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With an increasing number of children diagnosed with Autism-Spectrum-Disorder in Canada, this paper focuses on how their mothers, as Asian immigrant women, experience the process of diagnosis and learn to parent their children. By taking two Asian (Korean and Chinese) mothers' critical personal narratives as major data sources, this paper aims to explore the diagnosis process of Autism-Spectrum-Disorder through a sociocultural lens on the intersectionality of (im)migrants and their cultural competence, and argues that their identity (re)construction and learning for parenting take place at the intersectionality of race, gender, class, and disability. This paper highlights possible implications for everyone involved in this 'medical' process, in the context of Canadian or other similar multicultural societies. Asian immigrant mothers usually have to deal with children with Autism-Spectrum-Disorder (ASD) and they have bitter experience of mistreatment tied to race, gender and class. This study reveals how Asian immigrant mothers struggled in their integration to Canadian society as well as their experiences of denial into Canada's medical system. The stories of these two women shed lights on the social and cultural aspects of immigrant mothers' learning strategies, including how they utilize accessible resources and networks for their children's treatment and diagnosis. This paper suggests that policymakers need to consider the social and cultural aspects of diagnosis in immigrant families to better fit their needs and provide them appropriate medical and social support. [ABSTRACT FROM AUTHOR]

Background: The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism. Aims and Methods: This paper uses the model of the intercultural development continuum and the concept of 'cultural fit' to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences as medical educators working abroad and supported by evidence in the literature, we have developed four anecdotal scenarios to highlight some of the challenges that different cultural contexts bring to our current (Western) understanding of professionalism. Results and Conclusions: The scenarios highlight some of the potentially different regional and/or cultural perspectives and nuances of professional behaviours, attitudes or values that many of us either take for granted or find difficult, depending on our training and socio-cultural upbringing. With this paper, we hope to start a long overdue conversation about global professionalism amongst medical educators, identify potential areas for research and highlight a need for medical schools to embrace a 'global' approach to how professionalism is embedded in their curricula. [ABSTRACT FROM AUTHOR]

Background: Rare diseases, also referred to as orphan diseases, are characterised by their low prevalence with majority of them are chronically debilitating and life threatening. Given the low prevalence and the widely dispersed but very small patient base for each disease, there may often be a disproportion in the availability of treatments and resources to manage patients, spur research and train experts. This is especially true in Southeast Asian countries that are currently in the process of implementing or revising their universal health coverage schemes. This paper aims to examine the status of rare disease management in Southeast Asian countries. It will serve as the basis for a more active discussion on how countries in the region can address an under-recognised rare disease burden and enhance national and regional capacities.Methods: The study consists of literature reviews and key stakeholders interviews in six focus countries, including the Philippines, Singapore, Malaysia, Indonesia, Vietnam, and Thailand and five countries as best practice, comprising of France, Canada, Australia, Taiwan, and South Korea. Rare disease management initiatives across each country were examined based on the World Health Organization's framework for action in strengthening health systems.Results: The results suggest rare disease management remains challenging across Southeast Asia, as many of the focus countries face fundamental issues from basic healthcare systems to funding. Nonetheless, there are substantial improvement opportunities, including leveraging best practices from around the world and organising a multi-stakeholder and regional approach and strategy.Conclusions: Southeast Asian countries have made significant progress in the management of rare disease, but there remain key areas for substantial development opportunities. [ABSTRACT FROM AUTHOR]

All the excitement around the great possibilities that the opening of the Northwest Passage could offer the shipping industry -- and Canada -- could not last. Just a few years ago, as sea ice in the North seemed to be steadily melting away, observers were eagerly tallying up the savings in time, fuel and costs that a reliably ice-free route across the top of the planet would provide for shippers. A couple of trial runs only confirmed that for shipments from Asia to Europe or North America, or the other way around, the route could shave thousands of kilometres off each trip, compared to journeys through the Suez or Panama canals. Rapid growth in shipping traffic across the Northwest Passage and its sister route, the Northern Sea Route, seemed not just inevitable, but imminent. Just a short while later, it now seems neither imminent nor inevitable. The retreat in sea ice may persist, but it is evident that due to regular fluctuations in ice coverage, the Northwest Passage will not be reliably ice-free for many, many years, if ever. Shipping may be more possible through the Northwest Passage than it was in the past, but it will not be consistently unobstructed. The challenges of ice combined with Arctic weather conditions may well mean that any shipping through the passage is slower than expected. Other complicating factors include uncharted or poorly charted sea lanes and the difficulty in securing insurance for Arctic shipping. At the same time, the competition from alternate routes is only becoming more intense, with expansions in both the Suez and Panama Canals and the potential for a new canal across Nicaragua. Regarding the Northwest Passage, Canada lacks much of the infrastructure in the North that would make Arctic passage a strong competitor, including multiple ports enroute and sufficient icebreaking equipment. There are still advantages that might draw some shipping away from traditional routes to the northern passages, particularly for the movement of western resources to growing Asian markets. But even moderate levels of shipping through the Northwest Passage do have the potential to change Canada's relationship with its Asian trading partners, especially China. The Canadian and Chinese governments share a number of priorities regarding the Arctic, including environmental protection, safer navigation and resource development. These will provide opportunities for more dialogue and engagement between the two countries. While the Northwest Passage may not become the important trans-shipment route to Asia once imagined by enthusiastic observers, the most meaningful impact that a more useful route may provide is to alter, and improve, the course of Canada's relations in the Asia-Pacific region. This paper seeks to examine likely developments and trends in Arctic shipping given the shrinkage of the polar ice cap, and to situate these trends in the broader context of changing global maritime and trade realities with particular focus on their impact on trade with Asia. There are implications for Canada and its relations with Asia, especially China, that flow from these developments. [ABSTRACT FROM AUTHOR]

