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)

The Buddha’s final illness, brought on by his last meal prior to his death, was traditionally seen as one of a set of ailments suffered by him at various points during his lifetime. This paper looks at different Buddhist explications of the causes of these ailments and applies them to the episode of the Buddha’s final illness. In both instances, three explanatory strategies are detected: the first stresses the causative importance of the Buddha’s own negative karmic deeds in past lives; (...) the second looks to the negative deeds and karma of others than the Buddha; the third offers non-karmic explanations. The first two engendered two rather different kinds of j?taka stories; the last did not involve any j?takas but highlighted various kinds of ‘natural’ explanations. (shrink)

Time and narratice technique compared. Two novelists, Heliodorus, 3rd century author of the novel Aethiopica and Sigrid Combüchen, contemporary Swedish novelist using a dystopian Europe around 2050 as a scenic setting. In both stories girls and women are captured and killed by soldiers. Both narrators are external to the story being told, presented in the past tense. But Combüchen´s narrator adopts it as a confession, and a turning point in his career as a commanding general, characterized by"double-bind".

On semantics and the process of word-generated knowledge in Hindu philosophy.

Contributed articles on self-realization.

Critical readings of the novels and essays by the Pakistani writer Mohsin Hamid tend to emphasize the social and political aspects of his work. In his discussion of Hamid's best known novel, Peter Morey, for example, affirms that "in both its form … and its content, The Reluctant Fundamentalist addresses contemporary questions about national vs globalized structures of power."1 He then goes on to cite Matthew Hart and Jim Hansen, for whom the novel "is concerned with subjects like cross-cultural romance, (...) transnational capitalism, and the limits of cosmopolitan space."2 As they see it, the story of Changez, the novel's protagonist, "is about the resurgence of inter-national politics from within the carapace of... (shrink)

On the philosophy of death in Hindu traditions; study based on Mr̥tyupurāṇa of Svāmī Mr̥tyujayānanda.

Liberal education prior to St. Augustine -- Education in Augustine's moral theology -- Perils of skepticism -- Liberal arts curriculum -- Pedagogy and liberal learning -- Authority and illumination -- Purposes of liberal education.

Frank Jackson has abandoned his famous knowledge argument, and has explained why in a brief "Postscript on Qualia" . This explanation consists of a direct argument, and an attempt to explain away the intuition that lies at the heart of the knowledge argument. The direct argument is clarified and found to be subtly question-begging. The attempt to explain away the key intuition is reviewed and found to be inadequate. False memory traces, which Jackson mentions at the beginning of the direct (...) argument, are discussed and found not to materially affect the force of the knowledge argument. (shrink)

A brief presentation of the major conclusions contained in the recently published monograph entitled "The Ascent to Law: Searches and Solutions," written over a period of many years. Chapter headings are: The law - an objective reality. The dogma of the law. The drama of scholarship. Searching. "The entire" substance of the law. Juridical constructs. The logic of laws. The secret of the law. Law - the highest purpose. Law in the life and fate of mankind.

A t first glance you might not noorder, which afflicts about 0.5 percent of tice anything odd on meeting a American children. Neither researcher young boy with autism. But if had any knowledge of the other’s work, you try to talk to him, it will and yet by an uncanny coincidence each quickly become obvious that gave the syndrome the same name: autism, something is seriously wrong. He may not which derives from the Greek word autos, make eye contact with (...) you; instead he may meaning “self.” The name is apt, because avoid your gaze and fidget, rock his body the most conspicuous feature of the disorto and fro, or bang his head against the der is a withdrawal from social interacwall. More disconcerting, he may not be tion. More recently, doctors have adopted able to conduct anything remotely resemthe term “autism spectrum disorder” to bling a normal conversation. Even though make it clear that the illness has many rehe can experience emotions such as fear, lated variants that range widely in severity rage and pleasure, he may lack genuine but share some characteristic symptoms. empathy for other people and be oblivious Ever since autism was identified, reto subtle social cues that most children searchers have struggled to determine would pick up effortlessly. what causes it. Scientists know that sus- In the 1940s two physicians—Americeptibility to autism is inherited, although.. (shrink)

Logic is concerned with the design or structure of arguments. It describes the forms of valid argument and is concerned with the public presentation and reception of arguments. Hence it has a close connection with politics and the public sphere, and with rhetoric as the science of persuasion. Philosophers have analysed the objective conditions of validation, that is, the justifiability of assertions about the world. This quest for objective and scientific validity in argumentation about the nature of reality dominated much (...) of the development of logic in the 20th century. Logical arguments are held to be successful as a result of the ‘force of reason’ rather than because one's opponents have been bribed or coerced. Logic involves the study of the abstract, deductive moves in argumentation rather than an empirical study of how actual arguments are conducted. However, there is also a tension between rhetoric and philosophy; Plato drew a clear distinction between knowledge and persuasion. Logic is intended to give security to the former. The historical drift of logic is towards abstraction, especially the use of mathematical forms of representation. The study of logic is an important component of any project on encyclopaedic knowledge, that is, with knowledge that circulates in the public sphere, but the globalization of culture has raised an important problem about the universalistic claims of traditions of logic, namely, are there different forms of logical reasoning? (shrink)

The Irish poet W. B. Yeats once wrote, with great sapience and perception: Nor dread, nor hope attend A dying animal; A man awaits his end Dreading and hoping all. That death has ever been a problem to man is attested as far back as we can trace our species in the archaeological record—indeed, it seems to have been a problem even for that immediate precursor of homo sapiens, the so-called Neanderthal Man; for he buried his dead.

There is no agreement at all, however, among translators, editors, and scholars, as to what is the number of problems that Aristotle proposes, nor what are the relations of importance among them. The list is given sometimes as fourteen or fifteen, sometimes as six, as nine, as twelve, as eight, and various other numbers. To a reader remembering the meticulous detail with which Aristotle told his students just how to construct topical notebooks and outlines, it seems quite unthinkable that he (...) could have poured this maze of problems over his audience like a bath-attendant, and left them to shift for themselves in discovering its intended organization. A priori, therefore, we would expect some indication within Aristotle's text of the coordination and subordination of his set of problems. (shrink)