Recently, the nutritional requirements of marine finfish larvae have received considerable attention, and studies have shown that docosahexaenoic acid (DHA) affects the growth and survival of marine finfish larvae. We investigated the effects of different rotifer diets containing variable amounts of DHA on the growth and survival of larval Atlantic cod (Gadus morhua L.). Four different commercial rotifer enrichment formulations were used: spray-dried whole cells composed of Crypthecodinium sp. (ED1), spray-dried whole cells of Schizochytrium sp. (ED2), an oil emulsion (ED3) and ED1, and dried Chlorella at a 7:3 ratio by weight (ED4). The resultant rotifers contained a similar concentration of DHA (1.1–1.6% DW), but the level of DHA differed in proportion to EPA for each enrichment, and was designated ER1–4. Twelve 30-l aquaria were used with three replicates per treatment. Larvae were fed with rotifers from 3 to 43 days post-hatch (dph) at 4000 prey l−1. At the end of the experiment, no significant differences were found in body length and dry weight between the larvae reared on ER1 and ER2. However, larvae reared on ER3 were significantly smaller (both in length and weight) than larvae reared on ER1 and ER2. Larval survival on the ER2 treatment at 43 dph was significantly higher than on the other three treatments. Our results showed a positive effect of rotifer DHA proportions on growth and survival of cod larvae, and demonstrated that Atlantic cod larvae require a high ratio of dietary DHA to EPA.

Access to GHCEs in US partner institutions should be an important underlying ethical principle in the establishment of institutional partnerships. The opportunities available to and experiences of students from LMIC partner institutions are important areas for future GH education research.

Global health education (GHE) continues to be a growing initiative in many medical schools across the world. This focus is no longer limited to participants from high-income countries and has expanded to institutions and students from low- and middle-income settings. With this shift has come a need to develop meaningful curricula through engagement between educators and learners who represent the sending institutions and the diverse settings in which GHE takes place. The Bellagio Global Health Education Initiative (BGHEI) was founded to create a space for such debate and discussion and to generate guidelines towards a universal curriculum for global health. In this article, we describe the development and process of our work and outline six overarching principles that ought to be considered when adopting an inclusive approach to GHE curriculum development.

In all, 63 of 84 (75%) LMIC and 61 of 152 (40%) U.S. students participated. Recall of predeparture training was low for both LMIC and U.S. students (44% and 55%, respectively). Opportunities to experience different healthcare systems, resource-different settings, and cultural exposure emerged as motivators for both groups. Both groups noted differences in doctor-patient relationships, interactions between colleagues, and use of diagnostic testing. U.S. respondents were more likely to perceive differences in the impact of social determinants of health and ethical issues. Both groups felt that their experience affected their interactions with patients and perspectives on education, but U.S. students were more likely to mention perspectives on healthcare delivery and social determinants of health, whereas LMIC respondents noted impacts on career goals. Insights: These results argue that GHE is not restricted to resource-constrained settings and that students from LMICs have similar reasons for participation as those from HICs. LMIC students also identified a lack of emphasis on GHE topics like social determinants of health during GH electives, which could diminish the effectiveness of these experiences. Both U.S. and LMIC students emphasized the cultural component of their GHE experience but had different perceptions regarding core tenets of GHE, such as the social determinants of health and health equity, during these experiences.

This study provided a method for understanding the student's experience that included student's learning about culture, health disparities, and exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a flexible, personalized experience. How we might design a curriculum to facilitate transformational learning experiences needs further research.