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Competing Interests: Competing interests:: Jillian Alston reports funding from the Canadian Institutes of Health Research. Stefan Baral is funded by the Inner City Health Associates. Aaron Orkin is supported by the University of Toronto Department of Family and Community Medicine and the Dalla Lana School of Public Health,, outside the submitted work. Sharon Straus is funded by a Tier 1 Canada Research Chair in Knowledge Translation. The Slaight Family Foundation provides funding to the geriatric shelter outreach initiative and its program evaluation mentioned in this manuscript; Jillian Alston and Sharon Straus are involved with this initiative. No other competing interests were declared.

Background: We previously reported that women from high-risk families who tested negative for a BRCA1 or BRCA2 (BRCA1/2) mutation were four times more likely to develop breast cancer compared to women in the general population. Preventive measures and risk factors for breast cancer development in these high-risk women have not been evaluated to the same extent as BRCA1/2 positive women. Further, there is virtually no scientific evidence about best practices in their management and care. The proposed study will examine a role of genetic and non-genetic factors and develop the systems and parameters for the monitoring and surveillance necessary to help establish guidelines for the care of this high-risk population., Methods/design: To achieve our goals, we will assemble and follow a Canadian cohort of 1,000 cancer-free women with a strong family history breast cancer (defined as two or more relatives affected by breast cancer under the age of 50, or three or more relatives diagnosed with breast cancer at any age from one side of the family and with no BRCA1/2 mutation in the family). All eligible participants will be mailed a study package including invitation to participate, consent form, a research questionnaire to collect data regarding family history, reproductive and lifestyle factors, as well as screening and surgery. Usual dietary intake will be assessed by a diet history questionnaire. Biological samples including toenail clippings, urine and blood samples will be collected. These women will be followed every two years by questionnaire to update exposure information, screening practices, surgical and chemoprevention, and disease development., Discussion: Findings from this study will serve to help establish clinical guidelines for the implementation of prevention, counseling, and treatment practices for women who face an elevated risk of breast cancer due to family history, but who do not carry a BRCA1/2 mutation.

Purpose: Since 2007, all Canadian medical schools have had at least one established student-led public health interest group (PHIG). The Association of Faculties of Medicine of Canada (AFMC), the Public Health Task Group, and the Public Health Agency of Canada (PHAC) have supported these PHIGs. The authors describe the activities and structure of PHIGs in Canada from 2007 to 2011, plus the extent to which PHIGs met the objectives set out for them by the AFMC Public Health Task Group., Method: Using a standardized template, the authors analyzed funding applications and reports that PHIG executives submitted to the AFMC from 2007 through 2011. The authors created activity categories and collected simple counts of activities within categories. They then used these data to assess how successfully PHIGs have been able to meet their objectives., Results: Fifty-two funding applications, 50 interim reports, and 48 final reports were available for analysis. All 17 Canadian medical schools had at least one established PHIG between 2007 and 2011, and 9 schools (53%) applied for PHIG funding in all four years. Academic activities such as lectures, seminars, and workshops were the most common activities conducted by PHIGs, followed by career exploration and networking., Conclusions: This study found that the AFMC, with funding support from PHAC, was instrumental in initiating PHIGs in 82% (n = 14) of Canadian medical schools. With consistent funding, national networking opportunities, and a common operating structure, PHIGs have been able to accomplish AFMC's objectives for increasing public health awareness amongst medical students.