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Almost 80 million people globally are forcibly displaced. A small number reach wealthy western countries and seek asylum. Over half are children. Wealthy reception countries have increasingly adopted restrictive reception practices including immigration detention. There is an expanding literature on the mental health impacts of immigration detention for adults, but less about children. This scoping review identified 22 studies of children detained by 6 countries (Australia, Canada, Hong Kong, Netherlands, the UK and the US) through searches of Medline, PsychINFO, Emcare, CINAHL and Scopus data bases for the period January 1992–May 2019. The results are presented thematically. There is quantitative data about the mental health of children and parents who are detained and qualitative evidence includes the words and drawings of detained children. The papers are predominantly small cross-sectional studies using mixed methodologies with convenience samples. Despite weaknesses in individual studies the review provides a rich and consistent picture of the experience and impact of immigration detention on children's wellbeing, parental mental health and parenting. Displaced children are exposed to peri-migration trauma and loss compounded by further adversity while held detained. There are high rates of distress, mental disorder, physical health and developmental problems in children aged from infancy to adolescence which persist after resettlement. Restrictive detention is a particularly adverse reception experience and children and parents should not be detained or separated for immigration purposes. The findings have implications for policy and practice. Clinicians and researchers have a role in advocacy for reception polices that support the wellbeing of accompanied and unaccompanied children who seek asylum. [ABSTRACT FROM AUTHOR]

This paper provides a narrative review of the existing literature on differences in demographic and biological features of breast cancer at time of diagnosis between Black and White women in Canada, the United Kingdom and the United States. Electronic database searches for published peer-reviewed articles on this topic were conducted, and 78 articles were included in the final narrative review. Differences between Black and White women were compared for eight categories including age, tumour stage, size, grade, lymph node involvement, and hormone status. Black women were significantly more likely to present with less favourable tumour features at the time of diagnosis than White women. Significant differences were reported in age at diagnosis, tumour stage, size, grade and hormone status, particularly triple negative breast cancer. Limitations on the generalizability of the review findings are discussed, as well as the implications of these findings on future research, especially within the Canadian context. [ABSTRACT FROM AUTHOR]

In this paper we present the current state of cultural diversity education for undergraduate medical students in three English-speaking countries: the United Kingdom (U.K.), United States (U.S.) and Canada. We review key documents that have shaped cultural diversity education in each country and compare and contrast current issues. It is beyond the scope of this paper to discuss the varied terminology that is immediately evident. Suffice it to say that there are many terms (e.g. cultural awareness, competence, sensitivity, sensibility, diversity and critical cultural diversity) used in different contexts with different meanings. The major issues that all three countries face include a lack of conceptual clarity, and fragmented and variable programs to teach cultural diversity. Faculty and staff support and development, and ambivalence from both staff and students continue to be a challenge. We suggest that greater international collaboration may help provide some solutions. [ABSTRACT FROM AUTHOR]

This paper examines the definition and measurement of time devoted to child care in the diary-based surveys administered by the United States, Canada, Australia, and Great Britain. Detailed analysis of the relationship between measures of care activity and supervisory care in the American Time Use Survey (ATUS) illustrate the larger conceptual issues at stake. [ABSTRACT FROM AUTHOR]

Objective: To assess rates of traversing barriers to care to access optimal clinical outcomes in people with migraine internationally. Background: People in need of medical care for migraine should consult a health care professional knowledgeable in migraine management, obtain an accurate diagnosis, and receive an individualized treatment plan, which includes scientific society guideline-recommended treatments where appropriate. Methods: The Chronic Migraine Epidemiology and Outcomes-International (CaMEO-I) Study was a cross-sectional, web-based survey conducted from July 2021 through March 2022 in Canada, France, Germany, Japan, the United Kingdom, and the United States (US). Respondents who met modified International Classification of Headache Disorders, 3rd edition, criteria for migraine and had Migraine Disability Assessment Scale (MIDAS) scores of ≥ 6 (i.e., mild, moderate, or severe disability) were deemed to need medical care and were included in this analysis. Minimally effective treatment required that participants were currently consulting a health care professional for headache (barrier 1), reported an accurate diagnosis (barrier 2), and reported use of minimally appropriate pharmacologic treatment (barrier 3; based on American Headache Society 2021 Consensus Statement recommendations). Proportions of respondents who successfully traversed each barrier were calculated, and chi-square tests were used to assess overall difference among countries. Results: Among 14,492 respondents with migraine, 8,330 had MIDAS scores of ≥ 6, were deemed in need of medical care, and were included in this analysis. Current headache consultation was reported by 35.1% (2926/8330) of respondents. Compared with the US, consultation rates and diagnosis rates were statistically significantly lower in all other countries except France where they were statistically significantly higher. Total appropriate treatment rates were also statistically significantly lower in all other countries compared with the US except France, which did not differ from the US. All 3 barriers were traversed by only 11.5% (955/8330) of respondents, with differences among countries (P < 0.001). Conclusions: Of people with migraine in need of medical care for migraine, less than 15% traverse all 3 barriers to care. Although rates of consultation, diagnosis, and treatment differed among countries, improvements are needed in all countries studied to reduce the global burden of migraine. Trial registration: NA. [ABSTRACT FROM AUTHOR]

