The International and Cultural Context of Cancer

This paper aims at advancing the conceptualization of leisure as a contributor to quality of life (QOL) in an international and multicultural context, based on an extensive and critical review of literature on leisure and QOL from a global, international perspective. Given the central role of culture in conceptualizing this notion, this paper gives attention to various cultural contexts world-wide. To illustrate the diversity of our societies, examples are introduced specifically from three culturally unique contexts in this paper – i.e., Asian, Middle-East, and Indigenous contexts. Also, some examples are drawn from other cultural groups in global and international contexts, particularly, in non-western contexts. Then, the final section of this paper aims at integrating and synthesizing the knowledge gained from this review to develop a tentative/working proposition about how leisure can contribute to QOL from international and cross-cultural perspectives. Specifically, based on such integration, this paper identifies and describes major pathways linking leisure to QOL. Overall, an overarching theme common to almost all cultural contexts examined appears to be the role of leisure-like activities as a context or space for creating meanings which then help to promote the quality of people’s lives. Major pathways or mechanisms that can facilitate meaning-making and life-quality-enhancement highlighted in this review include: (a) positive emotions and well-being experienced from leisure, (b) positive identities and self-esteem gained from leisure, (c) social and cultural connections and a harmony developed through leisure, and (d) leisure’s contribution to learning and human development across the life-span. Also, emphasized in this paper is the role of leisure as a context for realizing and utilizing human strengths and resilience. It is important, however, to stress that in people’s quest for a meaningful life, the benefits of meaning-making through leisure involve both “remedying the bad” and “enhancing the good,” as shown throughout this paper. Despite these benefits, we should not ignore that leisure experiences are socially and culturally constructed and shaped by the inequalities of society. Thus, the reality of power imbalance and inequalities should be acknowledged and appropriately addressed socially, culturally, and politically. Particularly, providing culturally relevant and meaningful leisure opportunities for less privileged population groups world-wide is clearly a top priority.

The Handbook of Cross-Cultural Management Research

Aim/Purpose: Learning to conduct research, including considerations for concepts such as reflexivity, is a key component of doctoral student preparation in higher education. Yet limited attention is given to doctoral student training for conducting international research, particularly in understanding researcher reflexivity within international contexts. Background: Incorporating reflexive practices in one’s scholarship is of particular importance because international research often includes U.S.-based researchers working with cultural groups and contexts that are very different from them. Thus, we examined the following: how do novice U.S. trained researchers understand the role of their reflexivity in qualitative international research? Methodology: We utilized qualitative inquiry to answer the study’s research question. In-depth, semi-structured interviews were conducted with 22 participants representing 11 higher education doctoral programs in the United States. Contribution: This study provides insight on how U.S. doctoral students reflect on their researcher reflexivity as emerging international researchers utilizing three types of reflexivity as outlined by the conceptual perspectives that frame this study: introspection, social critique, and discursive deconstruction Findings: Most participants believed that self-reflection is a critical component of reflexivity in international research. Several participants demonstrated an awareness of the privilege and power they bring to their international research based on their identities as Western-trained researchers. Participants utilized different forms of self-reflection when collecting, analyzing, and interpreting their data in order to ensure that the voices of their participants were appropriately represented in their research Recommendations for Practitioners: Our recommendations for graduate preparation programs include helping doctoral students to understand reflexivity as both a research concept and an applied practice in international context. Recommendation for Researchers: We recommend that novice researchers learn how to incorporate reflexive practices when conducting research because as emerging scholars they can have a better sense of how who they are and how they think about research influences their research activities. Impact on Society: Implications from this study affect Western-based education programs that seek to internationalize curriculum and research priorities. Future Research: In terms of next steps, we recommend research that explores how faculty train doctoral students to participate in the global contexts of educational research.

