps
85 Medical Case Studies for High School Students!
49 Free Case Study Templates ( + Case Study Format Examples + )
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The Med Student Life: A Day In The Journey Of Medical School

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Health Case Studies
Health Case Studies is composed of eight separate health case studies. Each case study includes the patient narrative or story that models the best practice (at the time of publishing) in healthcare settings. Associated with each case is a set of specific learning objectives to support learning and facilitate educational strategies and evaluation.
85 Medical Case Studies for High School Students!
This download could be used in an A&P, Health Science or any Medical-based class. This download includes the following: PDF with 85 cases listed (75 that are considered "common" with 10 "unusual" diagnoses) Fillable PDF with the 85 cases listed that can be completed electronically. PDF Quick Answer Key.
Student Designed Case Studies for Anatomy
Students in my anatomy class complete many case studies throughout the year focused on body system units. Case studies are a way to add a personal story to (sometimes) technical information about physiology. For my high school students, I try to find cases that are about younger people or even children, cases like " A Tiny Heart ," which ...
Using Case Studies for Anatomy and Physiology
As my A&P course is an introduction for high school students and most of them are not necessarily planning to be medical professionals, I kept the case studies relatively simple and assigned them to my Honors students as extended homework assignments. I created guided reading and research options for each case study.
PDF Clinical Case Studies for Students and Health Professionals
Clinical Case Studies 12/6/2018 2 . warnings can help to ease the toll of heat -related illness and prevention may ease the burden of such events on the health care system. Integrating weather modeling and public health intervention to address vulnerable populations may ease the burden of heat stress on individuals and the health care system.
Case Library
The Harvard Chan Case Library is a collection of teaching cases with a public health focus, written by Harvard Chan faculty, case writers, and students, or in collaboration with other institutions and initiatives. Use the filters at right to search the case library by subject, geography, health condition, and representation of diversity and identity to find cases to fit your teaching needs.
Four Web-Based Interactive Endocrine Case Studies for Use in
Introduction: This resource is a collection of four case-based exercises intended to provide medical students with structured and focused opportunities to link basic science with clinical application. The cases are designed to help students self-evaluate their knowledge and develop a robust and well- integrated understanding of endocrine physiology and pathophysiology in the context of a ...
NCCSTS Case Studies
The NCCSTS Case Collection, created and curated by the National Center for Case Study Teaching in Science, on behalf of the University at Buffalo, contains over a thousand peer-reviewed case studies on a variety of topics in all areas of science. Cases (only) are freely accessible; subscription is required for access to teaching notes and ...
85 Medical Case Studies for High School Students!
Each case is 4-8 sentences in length and provides enough vital information to make an educated guess of the diagnosis. This download could be used in an A&P, Health Science or any Medical-based class. This download includes the following: PDF with 85 cases listed (75 that are considered "common" with 10 "unusual" diagnoses)
Educational Case: A 57-year-old man with chest pain
A 57 year-old male lorry driver, presented to his local emergency department with a 20-minute episode of diaphoresis and chest pain. The chest pain was central, radiating to the left arm and crushing in nature. The pain settled promptly following 300 mg aspirin orally and 800 mcg glyceryl trinitrate (GTN) spray sublingually administered by ...
PDF Case Studies
Case Study 1: A Pain in the Knee. David Robertson is a 15 year old high school student from the Bronx, New York City, who presents to the ER in February 1998 with a complaint of "dull, aching pain" in his left knee for the past month. David is a track athlete on his high school team, and reports accidentally tripping and falling on his left ...
Case Studies
A 53 year old man presents to clinic with swelling of his hands and a uric acid of 12. 15. A 58-year-old woman presents to clinic with difficulty walking. 16. A 49-year-old woman is seen with an abnormal Nerve Conduction Study. 17. A 55-year-old woman is seen because of her right knee is "giving out". 18.
Case Studies
Case Study 1 — Barbara's dilemma: radiation therapy. In this study, students must wrestle with the unknowns of science and medicine. After being diagnosed with breast cancer, a patient receives conflicting treatment suggestions from two different doctors. Students must evaluate the pros and cons to each treatment option to arrive at their ...
Anatomy and Physiology Clinical Case Studies for High School Students
High school students love learning about diseases through anatomy case studies! This is a great addition to an Anatomy & Physiology, Health Sciences, or Medical Pathology course and the problem-based lessons provide a great example of real NGSS phenomena. Case studies are perfect for extending thinking on a topic, homework assignments, bell ...
