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)

Modern Indian nationalist thought has dealt with political ideas such as freedom, equality, liberty, democracy, so on and so forth. The idea of freedom received enough attention on the part of most of the modern Indian political thinkers. However, the idea of freedom as envisaged by the nationalist thinkers did not receive positive response from the other stream of modern Indian thought. Dalit-Bahujan political thinkers questioned the narration of freedom as propagated by the nationalist thinkers. Nationalist thinkers aspired for universal (...) values and at the same time reaffirmed ancient religious principles. Such effort was questioned and doubted by the other thinkers of modern India. Thus, one can find different narrations of freedom, such as social, economic and political. The social categories such as caste, class and gender became bases for their narration on the idea of freedom. The ideas and arguments of B. G. Tilak, M. K. Gandhi, Pandita Ramabai, Jyotiba Phule, B. R. Ambedkar E. M. S. Namboodripad and others would help in larger understanding of the idea of freedom. (shrink)

_This paper discusses the concept of compassion fatigue in light of the importance that political decisions, especially the application of the concept of public spirit, have had on care and nursing in a Danish hospital context during the COVID-19 pandemic. The paper is based on recent research literature in the field as well as the author’s own participatory observation study. The paper suggests that nurses already show a sense of public spirit due to their authorization and professional ethics, but at (...) the same time they must balance the ambiguity of nursing care. A linguistic-philosophical study of public spirit shows that the concept can have a discursive, double-binding and interpellative effect on nurses, who may therefore have an experience of inadequacy and compassion fatigue. In this context, compassion fatigue must be understood as the fact that nurses cannot provide the care they want or that is expected of them. Public spirit can be said to have had a renaissance and linguistic and moral supremacy during the COVID-19 pandemic. The paper views the concept of __waywardness 1 as a possible response for how to prevent or completely avoid compassion fatigue, so that nurses instead have an experience of compassion / self-compassion. This could in the end be important for encouraging more nursing students and nurses who have the desire and opportunity to stay in the profession._ _Keywords_: Nursing care, compassion fatigue, public spirit, compassion, COVID-19 pandemic. (shrink)

From the cutting edge of science and living spirituality: a guide to understanding our identity and purpose in the world • Outlines the new understanding of matter and mind coming to light at the cutting edge of physics and consciousness research • Explains how we can evolve consciously, become connected with each other, and flourish on this planet • Includes contributions from Maria Sagi, Kingsley L. Dennis, Emanuel Kuntzelman, Dawna Jones, Shamik Desai, Garry Jacobs, and John R. Audette For (...) the outdated mainstream paradigm the world is a giant mechanism functioning in accordance with known and knowable laws and regularities. The new paradigm emerging in science offers a different concept: The world is an interconnected, coherent whole, and it is informed by a cosmic intelligence. This is not a finite, mechanistic-material world. It is a consciousness-infused whole-system world. We are conscious beings who emerge and co-evolve as complex, cosmic-intelligence in-formed vibrations in the Akashic Field of the universe. Ervin Laszlo and his collaborators from the forefront of science, cosmology, and spirituality show how the re-discovery of who we are and why we are here integrates seamlessly with the wisdom traditions as well as with the new emerging worldview in the sciences, revealing a way forward for humanity on this planet. They explain how we have reached a point of critical incoherence and tell us that to save ourselves, our environment, and society, we need a critical mass of people to consciously evolve a new thinking. Offering a guidepost to orient this evolution, Laszlo examines the nature of consciousness in the universe, showing how our bodies and minds act as transmitters of consciousness from the intelligence of the cosmos and how understanding science’s new concept of the world enables us to re-discover our identity and our purpose in our world. With bold vision and forward thinking, Laszlo and his contributors Maria Sagi, Kingsley L. Dennis, Emanuel Kuntzelman, Dawna Jones, Shamik Desai, Garry Jacobs, and John R. Audette outline the new idea of the world and of ourselves in the world. They help us discover how we can overcome these divisive times and blossom into a new era of peace, coherence, connection, and global wellbeing. (shrink)