Last year represented the 10th anniversary of the establishment of ACGME–International (ACGME-I).1 Since Singapore's initial accreditation in 2010, ACGME-I has contributed to global graduate medical education (GME) reform efforts focused on promoting and supporting competency-based medical education (CBME) in various regions, including Asia, the Middle East, the Caribbean, and Central America.1,2 GME in ACGME-I institutions involves the implementation of competency-based training and assessment, as well as the adoption of all ACGME regulations and governance, including a clinical competency committee (CCC), with similar roles and responsibilities as in the United States. The diversity of educational environments, scopes of practice, health care delivery models, and regulatory requirements, in the setting of different social and cultural contexts, have spurred a burgeoning body of literature exploring the need for local adaptation of educational standards.3,4 These initiatives have led to country-specific accreditation criteria and ongoing efforts in adopting international Milestones.5–7The implementation of ACGME-I accreditation has also standardized governance, infrastructure, and operational processes of accredited GME programs, including the critical role of the CCC as an essential component of trainee assessment.8 CCCs are expected to use a multidimensional approach to assessments to make informed decisions about resident performance and reach a consensus regarding trainee progress and Milestone attainment.9 The efficacy of international CCCs may be influenced by the sociocultural constructs that affect learning, teaching, and communication among faculty and residents, as well as the different mental models that inform faculty and trainee expectations. Despite these challenges, the multiculturalism and diversity of an international faculty can be leveraged to improve CCC functioning by including diverse perspectives to enhance group function and facilitate more information sharing, leading to well-informed judgments.10Drawing on studies of group decision-making and published literature on CCC effectiveness,11–13 as well as personal experiences in conducting CCC meetings for the past decade at our respective institutions, we review specific challenges that international GME programs may face in assessing residents, providing feedback and running CCCs, and implement evidence-based solutions in the internal arena.Group decision-making forms the core of CCC meetings.13 The 3 main principles of group decision-making that shape CCC process are: (1) utilizing data from multiple assessment tools, (2) having a shared mental model around a competency framework, and (3) having structured discussions to reach a consensus regarding trainee performance.9,13 It is the latter 2 principles that can pose specific challenges in the international context.In many ACGME-I-accredited institutions, CCCs consist of faculty members from significantly diverse training backgrounds and health delivery systems, many of whom lack personal experience with a competency-based framework. This lack of experience or familiarity with CBME causes evaluators to rely heavily on their own training, and often shapes their expectations of residents and influences their views on assessments and evaluations, leading evaluators to compare residents against their personal standards and frame of reference, rather than against a standardized competency framework.14 These variations in cultural and training backgrounds can also influence how faculty rate and interpret assessment scores,15 impacting the accuracy of evaluations of resident competence.16 This variability may be compounded at the CCC level, where members assimilate aggregate data into a consensus assessment of resident performance.Faculty-to-faculty communication affects CCC dynamics. A critical component of successful CCCs is the use of structured open dialogue to facilitate consensus among members.9,13 Research has shown that communication styles differ across cultural contexts.28 For example, many non-Western societies demonstrate a preference for collectivistic communication styles, which avoid disagreement and favor harmonious group relations.28 Diversity in culture also affects assumptions about CCC purpose and how the group's decisions are used to judge trainee performance. In Hofstede's cultural dimensions theory,29 Asian and Middle Eastern countries have a tightly integrated collectivist society. CCC members in some Eastern cultures may, therefore, be less inclined to participate in the sharing of unknown information, open discourse, or voicing unpopular opinions for fear of disrupting the group's harmony or concerns about potentially provoking offense from peers. Another important factor influencing CCC dynamics is the hierarchical structures of some Eastern cultures, which place a high value on professional position and social status. This might impede junior faculty members' ability to openly voice their opinions, speak out of turn, or openly disagree with senior faculty opinions.30The effectiveness of CCC decisions is closely related to the ability to inform resident performance through effective feedback. These conversations can be complicated if the feedback provider and recipient do not have a shared understanding of the goals of feedback. This challenge is compounded in the international arena where sociocultural factors play an important role and can significantly affect the provision and receipt of feedback.31 In some countries, faculty may be uncomfortable or unwilling to engage in feedback conversations, as they can be challenging. This is especially true when negative feedback is involved, as there is a fear of offending the trainee, leading to rejection of feedback and subsequent damage to the educator-learner relationship.27,31 Conversely, while praise can motivate and reinforce positive behaviors, it may not be given, reflecting a cultural stance of excellence as a minimal expectation.32 In some societies, feedback, irrespective of type, is often taken personally.32 While this may be a universal challenge, it is especially significant in Eastern cultures, where the distinction between professional and personal attributes is often blurred.3,4 These dynamics often result in fear of giving, seeking, and receiving feedback.Another significant cultural construct affecting feedback in Eastern (particularly Asian) cultures is modesty.32 Individuals who speak highly of themselves and their achievements may be seen as arrogant, self-promoting, or grandiose. As such, during self-assessment of Milestones or self-reflection for CCCs, residents are often observed to rank themselves lower than expected, with a tendency to focus on areas for improvement while downplaying strengths. They may also avoid seeking feedback for fear of appearing to seek praise.27Addressing these challenges within local context, the Table summarizes evidence-based strategies to improving CCC function from the US-based literature and provides potential solutions within international cultural settings.There is a paucity of published studies on the role and characteristics of CCCs in the international setting. Faculty diversity adds unique perspectives and can facilitate rich and meaningful conversations, but can also create challenges for CCCs. From our experience running CCCs in Singapore and the United Arab Emirates for the past decade, this article represents our insights on the impact of the various factors in the international context that can affect the efficacy of CCCs. Primary areas identified include the role of the social context in feedback on trainee performance and best practices in CCC operations, with a focus on potential international adaptations. We hope that these recommendations serve as a resource to educators involved in ACGME-I reform efforts worldwide. More research on the impact of sociocultural practices and behaviors is needed to better direct and define CCC processes and outcomes in the global arena.