This paper seeks to move beyond what Martin and Ruhs described as the numbers versus rights equation in temporary labour migration programs. We do this by examining the ideology of temporary labour migration. This ideology has three key elements: temporariness, labour markets and rights. The paper describes how these concepts obscure key features of temporary labour migration programs. The argument is developed by examining points of contrast between current programs in place in the USA, Canada, Australia and the UK. The paper concludes by demonstrating how unmasking the power imbalances of this ideology will lead to new policy directions. [ABSTRACT FROM AUTHOR]

On the basis of a study of American, British and Canadian records, this article examines the relationship of France to the negotiation of the North Atlantic Treaty from the perspective of the ‘ABC’ countries, particularly Canada. How did the perceived vulnerability of France influence the approach of the members of the ‘North Atlantic Triangle’ to the justification, timing and contents of the proposed pact? How did France's inclusion in Western Union and its exclusion from the preliminary talks in the Pentagon affect American, British and Canadian attitudes to the development of the draft alternatively known as the ‘Pentagon Paper’ or the ‘State Department Draft’? These questions are addressed, as well as the impact on the later ambassadorial talks of France's priority to immediate rearmament and its determination to include the departments of Algeria within the defensive perimeter of the North Atlantic Treaty Organisation. Finally, the article assesses the extent to which France and its requirements influenced the policies and actions of the Canadian government throughout the negotiation of the North Atlantic Treaty. [ABSTRACT FROM PUBLISHER]

There have recently been a number of high profile political incidents, and legal cases, that raise questions about hate speech. At the same time, the tensions, and perceived conflicts, between religion and sexuality have become controversial topics. This paper considers the relationship between religious freedom, free speech and equality through an analysis of recent case law in Great Britain, Canada and the United States. The paper starts with a discussion of how conflicts between these values arise in areas such as hate speech and explores the differences between the European and US approach to this issue. In Council of Europe member states there is an increasing use of the criminal law to regulate hate speech. This paper argues that criminalisation of hate speech poses a distinct risk to the values of free speech and proposes alternative non-legal responses such as a greater use of cultural policy. The paper also explores a range of cases where the religion and sexual orientation conflict has arisen in areas such as the workplace. An analysis of these cases suggests that although there is no perfect resolution of this issue, it is possible to develop a set of principles that encourage a balance between the values of religious freedom, free speech and equality even in difficult situations where there is a conflict between religion and sexuality. The paper concludes with some practical recommendations for managing the tensions or conflicts between religious freedom, free speech and equality in liberal democracies. [ABSTRACT FROM AUTHOR]

In this paper, we consider whether certain countries are particularly adept (or particularly poor) at getting children from disadvantaged homes to study for a bachelor's degree. A series of university access models are estimated for four English-speaking countries (England, Canada, Australia and the USA), which include controls for comparable measures of academic achievement at age 15. Our results suggest that socioeconomic differences in university access are more pronounced in England and Canada than Australia and the USA and that cross-national variation in the socioeconomic gap remains even once we take account of differences in academic achievement. We discuss the implications of our findings for the creation of more socially mobile societies. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

