Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Incentives”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 847 records · Page 47Linked to original sources

Incentive learning following reinforcer devaluation is not conditional upon the motivational state during re-exposure.

Three experiments analysed the effect of re-exposure to the reinforcer following aversion conditioning on instrumental performance. In the first experiment, groups of hungry and thirsty rats were trained to press a lever for sucrose, which was then followed by a single injection of lithium chloride (LiCl). On the following day, half the animals in each motivational condition received re-exposure to the sucrose solution; the remaining animals were not re-exposed. In a subsequent extinction test animals that had received re-exposure to the sucrose pressed less than animals that were not re-exposed. Moreover, the effect of re-exposure to the sucrose solution was similar following training under hunger and thirst. In the remaining studies, animals were trained to lever-press for sucrose while either hungry or thirsty. They were then injected with LiCl and re-exposed to the sucrose while either hungry or thirsty, i.e. in the same or different motivational state employed during training, or they were not re-exposed. Lever pressing was then tested in extinction in the training motivational state. As in the first experiment, re-exposure to the reinforcer after aversion conditioning enhanced the magnitude of the reinforcer devaluation effect. More importantly, re-exposure to the sucrose produced a comparable effect on instrumental performance, whether re-exposure was given under the same or different motivational state to that employed during training. These results suggest that the instrumental reinforcer devaluation effect depends upon a process of incentive learning, but that this process is not conditional upon the current motivational state of the animal.

Animals↗

Signalling and incentive processes in instrumental reinforcer devaluation.

We have previously reported that conditioning an aversion to the reinforcer using an isotonic lithium chloride (LiCl) solution following instrumental training reduces performance in a subsequent extinction test only if animals are re-exposed to the reinforcer prior to the test. Rescorla (1992), in contrast, reported an immediate devaluation effect using a hypertonic LiCl solution that did not depend upon re-exposure. In two experiments we examined the effect of using a hypertonic LiCl solution to condition the aversion to the reinforcer on subsequent instrumental performance in extinction, with and without re-exposure. In Experiment 1 thirsty rats were trained to press a lever for a sucrose solution before being injected with 0.6 M LiCl either immediately or after a delay. Half of the immediate and delay groups were then re-exposed to the sucrose in the absence of the lever, with the remainder being exposed to water. Contrary to the previously reported effects of isotonic LiCl, a hypertonic solution induced a reinforcer devaluation effect in all the immediately poisoned animals, which did not depend upon re-exposure to the reinforcer. In Experiment 2 the possibility that this devaluation effect was induced by the discomfort associated with the hypertonicity of the solution was assessed by replicating Experiment 1 but, in addition, using two immediately poisoned groups given the LiCl injection under anaesthesia. In the absence of anaesthesia, the devaluation effect observed without re-exposure to the reinforcer in Experiment 1 was replicated. When the injection was given under anaesthesia, however, a reinforcer devaluation effect was observed only in animals that were re-exposed to the reinforcer prior to the extinction test. These results were interpreted as evidence that a reinforcer devaluation effect induced by pairing the reinforcer with illness depends upon a process of incentive learning, whereas a devaluation effect mediated by learning a signalling relationship between the reinforcer and somatic discomfort does not.

Animals↗

[Project models to improve the ambiance during meal times in Dutch nursing homes: incentives and barriers for implementation].

In many Dutch nursing homes, meals are not served in a cozy setting. This study makes an inventory of project models used in nursing homes to improve the ambiance during mealtimes and identifies the beneficial factors (incentives) and barriers of the meal ambiance models. Three different meal ambiance project models were found: restaurant, cooking on the nursing ward and bulkmeals. Each of the three models was experienced as a success by the nursing home inhabitants, the nursing home management and the staff. They pointed out that the cooperation and motivation of staff, sufficient space and management support were the most important beneficial factors of the project models. The most important barriers were absence of cooperation and motivation of the staff, insufficient finances and insufficient personnel.

Aged↗

Benchmarking farmer performance as an incentive for sustainable farming: environmental impacts of pesticides.