What does “armed struggle” refer to? Is it possible to borrow a non-philosophical perspective of history, not monistic, in order to bring women back to their historical, social and moral responsibilities? How has the concept of women changed in the public eye, and to what extent does gender bias persist? This work focuses on contrasting traditional historiography with new historiographic perspectives and emphasizes the importance of specific terminology for distinguishing key interpretative categories. Armed struggle, destabilization, terrorism, revolution and sedition are included in an international context, after comparing the peculiarities of the Italian revolutionary fringes to the multifaceted american, japanese, german and french experiences. Currently, we are experiencing an even more complex, stratified and liquid social and cultural context, which is struggling to overcome a political violence and its consequences. It seems therefore necessary to explain the actions of certain female representatives of the extra-parliamentary left, while destroying obsolete and anachronistic stereotypes. Thanks to the suggested rich bibliography, the most significant steps of this path will be reconstructed while bringing up new questions.

The relationship between early adversity and numerous negative outcomes across the lifespan is evident in a wide range of societies and cultures (e.g., Pakulak, Stevens, & Neville, 2018). Among the most affected neural systems are those supporting attention, self-regulation, and stress regulation. As such, these systems represent targets for neurobiologically informed interventions addressing early adversity. In prior work with monolingual native English-speaking families, we showed that a two-generation intervention targeting these systems in families improves outcomes across multiple domains including child brain function for selective attention (for detail, see Neville etal., 2013). Here, we discuss the translation and cultural adaptation (CA) of this intervention in local and international contexts, which required systematic consideration of cultural differences that could affect program acceptability. First, we conducted a translation and CA of our program to serve Latino families in the United States using the Cultural Adaptation Process (CAP), a model that works closely with stakeholders in a systematic, iterative process. Second, to implement the adapted program in Medellín, Colombia, we conducted a subsequent adaptation for Colombian culture using the same CAP. Our experience underscores the importance of consideration of cultural differences and a systematic approach to adaptation before assessing the efficacy of neurobiologically informed interventions in different cultural contexts.

The aim of the book is to explain a range of options for implementing the reflective practice cycle in educational settings in various international contexts. It presents a series of empirical case studies illustrating many different ways of implementing the reflective practice cycle, and how they can be researched by practitioners and academics. Increasing attention is given by teachers and teacher educators to the construct and implementation of reflective practice as a form of bottom-up, autonomous professional development. The aim of the book is to explain a range of options for implementing the reflective practice cycle in educational settings in various international contexts. Written by international academics, these studies show how reflection can be interpreted in different cultural contexts. The book concludes with a discussion by Anne Burns of the implications of these case studies for action research. It is hoped that the book will enable practitioners, and their mentors, to consider how best to implement reflective procedures in the specific contexts in which they work. Chapters in the book include: • Lesson planning: The fundamental platform for reflecting for action • Reflecting on action: Lesson transcripts • Pair discussions for reflecting on action: Stimulated recall • Observation leading to reflection This book will be key reading for researchers in the fields of teacher education. https://www.routledge.com/Reflective-Practice-Voices-from-the-Field/Barnard-Ryan/p/book/9781138226463