Millions of people cross political borders yearly without having the proper documents. This has led to increased detention and deportation practices in destination countries for reasons related to security and sovereignty. The objective of the current study was to analyze and visualize research publications on the detention and deportation of migrants to identify current research hotspots, research gaps, and potential future research in the field. Relevant research articles were obtained from the Scopus database for the study period from 1900 to December 31, 2022. The analysis included presentations of key contributors to the field and visualization of topics, themes, and international collaboration. In total, 906 articles were found. The earliest was in 1982. The majority of articles were published in journals within the subject areas of social sciences and humanities. The number of publications showed a steep rise from 2011 to 2022. The Journal of Ethnic and Migration Studies was the most prolific, but publications in the Citizenship Studies journal received the highest number of citations per article. Researchers from the United States contributed the most. Mexico ranked fifth in the number of publications. Oxford University was the most prolific institution, followed by three universities in Australia. The majority of articles were single-authored, indicative of limited author-author collaboration. Research hotspots in the field were "human rights" and "mental health". The detention and deportation of Mexican and other Latino migrants in the United States constituted a distinct research theme in the field. International research collaboration was limited by geographical proximity (e.g., the United States and Mexico) or common language (e.g., the United Kingdom and Australia). Future research topics should focus on alternatives to detention, family separation, and healthcare services for detained migrants. Research activity on detention and deportation is required from all world regions, including the source countries of migrants. Future research should promote alternatives to traditional detentions. The contribution of countries in Africa, the Middle East, and South-Eastern Asian regions needs to be encouraged. Future research on the detention and deportation of non-Latino migrants is highly required. [ABSTRACT FROM AUTHOR]

In vitro fertilization using donated oocytes is an important medical technique that provides the only option for some infertile patients to have children. The technique remains ethically contentious, however, and, as a result of this controversy, different oversight approaches have been developed in countries around the world. This paper examines the oversight and practice of oocyte donation in Canada, the United Kingdom and the United States to examine how policy choices have influenced the development and use of this medical technology. Examining per capita utilization of oocyte donation in these three countries provides evidence that supply-side policies-specifically policies affecting the compensation of potential oocyte donors-have substantially influenced the use of this technology. These results should provide useful insight for policymakers developing or revising oocyte donation policies. [ABSTRACT FROM AUTHOR]

Bibliometrics is a high-demand and fast-growing statistical area for the analysis of scientific literature in a certain field. Although religion and health (R&H) field has been a developing study area in recent years, only a few bibliometric studies have been published on the literature in R&H. In this study, we aimed to perform bibliometric analysis of the health literature related to the most populous Abrahamic religions during the period of 1975-2017 by using Web of Science database including WoS Collection Core Collection, Korean Journal Database, Russian Science Citation Index and SciELO Citation Index. In overall evaluation, the USA ranked first in publication productivity with 1388 items and covered 37.21% of total literature. The Journal of Religion and Health published the highest number of documents (n = 351). We found a total of 1329 items in health and Christianity field, and the USA was the most productive country followed by the UK and Canada (n = 166 and 63 documents, respectively). Loma Linda University was found to publish the highest number of items. We detected 1965 publications in Islam and health area, and top three countries were the USA, the UK and Saudi Arabia (n = 387, 194 and 137 items, respectively). University of London was the most productive institution (n = 72, 3.67%). A total of 436 articles were detected in Judaism and health. Top three countries in productivity were the UK, Israel and the UK (211, 151 and 36 items, respectively). Hebrew University of Jerusalem produced 17.43% of total documents as the topmost institution. Although Abrahamic religions originated from Middle East, we noted that most productive authors in this field were not Middle Eastern and from developed countries. Researchers from developing or least developed countries should be encouraged to carry out more studies in R&H field. [ABSTRACT FROM AUTHOR]

