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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]

Recent theoretical and empirical evidence has been pointing toward a new development with regard to religion in the Western world: one of polarization between secular and religious individuals. Statistical analyses test the existence of such a trend from 1985 until 2009–2010 at a regional level within three separate national contexts: the United States, the UK, and Canada. Repeated cross-sectional survey data are studied by means of a series of multinomial logit and logistic regression models with generated predicted probabilities. The results show the existence of three distinct patterns of trends since the mid-1980s, one of which consists of religious polarization as measured by the present study: the proportional decline of nominal affiliates coupled with no decline or an increase of unaffiliated and religiously committed individuals. This trend can be found in Great Britain as well as in the Canadian provinces of Alberta and British Columbia. [ABSTRACT FROM AUTHOR]

Since previous research has shown that nation-states take the acts of other states in consideration when making decisions about their policies, this article focuses on analyzing national decision-making in actual practice by studying the justifications used in debating new legislation. The data comprises second readings of bills from Canada and the UK and House debates of US bills from 2001 to 2011. The total amount of bills analyzed is 208. The results show that the acts of governments and other agents in the global system are an essential part of the factors to which actors refer in their argumentation. The analysis also shows that the US political culture is less receptive to considering cross-national differences or policies adopted in other states as justification for domestic reforms than the other two countries, whereas Canadians are most sensitive to the international community and their position and reputation among the nations. From these differences in national political cultures we cannot deduce, however, that the United States is immune to external factors or the center of a unilateral system. Although decisions are less often justified by policies adopted in other countries, the global community and economic competition are an essential part of the environment to which US politicians place themselves as decision makers. [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]

ABSTRACT Aims This study aimed to examine the associations between reported exposure to anti-smoking warnings at the point-of-sale (POS) and smokers' interest in quitting and their subsequent quit attempts by comparing reactions in Australia where warnings are prominent to smokers in other countries. Design A prospective multi-country cohort design was employed. Setting Australia, Canada, the United Kingdom and the United States. Participants A total of 21 613 adult smokers who completed at least one of the seven waves (2002-08) of the International Tobacco Control Four Country Survey were included in the analysis. Measurements Reported exposure to POS anti-smoking warnings and smokers' interest in quitting at the same wave and quit attempts over the following year. Findings Compared to smokers in Canada, the United Kingdom and the United States, Australian smokers reported higher levels of awareness of POS anti-smoking warnings, and this difference was consistent over the study period. Over waves in Australia (but not in the other three countries) there was a significantly positive association between reported exposure to POS anti-smoking warnings and interest in quitting [adjusted odds ratio = 1.139, 95% confidence interval (CI) 1.039-1.249, P < 0.01] and prospective quit attempts (adjusted odds ratio = 1.216, 95% CI 1.114-1.327, P < 0.001) when controlling for demographics, smoking characteristics, overall salience of anti-smoking information and awareness of anti-smoking material from channels other than POS. Conclusions Point-of-sale health warnings about tobacco are more prominent in Australia than the United Kingdom, the United States or Canada and appear to act as a prompt to quitting. [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]