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)

L'auteur s'interroge sur la séparation de la métropole unique du Péloponnèse en deux métropoles: celle de Corinthe et celle de Patras. A cause de l'absence de sources, la date de cette scission est approximativement située entre les règnes de Nicéphore Ier et de Léon VI . L'auteur, quant à lui, s'intéresse aux raisons qui l'on provoquée et aux principes qui ont régis le tracé des limites de chaque métropole.

P S Wilson; Child-Centred Education, Journal of Philosophy of Education, Volume 3, Issue 1, 30 May 2006, Pages 105–126, https://doi.org/10.1111/j.1467-9752.1969.

Glava 1. Religiozno-filosofskie istoki teisticheskogo uchenii︠a︡ o Boge-Absoli︠u︡te, absoli︠u︡tnoĭ Lichnosti i religioznoĭ psikhologii Rossii XIX v. -- Lichnostʹ v probleme Boga kak Absoli︠u︡ta i religioznoĭ psikhologii v Rossii XIX veka -- Religiozno-filosofskoe predstavlenie I.P. Chetverikova ob absoli︠u︡tnoĭ Lichnosti v kontekste teisticheskoĭ i psikhologicheskoĭ mysli -- Uchenie professora Kievskoĭ Dukhovnoĭ Akademii I.P. Chetverikova o lichnosti v kontekste russkoĭ teisticheskoĭ mysli i ideĭ umozritelʹnoĭ psikhologii XIX veka: Dissertat︠s︡ii︠a︡ kandidata bogoslovii︠a︡.

New Blackfriars, Volume 102, Issue 1101, Page 677-693, September 2021.

The objective of the paper is to examine the role of the two donor agencies, the IMF and the World Bank in the formulation of social welfare policies in the post-independence Sri Lanka. The ideologies of the two major parties in Sri Lanka, the United National Party (UNP) and the Sri Lanka Freedom Party (SLFP), became the determining factor in the formulation of social welfare policies before 1977. In this context, the IMF and the World Bank played two different roles (...) before 1977. Meanwhile, the ideological gap existed between the two major parties began to disappear after 1977 with the introduction of liberalized economic policies. The IMF and the World Bank played an important role during the post-1977 period. There was evidence that these funding bodies influenced in the formulation of social welfare programmes under the two major parties. The guideline recommended by these two organizations adversely affected the subsidized rice ration, one of the major welfare programmes, in the country. (shrink)

Ian Kennedy extols the virtues of self-determination by patients: they should make their own decisions about medical treatment after being given advice by their doctors; for doctors to make such decisions on their patients' behalf is authoritarian and unacceptable (I). I present a case where, despite thorough consultation and counselling, the decisions made by the patient and supported by her doctors were found to be consistently inappropriate to her changing lifestyle.

Science as a social institution today is experiencing a phase of profound transformation. Objects, methods, research technological tools, methods of institutional communication and mechanisms for commercializing new knowledge are changing. The creation of new interdisciplinary communication platforms is more relevant today than ever before. This review pro[1]vides key information about the First Conference «Mind, Body, Intelligence, Language in the Age of Cognitive Technologies». The organizers created an event that brought together IT developers, academic researchers, and business representatives.

The desire to see a sign phenomenon in different ways always has a reason to interpret it in an unbiased, panoramic way, and in some places - even allowing for contradictions in its understanding by different participants in the interpretative process. For modern humanities, this disposition is quite understandable, since it follows from its very postmodern nature, thereby defining the semantic semantic fields of the leading humanities. True, it is not so wide-spread, but instead, it is evident that Ukrainian religious (...) thinkers of the Middle Ages and Baroque have interpreted the iconic phenomena more deeply. In the story of Petro Mohyla "On the Wonderful Elder Grigory Mezhyhirsky" the metropolitan Mohyla clearly expresses the need to build before the thinking gaze of the reader his own, immanently religious-philosophical conception of the Divine, which every time would present him not just as an act of manifestation, otherwise he appears before the person, while remaining alone. The contemporary study of this issue in order to integrate its leading concepts in the religious-philosophical and general cultural discourse of the postmodern era has largely determined the relevance of the proposed article. The study of the phenomenon of "leaving" by itself in changing forms of the phenomenon of the Divine is also one of the key ones in the proposed studio, because it expresses the very meaning of the Divine as a religious, and therefore a cultural phenomenon. (shrink)