Farmers’ markets have enjoyed a resurgence in the past two decades in Canada, the United States, and the United Kingdom. This increase in popularity is attributed to a host of environmental, social, and economic factors, often related to the alleged benefits of local food, alternative farming, and producer–consumer interactions. Steeped in tradition, there are also widely held assumptions related to the type of food and food vendors that belong at a farmers’ market in addition to the type of experience that should take place. There remains a need to explore and analyze these fundamental aspects of the farmers’ market and to consider how they influence their formation and function. This paper argues that discourses of authenticity are central to the identity of the farmers’ market, and that they are constructed differently “from above” by those seeking to regulate farmers’ markets in particular jurisdictions and “from below” by managers, producers, and consumers at individual markets. A literature-based discussion is complemented and grounded by consideration of institutional statements regarding authenticity and of key results from a survey of managers, food vendors, and customers at 15 farmers’ markets in Ontario, Canada. It is demonstrated that while the general discourse about authenticity at the farmers’ market is built around strict, almost ideological assumptions about the presence of “local food” and those who produce it, community-level responses reflect considerable diversity in the interpretation and composition of the farmers’ market. It is suggested that a binary view of authenticity, where some farmers’ markets are cast as “real” and others presumably not, is highly problematic as it tends to ignore a large and important middle ground with multiple identities. [ABSTRACT FROM AUTHOR]

Official science and technology statistics are fifty years old. Among industrial countries, the forerunners were the United States, Canada and Great Britain. This paper traces the development and the construction of S&T statistics in these three countries, and their subsequent standardization, mainly by the OECD, in the 1960s. It shows how military and science policy needs drove the construction of statistics, until economic considerations came to dominate their development. It also discusses how statistics interacted with politics by way of studies that documented gaps between OECD Member countries and between the OECD and the USSR. [ABSTRACT FROM AUTHOR]

The global expansion of access to higher education has increased demand for information on academic quality and has led to the development of university ranking systems or league tables in many countries of the world. A recent UNESCO/CEPES conference on higher education indicators concluded that cross-national research on these ranking systems could make an important contribution to improving the international market for higher education. The comparison and analysis of national university ranking systems can help address a number of important policy questions. First, is there an emerging international consensus on the measurement of academic quality as reflected in these ranking systems? Second, what impact are the different ranking systems having on university and academic behavior in their respective countries? Finally, are there important public interests that are thus far not reflected in these rankings? If so, is there a needed and appropriate role for public policy in the development and distribution of university ranking systems and what might that role be? This paper explores these questions through a comparative analysis of university rankings in Australia, Canada, the UK, and the US. [ABSTRACT FROM AUTHOR]

We examine demand for union membership amongst young and adult workers in Britain, Canada, and the United States. Using a model of representation advanced by Farber (1983, 2001) and Riddell (1993), we find that a majority of the union density differential between young and adult workers in all three countries is due to supply-side constraints rather than a lower desire for unionization by the young. This finding lends credence to two conjectures: first, tastes for collective representation do not differ substantially among workers (either by nationality or by age) and second, union representation can be fruitfully modeled as an experience-good. The experience-good properties of union membership explain the persistence of union density differentials (in this case between youth and adults) in the face of equal levels of desired representation. [ABSTRACT FROM AUTHOR]

South Asian communities comprise one of the fastest growing populations in Western countries. However, the sexual health of immigrant men in particular remains vastly understudied and little is known about how and if men access these services. Four multi-disciplinary electronic databases were searched to between 1998 and 2018. The search yielded 586 articles; 407 duplicate articles were removed, and 376 did not meet the inclusion criteria. A total of 10 articles were included in this review. Herein we report the factors shaping sexual health service access and use, namely: (1) cultural and psychological factors; (2) sexual health service accessibility; (3) personal beliefs and patterns in service use; (4) social perspectives and conflicting values on sexual health. We identify the gaps in research needed for policymakers, formal healthcare providers, and South Asian community stakeholders to develop effective and inclusive sexual health programs for South Asian men in Western countries. [ABSTRACT FROM AUTHOR]

Asians immigrants (AIs) are one of the fastest growing racial groups in many countries globally. Despite pain prevalence, studies on chronic pain management among AIs is limited in the literature. An integrative review was conducted exploring the current state of science on chronic pain management among AIs. Several databases were used to identify related articles and 15 studies met the inclusion criteria. Two major themes emerged: (a) self-management, pertaining to how AIs take responsibility for their pain, and (b) resilience, their adaptive behaviors indicating low levels of pain-related dysfunction and burden despite chronic pain severity. Resilience plays a significant role in the mechanism by which self-management works in pain among AIs. Chronic pain management is a complex process where challenges to effective treatments exist. Findings have significant implications to healthcare providers and the general pain population. Future research directions include the necessity for increased participation of AIs in studies. [ABSTRACT FROM AUTHOR]

