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Low-dose aspirin has been shown to reduce the incidence of cancer, but its role in the treatment of cancer is uncertain. We conducted a systematic search of the scientific literature on aspirin taken by patients following a diagnosis of cancer, together with appropriate meta-analyses. Searches were completed in Medline and Embase in December 2015 using a pre-defined search strategy. References and abstracts of all the selected papers were scanned and expert colleagues were contacted for additional studies. Two reviewers applied pre-determined eligibility criteria (cross-sectional, cohort and controlled studies, and aspirin taken after a diagnosis of cancer), assessed study quality and extracted data on cancer cause-specific deaths, overall mortality and incidence of metastases. Random effects meta-analyses and planned sub-group analyses were completed separately for observational and experimental studies. Heterogeneity and publication bias were assessed in sensitivity analyses and appropriate omissions made. Papers were examined for any reference to bleeding and authors of the papers were contacted and questioned. Five reports of randomised trials were identified, together with forty two observational studies: sixteen on colorectal cancer, ten on breast and ten on prostate cancer mortality. Pooling of eleven observational reports of the effect of aspirin on cause-specific mortality from colon cancer, after the omission of one report identified on the basis of sensitivity analyses, gave a hazard ratio (HR) of 0.76 (95% CI 0.66, 0.88) with reduced heterogeneity (P = 0.04). The cause specific mortality in five reports of patients with breast cancer showed significant heterogeneity (P<0.0005) but the omission of one outlying study reduced heterogeneity (P = 0.19) and led to an HR = 0.87 (95% CI 0.69, 1.09). Heterogeneity between nine studies of prostate cancer was significant, but again, the omission of one study led to acceptable homogeneity (P = 0.26) and an overall HR = 0.89 (95% CI 0.79-0.99). Six single studies of other cancers suggested reductions in cause specific mortality by aspirin, and in five the effect is statistically significant. There were no significant differences between the pooled HRs for the three main cancers and after the omission of three reports already identified in sensitivity analyses heterogeneity was removed and revealed an overall HR of 0.83 (95% CI 0.76-0.90). A mutation of PIK3CA was present in about 20% of patients, and appeared to explain most of the reduction in colon cancer mortality by aspirin. Data were not adequate to examine the importance of this or any other marker in the effect of aspirin in the other cancers. On bleeding attributable to aspirin two reports stated that there had been no side effect or bleeding attributable to aspirin. Authors on the other reports were written to and 21 replied stating that no data on bleeding were available. The study highlights the need for randomised trials of aspirin treatment in a variety of cancers. While these are awaited there is an urgent need for evidence from observational studies of aspirin and the less common cancers, and for more evidence of the relevance of possible bio-markers of the aspirin effect on a wide variety of cancers. In the meantime it is urged that patients in whom a cancer is diagnosed should be given details of this research, together with its limitations, to enable each to make an informed decision as to whether or not to take low-dose aspirin. CRD42015014145.

This article is the first part of a Citation Classics and Foundational Works feature focused on metaphor and organizational studies. The second part of the feature is a personal reflection by Gareth Morgan on the genesis and impact of his pathbreaking book, Images of Organization (IO). In this article, we summarize the nature of the contributions made by IO, sketch ways in which the book has prompted and served as a touchstone for new research on metaphor and organization, and discuss the application of contemporary metaphorical analysis to the problems of theory development, research methods, and puzzle solving facing scholars interested in sustainability studies and research on organizations and the natural environment (ONE). We illustrate how early research that fostered ONE scholarship is marked by the use of particularly powerful metaphorical language and attention to poetic technique as well as rigorous science. We suggest how ONE research (and organizational studies in general) can benefit from studying IO and related literature on metaphorical analysis.

[...]the Commission will develop new understandings of the underlying systems that are driving obesity and also devise innovative approaches to reorient those systems in a sustainable and scalable way to encourage healthy weight.Other relevant, independent activities include other Lancet Series and Commissions and existing monitoring systems for obesity and its determinants, such as the Global Nutrition Report,6 the INFORMAS group's monitoring of food environments,7 and Global Burden of Disease analyses.8 The Commissioners include high-level experts in global obesity and the underlying systems that are driving obesity, and represent diverse sectors including nutrition, physical activity, urban planning, food systems, agriculture, climate change, economics, governance and politics, law, business, marketing and communication, trade and investment, human rights, equity, systems science, consumer advocacy, monitoring and evaluation, Indigenous health, epidemiology, medicine, and health care.The systems lens that the Commission will bring to its analyses is expected to uncover a deeper understanding of obesity as an emergent problem of underlying complex adaptive systems, such as food systems, urban systems, and economic systems, that are fundamentally designed to improve people's lives.[...]obesity is likely to share common determinants and solutions with other major emergent problems that the world is facing, such as climate change and inequities.

