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)

Joseph Conrad’s ‘The secret sharer’ has often been associated with what can be called initiation stories. However, in this article I argue that Conrad’s text is more than that. It can, I suggest, be read as an allegory of the inaccessibility to reveal the essence of being in command, being in education, and also the inaccessibility of the essence of the meaning of the text itself. It keeps its secret by allegorically staging alternative readings. This inaccessibility gives rise to a (...) feeling of strangeness, of the uncanny, that must be faced in order to pass through the initiation into the unknown that all the possible allegorical meanings of the text produce. In other words, ‘The secret sharer’ has an educational value that goes beyond the act of merely using it to exemplify a certain type of initiation. In this way I connect Conrad’s text to the themes of strangeness and the stranger and show how they mutually can involve a reading of education and literature as two distinct discourses of learning. (shrink)

In 2018, the first full year of the Trump presidency, it became abundantly clear that the transatlantic relationship had entered a period of intense discord, causing a series of pessimistic reports and commentary in the mainstream Anglo-American media. With this as the starting point, the article re-examines the study of the ‘transatlantic’ as a region. It engages with thinking of time (periodisation), space (scale), and discipline (methodology) in order to question standard assumptions and open up new avenues for research, identity-formation, (...) and emancipatory commitment. (shrink)

BackgroundFunding agencies have long used panel discussion in the peer review of research grant proposals as a way to utilize a set of expertise and perspectives in making funding decisions. Little research has examined the quality of panel discussions and how effectively they are facilitated.MethodsHere, we present a mixed-method analysis of data from a survey of reviewers focused on their perceptions of the quality, effectiveness, and influence of panel discussion from their last peer review experience.ResultsReviewers indicated that panel discussions were (...) viewed favorably in terms of participation, clarifying differing opinions, informing unassigned reviewers, and chair facilitation. However, some reviewers mentioned issues with panel discussions, including an uneven focus, limited participation from unassigned reviewers, and short discussion times. Most reviewers felt the discussions affected the review outcome, helped in choosing the best science, and were generally fair and balanced. However, those who felt the discussion did not affect the outcome were also more likely to evaluate panel communication negatively, and several reviewers mentioned potential sources of bias related to the discussion. While respondents strongly acknowledged the importance of the chair in ensuring appropriate facilitation of the discussion to influence scoring and to limit the influence of potential sources of bias from the discussion on scoring, nearly a third of respondents did not find the chair of their most recent panel to have performed these roles effectively.ConclusionsIt is likely that improving chair training in the management of discussion as well as creating review procedures that are informed by the science of leadership and team communication would improve review processes and proposal review reliability. (shrink)

This work summarizes an already comprehensive field of criticisms of received economics and advanced new ones, particularly with respect to free trade and the industrialisation of economic systems. If global economic and ecological catastrophe is to be avoided, nations and communities must move towards greater self-reliance within the framework of a much less resource-wasteful existence. But to do this will require not merely a cosmetic change in the present socio-economic system, but a change of such magnitude that it dwarfs previous (...) social transformations in human history. This great transformation must occur by conscious human activity and it must occur quickly if human civilizations, and indeed human life itself, is to continue. (shrink)

This book provides a postmodernist critique of philosophy through ecological limitationism and common-sense realism. The authors demonstrate the reality of life, the world and the primacy of practice in relation to the failings of Anglo-American analytic philosophy to meet the challenges of the age.

BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

On August 30, 2013, the American Political Science Association sponsored a roundtable on political epistemology as part of its annual meetings. Co-chairing the roundtable were Jeffrey Friedman, Department of Government, University of Texas at Austin; and Hélène Landemore, Department of Political Science, Yale University. The other participants were Scott Althaus, Department of Political Science, University of Illinois at Urbana-Champaign; Mark Bevir, Department of Political Science, University of California at Berkeley; Rogers Smith, Department of Political Science, University of Pennsylvania; (...) and Susan Stokes, Department of Political Science, Yale University. We thank the participants for permission to republish their remarks, which they subsequently edited for clarity. (shrink)

Studies on why small and medium enterprises engage in pro-environmental behavior suggest that managers’ environmental responsibility plays a relatively greater role than competitiveness and legitimacy-seeking. These categories of drivers are mostly considered independent of each other. Using survey data and comparative case studies of wine firms in South Africa, this study finds that managers’ environmental responsibility is indeed the key driver in a context where state regulation hardly plays any role in regulating dispersed, rural firms. However, especially proactive firms are (...) also characterized by expectations of competitiveness gains. The authors thus emphasize the role of institutional context and potential interaction effects between these drivers in explaining the reasons why SMEs engage in pro-environmental behavior in developing countries. (shrink)

De-Signing Design: Cartographies of Theory and Practice throws new light on the terrain between theory and practice in transdisciplinary discourses of design and art. The collection brings together a selection of essays on spatiality, difference, cultural aesthetics, and identity in the expanded field of place-making and being.