This book is the authorized political biography of Kenneth Waltz. The theoretical work of Kenneth Neal Waltz (June 8, 1924 - May 12, 2013) during the last half of the twentieth century in international relations theory is known by virtually everyone in this scholarly field. He is among the few likely still to be cited in the last half of the twenty-first century. Then, as now, he no doubt has followers within the realist camp who see him as an earlier (...) luminary as well as his critics drawn to the lightning-rod quality of his work. Paul Viotti identifies the intellectual sources and experiences leading to the ideas that underlie Waltz's theoretical work. Viotti has been granted unfettered access to Waltz's files at Columbia, in his residences in Manhattan and Maine, and in archives at Oberlin, and uses these documents to paint a thorough, insightful biography bolstered by some of Waltz's previously-unexplored work. Through a series of interviews with Waltz about his life-starting with his German great-grandparents' immigration to the US in the 19th century-this biography produces personal insights into the development of his theoretical and policy-based contributions. (shrink)

Georg Lukács (1885-1971) was one of the most original Marxist philosophers and literary critics of the twentieth century. His work was a major influence on what we now know as critical theory. Almost fifty years after his death, Lukács's legacy has come under attack by right-wing extremists in his native Hungary. Despite efforts to erase his memory, Lukács remains a philosophical gadfly. In Confronting Reification, an international team of fourteen scholars explicate, reassess, and apply one of Lukács's most significant philosophical (...) contributions, his theory of reification. Based on papers presented at the 2017 Legacy of Georg Lukács conference held in Budapest, the essays in this volume demonstrate the vitality of Lukács's thought and its relevance. Contributors include: Rüdiger Dannemann, Frank Engster, Andrew Feenberg, Joseph Grim Feinberg, Andraž Jež, Christian Lotz, Csaba Olay, Tom Rockmore, Gregory R. Smulewicz-Zucker, Mariana Teixeira, Michael J. Thompson, Tivadar Vervoort, Richard Westerman, and Sean Winkler. (shrink)

Cristina Lafont's recent reading of Heidegger offers a powerful formulation of the widespread view that once one recognizes our `facticity' and the role of language in shaping it, there is no room left to talk about transcendental structures of meaning or experience. In this article I challenge this view. I argue that Lafont inaccurately conflates what Heidegger calls our `understanding of being' with that which language discloses. In order to show that the philosophical motivation for this conflation is unsound, I (...) also argue that Lafont's own positive theory of meaning itself tacitly assumes a distinction between factical and transcendental, and so rests on exactly what she finds problematic in Heidegger. This still leaves a puzzle as to how factical individuals are actually able to grasp anything transcendental, so I conclude by sketching Heidegger's method of `formal indication', which is meant to show precisely how this can be done. (shrink)

The present article offers three critiques of the universal basic income guarantee (BIG) proposal discussed by Standing in this volume. First, there is a fundamental tension between the way income in a monetary production economy is generated, the manner in which BIG wishes to redistribute it, and the subsequent negative impact of this redistribution on the process of income generation itself. The BIG policy is dependent for its existence on the very system it wishes to undermine. Second, the macroeconomic effects (...) of BIG on contemporary economies that use modern money are destabilizing. The job guarantee (JG), by contrast, stabilizes both the macro-economy and the currency while helping transform the nature of work itself. Finally, the employment safety-net in Standing’s piece is not an accurate representation of the modern JG proposals – a confusion which this paper aims to remedy. (shrink)