Pesticide use in The Netherlands is very high, and pesticides are found across all environmental compartments. Among individual farmers, though, there is wide variation in both pesticide use and the potential environmental impact of that use, providing policy leverage for environmental protection. This paper reports on a benchmarking tool with which farmers can compare their environmental and economic performance with that of other farmers, thereby serving as an incentive for them to adopt more sustainable methods of food production methods. The tool is also designed to provide farmers with a more detailed picture of the environmental impacts of their methods of pest management. It is interactive and available on the internet: www.agriwijzer.nl. The present version has been developed specifically for arable farmers, but it is to be extended to encompass other agricultural sectors, in particular horticulture (bulb flowers, stem fruits), as well as various other aspects of sustainability (nutrient inputs, 'on-farm' biodiversity, etc.). The benchmarking methodology was tested on a pilot group of 20 arable farmers, whose general response was positive. They proved to be more interested in comparative performance in terms of economic rather than environmental indicators. In their judgment the benchmarking tool can serve a useful purpose in steering them towards more sustainable forms of agricultural production. The benchmarking results can also be used by other actors in the agroproduction chain, such as food retailers and the food industry.

Agriculture↗

[The PAL+ program, an incentive concerted action about malaria and associated infectious diseases, for developing countries].

The French Ministry in charge of Research has launched a multi-institutional incentive concerted action to assist Southern countries on malaria: the PAL+ program. PAL+ aims at bringing out: 1) conditions to promote novel preventive and therapeutic tools adapted to existing situations in the countries concerned; 2) a contribution to help research teams in Southern countries become competitive. PAL+ plans to strengthen cooperative relationships with developing countries (subsaharian Africa, South East Asia and South American countries). Research programs were oriented towards public health needs in malaria-endemic countries and thus mainly focused on: i) development of new antimalarial drugs and new therapeutical strategies: new targets and new leads for drugs, clinical assays for recognition of malaria and optimization of effective treatment or prophylactic drug dosage; ii) pathophysiology of severe malaria: mechanisms of immunity, biology and genome of host and parasite and research leading to vaccine trials; iii) basic and field research on mosquito genetics and biology which may lead to new prevention and control opportunities; iv) social studies on behaviours and habits around prevention and medication of malaria. The objective is to help Southern countries increase their capacity in clinical research, epidemiology, therapeutics, public health and social science (e.g. behaviours and habits accompanying medicine-taking). This means a true partnership and training adapted to specific needs and based on sound science. Research was therefore largely pursued in the laboratories of Southern countries and PAL+ supported the initiative in different ways by: i) providing easier opportunities for scientists from the North to collaborate with scientists from the South; ii) supporting networks of scientist collaborations. This was achieved by setting up a new type of relationships between scientists, based on a continuous dialogue and on bringing them together in small meetings on thematic discussions, the so-called Ateliers de PAL+. The Ateliers should play a major role in increasing the scientific capacity in developing countries. PAL+ program is a commitment to speed up better understanding of the disease by helping endemic countries contribute to research for their own benefit.

Africa South of the Sahara↗

Governed financial incentives as an alternative to altruistic organ donation.

In 1984, an offensive proposal for kidney sales by a US physician led the National Organ Transplant Act to become a law in the United States. Similar legislation passed in many other countries. An ethical consensus developed around the world that there should be no monetary compensation for transplantable organs, either from living or deceased persons. Unfortunately, the altruistic supply of organs has been much less than adequate, and thousands of patients die each year waiting for organ transplantation. As the altruistic system of organ donation has met with failure, some from the transplant community believe that altruism alone is not enough to satisfy the needs of the thousands of patients on organ transplant waiting lists, and providing some financial incentives or social benefits to organ sources is necessary to increase the number of cadaveric or living organ donations. In this article, the many controversies surrounding altruistic and compensated organ donation systems are discussed. The Iran model for renal transplantation, a compensated and well-regulated living-unrelated donor renal transplantation program that has successfully eliminated a renal transplant waiting list in Iran, is briefly reviewed.

Altruism↗

Positive expiratory pressure device acceptance by hospitalized children with sickle cell disease is comparable to incentive spirometry.

