Global health education in general preventive medicine residencies.

Opportunities for global health training during residency are steadily increasing. For example, surveys show that more than half of residency programs now offer international electives. Residency programs are increasingly recognizing that global health training improves communication skills, fosters awareness of health disparities, and inspires careers in primary care and public health. Although research has focused on global health education in other specialties, there is a paucity of research on global health training in public health and general preventive medicine (GPM). We sought to describe the extent of global health training across GPM residencies, capture the perspectives of program directors regarding competencies residents need for careers in global health, and identify program directors' perceived barriers to providing global health training. The survey was sent electronically to 42 U.S. GPM residency program directors from September to October 2013. Twenty-three completed surveys were returned. Information from residencies that did not complete the study survey was collected through a predefined search protocol. Data analysis was performed from February through July 2014. Among program directors completing the survey, the most common types of reported global health education were courses (n=17), followed by international rotations (n=10). Ten program directors indicated that resident(s) were involved in global health training, research, or service initiatives. Commonly perceived barriers included funding (87%), scheduling (56.5%), and partnership and sustainability (34.8%). Through global health coursework, research, and practicum rotations, GPM residents could acquire skills, knowledge, and attitudes contributing to careers in global health.

Type 2 diabetes and mammographic breast density among underserved women.

PURPOSE: We conducted a study of women recruited at Meharry Medical College, a historically black medical school, to investigate the relationship between diabetes and mammographic breast density. METHODS: A total of 476 women completed in-person interviews, body measurements, and full-field digital mammograms on a Hologic mammography unit from December 2011 to February 2014. Average percent breast density for the left and right breasts combined was estimated using Quantra, an automated algorithm for volumetric assessment of breast tissue. The prevalence of type 2 diabetes was determined by self-report. RESULTS: After adjustment for confounding variables, the mean percent breast density among premenopausal women with type 2 diabetes [[Formula: see text] 13.8 %, 95 % confidence interval (CI) 11.6-15.9] was nonsignificantly lower than that of women without type 2 diabetes ([Formula: see text] 15.9 %, 95 % CI 15.0-16.8) (p = 0.07); however, there was no association among postmenopausal women. The effect of type 2 diabetes in severely obese women (BMI ≥ 35) appeared to differ by menopausal status with a reduction in mean percent breast density in premenopausal women, but an increase in mean percent breast density in postmenopausal women which could have been due to chance. CONCLUSIONS: Confirmation of our findings in larger studies may assist in clarifying the role of the insulin signaling breast cancer pathway in women with high breast density.

Male involvement for the prevention of mother-to-child HIV transmission: A brief review of initiatives in East, West, and Central Africa.

Current trends in HIV/AIDS research in sub-Saharan Africa (SSA) highlight socially and culturally sensitive interventions that mobilize community members and resources for universal access to HIV prevention, treatment, and care services. These factors are particularly important when addressing the complex social and cultural nature of implementing services for prevention of mother-to-child transmission of HIV (PMTCT). Across the globe approximately 34 % fewer children were infected with HIV through the perinatal or breastfeeding route in 2011 (est. 330,000) than in 2001 (est. 500,000), but ongoing mother-to-child HIV transmission is concentrated in sub-Saharan Africa, where fully 90 % of 2011 cases are estimated to have occurred. Recent literature suggests that PMTCT in Africa is optimized when interventions engage and empower community members, including male partners, to support program implementation and confront the social, cultural and economic barriers that facilitate continued vertical transmission of HIV. In resource-limited settings the feasibility and sustainability of PMTCT programs require innovative approaches to strengthening male engagement by leveraging lessons learned from successful initiatives in SSA. This review presents an overview of studies assessing barriers and facilitators of male participation in PMTCT and new interventions designed to increase male engagement in East, West, and Central Africa from 2000-2013, and examines the inclusion of men in PMTCT programs through the lens of community and facility activities that promote the engagement and involvement of both men and women in transformative PMTCT initiatives.