Academia can be a lonely place, especially for those people who are members of marginalized communities. Although at its core institutions of higher education are supposed to be places for knowledge production, exchange and transformation, they can also be the source of anxiety, confusion, and hurt. Effective mentoring helps to provide guidance and support and can ease the transition to and success in higher education. In this book the authors conceptualize mentoring in the context of critical communication pedagogy and intercultural communication pedagogy. Each chapter employs a critical and cultural lens to mentoring and offers discussions about how our cultural identities or intercultural communication experiences impact our mentoring. It is separated into two major sections. The chapters in "Mentoring and International Experiences" analyze unique situations that international students face in higher education and how effective mentoring can guide these students through academic and life challenges. The second section, "Mentoring and Cultural Contexts," focuses on diverse cultural settings within the higher educational system in the United States and on historically marginalized students and/or faculty. This edited book will be helpful for various audiences. First, it provides guidance for graduate students, faculty and staff members who are asked to mentor others of diverse backgrounds. Second, it also helps diverse students and faculty to better understand the role of mentoring. And third, it gives ideas on what to do in successful international/intercultural mentor-mentee relationships. "Mentoring in Intercultural and International Contexts provides compelling examples of critical mentoring partnerships and programs that successfully assist vulnerable students to navigate systemic disadvantages withing the academy. This book is vital reading for anyone who wants a better understanding of mentorship in complex and contradictory environments." Alberto González, Bowling Green State University

Culture has been increasingly recognized as being central to human experience and in understanding intergroup relations, power, social identities and interpersonal interactions in everyday life in diverse societies, with distinct legal, religious, family and social systems. This chapter is grounded on the recognition that discrimination and violence against LGBTQ+ persons are best understood in a cultural context, as culture shapes attitudes toward gender, sexual orientation and gender identities and expressions. It examines the role of culture in shaping violence against LGBTQ+ persons internationally, as well as the literature on LGBTQ+ migrants, refugees and asylum seekers in contemporary societies. It also presents a case illustration of Chechen queer people and multi-dimensional levels of violence. The chapter ends with reference to the facilitation of healing and resilience among LGBTQ+ survivors of violence in international contexts.

Abstract: In this article we provide a comprehensive review of 71 studies on evaluation in international development contexts published over the past 18 years. The primary purpose of the review is to explore how culture is being conceptualized and defined in international development contexts and how evaluation practitioners, scholars, and/or policymakers who work in international development evaluation frame the role of culture and cultural context in these settings. In this article we ask: How is culture framed in the international development evaluation literature? To what extent do descriptions of evaluation (design, processes, and outcomes) reflect other knowledge and value systems and perspectives? Whose values and world-views inform the evaluation design and methodology? How does the community's cultural context inform the evaluation methodology and methods used? Based on our analysis, we identify and discuss five themes: the manifestation of culture along a continuum from explicit to implicit, a cultural critique of participatory practice in international development, the limits of social constructivist epistemologies and representations of voice, evaluation as a cultural practice, and cultural engagement and the multifaceted evaluator role.

Trust in leadership in the international context of enterprise organizational culture. Theoretical and empirical analysis

Problem-solving approach in an international context: Antecedents and outcome

The paper deals with the structural roots of political instability in the Middle East that has been manifested by the Arab Spring throughout the region since early 2011. The roots of the instability are seen in cumulative effects of highly uneven long‐term social change in its three main dimensions since 1960s: (1) rapid social and demographic changes, (2) slower and fluctuating economic development, and (3) rigid political subsystem. The Middle Eastern uneven social change is also under way in a specific (4) cultural and (5) international context. The political instability is thus seen as a consequence of multiple and complex interactions among various dimensions of uneven modernisation process, Islamic political imagination and the international context. The paper deals with the interactions on the macro‐level and with its politically destabilizing consequences on micro‐level using selected examples of causal mechanisms. The Middle Eastern uneven modernisation pattern is systematically documented by empirical macro‐indicators and is compared with the modernisation process in other post‐colonial world macro‐regions.