BACKGROUND: The pulmonary complication in sickle cell disease known as acute chest syndrome (ACS) has potential for high morbidity and mortality. A randomized trial demonstrated that incentive spirometry (IS) reduces the rate of ACS, leading to a role for respiratory therapy in hospital management of sickle cell pain. However, use of IS can be limited by chest wall pain, or by difficulty with the coordinated inspiration in a young child. Intermittent positive expiratory pressure (PEP) therapy may be easier for a child's coordination and more comfortable than IS for a child with chest wall pain. PURPOSE: To compare PEP therapy with conventional IS for children hospitalized for sickle cell pain with respect to patient satisfaction, length of hospital stay, and progression to ACS. METHODS: This pilot study enrolled 20 children upon hospitalization for sickle cell pain in the thorax, randomly assigning them to either PEP (n = 11) or IS (n = 9) therapy, administered by a therapist hourly while awake. RESULTS: The randomization assigned an older distribution to PEP than IS (12.3 vs 8.8 y). Patient satisfaction was high for both respiratory care devices, and there was no difference between the PEP and IS groups (4.5 vs 4.4, p = 0.81). Length of hospital stay was similar (5 vs 4.3 d, p = 0.56). No children in either group progressed to ACS. CONCLUSION: These preliminary results show no difference in the primary outcomes in the 2 groups. Intermittent PEP therapy warrants further study as an alternative to IS for sickle cell patients at high risk for ACS, as effective preventive respiratory therapy.

Anemia, Sickle Cell↗

[Generic drugs and legal incentives: which impact?].

The dispositions that regulate generic substitution in Switzerland have been recently revised, and impose definite incentives on prescribers. The benefits and drawbacks associated with the prescription of generic drugs are reviewed, considering the viewpoints of patients, practitioners and third party payers. While the initial prescription of a generic drug raises no specific concerns, the generic switch during long-term treatment may require some caution. The advantages of using International Nonproprietary Names (INN) for drug prescription are discussed. A renewal of prescription habits would be welcomed however several practical issues would have to find rational solutions.

Drug Prescriptions↗

[Ineffectiveness of incentive spirometry as coadjuvant of conventional physiotherapy for the prevention of postoperative respiratory complications after thoracic and esophageal surgery].

We have studied the efficacy of routine use of incentive spirometry (IS) in two groups of patients: group 1 (n = 18) with IS, and group 2 (n = 19), no IS. All patients suffered from lung or esophagus neoplasm and received respiratory physiotherapy before and after the operation. They underwent high chest and abdomen surgery. The incidence of alterations of pulmonary auscultation, roentgenologic abnormalities and alterations of the alveolar-arterial difference of oxygen (D[A-a]O2) as well as postoperative complications were similar in both groups. Patients undergoing digestive surgery presented a higher frequency of pleural effusion (p less than 0.05) and of them, the subgroup with IS stayed at the hospital for a longer time (47.2 +/- 32 days) than the subgroup undergoing digestive surgery not submitted to IS (p less than 0.01) probably because of the higher incidence of neoplasms of the mean third of the esophagus in such group. In our study and in the context of the type of surgery studied, the routine use of IS does not decrease the frequency of clinical and roentgenologic alterations neither improves the efficacy of postoperative gas interchange.

Adult↗

A specialty certification incentive program. Costs versus benefits.

Certification benefits nurses and their institution of employment. Although certification seems costly initially, it can be used to help reduce hospital expenditures in the areas of staff retention and recruitment, liability, and quality of patient care. The financial implications of certification and the development of a successful hospital incentive program to assist nurses to obtain certification is reported. Staff development educators can use this information to evaluate the cost-to-benefits ratio of specialty certification and to determine if a similar program could work in their institution.

Certification↗

Information theory and collative motivation: incentive value of uncertainty, variety, and novelty for children.

