ABSTRACTEmotion knowledge, the ability to accurately perceive and label emotions, predicts higher quality peer relations, higher social competence, higher academic achievement, and fewer behaviour...

We present a conceptual model of the ways in which built and social environments shape the development of self-regulation in early childhood. Importantly, in centering children of color growing up in historically disinvested neighborhoods, we first describe how systemic structures of racism and social stratification have shaped neighborhood built and social environment features. We then present evidence linking these neighborhood features to children’s development of self-regulation. Furthermore, we take a multilevel approach to examining three potential pathways linking neighborhood contexts to (...) self-regulation: school environment and resources, home environment and resources, and child health behaviors. Finally, we consider how racial-ethnic-cultural strengths and multilevel interventions have the potential to buffer children’s development of self-regulation in disinvested neighborhood contexts. Advancing multilevel approaches to understand the development of self-regulation among children of color living in historically disinvested neighborhoods is an important step in efforts to promote equity in health and education. (shrink)

This paper is a philosophical, socio-political, analysis of the problem of democratic despair and the possibility of finding hope in the midst of it. The analysis spring boards from a dialectical discussion on the state of Black America between Harry Belafonte, Minister Louis Farrakhan, and Cornel West, to an examination of the reasons for believing this house called America is on fire. The paper then moves to two possible responses for African Americans to the burning house: separatism (physical or (...) psychological), and radical cultural pluralism grounded in a transformative deep democracy. The paper opts for the latter, concludes by offering a new cultural pluralistic democracy as a model for hope, and suggests the basic tools necessary for building such a transformative democracy. (shrink)

The question of the existence and the properties of time has been subject to debate for thousands of years. This considered and complete study offers a contrastive analysis of phenomenologies of time from the perspective of the problematics of the visibility of time. Is time perceptible only through the veil of change? Or is there a naked presence of 'time itself'? Or has time always effaced itself? McClure's new work also stages confrontations between phenomenology of time and analytical philosophy (...) of time. By doing so he explores ancient issues from a fresh perspective, such as whether time passes, whether experimental time is 'real time', and whether the very concept of time is contradictory. (shrink)