Scientific peer reviewers play an integral role in the grant selection process, yet very little has been reported on the levels of participation or the motivations of scientists to take part in peer review. The American Institute of Biological Sciences developed a comprehensive peer review survey that examined the motivations and levels of participation of grant reviewers. The survey was disseminated to 13,091 scientists in AIBS’s proprietary database. Of the 874 respondents, 76% indicated they had reviewed grant applications in the (...) last 3 years; however, the number of reviews was unevenly distributed across this sample. Higher review loads were associated with respondents who had submitted more grant proposals over this time period, some of whom were likely to be study section members for large funding agencies. The most prevalent reason to participate in a review was to give back to the scientific community and the most common reason to decline an invitation to review was lack of time. Interestingly, few suggested that expectation from the funding agency was a motivation to review. Most felt that review participation positively influenced their careers through improving grantsmanship and exposure to new scientific ideas. Of those who reviewed, respondents reported dedicating 2–5% of their total annual work time to grant review and, based on their self-reported maximum review loads, it is estimated they are participating at 56–87% of their capacity, which may have important implications regarding the sustainability of the system. Overall, it is clear that participation in peer review is uneven and in some cases near capacity, and more needs to be done to create new motivations and incentives to increase the future pool of reviewers. (shrink)

Without complete and accurate status information, a project manager’s ability to monitor progress, allocate resources effectively, and detect and respond to problems is greatly diminished, and this can lead to impaired project performance. Many different factors can contribute to intentional misreporting of status information by project members to the project manager. In this study, the impact of organizational ethical climate was assessed through the analysis of responses from 228 project members drawn from a variety of ongoing information systems projects. Our (...) results revealed that project members who perceived their organization to be one in which rules are followed strictly tended to misreport less, while those operating in an environment dominated by personal self-interest tended to misreport more. Somewhat surprisingly, the existence of a caring, team-spirited environment did not appear to have an impact on misreporting behaviors. Implications for researchers and project managers are discussed. (shrink)

Human sleeping arrangements have evolved over time and differ across cultures. The majority of adults share their bed at one time or another with a partner or child, and many also sleep with pets. In fact, around half of dog and cat owners report sharing a bed or bedroom with their pet. However, interspecies co-sleeping has been trivialized in the literature relative to interpersonal or human-human co-sleeping, receiving little attention from an interdisciplinary psychological perspective. In this paper, we provide a (...) historical outline of the “civilizing process” that has led to current sociocultural conceptions of sleep as an individual, private function crucial for the functioning of society and the health of individuals. We identify similar historical processes at work in the formation of contemporary constructions of socially normative sleeping arrangements for humans and animals. Importantly, since previous examinations of co-sleeping practices have anthropocentrically framed this topic, the result is an incomplete understanding of co-sleeping practices. By using dogs as an exemplar of human-animal co-sleeping, and comparing human-canine sleeping with adult-child co-sleeping, we determine that both forms of co-sleeping share common factors for establishment and maintenance, and often result in similar benefits and drawbacks. We propose that human-animal and adult-child co-sleeping should be approached as legitimate and socially relevant forms of co-sleeping, and we recommend that co-sleeping be approached broadly as a social practice involving relations with humans and other animals. Because our proposition is speculative and derived from canine-centric data, we recommend ongoing theoretical refinement grounded in empirical research addressing co-sleeping between humans and multiple animal species. (shrink)

Drug regulatory bodies aim to ensure that patients have access to safe and effective drugs; however, no matter the quality of pre-licensure studies, uncertainty will remain regarding the safety and effectiveness of newly approved drugs until a large and diverse population uses those drugs. Recent analyses of Canada’s post-market drug surveillance system have found that Canada is not keeping pace with international requirements for PMDS, and have noted that efforts must be improved to monitor and address the safety and effectiveness (...) of approved drugs among vulnerable populations. Given the uncertainty that exists when drugs enter the market, some have suggested that the precautionary principle is relevant to guiding decision-making in this context. This paper responds to recommendations that the Canadian PMDS system should be responsive to the health needs of vulnerable populations by assessing the utility of deploying the precautionary principle to guide a post-market strategy for vulnerable populations. (shrink)

Health regulators must carefully monitor the real-world safety and effectiveness of marketed vaccines through post-market monitoring in order to protect the public’s health and promote those vaccines that best achieve public health goals. Yet, despite the fact that vaccines used in collective immunization programmes should be assessed in the context of a public health response, post-market effectiveness monitoring is often limited to assessing immunogenicity or limited programmatic features, rather than assessing effectiveness across populations. We argue that post-market monitoring ought to (...) be expanded in two ways to reflect a ‘public health notion of post-market effectiveness’, which incorporates normative public health considerations: effectiveness monitoring should yield higher quality data and grant special attention to underrepresented and vulnerable populations; and the scope of effectiveness should be expanded to include a consideration of the various social factors that maximize a vaccine’s effectiveness at the population level, paying particular attention to how immunization programmes impact related health gradients. We use the case of the human papillomavirus vaccine in Canada to elucidate how expanding post-market effectiveness monitoring is necessary to close the gap between clinical practice and public health, and to ensure that vaccines are effective in a morally relevant sense. (shrink)

