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)

Margaret Egan and Jesse Hauk Shera's original conception of social epistemology has never been defined unambiguously, or developed significantly beyond its early formulation. An interesting consequence of this lack of conceptual clarity has been the application of several interpretations of social epistemology. This article discusses how social epistemology was linked with the ideology of apartheid, and with racially segregated library and information services in the Republic of South Africa. In a fraudulent scientific vision for librarianship, social epistemology was assigned a (...) role that violated its original purpose. The intellectual content of social epistemology needs to be articulated in order to prevent further examples of such conceptual abuse. The paper ends with an attempt to do this with some suggestions based on Shera's own seminal ideas. (shrink)

Brings together scholars who use literary interpretation and discourse analysis to read 18th-century British philosophy in its historical context. This work analyses how the philosophers of the Enlightenment viewed their writing; and, how their institutional positions as teachers and writers influenced their understanding of human consciousness.

Brings together scholars who use literary interpretation and discourse analysis to read 18th-century British philosophy in its historical context. This work analyses how the philosophers of the Enlightenment viewed their writing; and, how their institutional positions as teachers and writers influenced their understanding of human consciousness.

With a focus on receptive language, we examine the neurobiological evidence for the interdependence of receptive and expressive language processes. While we agree that there is compelling evidence for such interdependence, we suggest that Pickering & Garrod's (P&G's) account would be enhanced by considering more-specific situations in which their model does, and does not, apply.