theories. What was Freud thinking, when, and why and what were the major influences which shaped his ideas? We follow the inner movement of his theory construction, its meaning and coherence, as well as his conceptual logic and personal directions concerning his evolving views of the reciprocal interactions between mind and body, the motivational force of instinctual drives, and the dominant role of sexuality rooted in evolutionary biology in human development, behaviour, and the creation of neurotic disturbances. We follow Freud's (...) construction and sequential reconstructions of his theoretical models concerning the nature, dynamics, and principles of unconscious mental functioning, including his changing concepts on the nature and purpose of dreams. We trace his changing views on the role of deferred action of early childhood experiences and the determining role of unconscious fantasy, psychic reality, in the formation of adult character structure and neuroses. Through such historical analysis this book provides grounding for a meaningful understanding of Freud's familiar concepts: id, ego, superego, and the Oedipus complex. We explore what these concepts meant to Freud, why he conceived them, and what functions they served in his theory of mind. This is the perfect book for students and trainees wanting to learn more about the development of Freud's ideas, as well as for established psychoanalysts and psychotherapists interested in expanding their knowledge of Freud's theories. (shrink)

An algebraic semantics, based on factor algebras, for one-way and two-way implicative verbs is proposed. Implicative verbs denote elements of filters or of ideals generated by identity functions in factor algebras. This semantics explains in particular the problem of implicational equivalence raised by two-way implicative verbs, and shows that the negation necessary to establish the implicativity of these verbs is the negation which preserves the presuppositions of sentences with implicative verbs. In addition, it follows from the proposed semantics that any (...) two implicative verbs denoting in the same algebra but belonging to different categories, are semantically related. (shrink)

Two of the most important topics in the field of medical ethics today are insemination by donor (AID) and in-vitro fertilization. The conclusions of a working party set up by the British Association for the Advancement of Science are embodied in a small book reviewed on pate 108 of this issue, but we feel that more discussion than can be set out in the space allocated to book reviews is justified. Also, this journal in its first number has already devoted (...) a group of papers to the issue of abortion, so the conclusions of the working party and our own comments overlap and we hope illuminate further the problems enunciated. (shrink)

The insurance hypothesis is a reasonable explanation for the current obesity epidemic. One alternative explanation is that the marketing of high-sugar foods, especially sugar-sweetened beverages, drives the rise in obesity. Another prominent hypothesis is that obesity spreads through social influence. We offer a framework for estimating the extent to which these different models explain the rise in obesity.

Annihilationism provides a fruitful point of contact between philosophers and theologians for further reflection on nonexistence. In this paper I articulate a key commitment of annihilationism; namely, that some persons cease to exist. Such a commitment, I argue, amounts to the claim that some persons exist at time t and then do not exist at t+1, become ‘annihilated objects.’ Claims about annihilated objects induct the annihilationist into a wider realism/anti-realism debate about nonexistent objects. I survey some major viewpoints in this (...) debate. I then draw out some implications for each view for the annihilationist’s commitment to annihilated objects. I show that annihilationism is consistent with some forms of realism and anti-realism and inconsistent with others. (shrink)

John Haugeland aimed throughout his career to determine what it is for an entity to count as having intelligence or thought, and at each stage he developed the idea from the phenomenological tradition that genuine thought requires intentionality. His most mature essay to do this, “Authentic Intentionality,” shows how the intentional directedness of thought requires that thinkers understand themselves as responsive to entities they think about, that they be committed to maintaining the socially shared forms of understanding of those entities, (...) and yet that they be self-critically open to the possibility of needing to revise or reject those forms of understanding. In this essay I argue that, while Haugeland’s account of intentionality sheds much light on empirical thought (thought directed at different kinds of things in the world), it doesn’t address what it takes for thought to intend or think its own form—and so it fails to describe the kind of transcendental thought of which the account itself is an instance. Building on Haugeland’s own rich picture of self-understanding, I show how we can remedy this omission, and that when we do, we see that transcendental thought is performed by each of us as concrete individuals and yet takes place from a perspective outside of, and thus free from, the normative demands and existential situations of our empirical lives. It is thus of at most therapeutic use in them, even as it is valuable for its own sake as an exercise of our finite freedom. (shrink)