Ontology is one strategy for promoting interoperability of heterogeneous data through consistent tagging. An ontology is a controlled structured vocabulary consisting of general terms (such as “cell” or “image” or “tissue” or “microscope”) that form the basis for such tagging. These terms are designed to represent the types of entities in the domain of reality that the ontology has been devised to capture; the terms are provided with logical defi nitions thereby also supporting reasoning over the tagged data. Aim: This (...) paper provides a survey of the biomedical imaging ontologies that have been developed thus far. It outlines the challenges, particularly faced by ontologies in the fields of histopathological imaging and image analysis, and suggests a strategy for addressing these challenges in the example domain of quantitative histopathology imaging. The ultimate goal is to support the multiscale understanding of disease that comes from using interoperable ontologies to integrate imaging data with clinical and genomics data. (shrink)

En 2018, première véritable année de la présidence de Trump, il devint parfaitement clair que la relation transatlantique était entrée dans une phase de profond désaccord, suscitant quantités de témoignages et de commentaires pessimistes dans la presse anglo-américaine. A partir de ce constat, l’article reconsidère l’étude du « transatlantique » en tant qu’aire géographique. Il aborde la manière d’appréhender le temps (la périodisation), l’espace (l’échelle) et la discipline (la méthodologie) afin de remettre en question les hypothèses classiques et d’ouvrir de (...) nouvelles voies pour la recherche, la formation identitaire et l’engagement émancipateur. (shrink)

While central to the Christian religion, the act of faith has been notoriously difficult to define. This essay is an attempt to illuminate, with the aid of insights from cognitive science and process philosophy, what it means for a Christian to have faith, specifically in God. In doing so, the apriori and aposteriori aspects of faith are explored, along with its connections to science and empirical evidence, revelation, knowledge, doubt, morality, and additional Christian beliefs.

Research has shown that individuals with high levels of psychopathic personality traits are likely to cause harm to others in the workplace. However, there is little academic literature on the potentially adaptive outcomes of corporate psychopathy, particularly because the “boldness” psychopathy domain has largely been under-acknowledged in this literature. This study aimed to elaborate on past findings by examining the associations between psychopathy, as operationalized using scales from the relatively new triarchic model of psychopathy, and both adaptive and maladaptive workplace (...) behaviors. Participants were 343 working community adults who completed a series of self-report questionnaires that measured psychopathy and various workplace behaviors, including counterproductive work behaviors, tactics of influence, unethical decision-making, leadership strategies, team play, and creativity. Structural equation modeling was used to estimate the associations between latent constructs of boldness, meanness, and disinhibition, and the eight different constructs related to workplace behaviors. It was found that boldness preferentially predicted the use of soft tactics of influence, adaptive leadership, and team play, and negatively predicted passive leadership. Meanness predicted unethical decision-making, poor team play, and hard tactics of influence. Disinhibition positively predicted CWB and passive leadership. Meanness also moderated the association between disinhibition and CWB, in that greater scores on both psychopathy domains indicated greater levels of CWB. These findings provide conceptual support for the triarchic model, including the “boldness” domain, which measures adaptive aspects of psychopathy in addition to maladaptive ones, as well as suggest that not all individuals high on psychopathy would be an overt menace to the workplace. The different psychopathy traits may also interact with each other to predict different types or levels of workplace behaviors. (shrink)

ABSTRACT Dealing primarily with implications rather than foundations, and focusing downstream at the expense of upstream prevention, mainstream bioethics is at a toxic watershed. Through an extended analysis of the Environmental Genome Project (EGP), we offer new tools from the philosophy of science and from critical epidemiology to help bioethics to move ahead. Our aim in this paper is not to resolve the moral and conceptual problems we reveal, but rather to outline ways to prevent such problems from arising in (...) future research. (shrink)

En 2018, première véritable année de la présidence de Trump, il devint parfaitement clair que la relation transatlantique était entrée dans une phase de profond désaccord, suscitant quantités de témoignages et de commentaires pessimistes dans la presse anglo-américaine. A partir de ce constat, l’article reconsidère l’étude du « transatlantique » en tant qu’aire géographique. Il aborde la manière d’appréhender le temps (la périodisation), l’espace (l’échelle) et la discipline (la méthodologie) afin de remettre en question les hypothèses classiques et d’ouvrir de (...) nouvelles voies pour la recherche, la formation identitaire et l’engagement émancipateur. (shrink)

The present article challenges the bifurcation of the world established by Kant, a bifurcation that continues to plague contemporary thinking about science, religion, and morality. This challenge is aided by Whitehead's alternative worldview.