In a powerful and original contribution to the history of ideas, Hannah Dawson explores the intense preoccupation with language in early-modern philosophy, and presents a groundbreaking analysis of John Locke's critique of words. By examining a broad sweep of pedagogical and philosophical material from antiquity to the late seventeenth century, Dr Dawson explains why language caused anxiety in writers such as Montaigne, Bacon, Descartes, Hobbes, Gassendi, Nicole, Pufendorf, Boyle, Malebranche and Locke. Locke, Language and Early-Modern Philosophy demonstrates that (...) new developments in philosophy, in conjunction with weaknesses in linguistic theory, resulted in serious concerns about the capacity of words to refer to the world, the stability of meaning, and the duplicitous power of words themselves. Dr Dawson shows that language so fixated all manner of early-modern authors because it was seen as an obstacle to both knowledge and society. She thereby uncovers a novel story about the problem of language in philosophy, and in the process reshapes our understanding of early-modern epistemology, morality and politics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 27.2 (2003) 304-317 [Access article in PDF] Sovereign Love and Atomism in Racine's Bérénice Ellen Mcclure ALTHOUGH CRITICS HAVE NOTED links between the new science of the seventeenth century and the works of La Fontaine and Molière, 1 a similar influence of Epicureanism or even Cartesianism upon French classical tragedy is harder to trace. No two areas of seventeenth-century cultural life would seem farther apart (...) than the emerging science, with its rejection of Aristotelian categories as inadequate to experienced reality, and classical French tragedy, with its antimaterialism and claims to universal truth often bolstered by references to none other than Aristotle himself. Yet René Pintard reminds us that the 1660s and 1670s—the period when many of the tragedies we regard as "classical" were written—saw a strong renewal of interest in the philosophies articulated in the first half of the century. 2 So widespread was this interest that Pierre Gassendi's friend and follower Bernier was able to publish an edition and translation of the philosopher's works in 1674-1675 which proved to be a resounding success. It is hard to believe that the much-discussed new science somehow missed writers of tragedies, especially given the extensive contacts between Molière, La Fontaine and Racine.In this article, I demonstrate this influence by positing that Racine's play Bérénice, ostensibly a reworking of a well-known love story that Corneille was also producing on the Paris stage at the same time, is in part a reflection on the pressing question of what holds the universe together. Through his exploration of the possibility of satisfactory love between two independent sovereigns, Racine explores issues that the revival of Epicureanism had brought into the philosophical foreground. This reading of the play brings into focus the incredibly [End Page 304] important, yet too-often neglected, 3 role of Antiochus, the character whom Racine invented for his version of the play. I will show that his tragic in-betweenness offers a necessary alternative to Titus' and Bérénice's valorization of self-contained sovereignty. I Before embarking on a close reading of the play itself, however, I would like to offer a brief survey of the debate to which I believe Racine refers. Both Michel Foucault and Timothy Reiss have identified the seventeenth century as a transitional period between the age of correspondences exemplified in Aristotelian philosophy and the age of representation and quantification that characterized eighteenth-century thought. 4 This transition, however, was far from smooth, as philosophers sought to articulate a universe whose separate and radically de-hierarchized elements remained somehow joined together.For most seventeenth-century philosophers, the sacrifice of Aristotelian categories and scholasticism in no way lessened the imperative for a sense of divine order and causation. Gassendi's often self-contradictory efforts to reconcile Epicurus and Christianity provide perhaps the most striking example of this transitional struggle. The atomism posited by Epicurus through Lucretius posed particular difficulties for a Christian worldview. A world governed by the chance interactions of atoms eliminates any sense that things happen for a purpose; God cannot be the benevolent author and overseer of the universe. Gassendi's equal respect for atomism and for Christianity should be read as evidence of the profound struggle between separateness and interconnection (or, as Gassendi would call it, harmony) taking place during this period. 5 For, as Bloch points out, although Gassendi partially reconciled the demands of the two systems by situating atoms in an uncreated, infinite, and contiguous space and time, he continued to hold to the profoundly troubling existence of the void in the universe. Once again, the chief objection to the void implicit in atomism was religious, since if God is everywhere, the void cannot exist, and likewise, God cannot create nothing. The revival of stoicism supplied instead a vision of the universe ultimately comprised and held together by an ethereal pneuma that some neo-Stoics did not hesitate to identify as a sort of divine presence. 6 Descartes himself made heroic attempts, in his Principes... (shrink)

From ancient times to the present, the discovery and presentation of new proofs of previously established theorems has been a salient feature of mathematical practice. Why? What purposes are served by such endeavors? And how do mathematicians judge whether two proofs of the same theorem are essentially different? Consideration of such questions illuminates the roles that proofs play in the validation and communication of mathematical knowledge and raises issues that have yet to be resolved by mathematical logicians. The Appendix, in (...) which several proofs of the Fundamental Theorem of Arithmetic are compared, provides a miniature case study. (shrink)

Raanan Gillon is a noted defender of the four principles approach to healthcare ethics. His general position has always been that these principles are to be considered to be both universal and prima facie in nature. In recent work, however, he has made two claims that seem to present difficulties for this view. His first claim is that one of these four principles, respect for autonomy, has a special position in relation to the others: he holds that it is first (...) among equals. We argue that this claim makes little sense if the principles are to retain their prima facie nature. His second claim is that cultural variation can play an independent normative role in the construction of our moral judgments. This, he argues, enables us to occupy a middle ground between what he sees as the twin pitfalls of moral relativism and moral imperialism. We argue that there is no such middle ground, and while Gillon ultimately seems committed to relativism, it is some form of moral imperialism that will provide the only satisfactory construal of the four principles as prima facie universal moral principles. (shrink)

The author takes up a provocative question poised by Charles Taylor about the relationship between our commitments to a good such as neighbor love and the possibilities of achieving and sustaining social justice. Taylor's concern is not only that we make such a commitment but that we make it in such a way that we avoid its ability to lead us towards injustice rather than justice. After articulating conceptions of love, justice, and injustice, the author turns to Charles Dickens's treatment (...) of love and injustice in Bleak House, to explore more fully how love can lead to injustice, and also its potential role in promoting justice. Dickens's view, profoundly shaped by his own sense of Christian virtues, helps us see the inner workings of love, justice, and injustice, so that we can appreciate their interconnectedness anew and understand better the urgency of Taylor's question for our time. (shrink)

