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)

SummaryEarly geological investigations in the St David's area (Pembrokeshire) are described, particularly the work of Murchison. In a reconnaissance survey in 1835, he regarded a ridge of rocks at St David's as intrusive in unfossiliferous Cambrian; and the early Survey mapping (chiefly the work of Aveline and Ramsay) was conducted on that assumption, leading to the publication of maps in 1845 and 1857. The latter represented the margins of the St David's ridge as ‘Altered Cambrian’. So the supposedly intrusive ‘syenite’ (...) was regarded as younger, and there was no Precambrian. These views were challenged by a local doctor, Henry Hicks, who developed an idea of the ex-Survey palaeontologist John Salter that the rocks of the ridge were stratified and had formed a Precambrian island, round which Cambrian sediments (now confirmed by fossil discoveries) had been deposited. Hicks subsequently proposed subdivision of his Precambrian into ‘Dimetian’, ‘Pebidian’, and (later) ‘Arvonian’, and he attempted correlations with rocks in Shropshire, North Wales, and even North America, seeking to develop the neo-Neptunist ideas of Sterry Hunt. The challenge to the Survey's work was countered in the 1880s by the Director General, Geikie, who showed that Hicks's idea of stratification in the Dimetian was mistaken. A heated controversy developed, several amateur geologists, supported by a group of Cambridge Sedgwickians, forming a coalition of ‘Archaeans’ against the Survey. Geikie was supported by Lloyd Morgan. Attention focused particularly on Ogof Lle-sugn Cave and St Non's Arch, with theory/controversy-ladenness of observations evident on both sides. Evidence from an eyewitness student record of a Geological Society meeting reveals the ‘sanit`ized’ nature of the official summary of the debate in QJGS. Field mapping early in the twentieth century by J. F. N. Green allowed a compromise consensus to be achieved, but Green's evidence for unconformity between the Cambrian and the Dimetian, obtained by excavation, can no longer be verified, and his consensual history of the area may need revision. Unconformity between the Cambrian and the Pebidian tuffs is not in doubt, however, and Precambrian at St David's is accepted. The study exhibits features of geological controversy and the British geological community in the nineteenth century. It also furnishes a further instance of the great influence of Murchison in nineteenth-century British geology and the side-effects of his controversy with Sedgwick. (shrink)

Originally published in 1963, this classic book is a rethinking of the history of Western political philosophy. Charles N. R. McCoy contrasts classical-medieval principles against the "hypotheses" at the root of modern liberalism and modern conservativism. In Part I, "The Classical Christian Tradition from Plato to Aquinas," the author lays the foundation for a philosophical "structure" capable of producing "constitutional liberty." Part II, "The Modern Theory of Politics from Machiavelli to Marx," attempts to show, beginning with Machiavelli, the reversal and (...) destruction of the pre-modern "structure" postulated in Part I. McCoy stresses the great contributions of Aristotle to political thought found in his more familiar Ethics and Politics, but also includes key insights drawn from Metaphysics and Physics. These contributions are developed and perfected, McCoy argues, by Augustine and Aquinas. Two other important features include McCoy's epistemological insights into Plato's work that will be new to many readers and the author's juxtaposition of traditional natural law with "the modernized theory of natural law." The modern account of autonomous natural law, in McCoy's view, helps explain the totalitarian direction of key aspects of modern political thought. This classic volume on the origins of modern philosophical thought remains a standard in the field. (shrink)

The Republic represents the good life as some sort of harmony or composition between the different interests of which the threefold nature of the soul makes it capable. The rational factor, τ λολιστικν, not only chooses which impulses shall be satisfied and which rejected but is credited also with impulses of its own, such as the desire for knowledge, to the importance of which the Republic testifies by various strands of argument. But in Plato's attempt to prove the goodness of (...) this mixed life he may be thought to have relied too much on arguments about its pleasantness. If he had really meant from the first to prove against Thrasymachus that the just life is more prolific in pleasure1 than the unjust, he would have had to undertake the task of proving a necessary connection between just activities and pleasant states of feeling which could scarcely exist unless feelings were under the control of the will. If this had been his intention, the whole weight of the argument would rest on the two comparatively short passages in Book IX in which he makes first a dubious appeal to experience and then, by an equally dubious piece of metaphysics, attempts to reinforce his ethical conclusion by denying the reality of such pleasures as might tend to throw doubt on it. (shrink)

The paper is devoted to the research by H. Petrovsky “Desturbance of the Sign. Culture against Transcendence.” The article attempts a reconstruction of some important conceptual topoi of the book. The ideas of the book are presented through the material of one of the chapters — the photo archive of Zofia Rydet. The second part offers a conceptual variation of a different type, due to J.-M. Vappereau, which is related to the range of issues raised in the book.

This paper makes an attempt to examine the various facets of human values in the background of the widely shared popular beliefs about erosion of values. A random sample of elite opinions on the nature of decline of values brings out the difficulties involved in identifying values for social analysis. Values are an integral part of the religious, spiritual and governmental spheres of social behaviour within a culture. It is argued that the problem of erosion of values is shared across (...) cultures and has existed throughout the history of human society. It is suggested that material and spiritual values follow a dialectical process of coexistence and conflict. The current wave of concern over degeneration of values is explained in relation to the unprecedented complexity of today's global society and the socio-economic challenges posed by this complexity for the individual and the society at various levels. This discussion is followed by a brief review of the recent contributions of social sciences to the concept of values and their decline in modern society. Finally, some thoughts are expressed, from a sociologist's vantage point, regarding the multi-dimensional problem of values in the emerging global culture. (shrink)

What cognitive process allows a spectator to experience shock and surprise at a character’s actions, yet, a moment later, to decide that the actions presented onstage are coherent and understandable? Drawing upon theories of mindreading and conceptual blending, I offer a dynamic model of character that accounts for surprise, ambiguity, and dramatic shifts of understanding. Subtle changes to one’s perceptions, empathic imagination, and social knowledge—the sort of changes that accumulate throughout the viewing of Shakespeare’s Twelfth Night —can alter one’s understanding (...) of a character in unexpected ways. (shrink)

The present volume completes the cataloguing of manuscripts. This impressive undertaking will be concluded with one further volume, which will contain addenda and extensive indexes to all the volumes. `a remarkable achievement of scholarship...The descriptions of the manuscripts are full and at the same time admirably concise...Any user of the work, whether his interests are palaeographical, iconographical, or textual, will be deeply grateful for the wealth of information contained in this volume'. Review of English Studies`will be invaluable not only for (...) reference but for the comprehensive and immensely precise assurance that it will give to scholars in every field of medieval studies that nothing relevant to their purposes now lurks in unrecorded concealment'. English Historical Review. (shrink)