BackgroundThe objective of this scoping study is to review the published literature and summarize findings related to barriers experienced by immigrant women in Canada while accessing cervical cancer screening.MethodsElectronic databases of peer-reviewed articles and grey literature were searched using comprehensive sets of keywords, without restricting the time period or language. Articles were selected based on the following criteria: (a) the study population consisted of Canadian immigrant women and healthcare providers and other stakeholders serving immigrant women, (b) the research focused on the barriers to accessing cervical cancer screening, and (c) the study was conducted in Canada.ResultsExtracted data were grouped and analyzed, resulting in barriers comprised of six themes: economic barriers, cultural barriers, language barriers, healthcare system-related barriers, knowledge-related barriers, and individual-level barriers. Lack of education, low income, preference for a female physician, lack of knowledge, lack of effective communication, and embarrassment were some of the most common barriers mentioned.ConclusionsImmigrant access to health services, including cervical cancer screening, is a complex issue concerning a wide range of barriers. Our findings offer insights into barriers to cervical cancer screening in immigrant communities in Canada that can be used to assist policymakers, healthcare providers, and researchers enhance the health and well-being of these populations by mitigating barriers and improving screening.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0654-5) contains supplementary material, which is available to authorized users.

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Triple C has been successfully implemented across Canada but in differing ways and with different impacts.

When accounting for the effect of numerous pertinent demographic and clinical factors, the odds of undergoing minimally invasive hysterectomy were diminished in women of Hispanic ethnicity and in those enrolled in Medicaid but were not discrepant along racial lines. However, both racial and socioeconomic disparities were observed with respect to access to robot-assisted hysterectomy despite the availability of robotic assistance in all hospitals treating the study population. Strategies to ensure equal access to all minimally invasive routes for all women should be explored to align delivery of care with the evidence supporting the broad implementation of these procedures as safe, cost-effective, and highly acceptable to patients.

Virtual patients can be used for more than independent study. Clinical teachers are encouraged to explore the multitude of uses that virtual patients can be put to, and the ways in which activities can be constructed around them. Different kinds of activity can employ different kinds of virtual patients, of varying levels of complexity.

Thermodynamic stability represents one important constraint on protein evolution, but the molecular basis for how mutations that change stability impact fitness remains unclear. Here, we demonstrate that a prevalent global suppressor mutation in TEM β-lactamase, M182T, increases fitness by reducing proteolysis in vivo. We also show that a synthetic mutation, M182S, can act as a global suppressor and suggest that its absence from natural populations is due to genetic inaccessibility rather than fundamental differences in the protein's stability or activity.

As part of an e-learning project for medical students, designed to highlight some problems and approaches around addictions, we created some virtual patients to accompany an online primer. For the section on process addictions, we created an online game, modeled on the classic board game 'Careers'. In this article, we describe how we used the OpenLabyrinth educational research platform to create a virtual scenario that could be played by 1-4 students, using a web browser. The internal activity metrics generated by OpenLabyrinth afford a very detailed look at what learners do within the game and how the game performs. We note some frustrations at engaging project reviewers and some mismatched expectations about e-learning resource usage. The e-learning resources are available for wider use and we encourage groups who might be interested in simple gamification approaches and learning analytics to explore these resources.

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