Driving With Cardiovascular Disease: The Impact of Implantable Cardioverter Defibrillators on Driver Safety

Cardiovascular disease (CVD) is the leading cause of death in the United States. With America’s workforce rapidly aging, more attention is being placed on CVD and its treatment among employees in safety sensitive occupations, such as the transportation industry. Implantable cardioverter defibrillators (ICDs) are increasingly being used to treat certain cardiovascular conditions, but despite the fact that they are effective in preventing sudden death from cardiac arrhythmia, there is concern about allowing individuals with an ICD to drive. A systematic review and meta-analysis was conducted to examine the health and safety impacts ICDs on driving. We considered data pertaining to four outcomes among individuals with an ICD: crash rate, the occurrence of sudden death while driving, the occurrence of syncope while driving, and the occurrence of at least one shock from their ICD while driving. Currently, the impact of an ICD on driver safety cannot be determined. Our assessments of the evidence pertaining to crash rates and sudden incapacitation while driving were inconclusive. Our results do indicate, however, that some individuals with an ICD will experience an inappropriate ICD discharge while driving (Strength of Evidence Rating: Strong). Experiencing such a discharge while driving is a potential hazard to driver safety. Quantitative assessment of the available data suggests that approximately 6.3% (95% CI: 4.7%-8.4%) of all individuals with an ICD who drive will experience a discharge while driving. These findings have potential implications for regulatory agencies with responsibility for road safety; particularly those agencies that regulate safety sensitive industries

Kant against the cult of genius: epistemic and moral considerations

In the Critique of Judgment, Kant claims that genius is a talent for art, but not for science. Despite his restriction of genius to the domain of fine art, several recent interpreters have suggested that genius has a role to play in Kant’s account of cognition in general and scientific practice in particular. In this paper, I explore Kant’s reasons for excluding genius from science as well as the reasons that one might nevertheless be tempted to think that his account allows room for the scientific genius. I then argue that Kant’s concerns are not only epistemic, but also moral, and together, they give us good reason for resisting the veneration of geniu

Opiate Written Behavioral Agreements: A Case for Abandonment

Written behavioral agreements (WBAs) are gaining popularity as part of the effort to manage the alarming increase in prescription drug abuse. The rationale for increased use of WBAs in managing patients with chronic pain is that they are believed to increase adherence to agreed-upon behaviors, reduce addiction to or diversion of prescription drugs, and satisfy informed consent requirements. However, there are no high-quality data to support their widespread use in any of these areas. The evidence used to support the use of WBAs is insufficient to justify their unfairness and the high risk of harm they pose to the doctor-patient relationship. Instead, we contend that WBAs are being used to provide leverage for severing relationships with some of our most challenging patients. We propose that physicians treating patients for chronic pain abandon the use of WBAs. Alternatives include open communication, detailed informed consent processes, carefully documented discussions, and most important, commitment to ongoing relationships even with difficult patients

Limited evidence for quantitative contribution of rare and endangered species to agricultural production

Biodiversity underpins ecosystem functions that provide benefits to people, yet the role of rare and endangered species (RES) in supporting ecosystem services is unclear. Thus, it remains controversial whether arguments for conservation that focus on ecosystem services align with the protection of RES. We designed a systematic review protocol to critically assess the evidence for quantitative contributions of RES to terrestrial agricultural production, which is a key driver of biodiversity change and, simultaneously, could suffer from the loss of ecosystem services provided by biodiversity. Our review search criteria required that studies: 1) provide information on RES, 2) focus on an ecosystem service relevant for agriculture; and 3) include a quantitative measure of agricultural production. Surprisingly, we found only four studies that fulfilled these criteria, which was insufficient to perform a meta-analysis of results. Thus, we highlight here the gap in quantitative research, discuss the implications of this knowledge gap for the conservation of RES, and suggest future research directions. We conclude that further quantitative research is urgently needed to better inform conservation and agricultural policies, including research that focuses specifically on RES, incorporates more ecosystem services, and covers a wider range of climatic and socioeconomic contexts

Conjoint Analysis of Breaded Catfish Nuggets: Consumer Preferences for Price, Product Color, Cooking Method and Country of Origin

A new product, marinated, breaded catfish nuggets, was developed. This conjoint study was designed to evaluate consumers’ preferences for certain attributes of the nuggets. An in-store survey was conducted to collect data. The data collected will be used to determine the market potential for the catfish nuggets.Food Consumption/Nutrition/Food Safety,