A core mode of governance in the era of neoliberalism is through the production of ‘entrepreneurial self’. This paper explores how the ‘entrepreneurial self’ is produced for 21 Chinese immigrant women in Canada. The women displayed extraordinary entrepreneurialism by investing in Canadian education. Becoming entrepreneurial, however, is more than an individualised ‘choice’. It is imbricated with the ideology of meritocracy cultivated in China, the ‘credential and certificate regime’ in Canada, and the gendered expectations in the host labour market and at home. Given the ideological confluence, and the material conditions the women lived, a feminized and racialized labour is reproduced. [ABSTRACT FROM PUBLISHER]

Objectives: This paper provides a quantitative review that estimates exposure rates by type of violence, setting, source, and world region. Design: A quantitative review of the nursing violence literature was summarized. Data sources: A literature search was conducted using the CINAHL, Medline and PsycInfo data bases. Studies included had to report empirical results using a nursing sample, and include data on bullying, sexual harassment, and/or violence exposure rates. A total of 136 articles provided data on 151,347 nurses from 160 samples. Procedure: Articles were identified through a database search and by consulting reference lists of review articles that were located. Relevant data were coded by the three authors. Categories depended on the availability of at least five studies. Exposure rates were coded as percentages of nurses in the sample who reported a given type of violence. Five types of violence were physical, nonphysical, bullying, sexual harassment, and combined (type of violence was not indicated). Setting, timeframe, country, and source of violence were coded. Results: Overall violence exposure rates were 36.4% for physical violence, 66.9% for nonphysical violence, 39.7% for bullying, and 25% for sexual harassment, with 32.7% of nurses reporting having been physically injured in an assault. Rates of exposure varied by world region (Anglo, Asia, Europe and Middle East), with the highest rates for physical violence and sexual harassment in the Anglo region, and the highest rates of nonphysical violence and bullying in the Middle East. Regions also varied in the source of violence, with patients accounting for most of it in Anglo and European regions, whereas patents' families/friends were the most common source in the Middle East. Conclusions: About a third of nurses worldwide indicated exposure to physical violence and bullying, about a third reported injury, about a quarter experienced sexual harassment, and about two-thirds indicated nonphysical violence. Physical violence was most prevalent in emergency departments, geriatric, and psychiatric facilities. Physical violence and sexual harassment were most prevalent in Anglo countries, and nonphysical violence and bullying were most prevalent in the Middle East. Patients accounted for most physical violence in the Anglo region and Europe, and patient family and friends accounted for the most in the Middle East. [ABSTRACT FROM AUTHOR]

Background: Endoscopic hemostasis is commonly practiced during GI endoscopy practice. We hypothesized that, because the choice of endoscopic intervention is influenced by many factors, for example personal experience, prior training, guidelines, etc., there would be differences in practice patterns among different groups of endoscopists.Objective: To explore the potentially different practices for endoscopic hemostasis between the "East" (eight Asian countries) and the "West" (USA and Canada).Design: Cross-sectional descriptive study (internet-based survey).Study Subjects: We administered a questionnaire survey to American Society of Gastrointestinal Endoscopy (ASGE) and Korean Society of Gastroenterology (KSGE) members (see: http://www4.utsouthwestern.edu/inetdemo/endoscopy/hemostasis.html , or supplementary paper for review online).Results: Eastern ASGE members (n = 112) were more likely to complete this survey than ASGE members in the West (n = 180): 15.1 vs. 5.0%, P < 0.001. Choice of hemostatic method, regardless of primary or recurrent bleeding, varied significantly among Eastern and Western endoscopists. For example, for treatment of a gastric ulcer with a visible vessel, a vast majority (70%) of Western endoscopists preferred pre-injection followed by thermocoagulation whereas responses from the East were more diverse, with endoclip application +/- pre-injection being the top choice (29%) (P < 0.001). Personal EGD volume and hospital bed numbers did not seem to be associated with hemostatic choices in either the East or the West.Conclusions: Endoscopic hemostasis practice patterns for upper GI tract bleeding differed among Eastern and Western endoscopists, suggesting fundamental differences in practice habit determinants. [ABSTRACT FROM AUTHOR]

This paper documents efforts in Canada, France, Finland, Germany, Hispanoamerica, Israel, Japan, The Netherlands, and Taiwan to disseminate the Model of Human Occupation (MOHO). We aim to characterize the challenges involved, the strategies used, and the impact of these efforts in diverse cultural and social conditions. [ABSTRACT FROM AUTHOR]