Previous research has documented significantly larger income-related gaps in children's early cognitive development in the United States than in the United Kingdom, Canada, and Australia. In this study, we investigate the extent to which this is a result of a more unequal income distribution in the United States. We show that although incomes are more unequal in the United States than elsewhere, a given difference in real income is associated with larger gaps in child test scores there than in the three other countries. In particular, high-income families in the United States appear to translate the same amount of financial resources into greater cognitive advantages relative to the middle-income group than those in the other countries studied. We compare inequalities in other kinds of family characteristics and show that higher income levels are disproportionately concentrated among families with advantageous demographic characteristics in the United States. Our results underline the fact that the same degree of income inequality can translate into different disparities in child development, depending on the distribution of other family resources. [ABSTRACT FROM AUTHOR]

Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016. Grey literature (e.g., Google scholar, conference abstracts/posters) were also hand searched through February 2017. Two independent reviewers screened titles and abstracts and conducted full-text review on qualified articles. All disagreements were resolved by discussion between reviewers to reach consensus or by a third reviewer. In total, 23 qualified studies that evaluated the economic aspects of FLS were included: 16 cost-effectiveness studies, 2 cost-benefit analyses, and 5 studies of cost savings. Patient populations varied (prior fragility fracture, non-vertebral fracture, hip fracture, wrist fracture), and FLS strategies ranged from mail-based interventions to comprehensive nurse/physician-coordinated programs. Cost-effectiveness studies were conducted in Canada, Australia, USA, UK, Japan, Taiwan, and Sweden. FLS was cost-effective in comparisons with usual care or no treatment, regardless of the program intensity or the country in which the FLS was implemented (cost/QALY from $3023-$28,800 US dollars (USD) in Japan to $14,513-$112,877 USD in USA. Several studies documented cost savings. FLS, implemented in different ways and countries, are reported to be cost-effective or even cost-saving. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. [ABSTRACT FROM AUTHOR]

Maternal depression can be accounted for one of the most common complications during pregnancy and the postpartum period affecting women all over the world. So far, no detailed map of the worldwide maternal depression research architecture has been constructed, which encompasses aspects of research activity, quality, and also socioeconomic features. Using the NewQIS platform, density-equalizing mapping projections, scientometric techniques, and economic benchmarking procedures were applied to evaluate global maternal depression research for the period between 1900 and 2012. In total, 7330 related publications and 3335 international collaborations were identified. The USA was the most active country concerning collaborations and total research activity. In the socioeconomic analysis of research activity in high-income countries, Australia was ranked first with an average of 412.05 maternal depression-related publications per 1000 billion US$ GDP (Q), followed by the UK (Q = 373.51) and Canada (Q = 306.32). The group of upper-middle-income countries was led by South Africa (Q = 145.67), followed by Turkey (Q = 91.8). China authored 11.95 maternal depression-related publications per 1000 billion US$ GDP. The USA had the highest activity of maternal depression research per GDP in billion US$ per capita (Q = 60.86). When research activity was related to population size (Q = publications per Mio. inhabitants), Australia (Q = 26.44) was leading the field, followed by Norway (Q = 18.48). Gender analysis revealed a relatively high degree of female scientists involved in this field of research with pronounced differences between single subject areas. In summary, we here present the first picture of the global scientific development in maternal depression research over a period of more than 100 years. The research landscape is clearly dominated by North American and Western European countries, with only minor contribution of Asian or South American countries. [ABSTRACT FROM AUTHOR]

Parenting has been conceptualized to mediate or moderate children's adaptation to family stress. Our study expanded the literature to determine, within the adoptive context, how non-child-related family stress (NCR-family stress; e.g., parent's problems at work) and parenting styles were related to internalizing and externalizing problems in school-age girls adopted from China. Using data from the third wave of a longitudinal study, 651 school-age girls were identified for the current analysis. On average, the girls were 9.3 years old ( SD = 2.7) and were adopted at 15.6 months ( SD = 13.8). Data on NCR-family stress, parenting styles and child behavior problems were collected from the adoptive mothers using the social problem questionnaire, parenting styles and dimensions questions, and Child Behavior Checklist (CBCL/6-18), respectively. After controlling for age at adoption, age, the adoptive mother's education level, household income, and the girls' corresponding behavior problems from the second wave of data (2 years prior), we found that that the association between NCR-family stress and the adopted Chinese girls' internalizing problems and externalizing problems was mediated by authoritarian parenting and moderated by authoritative parenting. [ABSTRACT FROM AUTHOR]