Medical Student Case Studies
General Diagnostic Case Studies. Arteriovenous Fistula Secondary to Trauma. Chylothorax, Cellulitis, Gas Gangrene. Ectopic ACTH-Secreting Tumor. Epiphrenic Diverticula. Incidental Mediastinal Hilar Lymphadenopathy. Liver Metastasis. Neurocystercircosis. Pneumoperitoneum.
Case 24-2020: A 44-Year-Old Woman with Chest Pain, Dyspnea, and Shock
A 44-year-old woman presented with cough, dyspnea, and chest pain. On examination, she had tachycardia and hypotension. Evaluation revealed SARS-CoV-2 RNA in a nasopharyngeal swab, as well as eleva...
Infectious Disease Case Study
Caused by one of three types of closely related viruses, flu can come on quickly, with chills, fatigue, headache and body aches. A high fever and severe cough may develop. Flu may be prevented in some cases through a vaccine. However, since the viruses that cause flu change slightly from year to year, a new vaccine is required each flu season.
Routes to Medical School for the High School Student
Routes to Medical School for the High School Student. You can take the traditional path or opt for a combined undergraduate-M.D. program that lasts seven or eight years. Students considering ...
Medical Coverage and Repatriation for Student on a School Trip| Case Study
Medical Coverage and Repatriation for Student on a School Trip| Case Study. Subscriber Assistance +1 215 942 8342. Subscriber Login. Language. Select.
About Adverse Childhood Experiences
Toxic stress, or extended or prolonged stress, from ACEs can negatively affect children's brain development, immune systems, and stress-response systems. These changes can affect children's attention, decision-making, and learning. 18. Children growing up with toxic stress may have difficulty forming healthy and stable relationships.
Straight Talk About Soy
The Shanghai Women's Health Study which followed 73,223 Chinese women for more than 7 years has been the largest and most detailed study of soy and breast cancer risk in a population with high soy consumption. [26] In this study, women who ate the most soy had a 59% lower risk of premenopausal breast cancer compared with those who ate the ...
6 keys to creating a medical student CV that sets you apart
Education: List the most recent institution first—your medical school—with the name of the institution, degree received and dates. You will then follow it with any graduate and undergraduate schooling. Academics: This should include honors and awards and course performance.
AI-Enabled Animal Behavior Analysis with High Usability: A Case Study
A case study at a medical laboratory where the platform was used to evaluate behavioral differences between sick and healthy animals demonstrated the high usability of the platform. ... Yuming, Tianzhe Jiao, Jie Song, Guangyu He, and Zhu Jin. 2024. "AI-Enabled Animal Behavior Analysis with High Usability: A Case Study on Open-Field Experiments ...
Study: Only half of U.S. residents trained to perform CPR or stop ...
1 of 2 | Dr. Nicholas Kman, an emergency medicine physician, helped design the first-aid study at The Ohio State University Wexner Medical Center in Columbus.
Case Studies
617/432-1939. [email protected]. David Robertson is a 15 year old high school student from the Bronx , New York City , who presents to the ER in February 1998 with a complaint of "dull, aching pain" in his left knee for the past month. David is a track athlete on his high school team, and reports accidentally tripping and falling on ...
New RSHE guidance: What it means for sex education lessons in schools
Relationships, Sex and Health Education (RSHE) is a subject taught at both primary and secondary school. In 2020, Relationships and Sex Education was made compulsory for all secondary school pupils in England and Health Education compulsory for all pupils in state-funded schools. Last year, the Prime Minister and Education Secretary brought ...
Prosecutors suddenly drop case against high school principal ...
A high school principal and basketball coach resigned after he was charged in March 2022 with murdering his wife, but he maintained his innocence. Now, the case has been dropped. The post ...
Moscow
Articles from Britannica Encyclopedias for elementary and high school students. Moscow - Children's Encyclopedia (Ages 8-11) Moscow - Student Encyclopedia (Ages 11 and up) ... Senior Lecturer in Geography, University College, 1972-94, and School of Slavonic and East European Studies, 1972-91, University of London. Author of The U.S.S.R. and ...
Elektrostal
Elektrostal, city, Moscow oblast (province), western Russia.It lies 36 miles (58 km) east of Moscow city. The name, meaning "electric steel," derives from the high-quality-steel industry established there soon after the October Revolution in 1917. During World War II, parts of the heavy-machine-building industry were relocated there from Ukraine, and Elektrostal is now a centre for the ...
628DirtRooster
Welcome to the 628DirtRooster website where you can find video links to Randy McCaffrey's (AKA DirtRooster) YouTube videos, community support and other resources for the Hobby Beekeepers and the official 628DirtRooster online store where you can find 628DirtRooster hats and shirts, local Mississippi honey and whole lot more!