Does phasic dopamine release cause policy updates?

Phasic dopamine activity is believed to both encode reward-prediction errors (RPEs) and to cause the adaptations that these errors engender. If so, a rat working for optogenetic stimulation of dopamine neurons will repeatedly update its policy and/or action values, thus iteratively increasing its work rate. Here, we challenge this view by demonstrating stable, non-maximal work rates in the face of repeated optogenetic stimulation of midbrain dopamine neurons.

Fecal Microbiota Transplantation for Clostridioides difficile Infection in Immunocompromised Pediatric Patients.

Objectives: We sought to evaluate the safety and effectiveness of fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (CDI) in pediatric immunocompromised (IC) patients.

Methods: This is a multicenter retrospective cohort study of pediatric participants who underwent FMT between March 2013 and April 2020 with 12-week follow-up. Pediatric patients were included if they met the definition of IC and were treated with FMT for an indication of recurrent CDI.

Qualitative investigation of factors impacting pre-exposure prophylaxis initiation and adherence in sexual minority men.

Introduction: Men who have sex with men continue to account for the majority of new HIV infections in the United States. Many of those with new infections are unaware that they have HIV. Preventative measures continue to be essential in reducing new infections, with pre-exposure prophylaxis (PrEP) being widely recommended.

Perceptions of ableist microaggressions among target and nontarget groups.

Purpose: There appears to be a negative association between reported microaggressions and mental health. Due to the subjective nature of microaggressions, however, certain factors may affect whether an interaction is perceived as microaggressive. This study investigated perceptions of microaggressions and neutral interactions, and influencing factors.

Pediatric Metastatic Crohn's Disease of the Liver.

Metastatic Crohn's disease (MCD) is the manifestation of Crohn's disease outside of the gastrointestinal tract and most frequently involves mucocutaneous and pulmonary tissues. This is an uncommon phenomenon but is well characterized in the pediatric literature. In contrast, MCD affecting the liver has not previously been described in pediatrics.

Leader-member exchange and organizational climate effects on clinician turnover intentions.

Purpose: Clinician turnover in mental health settings impacts service quality, including availability and delivery of evidence-based practices. Leadership is associated with organizational climate, team functioning and clinician turnover intentions (TI). This study examines leader-member exchange (LMX), reflecting the relationship between a supervisor and each supervisee, using mean team LMX, dispersion of individual clinician ratings compared to team members (i.

Dopamine neurons do not constitute an obligatory stage in the final common path for the evaluation and pursuit of brain stimulation reward.

The neurobiological study of reward was launched by the discovery of intracranial self-stimulation (ICSS). Subsequent investigation of this phenomenon provided the initial link between reward-seeking behavior and dopaminergic neurotransmission. We re-evaluated this relationship by psychophysical, pharmacological, optogenetic, and computational means.

Tell Me A Story: Promoting resiliency in military children with a bibliotherapy intervention.

Purpose: Research demonstrates the complex effect of the military lifestyle on children of military members. Problem behaviors can manifest in military children as young as 6 years old (eg, physical violence). Some military children have better outcomes (ie, resiliency).

Learning to use past evidence in a sophisticated world model.

Humans and other animals are able to discover underlying statistical structure in their environments and exploit it to achieve efficient and effective performance. However, such structure is often difficult to learn and use because it is obscure, involving long-range temporal dependencies. Here, we analysed behavioural data from an extended experiment with rats, showing that the subjects learned the underlying statistical structure, albeit suffering at times from immediate inferential imperfections as to their current state within it.

Microaggressions and social support among sexual minorities with physical disabilities.

Purpose: Prejudice and discrimination have been associated with mental and physical health disparities among people with disabilities (Emerson, 2010) and sexual minorities (American Psychological Association [APA], 2012b). Subtle everyday communications of prejudice, known as microaggressions, are one form of oppressive experience that contribute to minority stress among these groups. As sexual minority people with disabilities (SMPWDs) embody at least two marginalized statuses, they may face unique levels of risk.

Drowning Prevention in Pediatrics.

Drowning contributes significantly to morbidity and mortality in the pediatric population but it is largely preventable through judicious use of safety measures. To affect outcomes surrounding drowning, pediatricians need to understand the most updated terminology, the basic resuscitation protocols, and the assessment and management of a drowning victim. Most importantly, pediatricians must appreciate the importance of properly counseling patients and families about drowning prevention.

Valuation of opportunity costs by rats working for rewarding electrical brain stimulation.

Pursuit of one goal typically precludes simultaneous pursuit of another. Thus, each exclusive activity entails an "opportunity cost:" the forgone benefits from the next-best activity eschewed. The present experiment estimates, in laboratory rats, the function that maps objective opportunity costs into subjective ones.

Medical Oversight, Educational Core Content, and Proposed Scopes of Practice of Wilderness EMS Providers: A Joint Project Developed by Wilderness EMS Educators, Medical Directors, and Regulators Using a Delphi Approach.

