Topic

• Greetings and Introduction
  • The RF and the WGO: a global collaboration
  • Introduction and goals of the symposium

• Epidemiology and Socio-Cultural Issues
  • How symptoms mediate culture and biology
  • Interpretation and reporting of GI symptoms, differential diagnosis and diagnostic work-up around the world
  • •   - Asia
    •   - India
    •   - Eastern Europe
    •   - Mexico and Latin-America
  • Discussion and Q & A

• Culture, Health and FGIDs
  • Culture and health care
  • Explanatory models of illness: basic framework & applications for care of people with FGIDs
  • Discussion and Q & A

• Mechanisms and Pathophysiology
  • A global perspective on the effect of genetics and ethnicity on pathophysiology and management
  • GI microbiology – pathogens, exposure patterns and immune responses
  • Geographical and cultural food-related symptoms, food avoidance and elimination
  • Worldwide differences in psychopathology and the interpretation and effects of stress
  • Discussion and Q & A

• Lunch

• Patient care in different geographical areas and cultural settings
  • Practicing in a multicultural milieu – physician competence
  • Practicing in a multicultural milieu – listening for stories
  • Folk remedies, self-medicating, and CAM around the world
  • Impact of local regulations and healthcare organization on management options
  • Cultural beliefs and health care: searching for balance

• Clinical Competency Workshop: Working in a Multiethnic Clinic
  • 1. Introduction to Workshop and Role Plays
  • 2. Role play with Physician Actors – clinical encounters with
    cross-cultural issues
  • •   - Mexican Patient Interview
    •   - Nigerian Patient Interview
    •   - Russian Patient Interview
  • 3. Summary

• Research competence workshop
  • 1. Cross – cultural, multinational research
  • 2. Examples of cross-cultural studies
  • •   - Gerson
    •   - Hungin
    •   - Zuckerman
  • 3. Translation and validation of instruments for cross – cultural studies
  • 4. Expression of gastrointestinal symptoms across countries: similarities and differences
  • 5. Discussion

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• Conducting Multinational Drug Trials
  • Unique problems in multi-national studies: organizational challenges
  • Unique problems in multi-national studies: ethical issues, inclusion criteria and recruitment problems
  • Unique problems in multi-national studies: regional perspectives on endpoints and outcomes
  • •   - Japan perspective
    •   - EMEA perspective
    •   - FDA perspective
  • Discussion and Q & A

• Break

• Summary of workshops and meeting
  • Summary of clinical practice workshop
  • Summary of research practice workshop

• General discussion: How should we proceed?