Background: Emergency exception to informed consent regulation was introduced to provide a venue to perform research on subjects in emergency situations before obtaining informed consent. For a study to proceed, institutional review boards need to determine if the regulations have been met.Aim: To determine IRB members’ experience reviewing research protocols using emergency exception to informed consent.Methods: This qualitative research used semistructured telephone interviews of 10 selected IRB members from around the US in the fall of 2003. IRB members were chosen (...) as little is known about their views of exception to consent, and part of their mandate is the protection of human subjects in research. Interview questions focused on the length of review process, ethical and legal considerations, training provided to IRB members on the regulations, and experience using community consultation and notification. Content analysis was performed on the transcripts of interviews. To ensure validity, data analysis was performed by individuals with varying backgrounds: three emergency physicians, an IRB member and a layperson.Results: Respondents noted that: emergency exception to informed consent studies require lengthy review; community consultation and notification regulations are vague and hard to implement; current regulations, if applied correctly, protect human subjects; legal counsel is an important aspect of reviewing exception to informed-consent protocols; and IRB members have had little or no formal training in these regulations, but are able to access materials needed to review such protocols.Conclusions: This preliminary study suggests that IRB members find emergency exception to informed consent studies take longer to review than other protocols, and that community consultation and community notification are the most difficult aspect of the regulations with which to comply but that they adequately protect human subjects. (shrink)

ABSTRACT This essay is an attempt to examine the idea that a professional code of practice can entail ethical conduct. It is focused around two differing perspectives on ethics. It will be argued that the professions have, perhaps too hastily, adopted one theory without considering the merits, or the objections offered by the alternative account. This alternative, a ‘cognitivist’ theory, is sketched, and the possible advantages of such an approach are discussed. Such a perspective means adopting a radically different approach (...) to the nature of ethics and what it is to be a moral agent, and could have interesting consequences for professional practice. Even if a cognitivist account is ultimately unconvincing, it does provide a number of worrying arguments for those professionals who believe that ethical conduct is generated by following a code of practice, and these arguments need to be addressed. (shrink)

Recent policy in relation to clinical research proposals in the UK has distinguished between two types of review: scientific and ethical. This distinction has been formally enshrined in the recent changes to research ethics committee structure and operating procedures, introduced as the UK response to the EU Directive on clinical trials. Recent reviews and recommendations have confirmed the place of the distinction and the separate review processes. However, serious reservations can be mounted about the science/ethics distinction and the policy of (...) separate review that has been built upon it. We argue here that, first, the science/ethics distinction is incoherent, and, second, that RECs should not only be permitted to consider a study’s science, but that they have anobligation do so. (shrink)

This article provides an English translation of a historic discussion on the foundations of mathematics, during which Kurt GÖdel first announced his incompleteness theorem to the mathematical world. The text of the discussion is preceded by brief background remarks and commentary.

The obligations of organisations associated with policy formation and implementation of international mass public health programmes are explored. Lines of responsibility are considered to become unclear because of the large number of agencies associated with such programmes. A separation of the relevant obligations among the bodies responsible for the formulation and those responsible for the implementation of the policies is suggested. The continuing oral polio vaccine campaign against poliomyelitis in India is used to illustrate the general argument. Although the aim (...) of the programme is legitimate and laudable, unnecessary harm is currently being caused to some children as a result of elements of the policy and this should be rectified immediately. Such mass programmes should take care to ensure that people are not unnecessarily sacrificed in the drive to attain the desirable ends of the policy. (shrink)

