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Effort and reward

Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
Belin G Teklezgi, Annapurna Pamreddy, Sooraj Baijnath, Hendrik G Kruger, Tricia Naicker, Nirmala D Gopal, Thavendran Govender
Opioid addiction is a serious public health concern with severe health and social implications; therefore, extensive therapeutic efforts are required to keep users drug free. The two main pharmacological interventions, in the treatment of addiction, involve management with methadone an mu (μ)-opioid agonist and treatment with naltrexone, μ-opioid, kappa (κ)-opioid and delta (δ)-opioid antagonist. MET and NAL are believed to help individuals to derive maximum benefit from treatment and undergo a full recovery...
February 14, 2018: Addiction Biology
Jie Yin, Zhiling Zou, Hongwen Song, Zhuo Zhang, Bo Yang, Xiting Huang
Romantic love is a cross-culturally universal phenomenon that serves as a commitment device for motivating pair bonding in human beings. Women and men may experience different feelings when viewing the same warm, romantic scenes. To determine which brain systems may be involved in romance perception and examine possible sex differences, we scanned 16 women and 16 men who were intensely in love, using functional MRI. Participants were required to rate the romance level of 60 pictures showing romantic events that may frequently occur during romantic relationship formation...
February 12, 2018: Scientific Reports
Sarah E Hughes, Hayley A Hutchings, Frances L Rapport, Catherine M McMahon, Isabelle Boisvert
OBJECTIVES: Individuals with hearing loss often report a need for increased effort when listening, particularly in challenging acoustic environments. Despite audiologists' recognition of the impact of listening effort on individuals' quality of life, there are currently no standardized clinical measures of listening effort, including patient-reported outcome measures (PROMs). To generate items and content for a new PROM, this qualitative study explored the perceptions, understanding, and experiences of listening effort in adults with severe-profound sensorineural hearing loss before and after cochlear implantation...
February 8, 2018: Ear and Hearing
Christine Cohidon, Pascal Wild, Nicolas Senn
BACKGROUND: Good patient experience is recognized as an important component of a strong primary care system. Among the dimensions related to experience in family medicine, the ability to cope better with health problems is considered to be a measure of the quality of a consultation with a family physician (FP). The objective is to identify factors related to patients, physicians and practice, associated with patients' ability to cope better with their health problems after a family medicine consultation...
February 7, 2018: BMC Family Practice
Raphael M Herr, Christian Almer, Adrian Loerbroks, Amira Barrech, Irina Elfantel, Johannes Siegrist, Harald Gündel, Peter Angerer, Jian Li
There is ample evidence supporting the link between stress at the workplace and physical and mental health. One of the pathways potentially mediating those associations may involve the hypothalamic-pituitary-adrenal (HPA) axis, with cortisol as an end product. While theoretically plausible, findings on the association of self-reported work stress with hair cortisol concentrations (HCC) are inconclusive, being potentially biased by omitted pertinent factors. This issue can be addressed, among others, by eliminating time-invariant factors through consideration of variation within persons over time...
January 18, 2018: Psychoneuroendocrinology
Maria P Lemos, Terrie E Taylor, Suzanne M McGoldrick, Malcolm E Molyneux, Manoj Menon, Steve Kussick, Nonhlanhla N Mkhize, Neil A Martinson, Andrea Stritmatter, Julie Randolph-Habecker
The process of conducting pathology research in Africa can be challenging. But the rewards in terms of knowledge gained, quality of collaborations, and impact on communities affected by infectious disease and cancer are great. This report reviews 3 different research efforts: fatal malaria in Malawi, mucosal immunity to HIV in South Africa, and cancer research in Uganda. What unifies them is the use of pathology-based approaches to answer vital questions, such as physiology, pathogenesis, predictors of clinical course, and diagnostic testing schemes...
March 2018: Clinics in Laboratory Medicine
Jovita Bruening, Vera U Ludwig, Lena M Paschke, Henrik Walter, Christine Stelzel
Delaying intentions bears the risk of interference from distracting activities during the delay interval. Motivation can increase intention retrieval success but little is known about the underlying brain mechanisms. Here, we investigated whether motivational incentives (monetary reward) modulate the processing of delayed intentions in the anterior prefrontal cortex (aPFC), known to be crucial for intention processing. Using a mixed blocked and event-related functional Magnetic Resonance Imaging design, we specifically tested whether reward affects intention processing in the aPFC in a transient or in a sustained manner and whether this is related to individual differences in retrieval success...
