Curricular Models and Learning Objectives for Undergraduate Minors in Global Health.

Background: A growing number of institutions of higher education offer undergraduate educational programs in global health. Objective: To identify all undergraduate minors in global health being offered in the United States during the 2019-20 academic year, categorize the curricula being used by secondary programs of study, evaluate the content of required foundational courses, and examine the types of experiential learning opportunities that are offered. Methods: A working group of the Consortium of Universities for Global Health (CUGH) conducted a systematic review of the websites of all accredited 4-year colleges and universities, identifying 84 institutions offering general global health minors. Findings: A typical global health minor consists of one introduction to global health course, one epidemiology or health research methods course, several additional required or selective courses, and one applied learning experience. Within this general structure, five curricular models are currently being used for global health minors: (1) intensive minors composed of specialty global health courses, (2) global public health minors built on a core set of public health courses, (3) multidisciplinary minors requiring courses in the sciences and social sciences, (4) anthropology centric minors, and (5) flexible minors. Conclusions: CUGH recommends ten undergraduate student learning objectives in global health that encompass the history and functions of global health; globalization and health; social determinants of health; environmental health; health and human rights; comparative health systems; global health agencies and organizations; the global burden of disease; global health interventions; and interdisciplinary and interprofessional perspectives.

Efficacy and effectiveness of maternal influenza vaccination during pregnancy: a review of the evidence.

Influenza vaccine is universally recommended for pregnant women during any trimester of pregnancy. In light of this recommendation, a comprehensive literature review was conducted to examine the available evidence regarding influenza vaccine efficacy and effectiveness during pregnancy. A comprehensive Medline search identified potentially relevant articles published between January 1, 1964 and February 1, 2013. Articles were selected that specifically evaluated the efficacy and effectiveness of maternal influenza vaccine in protecting women and infants from influenza infection. These were reviewed with a particular focus on the methods used to confirm influenza infection. Ten of 476 articles met the inclusion criteria. None of the six studies evaluating maternal outcomes were randomized controlled studies using a laboratory-confirmed influenza diagnosis to measure vaccine efficacy. Two studies included reverse-transcriptase polymerase chain reaction confirmation; four relied solely on clinical outcomes. The reported vaccine effectiveness (VE) ranged from -15 to 70 %. Seven studies examined the potential for maternal vaccination to protect infants. Four of these applied some form of laboratory confirmation, with VE ranging from 41 to 91 %. Vaccination against infectious disease is an unparalleled public health success. However, studies to date demonstrate that influenza vaccine provides only moderate protection from influenza infection in pregnant women. This review found broad heterogeneity among studies, with no uniform outcome measured and little data based on laboratory-confirmed influenza, leading to wide-ranging estimates of effectiveness. Rigorously designed studies assessing clearly defined outcomes are needed to support the development of reasoned public health policy about influenza prevention in this population.

Substance-P-mediated immunomodulation of tumor growth in a murine model.

BACKGROUND/OBJECTIVE: Substance P (SP) has been reported to have immunoregulatory properties including effects on many of the mediators involved in anti-tumor immunity. In this study, we investigated the effect of SP on tumor development in a murine model of melanoma. In addition, we examined the role of natural killer (NK) and T cells in SP-mediated modulation of tumor growth. MATERIALS AND METHODS: Mice were implanted with mini-osmotic pumps that delivered a continuous infusion of either SP or PBS over a 14-day period. Five days following implantation, animals received K1735 melanoma cells and tumor growth was monitored. The role of NK and T cells in SP-mediated protection was examined by antibody depletion studies. To determine if cells from SP-treated animals could delay tumor growth in animals in the absence of exogenous SP infusion, splenocytes from mice treated with SP were adoptively transferred into SCID mice. RESULTS: In vivoSP treatment led to a significant delay in tumor growth. When animals were depleted of NK or T cells, this protective effect was lost. Adoptive transfer of cells from SP-treated animals led to a significant protective effect on tumor growth in SCID mice. CONCLUSION: Pretreatment of mice with SP provides protection against K1735 tumor growth, and this protection requires both T cells and NK cells. SP-mediated tumor protection can be transferred by the adoptive transfer of cells from SP-treated animals into animals that do not receive exogenous SP. These studies suggest a model in which in vivo SP treatment prior to tumor challenge primes immune mediators to prevent or delay tumor establishment.