Tryptophan Depletion Promotes Habitual over Goal-Directed Control of Appetitive Responding in Humans.

BACKGROUND: Optimal behavioral performance results from a balance between goal-directed and habitual systems of behavioral control, which are modulated by ascending monoaminergic projections. While the role of the dopaminergic system in behavioral control has been recently addressed, the extent to which changes in global serotonin neurotransmission could influence these 2 systems is still poorly understood. METHODS: We employed the dietary acute tryptophan depletion procedure to reduce serotonin neurotransmission in 18 healthy volunteers and 18 matched controls. We used a 3-stage instrumental learning paradigm that includes an initial instrumental learning stage, a subsequent outcome-devaluation test, and a slip-of-action stage, which directly tests the balance between hypothetical goal-directed and habitual systems. We also employed a separate response inhibition control test to assess the behavioral specificity of the results. RESULTS: Acute tryptophan depletion produced a shift of behavioral performance towards habitual responding as indexed by performance on the slip-of-action test. Moreover, greater habitual responding in the acute tryptophan depletion group was predicted by a steeper decline in plasma tryptophan levels. In contrast, acute tryptophan depletion left intact the ability to use discriminative stimuli to guide instrumental choice as indexed by the instrumental learning stage and did not impair inhibitory response control. CONCLUSIONS: The major implication of this study is that serotonin modulates the balance between goal-directed and stimulus-response habitual systems of behavioral control. Our findings thus imply that diminished serotonin neurotransmission shifts behavioral control towards habitual responding.This work was supported by a Wellcome Trust programme grant to T.W.R. (089589/z/09/z). The Behavioral and Clinical Neuroscience Institute is jointly funded by the MRC and the Wellcome Trust (G00001354).This is the final version of the article. It first appeared from Oxford University Press via http://dx.doi.org/10.1093/ijnp/pyv01

The Relationship Between Occupational Category and Workplace Aggression: Workaholism as a Potential Moderator

Work environments are ever-changing and differ between blue- and white-collar employees. Our goal is to investigate the relationship between occupational category, workplace aggression, and workaholism. The work environment hypothesis emphasizes the role of workplace contextual factors and the work environment on workplace aggression (Salin, 2015). Occupational category, which includes blue- and white-collar positions, is one such work environmental factor. Blue-collar positions are described using manual labor (Finstad et al., 2019), while white-collar positions deal with information rather than things (Anjum & Parvez, 2013). Workplace aggression is the intentional acts by individuals to harm others in an organization or the organization as a whole (Barling et. al., 2009). Work stress leads to higher levels of workplace aggression (Spector & Fox, 2005; Maufi, 2011). In the proposed study, we will investigate the relationship between occupational category and workplace aggression, and examine the potential moderating influence of workaholism. Workaholism, an individual’s compulsive need to work excessively, was chosen as a moderator due to its relation to increased work stress (Glomb, 2002; Clark et. al., 2016). If one occupational category is found to significantly relate to workplace aggression more than the other, this could provide focus for future interventions to target these workers to reduce work stress and workaholism risk. If workaholism is a significant moderator, this will provide incentive for companies to further encourage work-life balance to reduce the risk of workplace aggression and counterproductive work behavior (a form of workplace aggression) incidents. Due to the higher stress associated with the poor working conditions faced by blue-collar workers, we expect blue-collar work to be more strongly related to workplace aggression (H1). White-collar work provides greater access and opportunity to technology that allows for excessive work, along with internal motivation similar to the internal drive of workaholism. Thus, we expect white-collar work to be more strongly associated with workaholism (H2). Due to their similar relationship with work stress, workaholism is predicted to be positively related to workplace aggression (H3). Finally, we expect workaholism to have a moderating influence on the occupational category-workplace aggression relationship, such that with higher levels of workaholism, workplace aggression will increase across occupational categories (H4). Participants will consist of full-time faculty and staff at a large Southeastern university recruited through email distribution. Correlations and multiple regression analysis will be used to test the proposed hypotheses. Hayes’ PROCESS (2014) will be used to determine the potential moderating influence of workaholism

Quantitative Measurements of Alternating Finger Tapping in Parkinson's Disease Correlate With UPDRS Motor Disability and Reveal the Improvement in Fine Motor Control From Medication and Deep Brain Stimulation

Abstract: The Unified Parkinson's Disease Rating Scale (UP-DRS) is the primary outcome measure in most clinical trials of Parkinson's disease (PD) therapeutics. Each subscore of the motor section (UPDRS III) compresses a wide range of motor performance into a coarse-grained scale from 0 to 4; the assessment of performance can also be subjective. Quantitative digitography (QDG) is an objective, quantitative assessment of digital motor control using a computer-interfaced musical keyboard. In this study, we show that the kinematics of a repetitive alternating finger-tapping (RAFT) task using QDG correlate with the UPDRS motor score, particularly with the bradykinesia subscore, in 33 patients with PD. We show that dopaminergic medication and an average of 9.5 months of bilateral subthalamic nucleus deep brain stimulation (B-STN DBS) significantly improve UPDRS and QDG scores but may have different effects on certain kinematic parameters. This study substantiates the use of QDG to measure motor outcome in trials of PD therapeutics and shows that medication and B-STN DBS both improve fine motor control

Transactional Analysis: Conceptualizing a Framework for Illuminating Human Experience