January 31, 2018: NeuroImage
Bert Lenaert, Rebecca Jansen, Caroline M van Heugten
Chronic fatigue is highly prevalent in the general population as well as in multiple chronic diseases and psychiatric disorders. Its etiology however remains poorly understood and cannot be explained by biological factors alone. Occurring in a psychosocial context, the experience and communication of fatigue may be shaped by social interactions. In particular, interpersonal operant conditioning may strengthen and perpetuate fatigue complaints. In this experiment, individuals (N = 44) repeatedly rated their currently experienced fatigue while engaging in cognitive effort (working memory task)...
February 2, 2018: Behaviour Research and Therapy
Jiao Wang, Jia Huang, Simon S Y Lui, Eric F C Cheung, Xiao-Dong Yue, Raymond C K Chan
Patients with schizophrenia have been reported to exhibit anhedonia, a reduced hedonic capacity and deficits in motivation for reward pursuit. However, it is unclear whether these deficits also exist in at-risk individuals prone to psychosis or not. The present study compared 26 individuals with social anhedonia and 28 healthy controls using a grip Effort-based Pleasure Experience Task (E-PET). The findings showed that individuals with social anhedonia did not increase their hard task choices with the elevation of reward magnitude and probability while healthy controls did...
January 20, 2018: Psychiatry Research
Kevin A Blecha, Randall B Boone, Mathew W Alldredge
1.Conflicts between large mammalian predators and humans present a challenge to conservation efforts, as these events drive human attitudes and policies concerning predator species. Unfortunately, generalities portrayed in many empirical carnivore landscape selection studies do not provide an explanation for a predator's occasional use of residential development preceding a carnivore-human conflict event. In some cases, predators may perceive residential development as a risk-reward tradeoff. 2.We examine whether state dependent mortality-risk sensitive foraging can explain an apex carnivore's (Puma concolor) occasional utilization of residential areas...
January 30, 2018: Journal of Animal Ecology
Natalia Wege, Jian Li, Johannes Siegrist
PURPOSE: Cohort studies established elevated risks of depression among employees experiencing psychosocial stress at work, defined by 'job strain' or 'effort-reward imbalance' (ERI). Yet, conflicting evidence exists on whether the strength of these associations varies by gender. We explore this question in a nationally representative sample of working women and men where work stress (ERI) was related to reported depression over a 2-year follow-up. METHODS: Data were derived from the panel waves 2011 and 2013 of the German Socio-Economic Panel...
January 29, 2018: International Archives of Occupational and Environmental Health
Miyuki Yasue, Akiko Nakagami, Keiko Nakagaki, Noritaka Ichinohe, Nobuyuki Kawai
Humans and various nonhuman primates respond negatively to inequity not in their favor (i.e., inequity aversion), when inequity between two individuals is introduced. Common marmosets, a highly prosocial species, further discriminated between human actors who reciprocated in social exchanges, and those who did not. Conversely, marmoset models of autism, induced via prenatal exposure to valproic acid (VPA marmosets), did not discriminate. Interestingly, previous studies of inequity aversion in marmosets have produced negative results, or were limited to males...
January 24, 2018: Behavioural Brain Research
Nadine Häusler, Matthias Bopp, Oliver Hämmig
OBJECTIVE: Studies investigating the relative importance of effort-reward imbalance and work-privacy conflict for burnout risk between professional groups in the health care sector are rare and analyses by educational attainment within professional groups are lacking. METHODS: The study population consists of 1422 hospital employees in Switzerland. Multivariate linear regression analyses with standardized coefficients were performed for the overall study population and stratified for professional groups refined for educational attainment...