This article presents a commentary on a paper by Robert A. Stebbins in a previous issue of The American Sociologist which provided an account of professional and amateur sociology in the U.S. The British organization, Mass Observation existed in a relatively nonintrusive society with (as compared to the U.S.) greater concern for one's own and other people's privacy. Canada and Great Britain may in this respect have more built-in defenses against the risks of some kinds of amateur sociology that the U.S. would have. However, according to the commenter, Stebbins already anticipates this objection by requiring amateurs to be supervised and to start with a certain amount of instruction and proper cautionary comments. By engaging primarily in the use of unobtrusive measures and observations, the amateur will avoid the risks of harm to which Stebbins is already sensitive. The commenter relates that one of the public areas in which he has encouraged such unobtrusive observations is in churches, where the observer in outward appearance is similar to the congregation and hence not seen as an intruder. According to him, he has had a fair amount of experience with undergraduate amateurs of the sort described.

Some research suggests that the risk of physical aggression by an intimate partner is related to marital status, but this relationship may vary across cultures and by gender. In the present study, we systematically examine the relationship between marital status and physical partner aggression by gender across 19 countries. Logistic and multilevel regression confirmed previous findings of lower rates of physical aggression for legally married versus cohabiting and separated/divorced women and men across most, but notably, not all countries. Single status was associated with higher risk in some countries and lower in others reflecting possible cultural differences in risk for different marital statuses. For example, single women had significantly lower rates of victimization than did married women in India where violence against wives is often accepted. The variation in the cross-cultural findings highlights the importance of examining both men and women and considering the cultural context when interpreting the relationship between partner aggression and marital status. [ABSTRACT FROM AUTHOR]

Rapid expansion in scientific knowledge, changes in medical practice, and greater demands from patients and society necessitate reform of the medical curriculum. In recognition of this, medical educators across the world have recommended the adoption of competence-based education. This is intended to increase the rigour and relevance of the curriculum, move students beyond a focus on the memorisation and regurgitation of scientific facts, and better enable them to understand scientific principles and apply them to the practice of medicine. Experience from 40 years' use of competence-based curricula across the world suggests that the uncritical application of this approach to the medical curriculum may not achieve its intended aims. There are valuable lessons to be learnt from the history of competence-based education. By taking on board these lessons, confronting the pitfalls of this approach, and devising new and creative solutions to the problems inherent in this methodology, medical educators can better achieve their aim of providing a strong foundation for the practice of medicine in the twenty-first century. It is only through such a strategy-rather than the uncritical adoption of this educational approach-that we will have real movement and progress both in competence-based education in general, and in its applications to medicine in particular. [ABSTRACT FROM AUTHOR]

Corporate Social Responsibility (CSR) has existed in name for over 70 years. It is practiced in many countries and it is studied in academia around the world. However, CSR is not a universally adopted concept as it is understood differentially despite increasing pressures for its incorporation into business practices. This lack of a clear definition is complicated by the use of ambiguous terms in the proffered definitions and disputes as to where corporate governance is best addressed by many of the national bodies legislating, mandating, or recommending CSR. This article explores the definitions of CSR as published on the Internet by governments in four countries (United Kingdom (UK), France, the United States, and Canada). We look for a consensus of understanding in an attempt to propose a more universal framework to enhance international adoption and practice of CSR using the triple bottom line. Our results concur with the findings of both national and international bodies and suggest that both within and among the countries in our study there exists no clear definition of the concept of CSR. While there are some similarities, there are substantial differences that must be addressed. We present a number of proposals for a more universal framework to define CSR. [ABSTRACT FROM AUTHOR]