Though nominalism is a major presupposition in academia and western society, R. Scott Smith shows that nominalism undermines all knowledge whatsoever. In light of the many clear examples of knowledge that we do have, nominalism should be replaced by a realist view of properties.

For most of the church's history, people have seen Christian ethics as normative and universally applicable. Recently, however, this view has been lost, thanks to naturalism and relativism. R. Scott Smith argues that Christians need to overcome Kant's fact-value dichotomy and recover the possibility of genuine moral and theological knowledge.

Merold Westphal and James K. A. Smith argue forcefully that Christians should embrace the postmodern turn to interpretation. They draw upon Derrida and Heidegger, and they criticize Edmund Husserl’s “metaphysics of presence” and our ability to know reality directly. They reject his epistemology as modern and arrogant, as an attempt to gain pristine knowledge. But I argue that they radically misunderstand and therefore wrongly reject Husserl. This will allow me to show why their view, that “everything is interpretation,” is (...) mistaken. It also will allow me to show why Husserl’s earlier work shows us how we can know reality immediately. (shrink)

"Unlike most photographs of Eads Bridge, which are taken from a distance, Quinta Scott's intimate photographic essay shows the subtleties of form and texture that give this structure its remarkable aesthetic impact. Howard Miller's text complements the photos, explaining the place of James Eads's unorthodox design in the history of American architecture and aesthetics. Miller also explains the bridge's place in local and national economic history, describes its innovative engineering, and brings to life its unique creator."--Jacket.

Though William Lane Craig believes his anti-Platonism is compatible with objective, Christian morality, I argue that it is not. First, I survey the main contours of his nominalism. Second, I discuss how he sees those points in relation to objective, Christian morality. Then, I argue that his view cannot sustain the qualitative aspects of moral virtues or principles, or even human beings. Moreover, Craig’s view loses any connection between those morals and humans, thereby doing great violence to objective, Christian morals. (...) Finally, I sketch two advantages of a Platonic realism in regards to Christian morals. (shrink)

William Lane Craig rejects Platonism (the view that uncreated abstract objects (AOs) exist) in favor of nominalism because he believes Platonism fatally compromises God’s aseity. For Craig, concrete particulars (including essences) exist, but properties do not. Yet, we use property-talk, following Carnap’s “linguistic frameworks.” There is, however, a high cost to Craig’s view. I survey his views and then explore the importance of essences. But, next, I show that his nominalism undermines them. Thus, we have just interpretations of reality. Worse, (...) nominalism undermines creation’s determinacy. Last, I suggest AOs are created, but in a more fundamental sense than Craig considers. (shrink)

This is a polemical essay providing an historical and cultural analysis of John Rawls’s political liberalism, and arguing that the “original position” in his philosophy is not only hypothetical, but also unrealistic by virtue of ignoring comprehensive religious and philosophical points of view. Rawls attempts to derive the ideas of liberty, equality, and fraternity from a mere thought experiment withoutconsidering the foundational role of the Christian religion, which was instrumental in the birth and refinement of these ideas.

The “life phenomenology” theme of the 35th International Human Science Research Conference challenged participants to consider pressing questions of life and of living with others of our own and other-than-human kinds. The theme was addressed by keynote speakers Maxine Sheets-Johnstone, Ralph Acampora and David Abram who invoked a motile, affective and linguistic awareness of how we might dwell actively and ethically amongst human communities and with the many life forms we encounter in the wider, wilder world we have in common. (...) Conference participants were provoked to consider the following questions: “How might phenomenology have us recognize a primacy of movement and bring us in touch with the motions and gestures of the multiple lifeworlds of daily living? What worlds from ecology to technology privilege certain animations? What are the affects and effects of an enhanced phenomenological sensitivity? What senses, feelings, emotions and moods of self-affirmation and responsiveness to others sustain us in our daily lives? And to what extent might the descriptive, invocative, provocative language of phenomenology infuse the human sciences and engender a language for speaking directly of life?”. (shrink)

Many understand intentionality as the ofness or aboutness of mental states yet disagree about it metaphysically. I will argue that (1) intentionality seems best understood as an abstract universal; (2) it is needed to have factual knowledge of reality, yet (3) metaphysical treatments (or uses) of intentionality by several fashionable philosophies land us in constructivism. I will focus on Daniel Dennett’s treatment of intentionality and then extend my findings to other naturalist and physicalist views, postmodern epistemologies, and nominalism. I also (...) will sketch show how we use intentionality to know reality before suggesting an implication for epistemic externalism. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)