Introduction: A disparity exists between the skills needed to manage patients in wilderness EMS environments and the scopes of practice that are traditionally approved by state EMS regulators. In response, the National Association of EMS Physicians Wilderness EMS Committee led a project to define the educational core content supporting scopes of practice of wilderness EMS providers and the conditions when wilderness EMS providers should be required to have medical oversight.

Methods: Using a Delphi process, a group of experts in wilderness EMS, representing educators, medical directors, and regulators, developed model educational core content.

The process of self-regulation in adolescents: A narrative approach.

This qualitative study utilized a narrative approach to explore the process of self-regulation in adolescents and to examine the functions of various relational genres on psychological state and context expressions in this process. Nineteen participants, who live in high-risk settings were recruited from a youth development and life skills program located at an urban public high school in the United States. The goal of this project is to craft a process method for research and practice on adolescents' self-regulation while providing evidence for self-regulation being a complex process.

The Effects of Electrical and Optical Stimulation of Midbrain Dopaminergic Neurons on Rat 50-kHz Ultrasonic Vocalizations.

Rationale: Adult rats emit ultrasonic vocalizations (USVs) at around 50-kHz; these commonly occur in contexts that putatively engender positive affect. While several reports indicate that dopaminergic (DAergic) transmission plays a role in the emission of 50-kHz calls, the pharmacological evidence is mixed. Different modes of dopamine (DA) release (i.

The neural substrates for the rewarding and dopamine-releasing effects of medial forebrain bundle stimulation have partially discrepant frequency responses.

Midbrain dopamine neurons have long been implicated in the rewarding effect produced by electrical brain stimulation of the medial forebrain bundle (MFB). These neurons are excited trans-synaptically, but their precise role in intracranial self-stimulation (ICSS) has yet to be determined. This study assessed the hypothesis that midbrain dopamine neurons are in series with the directly stimulated substrate for self-stimulation of the MFB and either perform spatio-temporal integration of synaptic input from directly activated MFB fibers or relay the results of such integration to efferent stages of the reward circuitry.

Psychophysical inference of frequency-following fidelity in the neural substrate for brain stimulation reward.

The rewarding effect of electrical brain stimulation has been studied extensively for 60 years, yet the identity of the underlying neural circuitry remains unknown. Previous experiments have characterized the directly stimulated ("first-stage") neurons implicated in self-stimulation of the medial forebrain bundle. Their properties are consistent with those of fine, myelinated axons, at least some of which project rostro-caudally.

The effect of probability discounting on reward seeking: a three-dimensional perspective.

Rats will work for electrical stimulation of the medial forebrain bundle. The rewarding effect arises from the volleys of action potentials fired by the stimulation and subsequent spatio-temporal integration of their post-synpatic impact. The proportion of time allocated to self-stimulation depends on the intensity of the rewarding effect as well as on other key determinants of decision-making, such as subjective opportunity costs and reward probability.

Improving foster parent engagement: using qualitative methods to guide tailoring of evidence-based engagement strategies.

This qualitative study examined applicability and need for tailoring of an evidence-based engagement intervention, combined with Trauma-Focused Cognitive Behavioral Therapy, for foster parents. Qualitative methods were used, including individual interviews with participating foster parents (N = 7), review of interview findings with an independent group of foster parents (N = 5), and review of the combined foster parent findings by child welfare caseworkers (N = 5), an important stakeholder group. The engagement intervention, with its primary focus on perceptual barriers (e.

Optimal indolence: a normative microscopic approach to work and leisure.

Dividing limited time between work and leisure when both have their attractions is a common everyday decision. We provide a normative control-theoretic treatment of this decision that bridges economic and psychological accounts. We show how our framework applies to free-operant behavioural experiments in which subjects are required to work (depressing a lever) for sufficient total time (called the price) to receive a reward.

A new view of the effect of dopamine receptor antagonism on operant performance for rewarding brain stimulation in the rat.

Rationale: Previous studies of neuroleptic challenges to intracranial self-stimulation (ICSS) employed two-dimensional (2D) measurements (curve shifts). Results so obtained are ambiguous with regard to the stage of neural processing at which the drug produces its performance-altering effect. We substituted a three-dimensional (3D) method that measures reward-seeking as a function of both the strength and cost of reward.

Validation and extension of the reward-mountain model.

The reward-mountain model relates the vigor of reward seeking to the strength and cost of reward. Application of this model provides information about the stage of processing at which manipulations such as drug administration, lesions, deprivation states, and optogenetic interventions act to alter reward seeking. The model has been updated by incorporation of new information about frequency following in the directly stimulated neurons responsible for brain stimulation reward and about the function that maps objective opportunity costs into subjective ones.

Earache.

Earache, a common emergency department presentation, may be caused by a variety of conditions, some distant from the ear. This article discusses the diagnosis and treatment of acute otitis media, otitis media with effusion, otitis externa, otitis media with ruptured tympanic membrane or tympanostomy tubes, malignant otitis externa, mastoiditis and petrositis, traumatic ruptured tympanic membrane, cerumen impactions, and foreign bodies in the ears.