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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]

Purpose As libraries are required to become more accountable and demonstrate that they are meeting performance metrics, an assessment website can be a means for providing data for evidence-based decision making and an important indicator of how a library interacts with its constituents. The purpose of this paper is to share the results of a review of websites of academic libraries from four countries, including the UK, Canada, Australia and the USA.Design/methodology/approach The academic library websites included in the sample were selected from the Canadian Association of Research Libraries, Research Libraries of the United Kingdom, Council of Australian University Libraries, Historically Black College & Universities Library Alliance, Association of Research Libraries and American Indian Higher Education Consortium. The websites were evaluated according to the absence or presence of nine predetermined characteristics related to assessment.Findings It was discovered that “one size does not fit all” and found several innovative ways institutions are listening to their constituents and making improvements to help users succeed in their academic studies, research and creative endeavors.Research limitations/implications Only a sample of academic libraries from each of the four countries were analyzed. Additionally, some of the academic libraries were using password protected intranets unavailable for public access. The influences of institutional history and country-specific practices also became compelling factors during the analysis.Originality/value This paper seeks to broaden the factors for what is thought of as academic library assessment with the addition of qualitative and contextual considerations. [ABSTRACT FROM AUTHOR]

Abstract: Material deprivation is an important determinant of health inequalities in adults but there remains debate about the extent of its importance for adolescent wellbeing. Research has found limited evidence for an association between adolescent health and socio-economic status, leading authors to suggest that there is an ‘equalisation’ of health across socio-economic groups during the adolescent stage of the life-course. This paper explores this ‘equalisation’ hypothesis for adolescent psychological wellbeing from a geographical perspective by investigating associations between neighbourhood deprivation and self-esteem in Britain and Canada. Data from the British Youth Panel (BYP) and the National Longitudinal Survey of Children and Youth (NLSCY) on adolescents aged 11–15 for the time period 1994–2004 were used to estimate variations in low self-esteem between neighbourhoods using multilevel logistic regression. Models were extended to estimate associations between self-esteem and neighbourhood deprivation before and after adjustment for individual and family level covariates. Moderation by age, sex, urban/rural status, household income and family structure was investigated. There were no significant differences in self-esteem between the most deprived and most affluent neighbourhoods (Canada unadjusted OR = 1.00, 95% CI 0.76, 1.33; Britain unadjusted OR = 1.25, 95% CI 0.74, 2.13). The prevalence of low self-esteem was higher (in Canada) for boys in the least deprived neighbourhoods compared to other neighbourhoods. No other interactions were observed. The results presented here offer some (limited) support for the socio-economic equalisation in youth hypothesis from a geographical perspective: with specific reference to equalisation of the relationship between neighbourhood deprivation and self-esteem and psychological health in early adolescence. This contrasts with previous research in the United States but supports related work from Britain. The lack of interactions with key social and economic variables suggests that findings might apply across a range of family circumstances and different communities in Britain and Canada. Policy implications are discussed. [Copyright &y& Elsevier]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [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]