The patient is admitted to the hospital for debridement of the right fibula bone. After multiple outpatient diagnostic tests are performed, the diagnosis of acute osteomyelitis localized in the right fibula due to a staphyl ococcusfection is made in this 15-year-old male. The child began complaining of pain below the right knee and difficulty walking over the past two weeks. The patient denied any trauma to the leg but, as an active boy who plays soccer and softball, trauma could not be ruled out, although no evidence of an injury was found on the leg. To prevent bone destruction as well as the possibility of the infection spreading to other bones and joints in the lower leg, the child is admitted for surgery. The procedure is an open excisional debridement of the proximal fibula. The patient withstands the procedure well and is discharged to his parents for at-home recovery 1 day after surgery. Principal Diagnosis: Secondary Diagnoses: Principal Procedure: Secondary Procedure(s):

Your first big task is to plan a health promotion program to increase the number of college students who get the flu shot.

Using the Health Belief Model*, identify 2 factors related to each of the following constructs that are specific to this population (college students):

Perceived Susceptibility

Perceived Severity

Perceived Benefits

Perceived Barriers

Cues to Action

Self-Efficacy

Once you have used a behavior theory to get a better understanding of WHY students might or might not get a flu shot, you decide to plan a health promotion program to encourage more students to get the flu shot.

Discuss two reasons why it is important to use a planning model when preparing to conduct a health promotion intervention.

If you were implementing a health promotion program to encourage more college students to get the flu shot, based on your assessments above, briefly describe at least 3 SPECIFIC actions/interventions your health promotion program might include.

As a group instructor design a muscle conditioning group exercise class. Describe in detail the components of the warm-up routine you will use to begin your class; list the exercises you will use in the workout routine, the equipment needed, and the number of repetitions of each exercise; explain the process of communicating to your students during the class, including specifics regarding the cueing of transitions; and describe the cool-down session you will use to close out your class ?

Background: Many addictive substances can lead to changes in dopamine levels in the brain. For example, both cocaine and alcohol are associated with elevated levels of baseline striatal dopamine. Although other neurotransmitter systems have been implicated, there is strong evidence that substance addiction primarily involves the dopamine (dopaminergic) system. The dopaminergic system also seems to play a key role in behavioral addictions, especially pathological gambling

Suggested Readings: van Holst et al. (2018), DSM-V (2013) criteria for Pathological Gambling, Nutt et al. (2015)

Question : What do the findings of van Holst et al. (2018) tell us about dopamine in the brains of pathological gamblers?

A 65-year-old previously well man presents to the clinic with complaints of fatigue of 3 months duration. Questioning reveals diffuse weakness and feeling winded when walking uphill or climbing more than one flight of stairs. All symptoms have slowly worsened over time. There are no other complaints, and the review of systems is otherwise negative. The patient has no significant medical history, social history, or family history. On physical examination, he appears somewhat pale, with normal vital signs. The physical examination is unremarkable except for his rectal examination, which reveals brown, guaiac-positive stool (suggesting the presence of blood in the stool). A blood test reveals anemia.

Answer the following questions with regard to the case study above:

a)  What is the most likely form of anemia in this man? What is the probable underlying cause?

b)  What is the mechanism by which this disorder results in anemia?

c)  What might one expect to see in the peripheral blood smear?

d)  What other tests might be ordered to confirm the diagnosis?

e)  What is the pathophysiologic mechanism of this patient’s fatigue, weakness, and shortness of breath? Why is he pale?