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)

Polybius in a familiar passage, lists goods moving past Byzantium between the Mediterranean. world and the Black Sea region; among these goods, slaves are accorded a prominent place: …as regards necessities it is an unidsputed fact that the most plentiful supplies and best qualities of of cattle and slaves reach us from the countries lying round the Pontus, while among luxuries the same countries furnish us with an abundance of honey, wax and preserved fish; from the surplus of our (...) countries they take olive-oil and every kind of wine. As for grain, there is give and-take – with them sometimes supplying us when we require it and sometimes importing it from us. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino (...) and Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

This book draws on case examples of contemporary black activism in South Manchester and contrasts them with events that surrounded C.L.R. James and his activism between 1935 and 1950. In doing so, the author considers what Brexit, the Labour Party and Theresa May's audit on racism in the UK have in common with the wartime decline of the British Empire, the rise and fall of the trade unions and the Italian invasion of Ethiopia. Clennon dialogues with James' theoretical frameworks (...) around capitalism, neoliberalism and post-colonialism, and uses this creative interplay of ideas to help make sense of contemporary events and issues of social justice from a UK ethnic minority perspective. Using Fanon, Gordon, Marx and Chakrabarty amongst others, the study explores James' take on dialectical materialism and uses this as an ongoing analytical tool throughout the volume with which he weaves an uneasy path between post-colonial and post-Marxist theories. The Polemics of C.L.R. James and Contemporary Black Activism will be of interest to students and scholars across a range of social science disciplines, including sociology, cultural studies, education and black studies. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

Two recent studies by A. R. Giumlia-Mair and P. T. Craddock have been devoted to a form of bronze having a blackish tint.1, 2 The authors there describe examples ancient and modern, from as far apart as Mycenean Greece, Egypt, Rome, China and Japan. In Japan such bronze is prominently represented in decorative art and known as Shakudo.

In lieu of an abstract, here is a brief excerpt of the content:230 Feminist Studies 47, no. 1. © 2021 by Feminist Studies, Inc. Nneka D. Dennie The State and Future of Black Women’s Studies: The Black Women’s Studies Association and the National Women’s Studies Association in Conversation On February 25, 2021, the Black Women’s Studies Association (BWSA) and National Women’s Studies Association (NWSA) partnered for one of NWSA’s Kitchen Table Talks—a new initiative spearheaded by NWSA President (...) Kaye Wise Whitehead to foster dialogue between NWSA and other organizations. The event, titled “Space Making: State/Future of Black Women’s Studies,” featured three panelists and was moderated by Whitehead. The featured speakers were Stephanie Andrea Allen (BWSA conference chair), Jacinta R. Saffold (BWSA co-founder and treasurer), and Erica L. Williams (member of the NWSA Governing Council). Allen is a Black lesbian writer and publisher whose scholarship examines how lesbian literature and film responds to and resists the heteropatriarchal systems that invisibilize Black lesbians; she is a postdoctoral fellow and visiting assistant professor of gender studies at Indiana University. Saffold is an assistant professor of English at the University of New Orleans who researches twentieth- and twenty-first-century African American literature, hip hop studies, and digital humanities. Williams is an associate professor of anthropology at Spelman College, whose work has examined sex tourism and Black feminist activism in Brazil. Together, Whitehead, Allen, Saffold, and Williams explored their hopes for Black Women’s Studies and illuminated the challenges and joys of advancing the field. News and Views 231 The collaboration between BWSA and NWSA is a testament to how far Black Women’s Studies has come over the past fifty years and a promise of where it may continue to go in the future. NWSA was founded in 1977 and has since served as a hub for researchers, educators, and practitioners who interrogate questions of women and gender in their work. For decades, NWSA has been central to the nationwide US institutionalization of women’s, gender, and sexuality studies. By contrast, BWSA is a young organization that is continuing to grow. In 2018, Saffold and I co-founded BWSA in order to provide a community for scholars working in the field of Black Women’s Studies. BWSA is the only professional association specifically designed to bring scholars from a variety of disciplines into conversation about research that centers Black women. We launched BWSA with the goal of ensuring that future generations of scholars can readily access networks and mentorship from researchers who encounter a common question: when your work is simultaneously “too Black” and “too woman” for your field, department, or institution, what do you do? Drawing inspiration from well-established organizations in which we frequently participated, such as NWSA, the Association for the Study of African American Life and History (ASALH), the Association of Black Women Historians (ABWH), and the African American Intellectual History Society (AAIHS), Saffold and I sought to build a space that cultivated a Black feminist ethic of care for both the research and the researchers. In that spirit, BWSA provides resources to help scholars do their best work, including a mentorship program, a virtual writing community, a calls-for-papers list for publications, and article as well as graduate student paper prizes. It was an honor to join an organization as trusted and respected as NWSA for a dialogue about our shared visions for Black Women’s Studies. Three key themes emerged from the panelists’ conversation with each other. They repeatedly returned to the importance of making financial commitments to Black Women’s Studies, creating conditions to support Black women’s intellectual labor, and practicing self-care. Speakers explored the interplay between the responsibilities that institutions, communities, and individuals have to Black Women’s Studies and Black feminist scholars. They observed that in order for departments and universities to foster interdisciplinary work on Black women, they need to move beyond paying lip service to the idea that diversity, equity, and inclusion matter; there needs to be permanent funding for work on race, 232 News and Views gender, class, and sexuality. Panelists also emphasized that Black women being in community with each other and supporting one another have always been central to... (shrink)