The Report of the Ad Hoc Adivisory Group on the Operation of NHS Research Ethics Committees has resulted in a strange mixture of the timid, the revolutionary, and the bizarre.The Report of the Ad Hoc Advisory Group on the Operation of NHS Research Ethics Committees is a curious document.1 The remit of the review was focused on the workings and effectiveness of NHS research ethics committees and the multicentre committees ). The Group was primarily set up in response to a (...) series of complaints from medical researchers about the new research governance regime in the UK as a result of the Clinical Trials Directive2 and the Governance Arrangements for NHS Research Ethics Committees.3 The opportunity was also taken to consider the role of research ethics committees in a wider context, and take account of recent developments in relation to the ethics review of social care research,4 student projects,5 as well as recent legislation such as the Human Tissue Act,6 and the Mental Capacity Act.7 However, the resulting report is a strange mixture of the timid, the revolutionary, and the bizarre.A good example of the report’s timidity is its reluctance to propose fundamental change to the process of review or seriously limit the type of research that requires REC review. To its credit AHAG does suggest that some research ‘especially surveys and many studies on NHS staff, could normally be conducted safely without a requirement for REC review’ .1 This is, of course, to be welcomed. However, the report ultimately seems dismissive of the general complaint from researchers that the current process is inappropriately uniform. For example, in section 3.2, it is argued that the ‘common perception that the NHS REC system is dominated …. (shrink)

As initially envisioned, Gödel's Collected Works were to include transcriptions of material from his mathematical workbooks. In the end that material, as well as some other manuscript items from Gödel's Nachlass, had to be left out. This note describes some of the unpublished items in the Nachlass that are likely to attract the notice of scholars and surveys the extent of shorthand transcription efforts undertaken hitherto. Some examples of sources outside Gödel's Nachlass that may be of interest to Gödel scholars (...) are also indicated. (shrink)

Though regarded today as one of the most important results in logic, the compactness theorem was largely ignored until nearly two decades after its discovery. This paper describes the vicissitudes of its evolution and transformation during the period 1930-1970, with special attention to the roles of Kurt Gödel, A. I. Maltsev, Leon Henkin, Abraham Robinson, and Alfred Tarski.

This paper argues that qualitative research is both useful and necessary, as it provides an essential means of gaining a richer understanding of patients' perceptions, social processes and meanings. In their paper in this edition of Clinical Ethics, Hallowell and Lawton raise many issues relating to the way that qualitative research is treated by RECs in the UK. In this paper I discuss just three key topics stimulated by their paper: the way that methodology relates to ethics, the experience and (...) character of the researcher, and the normative/descriptive distinction. I strongly support Hallowell and Lawton's appeal for greater communication between qualitative researchers and RECs. In other respects, I would argue that they do not go far enough. The recent review of research ethics structures and the review process provides an opportunity to move away from the present 'one size fits all' approach to ethical review. I would argue that this change could only benefit qualitative research and researchers. (shrink)

The pipeline framework for identifying ethical issues in machine learning healthcare applications outlined by Char et al. is a very useful starting point for the systematic consideration...

Machine generated contents note: PART ONE: TOWARD A SOCIOLOGY OF HISTORY -- SECTION I: THE SOCIOLOGICAL -- FOUNDATIONS OF HISTORY -- I. The Sources of Culture Change -- 2. Sociology as a Science -- 3. Sociology and the Theory of Progress -- 4. Civilization and Morals -- 5. Progress and Decay in Ancient and Modern Civilization -- 6. Art and Society -- 7. Vitality or Standardization in Culture -- 8. Cultural Polarity and Religious Schism -- 9. Prevision in Religion -- (...) Io. T. S. Eliot on the Meaning of Culture -- SECTION II: THE MOVEMENT OF WORLD HISTORY -- I. Religion and the Life of Civilization -- 2. The Warrior Peoples and the Decline -- of the Archaic Civilization -- 3. The Origins of Classical Civilization -- 4. The Patriarchal Family in History -- 5. Stages in Mankind's Religious Experience -- SECTION III: URBANISM AND THE ORGANIC -- NATURE OF CULTURE -- I. The Evolution of the Modern City -- 2. Catholicism and the Bourgeois Mind -- 3. The World Crisis and the English Tradition -- 4. Bolshevism and the Bourgeoisie -- PART TWO: CONCEPTIONS OF WORLD HISTORY -- SECTION IV: CHRISTIANITY AND THE -- MEANING OF HISTORY -- I. The Christian View of History -- 2. History and the Christian Revelation -- 3. Christianity and Contradiction in History -- 4. The Kingdom of God and History -- SECTION II: THE VISION OF THE HISTORIAN -- I. The Problem of Metahistory -- 2. St. Augustine and the City of God -- 3. Edward Gibbon and the Fall of Rome -- 4. Karl Marx and the Dialectic of History -- 5. H. G. Wells and the Outline of History -- 6. Oswald Spengler and the Life of Civilizations -- 7. Arnold Toynbee and the Study of History -- 8. Europe in Eclipse -- Afterword by John J. Mulloy: Continuity and Development -- in Christopher Dawson's Thought -- Sources -- Notes -- Index. (shrink)