Tricaine methanesulfonate (TMS) is an anesthetic that is approved for provisional use in some jurisdictions such as the United States, Canada, and the United Kingdom (UK). Many hatcheries and research studies use TMS to immobilize fish for marking or transport and to suppress sensory systems during invasive procedures. Improper TMS use can decrease fish viability, distort physiological data, or result in mortalities. Because animals may be anesthetized by junior staff or students who may have little experience in fish anesthesia, training in the proper use of TMS may decrease variability in recovery, experimental results and increase fish survival. This document acts as a primer on the use of TMS for anesthetizing juvenile salmonids, with an emphasis on its use in surgical applications. Within, we briefly describe many aspects of TMS including the legal uses for TMS, and what is currently known about the proper storage and preparation of the anesthetic. We outline methods and precautions for administration and changes in fish behavior during progressively deeper anesthesia and discuss the physiological effects of TMS and its potential for compromising fish health. Despite the challenges of working with TMS, it is currently one of the few legal options available in the USA and in other countries until other anesthetics are approved and is an important tool for the intracoelomic implantation of electronic tags in fish. [ABSTRACT FROM AUTHOR]

Background: Adjuvant! Online is an internet-based computer programme providing 10-year prognosis predictions for early breast cancer patients. It was developed in the United States, has been successfully validated in Canada, and is used in the United Kingdom and elsewhere. This study investigates the performance of Adjuvant! in a cohort of patients from the United Kingdom.Methods: Data on the prognostic factors and management of 1065 women with early breast cancer diagnosed consecutively at the Churchill Hospital in Oxford between 1986 and 1996 were entered into Adjuvant! to generate predictions of overall survival (OS), breast cancer-specific survival (BCSS), and event-free survival (EFS) at 10 years. Such predictions were compared with the observed 10-year outcomes of these patients.Results: For the whole cohort, Adjuvant! significantly overestimated OS (by 5.54%, P<0.001), BCSS (by 4.53%, P<0.001), and EFS (by 3.51%, P=0.001). For OS and BCSS, overestimation persisted across most demographic, pathologic, and treatment subgroups investigated. Differences between Adjuvant! predicted and observed EFS appeared smaller, and were significant for far fewer subgroups, only 5 out of the 28. The likely explanation for such discordance is that US breast cancer mortality rates (upon which Adjuvant! is based) appear to be systematically lower than breast cancer mortality rates in the United Kingdom. Differences in survival after recurrence would seem to be one contributory factor, with data suggesting that prognosis after relapse appears poorer in the United Kingdom. This may reflect the fact that new and more effective cancer drugs are often only approved for use in the United Kingdom many years after their adoption in the United States.Conclusion: The use of Adjuvant! by clinicians within the UK National Health Service is increasing, under the assumption that the programme is transferrable to the United Kingdom. At least for women treated for breast cancer at the Churchill Hospital in Oxford, however, Adjuvant!'s predictions were on the whole overoptimistic. If the findings reported here could be shown to be generalisable to other areas of the United Kingdom, then thought should perhaps be given to the development of a UK-specific version of the programme. [ABSTRACT FROM AUTHOR]

The three fold purpose of this study is to (1) review the incipient age discrimination legislation in the U.K., (2) offer comparisons with the U.S., Australia, and Canada and (3) examine the new legislation in relation to relevant gerontological theory and research. Reviewed are Britain’s Employment Equality Age Regulations, the Age Discrimination in Employment Act of the U.S., the Age Discrimination Act of 2004 in Australia, and Canadian Human Rights Act of 1985. A comparison of the new legislation on age discrimination in the U.K. with existing legislation of this type in the U.S., Canada, and Australia reveals that the British law appears to be weaker on many facets relative to those in the other countries. By permitting more exceptions to the law than are allowed under other types of civil rights statutes, restricting applicability of the law to the workplace, and maintaining compulsory retirement, the power of the law may be circumscribed. Gerontological theory and research do not, by and large, support these choices comprising the new British law. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional; survey.Objectives:To describe the utilization, accessibility and satisfaction of primary and preventive health-care services to individuals with long-term spinal cord injuries, and compare results among three countries: the United States, Canada and the United Kingdom.Setting:The Canadian sample was obtained from the Canadian Paraplegic Association – Ontario and Manitoba Divisions. The British sample was recruited from the Northwest Regional Spinal Injuries Centre in Southport and National Spinal Injuries Centre at Stoke Mandeville Hospital in Aylesbury. The American sample was recruited through Craig Hospital in Englewood, CO, USA.Method:A total sample of 373 individuals aging with a spinal cord injury participated in a mailed survey. The Health Care Questionnaire was used to measure utilization, access and satisfaction with primary care and preventive services.Results:In total, 93% of individuals reported having a family doctor, 63% had a spinal injuries specialist and 56% had both a family doctor and spinal injuries specialist. Considerable duplication of services occurred for general medical and preventive services, although lifestyle and emotional issues were not addressed for over 75% of the participants. Significant differences were found in utilization among Canada, US and UK, with Canadians most likely to receive health care from family physicians and Americans most likely to receive care from specialists. Access to and satisfaction with health services was not significantly different among countries.Conclusion:People with long-standing spinal cord injuries develop complex maps by which they seek out appropriate primary health-care and preventive services. Given the differences among countries, it is clear that the health delivery model plays an important role in how and where individuals receive health services.Spinal Cord (2007) 45, 25–36. doi:10.1038/sj.sc.3101933; published online 30 May 2006 [ABSTRACT FROM AUTHOR]