Myriad methods exist for analyzing qualitative data. It is, however, imperative for qualitative researchers to employ data analysis tools that are congruent with the theoretical frameworks underpinning their inquiries. In this paper, I have constructed a framework for analyzing data that could be useful for researchers interested in focusing on the transactional nature of language as they engage in Social Science research. Transactional Analysis (TA) is an inductive approach to data analysis that transcends constant comparative methods of exploring data. Drawing on elements of narrative and thematic analysis, TA uses the theories of Bakhtin and Rosenblatt to attend to the dynamic processes researchers identify as they generate themes in their data and seek to understand how their participants' worldviews are being shaped. This paper highlights the processes researchers can utilize to study the mutual shaping that occurs as participants read and enter into dialogue with the world around them

Looking Through the Patients’ Eyes

Objective: Patient satisfaction is a personal evaluation of health-care services that is often used as an indicator of quality of care. The aim of this study was to identify aspects of hospital care that affect patient satisfaction by examining the structural and convergent validity of an in-house questionnaire. Methods: The sample consisted of 3320 patients discharged from an Italian public hospital. The questionnaire included items exploring communication with nurses and physicians, pain management, quality of accommodation, and discharge information. Data were analyzed using the Rasch model. Results: From the patients’ perspective, the number of response options was excessive and the questionnaire proved to have both medical and accommodation dimensions. Patients, on average, gave higher satisfaction scores to the medical dimension over the accommodation dimension. Higher satisfaction was associated with kindness and courtesy of the nursing staff, doctors’ courtesy, and the quality of bed linen. Conclusion: The results support the administration of the questionnaire but suggest change in the hospital’s analytical procedures in order to match the drivers of satisfaction as seen by the patients

Development of a Community-Sensitive Strategy to Increase Availability of Fresh Fruits and Vegetables in Nashville’s Urban Food Deserts, 2010–2012

Background Food deserts, areas that lack full-service grocery stores, may contribute to rising rates of obesity and chronic diseases among low-income and racial/ethnic minority residents. Our corner store project, part of the Centers for Disease Control and Prevention’s Communities Putting Prevention to Work initiative, aimed to increase availability of healthful foods in food deserts in Nashville, Tennessee. Community Context We identified 4 food deserts in which most residents are low-income and racially and ethnically diverse. Our objectives were to develop an approach to increase availability of fresh fruits and vegetables, low-fat or nonfat milk, and 100% whole-wheat bread in Nashville’s food deserts and to engage community members to inform our strategy. Methods Five corner stores located in food deserts met inclusion criteria for our intervention. We then conducted community listening sessions, proprietor surveys, store audits, and customer-intercept surveys to identify needs, challenges to retailing the products, and potential intervention strategies. Outcome Few stores offered fresh fruits, fresh vegetables, low-fat or nonfat milk, or 100% whole-wheat bread, and none stocked items from all 4 categories. Major barriers to retailing healthful options identified by community members are mistrust of store owners, history of poor-quality produce, and limited familiarity with healthful options. Store owners identified neighborhood crime as the major barrier. We used community input to develop strategies. Interpretation Engaging community residents and understanding neighborhood context is critical to developing strategies that increase access to healthful foods in corner stores

Internet-based physical assessment of people with Parkinson disease is accurate and reliable: A pilot study

Telerehabilitation may be an alternative service delivery model for people with Parkinson disease (PD) who live in areas where traditional rehabilitation services are not readily accessible. The aim of this study was to determine the accuracy and reliability of performing remote physical assessments of people with PD via telerehabilitation when compared with traditional face-to-face assessments. Twelve subjects were simultaneously examined by a face-to-face investigator and a remote investigator via the eHAB telerehabilitation system. The outcome measures evaluated included the timed stance test, Timed “Up and Go” test, step test, step s in 360 degree turn, Berg Balance Scale, and lateral and functional reach tests. Limits of agreements intervals and weighted kappa statistics demonstrated the telerehabilitation assessments to be accurate within clinically acceptable limits. A high level of inter- and intrarater reliability was demonstrated across all telerehabilitation assessments. This study indicates that it is possible to assess the physical ability of people with PD via telerehabilitation systems and provides support for the further development of telerehabilitation applications for patients with neurological disorders

Postoperative Achilles Pull-out Strength after Calcaneoplasty for Haglund’s Syndrome

Category: Hindfoot Introduction/Purpose: Haglund’s syndrome involves a prominent posterior superior prominence of the calcaneus, in conjunction with pain caused by local inflammation. Nonoperative management includes orthotic inserts, immobilization, shoe modification and physical therapy. If non-operative management fails, surgical management with calcaneoplasty is often needed. No study has assessed Achilles tendon pull-out strength after a calcaneoplasty for Haglund’s syndrome. The purpose of this study was to investigate those changes in a cadaveric model and provide objective data upon which to base postoperative recovery. Methods: 8 matched pairs of cadaveric specimens (mid-tibia to toes) were divided into two cohorts. The matched pairs compared Achilles pull-out strength between intact and open calcaneoplasty specimens. Prior to testing, BMD was determined and lateral X-ray images were obtained before and after surgery to quantify bone removal. The distal aspect of each calcaneus was potted and held at a 20 degree angle. The Achilles tendon was secured in a freeze-clamp, which was attached to a mechanical testing system. Specimens were then loaded to failure. Outcome measures include: Height of bony resection, angle of bone resection, load to failure, and mode of failure. Results: Specimens with open calcaneoplasty had a 45% reduction in strength (failure load: 742 N) compared to their intact counterpart (1341 N), p<0.05. Load to failure was significantly correlated with BMD (r=0.64, p<0.05). Conclusion: Traditional open calcaneus resection demonstrated a potentially catastrophic weakness of the Achilles tendon insertion. Mineral density further affects weakening of the Achilles insertion. . Biomechanical evidence presented above supports the practice of protected weight bearing and cautious return to activity after open calcaneoplasty for Haglund’s syndrome