January 24, 2018: Journal of Occupational and Environmental Medicine
Leo Beletsky
: At a time when death and disability linked to problematic substance use have reached crisis levels, integration of substance use disorder (SUD) services into primary care settings is a clear national priority. Incentive-based interventions can catalyze such adoption, but have thus far demonstrated limited efficaciousness. Behavioral Economics can inform efforts to incentivize healthcare providers to adopt SUD interventions. Choice architecture principles dictate pegging rewards to defined quality metrics, improving provider information about effective and cost-effective practices, and reducing barriers to SUD service provision through technological tools, tackling stigma, and addressing real and perceived regulatory burdens and risks...
February 2018: Journal of Addiction Medicine
Daniel Fulford, Michael Treadway, Joshua Woolley
Experiential negative symptoms-including diminished motivation-have a profound impact on functional outcomes in schizophrenia. Animal research suggests that abnormalities in dopaminergic regulation can negatively impact effort exertion, a translational model that has been applied to individuals with schizophrenia. Paradigms that assess effort-based decision making, for example, suggest less likelihood of choosing high effort tasks that are high in probability of success, and this preference varies with negative symptoms and impaired functioning...
January 2018: Journal of Abnormal Psychology
Matthew R Bailey, Olivia Goldman, Estefanía P Bello, Muhammad O Chohan, Nuri Jeong, Vanessa Winiger, Eileen Chun, Elke Schipani, Abigail Kalmbach, Joseph F Cheer, Peter D Balsam, Eleanor H Simpson
The functionally selective 5HT-2C receptor ligand SB242084 can increase motivation and have rapid onset anti-depressant like effects. We sought to identify the specific behavioural effects of SB242084 treatment and elucidate the mechanism in female and male mice. Using a quantitative behavioural approach we determined that SB242084 increases the vigor and persistence of goal-directed activity across different types of physical work, particularly when work requirements are demanding. We found this influence of SB242084 on effort, rather than reward to be reflected in striatal dopamine measured during behavior...
January 24, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Pennie Eddy, Eleanor H Wertheim, Matthew W Hale, Bradley J Wright
We assessed the relationship between physiological and psychological measures of workplace stress as measured by the effort-reward imbalance (ERI) model, with a seldom studied sample of owner-operator dairy farmers. Dairy farmers (N = 74) self-reported ERI, over-commitment (OC), dedication, and health then provided awakening saliva samples that were used to calculate the salivary alpha amylase awakening response (sAA-AR), cortisol awakening response (CAR), and salivary immunoglobulin A (sIgA) level. ERI, OC, and dedication levels were not related with sIgA or the CAR, but more over-committed farmers had a less pronounced sAA-AR...
January 25, 2018: Stress: the International Journal on the Biology of Stress
José Ignacio Cuitún Coronado, Tarani Chandola, Andrew Steptoe
Although associations between work stressors and stress-related biomarkers have been reported in cross-sectional studies, the use of single time measurements of work stressors could be one of the reasons for inconsistent associations. This study examines whether repeated reports of work stress towards the end of the working career predicts allostatic load, a measure of chronic stress related physiological processes. Data from waves 2 to 6 of the English Longitudinal Study of Ageing (ELSA) were analysed, with a main analytical sample of 2663 older adults (aged 50+) who had at least one measurement of effort-reward imbalance between waves 2-6 and a measurement of allostatic load at wave 6...
January 24, 2018: International Journal of Environmental Research and Public Health
Stefan M Kolata, Kazuhito Nakao, Vivek Jeevakumar, Emily L Farmer-Alroth, Yuko Fujita, Aundrea F Bartley, Sunny Zhihong Jiang, Gregory R Rompala, Robert E Sorge, Dennisse V Jimenez, Keri Martinowich, Yolanda Mateo, Kenji Hashimoto, Lynn E Dobrunz, Kazu Nakazawa
Whereas cortical GAD67 reduction and subsequent GABA level decrease are consistently observed in schizophrenia and depression, it remains unclear how these GABAergic abnormalities contribute to specific symptoms. We modeled cortical GAD67 reduction in mice, in which the Gad1 gene is genetically ablated from ~50% of cortical and hippocampal interneurons. Mutant mice showed a reduction of tissue GABA in the hippocampus and cortex including mPFC, and exhibited a cluster of effort-based behavior deficits including decreased home-cage wheel running and increased immobility in both tail suspension and forced swim tests...
December 6, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
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