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This paper used data from the Apathy in Dementia Methylphenidate Trial 2 (NCT02346201) to conduct a planned cost consequence analysis to investigate whether treatment of apathy with methylphenidate is economically attractive.
Methods:
A total of 167 patients with clinically significant apathy randomized to either methylphenidate or placebo were included. The Resource Utilization in Dementia Lite instrument assessed resource utilization for the past 30 days and the EuroQol five dimension five level questionnaire assessed health utility at baseline, 3 months, and 6 months. Resources were converted to costs using standard sources and reported in 2021 USD. A repeated measures analysis of variance compared change in costs and utility over time between the treatment and placebo groups. A binary logistic regression was used to assess cost predictors.
Results:
Costs were not significantly different between groups whether the cost of methylphenidate was excluded (F(2,330) = 0.626, ηp2 = 0.004, p = 0.535) or included (F(2,330) = 0.629, ηp2 = 0.004, p = 0.534). Utility improved with methylphenidate treatment as there was a group by time interaction (F(2,330) = 7.525, ηp2 = 0.044, p < 0.001).
Discussion:
Results from this study indicated that there was no evidence for a difference in resource utilization costs between methylphenidate and placebo treatment. However, utility improved significantly over the 6-month follow-up period. These results can aid in decision-making to improve quality of life in patients with Alzheimer’s disease while considering the burden on the healthcare system.
Many philosophers call themselves ‘naturalists’ because they believe theism is incompatible with science. However, many also hold that science is compatible with many other theistic beliefs about morality, free will, the mind, and the meaning of life. Those naturalists who reject these other beliefs need a different label for their view. This article recommends the term ‘scientism’.
Reductionism is a widely endorsed methodology among biologists, a metaphysical theory advanced to vindicate the biologist's methodology, and an epistemic thesis those opposed to reductionism have been eager to refute. While the methodology has gone from strength to strength in its history of achievements, the metaphysical thesis grounding it remained controversial despite its significant changes over the last 75 years of the philosophy of science. Meanwhile, antireductionism about biology, and especially Darwinian natural selection, became orthodoxy in philosophy of mind, philosophy of science, and philosophy of biology. This Element expounds the debate about reductionism in biology, from the work of the post-positivists to the end of the century debates about supervenience, multiple realizability, and explanatory exclusion. It shows how the more widely accepted 21st century doctrine of 'mechanism' - reductionism with a human face - inherits both the strengths and the challenges of the view it has largely supplanted.
In the two-and-a-half decades since the end of the Cold War, policy makers have become acutely aware of the extent to which the world today faces mass atrocities. In an effort to prevent the death, destruction and global chaos wrought by these crimes, the agendas for both national and international policy have grown beyond conflict prevention to encompass atrocity prevention, protection of civilians, transitional justice and the responsibility to protect. Yet, to date, there has been no attempt to address the topic of the prevention of mass atrocities from the theoretical, policy and practicing standpoints simultaneously. This volume is designed to fill that gap, clarifying and solidifying the present understanding of atrocity prevention. It will serve as an authoritative work on the state of the field.
Contemporary atheism usually conceives religion as centered on a core of statements, each of them designed to correspond to the cosmic facts. Classic anthropological and sociological studies of religion often start in a different place with practices attending to the multi-dimensional character of religious life. Worlds change when people revise their ideas about the boundaries of objects or about how to classify things together or what is the normal course of a process. The chapter introduces notions of fictional truth that might be extended directly to notions of mythical and religious truth. It presents the idea of the permanent progressiveness underlying strong ethical truth, suggests introducing more stringent demands on a notion of mythical truth. Religious truth includes mythical truth, but isn't exhausted by it. There are many dimensions of religious practice, and statements play other roles besides the telling of stories or the recounting of lore.
This article argues that at least very many judgments of homology rest on prior attributions of selected-effect (SE) function, and that many of the “parts” of biological systems that are rightly classified as homologous are constituted by (are so classified in virtue of) their consequence etiologies. We claim that SE functions are often used in the prior identification of the parts deemed to be homologous and are often used to differentiate more restricted homologous kinds within less restricted ones. In doing so, we discuss recent criticism of this view that has been offered (especially that offered by Paul Griffiths).
Among philosophers, naturalism is the view that contemporary scientific theory is the source of solutions to philosophical problems. Naturalists look to the theory of natural selection as a primary resource in coming to solve philosophical problems raised by human affairs in particular. For the theory combines relevance to human affairs and scientific warrant more strongly than does any other theory. Theories in physics and chemistry may be more strongly confirmed, especially because their more precise predictions can be tested in real time. But these theories have little to tell us about human conduct and institutions. On the other hand, actual and possible theories in the social and behavioural sciences may in the future have more to tell us about humanity than Darwinian theory; but these theories do not as yet have anything like the degree of confirmation of Darwin's theory. This chapter surveys contemporary strategies for providing a Darwinian understanding and vindication of morality, ethical norms, our conception of justice, and the cooperative human institutions which those norms and conceptions underlie. We will see that while the prospects for a Darwinian vindication of moral claims - as true or well founded - remain clouded, the prospects for explaining the normative dimension of human affairs by appeal to Darwinism appear to be improving.
Origin of man now solved. He who understands baboon would do more for metaphysics than Locke.
Darwin, Notebooks
THE EVOLUTION OF HUMAN BEHAVIOR AND “JUST-SO STORIES”
Darwin's claim is probably guilty of pardonable exaggeration. After all he did not prove the origin of man, and Locke's greatest contributions were to political philosophy, not metaphysics. But it may turn out that Darwin's twentieth-century grandchild, genomics, vindicates this claim with respect to both metaphysics and political philosophy. Here I focus on the latter claim alone, however.
From the year that William Hamilton first introduced the concept of inclusive fitness and the mechanism of kin selection, biologists, psychologists, game theorists, philosophers, and others have been adding details to answer the question of how altruism is possible as a biological disposition. We now have a fairly well-articulated story of how we could have gotten from there, nature red in tooth and claw, to here, an almost universal commitment to morality. That is, there is now a scenario showing how a lineage of organisms selected for maximizing genetic representation in subsequent generations could come eventually to be composed of cooperating creatures. Establishing this bare possibility was an important turning point for biological anthropology, for human sociobiology, and for evolutionary psychology. Prior to Hamilton's breakthrough it was intellectually permissible to write off Darwinism as irrelevant to distinctively human behavior and human institutions.