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)

Ensuring that life-saving antimicrobials remain available as effective treatment options in the face of rapidly rising levels of antimicrobial resistance will require a massive and coordinated global effort. Setting a collective direction for progress is the first step towards aligning global efforts on AMR. This process would be greatly accelerated by adopting a unifying global target — a well-defined global target that unites all countries and sectors. The proposed pandemic instrument — with its focus on prevention, preparedness and response — (...) represents an ideal opportunity to develop and adopt a unifying global target that catalyzes global action on AMR. We propose three key characteristics of a unifying global target for AMR that — if embedded within the pandemic preparedness instrument — could rally public support, funding, and political commitment commensurate with the scale of the AMR challenge. (shrink)

Jean-Frédéric de Pasquale ,Pierre Poirier.

In two chapters of Enn. II.9 [33], Plotinus discusses the Gnostic idea that the creation of the world is due to the ‘decline’ of a principle that he variously calls Soul or Sophia. The identity of Plotinus' Gnostics is notoriously difficult to establish with any degree of precision; I can only note here that the idea of Sophia's ‘decline’ features in a number of extant Gnostic texts, such as those from Nag Hammadi and the Berlin Codex, as a recent survey (...) of the evidence by Poirier has demonstrated. (shrink)

Cet ouvrage est né d'une réalité et d'un besoin. La petite Maëlle, enfant autiste, est devenue adolescente, alors il fallait la suivre pour mieux l'accompagner dans cette nouvelle étape de sa vie. Comme cela arrive chez les autres enfants qui entrent dans l'adolescence, tout est remis en question : les idéaux, l'identité, l'amitié, l'amour. Entre-temps, il y a eu la publication de la cinquième version du Manuel diagnostique et statistique des troubles mentaux (DSM-5). Il fallait donc étudier cette entrée dans (...) l'adolescence à partir des données diagnostiques les plus récentes. Autisme et adolescence est la suite de L'autisme, un jour à la fois et d'Accompagner un enfant autiste. Encore ici, la mère Catherine Kozminski et la psychologue Nathalie Poirier entrent en dialogue afin de se mettre à l'écoute des besoins de l'adolescente et d'élaborer les meilleures formes d'accompagnement. Il en résulte un ouvrage plein de sensibilité et rempli de solutions pratiques. (shrink)

Cet ouvrage vise à délimiter le champ d'investigation de la philosophie de l'esprit. Il comprend huit chapitres. Le premier, le plus général, se veut une première délimitation du champ d'investigation de la philosophie de l'esprit à l'aide de ses trois concepts clés: l'intentionnalité, la rationalité et la conscience. Le chapitre suivant se veut une réflexion plus générale sur les motivations philosophiques qui commandent des jugements si opposés sur le statut ontologique et épistémologique de la psychologie du sens commun. Le chapitre (...) IV dresse un tableau de ces différents programmes et des grands courants de la philosophie de l'esprit, en commençant par le behaviorisme, le physicalisme, le fonctionnalisme et le connexionnisme. Les trois chapitres suivants porteront sur les problèmes et débats liés à la naturalisation des trois propriétés principales de l'esprit, des trois problèmes principaux de la philosophie de l'esprit, soit les concepts d'intentionnalité, de rationalité et de conscience. Le chapitre V porte, d'une part, sur la nature de l'intentionnalité et les différents concepts de directionnalité (aboutness) que l'on retrouve actuellement en philosophie de l'esprit ; d'autre part, il s'agira pour nous de décrire et de classer les différents programmes de naturalisation de l'intentionnalité. Le chapitre six est ouvre de nouvelles perpectives en ce qu'il porte sur la nature de la rationalité et sur les différentes tentatives et arguments en faveur de sa naturalisation. Le chapitre VII s'attaque au problème central de la philosophie de l'esprit, à savoir la conscience. (shrink)

It has been theoretically proposed that employees’ perceptions of their supervisor social power in the organization entail a potential to influence their beliefs, attitudes, and behaviors. However, no study has investigated such potential. This lack of research stems from the absence of a common understanding around the meaning of perceived supervisor social power and the absence of any validated measure. Therefore, the purpose of this article is to establish PSSP definition and to validate a five-item scale to measure this construct. (...) Three studies encompassing four independent samples of employees from three different countries and three different languages were conducted to assess the validity of PSSP. Results showed that responses to the PSSP scale presented excellent psychometric properties. Furthermore, the structure of the proposed five-item measure of PSSP was found to be invariant across four samples. Finally, PSSP nomological validity was assessed. Study 1 and Study 2 showed that PSSP was positively related to affective organizational commitment. All three studies showed that PSSP acted as a positive moderator of the relation between affective commitment to the supervisor and affective organizational commitment. Together, these studies support the psychometric soundness of the PSSP scale and presented the first evidence of its potential to influence followers. Implications of these findings for future research on supervisor social power are discussed. (shrink)

Cet ouvrage rassemble les textes des interventions prononcées lors du colloque Cornelius Castoriadis. Réinventer l'autonomie qui s'est déroulé aux universités de Paris-VIII et de Cergy-Pontoise en mars 2007.