We question the role given to depiction in Clark and Fischer's account of interaction with social robots. Specifically, we argue that positing a unique cognitive process for handling depiction is evolutionarily implausible and empirically redundant because the phenomena it is intended to explain are not limited to depictive contexts and are better explained by reference to more general cognitive processes.

It will be argued that Wittgenstein did not outright reject the law of excluded middle for mathematics or the proof-techniques that constructivists reject in connection with the law of excluded middle. Wittgenstein can be seen to be critical of the dogmatic claims of Brouwer and Weyl concerning how proofs should be constructed. Rather than himself laying down a requirement concerning what is and is not a proof, Wittgenstein can be read as exploring the differences between constructive and non-constructive proofs. I (...) will read Wittgenstein as arguing that Brouwer’s rejection of excluded middle is based upon an over-extension from examples that Wittgenstein reads as special cases. Wittgenstein is certainly interested in the difference between constructive and non-constructive proof but only for the purposes of exploring the easily-missed differences between the two, not in order to reject non-constructive approaches. (shrink)

El artículo, tras validar la importancia de las organizaciones de derechos humanos y las de familiares de las víctimas en Chile, y del realce de este tema en los gobiernos de la Concertación, se centra en analizar el rol de las universidades frente a este tema, argumentando la necesidad de que estas desempeñen la noble tarea de formar profesionales ciudadanos, es decir personas con una formación basada en los derechos humanos. Para ello se focaliza en los objetivos y contenidos transversales (...) y postula un nuevo método pedagógico. (shrink)

In September of 2002, without fanfare, Ivor Grattan-Guinness retired from the faculty of Middlesex University. His scholarly activity, however, has continued unabated, his time now no longer fetter...

The thesis of this article is that engagement and suffering are essential aspects of responsible caregiving. The sense of medical responsibility engendered by engaged caregiving is referred to herein as clinical phronesis, i.e. practical wisdom in health care, or, simply, practical health care wisdom. The idea of clinical phronesis calls to mind a relational or communicative sense of medical responsibility which can best be understood as a kind of virtue ethics, yet one that is informed by the exigencies of moral (...) discourse and dialogue, as well as by the technical rigors of formal reasoning. The ideal of clinical phronesis is not (necessarily) contrary to the more common understandings of medical responsibility as either beneficence or patient autonomy — except, of course, when these notions are taken in their disengaged form (reflecting the malaise of modern medicine). Clinical phronesis, which gives rise to a deeper, broader, and richer, yet also to a more complex, sense than these other notions connote, holds the promise both of expanding, correcting, and perhaps completing what it currently means to be a fully responsible health care provider. In engaged caregiving, providers appropriately suffer with the patient, that is, they suffer the exigencies of the patient's affliction (though not his or her actual loss) by consenting to its inescapability. In disengaged caregiving — that ruse Katz has described as the silent world of doctor and patient — provides may deny or refuse any given connection with the patient, especially the inevitability of the patient's affliction and suffering (and, by parody of reasoning, the inevitability of their own. When, however, responsibility is construed qualitatively as an evaluative feature of medical rationality, rather than quantitatively as a form of calculative reasoning only, responsibility can be viewed more broadly as not only a matter of science and will, but of language and communication as well — in particular, as the task of responsibly narrating and interpreting the patient's story of illness. In summary, the question is not whether phronesis can save the life of medical ethics — only responsible humans can do that! Instead, the question should be whether phronesis, as an ethical requirement of health care delivery, can prevent the death of medical ethics. (shrink)