D. C. Matthew argues that although integration offers blacks social and economic benefits, it also creates the conditions for phenotypic devaluation that leads to harm against black self-worth and servile behavior. Therefore, he advises against integration because the resulting self-worth harms outweigh the benefits of integration. I argue that Matthew’s cost-benefit calculation against integration lacks the requisite evidence, and amounts to a luxury belief that will result in more harm. Moreover, his interpretation of behavior — which he construes as (...) being indicative of a lack of self-worth — is unfounded. Further, his cost-benefit calculation results in socially reactionary sexual policing and ideological purity tests. (shrink)

In a previous paper by Pollock and Singh, it was proven that the total entropy of de Sitter space-time is equal to zero in the spatially flat case K=0. This result derives from the fundamental property of classical thermodynamics that temperature and volume are not necessarily independent variables in curved space-time, and can be shown to hold for all three spatial curvatures K=0,±1. Here, we extend this approach to Schwarzschild space-time, by constructing a non-vacuum interior space with line element ds (...) 2=e2λ(r) dt 2−e−2λ(r) dr 2−r 2(dθ 2+sin2 θdϕ 2), where $\mathrm{e}^{2{\lambda }(r)}=-\frac{1}{2}(1-\frac{r^{2}}{R_{0}^{2}})$ , which matches onto the vacuum exterior Schwarzschild metric in such a way that e2λ and d(e2λ )/dr are both continuous at the Schwarzschild radius R 0=2M. Then we show that the volume entropy is equal to A/4, where $A\equiv 4\pi R_{0}^{2}$ is the area of the apparent horizon, as found by Hawking. (shrink)

In Bester’s article (2018) challenging the use of the harm principle and advocating sole reliance on the use of a best interest standard (BIS) in pediatric decision-making, we believe that the auth...

Background: The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care “upstream”. The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Methods: Directed content analysis was used to review ethics consultation notes from an academic children’s hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational issues derived (...) and modified from published quality improvement protocols. Results: Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Conclusions: Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns. (shrink)

Clinical biobanks processing data of participants in the European Union fall under the scope of the General Data Protection Regulation, which among others includes requirements for consent. These requirements are further specified by the Article 29 Working Party —an EU advisory body currently known as the European Data Protection Board. Unfortunately, their guidance is cause for some confusion. While the GDPR allows participants to give broad consent for research when specific research purposes are still unknown, the WP29 guidelines suggest that (...) additional consent for specific uses should be obtained in addition to broad consent when this becomes applicable. This discrepancy elicits the question whether clinical biobanks can fail the requirement of consent if they obtain broad consent, but not a specific consent for each biomedical study. We analysed this discrepancy within the framework of contextual integrity, in order to describe the context-relative informational norms that govern information flows in clinical biobanks. However, our analysis demonstrates that there is no uniform set of norms that can be applied to all clinical biobanks. As such, neither the GDPR nor the WP29 guidance can act as a “one size fits all” approach to all clinical biobanks. Rather, differences between clinical biobanks—especially regarding the scientific aims and patient populations—make the case for context-relative norms that determine the appropriate type of consent. (shrink)

Ethical guidelines for conducting clinical trials have historically been based on a perceived therapeutic obligation to treat and benefit the patient-participants. The origins of this ethical framework can be traced to the Hippocratic oath originally written to guide doctors in caring for their patients, where the overriding moral obligation of doctors is strictly to do what is best for the individual patient, irrespective of other social considerations. In contrast, although medicine focuses on the health of the person, public health is (...) concerned with the health of the entire population, and thus, public health ethics is founded on the societal responsibility to protect and promote the health of the population as a whole. From a public health perspective, research ethics should be guided by giving due consideration to the risks and benefits to society in addition to the individual research participants. On the basis of a duty to protect the population as a whole, a fiduciary obligation to realise the social value of the research and the moral responsibility to distribute the benefits and burdens of research fairly across society, how a public health perspective on research ethics results in fundamental re-assessments of the proper course of action for two salient topical issues in research ethics is shown: stopping trials early for reasons of efficacy and the conduct of research on less expensive yet less effective interventions. (shrink)

"By combining recent advances in the physical sciences with some of the novel ideas, techniques, and data of modern biology, this book attempts to achieve a new and different kind of evolutionary synthesis. I found it to be challenging, fascinating, infuriating, and provocative, but certainly not dull."--James H, Brown, University of New Mexico "This book is unquestionably mandatory reading not only for every living biologist but for generations of biologists to come."--Jack P. Hailman, Animal Behaviour , review of the first (...) edition "An important contribution to modern evolutionary thinking. It fortifies the place of Evolutionary Theory among the other well-established natural laws."--R.Gessink, TAXON. (shrink)