BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

The Constitution of the Athenians ascribed to Xenophon the orator.--The Politeia of the Spartans by Xenophon.--The Boeotian Constitution from the Oxyrhynchus historian.--The Constitution of Athens by Aristotle.

With the passing of S. A. Janovskaja, contemporary Soviet philosophy has lost one of its leading experts in logic and in combining creativity with survival.

Until now, adult crying has received relatively little interest from investigators, whereas in the popular media there are many strong claims about crying (e.g., crying brings relief) of which the scientific basis is not clear. In this review, we provide an overview of the current state of the scientific literature with respect to crying. We identify gaps in knowledge and propose questions for future research. The following topics receive special attention: Ontogenetic development, antecedents, individual and gender differences, and the intra- (...) and interindividual effects of crying. We conclude that the study of crying may help us obtain better insight into human nature, that is, not only our emotional, but also social, and moral functioning. (shrink)

Outstanding translations by leading contemporary scholars--many commissioned especially for this volume--are presented here in the first single edition to include the entire surviving corpus of works attributed to Plato in antiquity. In his introductory essay, John Cooper explains the presentation of these works, discusses questions concerning the chronology of their composition, comments on the dialogue form in which Plato wrote, and offers guidance on approaching the reading and study of Plato's works. Also included are concise introductions by Cooper and Hutchinson (...) to each translation, meticulous annotation designed to serve both scholar and general reader, and a comprehensive index. This handsome volume offers fine paper and a high-quality Smyth-sewn cloth binding in a sturdy, elegant edition. (shrink)

In this 1974 book a practising scientist and gifted expositor sets forth an exciting point of view on the nature of science and how it works.

BLWith new text and full apparatus criticus The Eudemian Ethics was one of two ethical treatises which Aristotle wrote on the subject of ethica or `matters to do with character'. Although the two works cover much the same ground, the Nicomachean Ethics is better known; the poor manuscript tradition of the Eudemian Ethics has made correct translation and interpretation of the text extremely difficult. The subject of the work is the choice of a certain means of conduct, made by a (...) `man of practical wisdom', between two extremes of behaviour: asceticism and yielding to uncontrolled impulses. Aristotle also stresses the notion of moral intention and the importance of virtue of character. This new Oxford Classical Text of the Eudemian Ethics is the result of many years of work. After Sir David Ross's death, his original text was substantially reworked and revised by his friend and colleague R. R. Walzer, who was aided in the revision by his former pupil Mrs Jean Mingay, who continued his work after his death in 1974. Mrs Mingay was fortunate in being able to make use of previously unpublished contributions from D. J. Allan after his death in the late seventies, and more recently has been helped in her work by the suggestions of Professor D. A. Russell, David Robinson, and Christopher Rowe. (shrink)

CONSCIOUSNESS AND THE BRAIN SELF-REGULATION PARADOX The relationship of consciousness to biology has intrigued mankind thoroughout recorded history. However, little progress has been made not only in understanding these issues but also in raising fundamental questions central to the problem. As Davidson and Davidson note in their introduction, William James suggested, almost a century ago in his Principles of Psychology, that the brain was the organ of mind and be havior. James went so far as to suggest that the remainder (...) of the Principles was but a "footnote" to this central thesis. This volume brings together diverse biobehavioral scientists who are addressing the various aspects of the mindlbrainlbodylbehavior issue. Although some of the authors have previously published together in other volumes, by and large the particular combination of authors and topics selected by the editors makes this volume unique and timely. Unlike the Consciousness and Self-Regulation series (Schwartz & Shapiro, 1976, 1978), also published by Plenum, this volume is devoted entirely to a psychobiological approach to consciousness. Although readers will differ in their interest in specific chapters, the well-rounded investigator who is concerned with the psychobiology of consciousness will want to become intimately acquainted with all the views presented in this volume. As noted by the individual contributors, the topic of this volume stimulates fundamental questions which, on the surface, may appear trivial, yet, on further reflection, turn out to have deep significance. (shrink)

Theodor W. Adorno is best known for his contributions to aesthetics and social theory. Critics have always complained about the lack of a practical, political or ethical dimension to Adorno's philosophy. In this highly original contribution to the literature on Adorno, J. M. Bernstein offers the first attempt in any language to provide an account of the ethical theory latent in Adorno's writings. Bernstein relates Adorno's ethics to major trends in contemporary moral philosophy. He analyses the full range of Adorno's (...) major works, with a special focus on Dialectic of Enlightenment, Minima Moralia and Negative Dialectics. In developing his account Bernstein lays particular stress on Adorno's contention that the event of Auschwitz demands a new categorical imperative. This book will be widely acknowledged as the standard work on Adorno's ethics and as such will interest professionals and students of philosophy, political theory, sociology, history of ideas, art history and music. (shrink)