This article briefly reviews the various papers contained in this volume. They were originally presented at a research workshop held at Keele University in the UK in February 2003. It is suggested that the different papers raise a series of related legal, social and ethical issues and can be collectively seen to demonstrate the fact that policy formation in relation to reproductive matters is highly contested. It is concluded that ethical policy formation in this area needs to be based on (...) actual evidence of harm rather than assumed harm and that this therefore entails more empirical research into reproductive matters. (shrink)

This study evaluated the biological dimension of meditation and self-transcendent states. A convenience sample of 513 participants was drawn from attendees at a 4-day guided meditation workshop. Half were randomly assigned to an active placebo control intervention. All were assessed on a variety of measures, both psychological [anxiety, pain, posttraumatic stress disorder, positive emotions, and transcendent states], and physiological. Additional biological assessments including salivary immunoglobulin-A, cortisol, and Quantitative Electroencephalography were obtained from subset of the Experimental group. No significant difference in (...) psychological symptoms or positive emotions was observed between Experimental and placebo groups at baseline. At post-test, significant improvements were noted in the Experimental group, including a 49.5% median increase in SIgA, though cortisol remained unchanged. qEEG z-score analysis identified sustained stress reduction, including delta frequency band amplitude increases, high beta decreases, and faster acquisition of sustained alpha states. Psychological symptoms also improved on all measures. At 6-month follow-up, PTSD and somatic symptoms significantly improved from baseline, and post-test versus 6-month follow-up results indicated significant increases in happiness and spiritual and physical oneness, along with decreases in depressive symptoms. These findings suggest that autonomic self-regulation and transcendent states may be measured in both biological and psychological dimensions and are associated with pervasive health benefits. (shrink)

The word “euthanasia” is hopelessly overloaded with emotional connotations. It means so many things to many different people. The implications of euthanasia associated with the Second World War have often rendered the term unsuitable for discussions of a rational manner. As far as I am concerned, what happened in Germany under Hitler had nothing to do with the classic meaning of a gentle and easy death but was rather simply a policy of mass murder.

The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric disorders (mixed psychiatric (...) group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2= 52.66;p< 0.001) and had a high rate of unresolved loss/trauma (χ2= 18.64;p< 0.001). Comorbid psychiatric diagnoses (n= 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88;SD= 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2= 2.43;p= 0.30) and rates of unresolved loss and trauma (χ2= 0.70;p= 0.40).Post hocanalyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs. (shrink)

We provide an intuitive motivation for the hyperreal numbers via electoral axioms. We do so in the form of a Socratic dialogue, in which Protagoras suggests replacing big-oh complexity classes by real numbers, and Socrates asks some troubling questions about what would happen if one tried to do that. The dialogue is followed by an appendix containing additional commentary and a more formal proof.

Often regarded simply as a nuisance in clinical drug trials in which the aim is to separate drug response from placebo response in a statistically significant manner, the placebo response has important implications. These implications relate to the nature of illness, the study of non-specific factors in the treatment setting that are related to clinical improvement, methods of enhancing these non-specific sources of benefit, and the neurobiology that is associated with the placebo response. Specific sources of clinical improvement in medical (...) and psychological treatment generally consist of drugs or clear interventions that appear to directly contribute to the desired treatment. Non-specific factors, on the other hand, include the clinician–patient relationship, installation of hope, relationship with authority, and other such factors that are more implicit to treatment and may contribute to the placebo response. Our understanding of how these non-specific aspects of treatment relate to clinical improvement and ways of enhancing these non-pharmacological elements of therapy may form important aspects of treatment. Furthermore, an important, albeit potentially overlooked element of the placebo response are clinical-trial designs and methodologies, themselves. Specific neurobiological changes also appear to be associated with the placebo response in at least some cases. Finally, it is suggested that the placebo response may in some instances represent a type of brain plasticity in which expectation and desire — agency — can result in specific changes in brain function that either may mirror or differ from the effects of certain drugs. (shrink)