We tested the applicability of concepts and measures from information theory to studies of the development and operation of collative motivation. Three variables nominated by Berlyne as potential motivators of information seeking--uncertainty, variety, and novelty--were put into correspondence with three informational theoretic measures--average uncertainty in bits, number of possible outcomes, and outcome probability--to investigate the incentive properties of each variable for first and fourth graders. Increasing bit levels of uncertainty by adding alternatives to the set of possible outcomes was generally positively related to cover choices; however, increasing bit values by varying outcome probabilities from unequal to equal had no effect on choice. Without uncertainty, variety provided a weak source of collative motivation, systematically related to the choice of the transparent cover only for the older children when rewards occurred equally frequently. In contrast, the transparent cover was chosen significantly more frequently when the outcome probability of the associated reward was low. We obtained developmental stability in motivational effects except for variety operating in the absence of uncertainty.

Arousal↗

Effect of incentive breathing on lung functions in chronic obstructive pulmonary disease (COPD).

The effect of incentive breathing exercise was evaluated on patients of blue-bloater variety of chronic obstructive pulmonary disease (COPD) in a controlled study. The study used a device working on the principles of biofeed back for imparting breathing exercise. Exercise was given for half an hour daily for six weeks. There was significant increase in the vital capacity (VC) and reduction in air trapping in exercise group. There was remarkable improvement in subjective feeling of well being and breathlessness.

Breathing Exercises↗

The financial incentive for hospitals to prevent nosocomial infections under the prospective payment system. An empirical determination from a nationally representative sample.

To clarify the financial incentives for hospitals to prevent nosocomial infections, we analyzed 9423 nosocomial infections identified in 169 526 admissions selected randomly from the adult admissions to a random sample of US hospitals. By classifying each admission into a baseline diagnosis related group (DRG) (after first excluding all diagnoses of nosocomial infection) and a final DRG (after including these diagnoses), we found that only 5% to 18% of nosocomial infections would have caused the admission to be reclassified to a higher-paying DRG, depending on the extent to which physicians recorded nosocomial infection diagnoses in patients' medical records. The extra payment from the reclassification, averaged over all nosocomial infections, would have been no more than $93 per infection (in 1985 reimbursement rates), constituting only 5% of the hospitals' costs for treating these infections. Thus, at least 95% of the cost savings obtained from preventing nosocomial infections represents financial gains to the hospital.

Adult↗

Economic incentives and organizational realities: managing hospitals under DRGs.

Diagnosis-related Groups (DRGs) offer hospitals financial incentives to improve efficiency. To be effective, DRGs require a realignment of management so that physicians' use of resources can be disciplined by administrators. The constituency for altering power relationships within hospitals, however, is, at best, a weak one: administrators see their primary task as the protection of physicians' clinical autonomy. Constraints imposed on hospitals by regulators can be accommodated by minor adjustments in behavior that ensure neither gains in efficiency nor changes in decision-making authority.

Accounting↗

The Hospital Capitation Payment Project: new incentives and tools for cost containment.

Blue Cross of North Dakota, Blue Cross of Massachusetts, and the Blue Cross and Blue Shield Association, along with 10 hospitals, developed and implemented the Hospital Capitation Payment Project as a novel approach for containing escalating hospital costs. The hospital is paid a prospective, fixed amount for each person covered; in exchange, it assumes responsibility to provide or pay for all covered services needed by that individual. This responsibility extends to payment for covered care provided by other hospitals. The new tools and incentives created by the program, notably an innovative management information system, are designed to help hospitals better manage the health care needs and related costs of a defined population.

Blue Cross Blue Shield Insurance Plans↗

Structure and incentive problems in economic regulation of medical care.

Health-care markets, characterized by unusual structures and incentives, are less effectively influenced by direct economic regulation than are other markets. Command-and-control economic regulation may contain costs but to the detriment of access, efficiency, innovation, and responsiveness to consumers. Market reform strategies offer a sound and feasible policy alternative.

Community Participation↗

Maze-cum-activity cage with automatic recording system for evaluation of circadian incentive drives in rats.

Maze-cum-activity cage is devised in order to record the activity shift patterns of incentive drive of rats. The main features of this instrument are its low cost, simplicity or recording system and evaluation of time shift patterns of the activity when animal is moving for preferential cues such as food, water socio-sexual environment provided in the cage during a 24 hour period.

Animals↗