States that the United States leads the world in the impact its research makes in almost every scientific domain as of late 1998. Chart of impact measures rebased against world baseline; Super-Units of Assessment (UOA) performance for comparator countries, including England, Canada and France; Two key impressions that emerge from the international overview.

The study reported here examines, in the context of Crawford's (1970) items, differences in research ethics attitudes among marketing professionals in Australia, Canada, Great Britian, and the United States. The study results indicate the lack of significant differences in research ethics attitudes among marketing professionals in the four countries. This finding is interpretable as implying the generalizability of the results of previous research ethics studies involving "domestic" (United States) marketing professionals as respondents. [ABSTRACT FROM AUTHOR]

In response to growing challenges, many labor organizations are reevaluating themselves in an effort to become more efficient and effective. Their efforts, however, are limited by their frames of reference. Seldom do unions compare practices across labor movements. To expand these frames of reference we compare union administrative practices in three countries: Canada, the United Kingdom, and the United States. Two specific areas of union administration are examined -- human resource/personnel practices and strategic planning. Results from these countries are presented and analyzed to identify and explain similarities and differences. [ABSTRACT FROM AUTHOR]

Opinion polls in Canada, the United States, Great Britain, Australia, and elsewhere suggest that most members of the public would like their criminal courts to be harsher. Does media coverage of criminal sentencing contribute to a preference for harsher sentencing? Most people derive their information about sentencing from the news media, and content analyses of news stories in Canada and the United States demonstrate that crimes of violence and sentences of imprisonment are overrepresented. Moreover, the news media provide little systematic information about the sentencing process or its underlying principles. This article reports the results of three studies examining the effects of media coverage on public opinion about sentencing. Subjects who read actual newspaper stories about sentencing that appeared in Canadian newspapers rated most reported sentences as too lenient. However, the specific account they read influenced their leniency judgments. Furthermore, in one experiment, participants assigned to read a newspaper account of a sentencing decision supported harsher sentences than participants who read a summary of actual court documents from the sentencing hearing. [ABSTRACT FROM AUTHOR]

Intervention: Social assistance programs supplement incomes of the most income-insecure. Because income is a fundamental source of health, income supplementation is expected to result in a boost to health status. As Canada finds itself in the midst of heated debate regarding the structuring (and restructuring) of social assistance programs, there is little evidence available for policymakers about the effectiveness of current social assistance programs in improving the health of the income-insecure., Research Question: In this paper, we evaluate the health effects of social assistance programs in Ontario, Canada-wide and in peer programs from the United States and the United Kingdom., Methods: We used nationally representative household panel surveys (e.g., Canadian Survey of Labour and Income Dynamics) which follow individuals over time. Using fixed effects modelling, which controls for time-invariant characteristics of individuals, and further controlling for key time-varying characteristics, we modelled change in health status associated with change in receipt of social assistance in these societies. Health status was measured using self-rated health (fair/poor versus good/very good/excellent)., Results: Our results suggest that the health of social assistance recipients was worse (Ontario, Canada, UK) or no different (US) than the health of non-recipients. For example, in Canada, receipt of social assistance was associated with 52.5% higher odds of reporting fair or poor health., Conclusion: Social assistance programs in Canada and peer countries are currently inadequate for improving the health of the income-insecure. This is likely due to insufficient benefits, exposure to precarious job conditions, or selection factors.