In October 2008, Dr. Richard Mgaga, Head of the Malaria Control Programme in Uganda reviewed the monthly malaria statistics report for the district of Apac, which in April of 2008 had undergone a pilot indoor residual spraying (IRS) program using DDT in a campaign to prevent mosquitoes from biting and spreading malaria. The campaign was halted by a court injunction requested by organic farmers, exporters and environmentalists in May 2008, and the injunction was upheld by the High Court in June. In early August, the Uganda Health Ministry began spraying a pyrethroid insecticide in place of DDT. Meanwhile the Ugandan Attorney General was challenging the High Court’s decision.  Dr. Mugaga was under pressure by the Presidential Malaria Initiative (PMI) to undertake a full program of IRS in 300,000 households in the northern districts of Uganda, including Apac. However, he was unsure whether to proceed, given the opposition and apparent problems that surfaced when the Apac pilot was implemented.

This case provides an introduction to the structure and dynamics of nonprofit hospital governance in the U.S. A hospital CEO two years into her position is grappling with how to make her board a more effective governing body. The hospital’s competitive position was eroding due in part to resistance by its independent medical staff to recruiting new physicians into the service area. In addition, some of the physicians had opened freestanding diagnostic and treatment facilities that reduced hospital revenues. But the board was reluctant to take this issue on. At the same time, the CEO felt that too much board attention was spent second-guessing her new hires and other operational decisions that she felt were her responsibility.  

This casebook published by the World Health Organization contains 64 case studies, each of which raises an important and difficult ethical issue connected with planning, reviewing, or conducting health-related research. Available for download free of charge from the World Health Organization in English, Arabic, Russian, and Spanish.

“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." 

In January 2003, Dr. David Acheson, the new Chief Medical Officer of Health of the FDA was charged by his boss with working jointly with the EPA to develop a comprehensive set of federal guidelines for fish consumption for all Americans. The guidelines needed to balance the benefits of fish consumption with the potential risks of exposure to mercury, dioxin, and PCBs - exposures of particular concern to pregnant women and young children. The case includes an additional document entitled Mercury and Fish Consumption that provides background material and reviews of studies of mercury exposure.

In 2007, Dr. Mark Horton took over as the head of the new California Department of Public Health (CDPH), at time when the governor, Arnold Schwarzenegger, had already identified obesity as a prevention priority in his health care reform proposal. However, it was not immediately clear how the CDPH should prioritize the spending on obesity prevention, nor how it should measure and evaluate the success of its interventions. A wide range of possibilities were on the table, accompanied by strong advocates on each side.

Governor A was preparing for a forum on health sector reforms to be held the next week. The Governor wanted to make health reform one of her flagship programs during the upcoming local elections, and, in particular, wanted to consider ways of lowering the cost of drugs for the poor who were faced with huge out-of-pocket expenses for medications. The case focuses on issues of health reform implementation, using the problem of high cost pharmaceuticals as an example.

Evidence for the superiority of guided instruction is explained in the context of our knowledge of human cognitive architecture, expert–novice differences, and cognitive load. Although unguided or minimally guided instructional approaches are very popular and intuitively appealing, the point is made that these approaches ignore both the structures that constitute human cognitive architecture and evidence from empirical studies over the past half-century that consistently indicate that minimally guided instruction is less effective and less efficient than instructional approaches that place a strong emphasis on guidance of the student learning process. The advantage of guidance begins to recede only when learners have sufficiently high prior knowledge to provide "internal" guidance. Recent developments in instructional research and instructional design models that support guidance during instruction are briefly described.