Aspirin has been shown to lower the incidence and the mortality of vascular disease and cancer but its wider adoption appears to be seriously impeded by concerns about gastrointestinal (GI) bleeding. Unlike heart attacks, stroke and cancer, GI bleeding is an acute event, usually followed by complete recovery. We propose therefore that a more appropriate evaluation of the risk-benefit balance would be based on fatal adverse events, rather than on the incidence of bleeding. We therefore present a literature search and meta-analysis to ascertain fatal events attributable to low-dose aspirin. In a systematic literature review we identified reports of randomised controlled trials of aspirin in which both total GI bleeding events and bleeds that led to death had been reported. Principal investigators of studies in which fatal events had not been adequately described were contacted via email and asked for further details. A meta-analyses was then performed to estimate the risk of fatal gastrointestinal bleeding attributable to low-dose aspirin. Eleven randomised trials were identified in the literature search. In these the relative risk (RR) of 'major' incident GI bleeding in subjects who had been randomised to low-dose aspirin was 1.55 (95% CI 1.33, 1.83), and the risk of a bleed attributable to aspirin being fatal was 0.45 (95% CI 0.25, 0.80). In all the subjects randomised to aspirin, compared with those randomised not to receive aspirin, there was no significant increase in the risk of a fatal bleed (RR 0.77; 95% CI 0.41, 1.43). The majority of the adverse events caused by aspirin are GI bleeds, and there appears to be no valid evidence that the overall frequency of fatal GI bleeds is increased by aspirin. The substantive risk for prophylactic aspirin is therefore cerebral haemorrhage which can be fatal or severely disabling, with an estimated risk of one death and one disabling stroke for every 1,000 people taking aspirin for ten years. These adverse effects of aspirin should be weighed against the reductions in vascular disease and cancer.

Purpose The purpose of this paper is to argue that rather than contest the artificial schism produced by social scientists between “qualitative” and “quantitative” research, we should to accept this binary, however, contingently, and use it productively. This would be an act of “strategic essentialism” that would allow us to be productive in the research and inquiry. Design/methodology/approach The paper uses postcolonial theory to make a case for contingent representation, i.e. using artificial categories to carve out a space for heterodox theoretical approaches. Findings Researchers devoted to qualitative research must resist thinking, speaking and evaluating that research using quantitative thinking. Also, while ethical considerations are paramount in qualitative research, we need to debunk the narrow understanding of ethics as “following rules.” Also, qualitative researchers need to be aware of the institutional pulls that the research will be subject to, and also be ready to resist them. Originality/value This paper discusses how good research resists the siren call of institutionalization. It challenges the “common sense” assumptions of the field and brings them into the realm of the questionable. It seeks to theorize the untheorizable, and anthropologize the dominant.

Dr. Gareth Morgan, former director of the Myeloma Institute for Research & Therapy at the University of Arkansas for Medical Sciences in Little Rock, said $29 million in operating losses detected by a recent audit were \"accounting errors\" outside his control. In 2009, the myeloma program got a five-year, $19.5 million grant from the National Cancer Institute, part of the National Institutes of Health. The school had received an anonymous gift of $75 million to create a blood cancer center with a focus on multiple myeloma.

In developing this feature, we asked Gareth Morgan to reflect on his classic book, Images of Organization (1986), a work known for its innovative framework for understanding and using metaphors in organizational studies. We asked him to comment on whether, adding up what has been written in the last 25 years, effective use has been made of the framework. As our exchange unfolded, the invitation to write this piece developed into a series of more detailed questions that embraced the origin, aims and intentions of Images of Organization as a contribution to organizational studies and its particular relevance for the issues addressed by Organization and Environment scholars. These questions are now reflected in the overall structure of his article. [Reprinted by permission of Sage Publications Inc., copyright holder.]

Editor's Note Eric Besson, a reporter at the Arkansas Democrat-Gazette, did some heavy lifting for his June 2 article explaining how the No. 2 administrator of the Arkansas State Crime Lab came to be selling tox-screening test kits to her own agency. Cindy Moran, the lab's assistant director, personally owns only 12% of the stock of PinPoint Testing LLC, which has been calibrating equipment and selling \"ToxBox\" screening kits to the Crime Lab - with and without the inconvenience of bidding - for the past couple of years. [...]it's notable that both the Crime Lab and the state Department of Finance & Administration recognized the conflict and made adjustments so that the Crime Lab could continue to buy Moran's company's product while Moran continued to collect her state salary.