514 Book Reviews TECHNOLOGY AND CULTURE Medieval Ironwork in Sweden. 2 vols. By Lennart Karlsson. Stockholm: Almqvist & Wiksell, 1988. Pp. 437 + 615; illustrations, bibliography. Skr 655.00. To some extent Medieval Ironwork in Sweden is misleadingly titled. It deals only with decorative ironwork and overwhelmingly with the decorative ironwork on church doors. Lennart Karlsson describes a few examples of medieval ironwork on grilles, chests, and cupboards, but he consciously excludes other examples of decorative ironwork, such as chandeliers and candlesticks. The book covers medieval Swedish church door ironwork within the modern boundaries of Sweden for the period 1150-1520. The first volume provides a descriptive account of surviving examples of this ironwork and its cultural, architectural, technological, and international context. The second volume is a catalog of 536 surviving examples of Swedish medieval ironwork arranged alphabetically by location and illustrated with 1,120 photographs and drawings. Karlsson’s work is as comprehensive and as complete a work on medieval Swedish church door ironwork as we are likely to see. He covers every possible aspect of the subject in considerable depth. For example, little is known about the smiths who fabricated medieval church ironwork. But Karlsson devotes seven pages to providing readers with everything that is known or can be conjectured about them. In addition, he discusses in some depth medieval Swedish church architecture, the provincial or regional characteristics of the surviving ironwork, the iconographic patterns used, the carpentry to which the iron was attached, and the paints, textiles, and other materials used in conjunction with iron on medieval church doors. Moreover, he places these discussions in both a cultural and an international context. In the cultural area, for example, he deals with the role of the church door and particularly its wrought-iron ring handle in the medieval right of asylum. Similarly, he provides a comprehensive review of ironwork on medieval church doors in Denmark, Norway, Finland, England, Germany, and France to pro­ vide a comparison with Swedish ironwork and to deal with the question of foreign influence versus domestic design. The focus of Karlsson’s work is overwhelmingly on the aesthetic elements of medieval Swedish church door ironwork, but some of the discussions are of potential interest to historians of technology. First, the aesthetic and decorative nature of most surviving Swedish iron­ work provides evidence to support Cyril Stanley Smith’s long-held contention of the importance of aesthetic elements in the emergence of metallurgy. In reviewing the photographs in Karlsson’s catalog, one can hardly avoid being struck by the importance of aesthetics in the early use of iron. Second, Karlsson’s discussion of the role of the Cistercians in the early development of the iron industry in Sweden is quite good, providing additional evidence of the role tbe Cistercians’ TECHNOLOGY AND CULTURE Book Reviews 515 centralized structure played in diffusing both technological and artistic innovations in medieval Europe. Third, Karlsson provides some new evidence of the importance of monasteries in diversifying the use of waterpower beyond grain milling. He argues convincingly that in certain regions of Sweden waterpower was used on a signifi­ cant scale in the medieval period by some monasteries for iron production (vol. 1, pp. 213—15). In addition, Karlsson provides extended and well-illustrated discussions of iron forging and carpen­ try practices in medieval Europe. On the other hand, the section on the techniques used to produce the wrought iron that went into medieval Swedish ironwork is too brief and based on questionable assumptions. The generally accepted date and place for the emergence of the blast furnace are the 15th century and Flanders. But Karlsson accepts contested claims made by several recent authorities that blast furnaces emerged far earlier in Europe, perhaps as early as the 12th century. He suggests further that some of the larger examples of iron construction from late in the medieval period presuppose the use of the blast furnace (vol. 1, p. 362). But he offers no evidence based on the surviving examples of medieval Swedish ironwork that he has cataloged to support this contention. This is, I suspect, because Karlsson made his judgments relating to Swedish medieval ironwork largely on the basis of aesthetic characteristics; he did not...

RESUMO Este artigo se propõe a compreender como se deu a ideia da vida moderna entre os empreendimentos vinculados ao movimento moderno, utilizando como objeto de análise os apartamentos duplex. Os arranjos espaciais vinculados a esta tipologia se relacionavam originalmente com a ideia de economia na construção e com o discurso da funcionalidade do espaço, que sugeria novas práticas domésticas ao considerar a entrada da mulher no mercado de trabalho, como também sua menor participação na organização do lar e da família. Para tanto, foram analisados exemplos em diversos conjuntos habitacionais a partir do estudo de seus projetos e do contexto de suas construções, tendo como ponto de partida o conjunto soviético Narkomfin (1928) e a difusão das ideias da habitação mínima no contexto nacional e internacional. Foram levantados os projetos dos conjuntos e dos apartamentos - no recorte temporal de 1920 a 1960 - de maneira a compreender a ênfase dada em cada setor da casa e como as ideias se concretizaram ao longo das décadas e em contextos culturais diferentes. Propõe-se ainda estabelecer um percurso dos formatos dessa tipologia, compreendendo o contexto de circulação de ideias, transformações e adaptações a contextos culturais variados.