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To determine the feasibility, acceptability and preliminary efficacy of an eHealth intervention with charity-based incentives to increase physical activity (PA) among young adult cancer survivors. Participants were randomized into two groups: PA (N = 25; Fitbit, step goal, electronic weekly newsletter) or PA + Charity (N = 26; same as PA plus charity donation if step goal achieved). At baseline and 12 weeks, steps/day were assessed using an activPAL. Motivation (e.g., BREQ-3) and patient reported outcomes (e.g., sleep quality, fatigue) were self-reported. The mean age was 36.8 years, 56.9% were Non-Hispanic White. We retained 82% (42/51) of participants. The PA + Charity vs. PA group had significantly higher satisfaction with intervention experience (100% vs 85%), greater increases in steps/day (1689 vs 516) and increases in overall self-determination score (13.5 vs 2.2). Both groups significantly improved sleep quality and reduced fatigue. A low-intensity eHealth intervention with charity-based incentives was feasible, acceptable, increased PA and self-determination. Trial registration Clinicaltrials.gov NCT03322059., Author(s): Sarah Kozey Keadle [sup.1] , Leah Meuter [sup.1] , Suzanne Phelan [sup.1] , Siobhan M. Phillips [sup.2] Author Affiliations: (1) grid.253547.2, 000000012222461X, Department of Kinesiology and Public Health, California [...]

Patients with psychogenic cough tic syndrome have been described as having a frequent cough - as often as every five minutes - which persists long after a minor cold and which subsides during sleep. Previous reports have described an aversive technique for treating psychogenic cough which provides negative social and physical reinforcement to encourage discontinuation of the cough. In this technique, a bedsheet is wrapped around the chest muscles and the patient is given a command of 'no more cough.' In previous evaluations of this technique, deception was involved, as affected children were told that the sheet provided support to weakened chest muscles, while parents were told that the coughing was psychosomatic but the child needed the sheet as a face-saving device and the alternative explanation of muscular involvement. The authors of this article provide an alternative treatment, which relies chiefly on positive rather than negative reinforcement to halt coughing, involves little deception, and encourages children to gain mastery over their condition. In this technique, parents and children are told that the cough may have originated from a particular likely disease process but has continued although the disease had resolved. The cough is compared to a habit like thumb-sucking, which could be broken if the child practiced gradual reduction of the symptom. After this explanation, parents record the frequency of coughing for rationed time periods, and children are informed of this. Declining cough frequency is then followed by setting goals of lower frequencies. In this study, stable or increased frequency of coughing was treated with a reward system, using tangible or social rewards. A return to normal school and other activities was strongly encouraged, to serve as distraction and to minimize possible avoidance of unpleasant tasks. Four cases are described in which this therapy was successful. Only one case required rewards to decrease cough frequency; the child was able to decrease coughing from 131 per half hour to 6 per half hour, with coughing finally ceasing. (Consumer Summary produced by Reliance Medical Information, Inc.)

This paper shows how the instruments of incentive theory can be used to develop some views about the proper design of governments to avoid the capture of politicians and bureaucrats by interest groups. First, treating politicians as informed supervisors to whom economic policy is delegated we show the usefulness of the separation of powers to increase the transaction costs of collusion, the relevance of asymmetric control for avoiding reciprocal favors. The incompleteness of the constitutional contract leaves discretion to politicians who become residual decision makers. We study the trade-offs between greater efficiency obtained by allowing powerful instruments to politicians and less discretion by restricting on the contrary those instruments. Determinants of those trade-offs are the variability of the environment, the extent of asymmetric information about tastes and technologies and the size of majorities. Finally, we show the new theory of incentives for group behavior can be used to determine the transaction costs of collusion under asymmetric information and to which extent these costs relax the constraints imposed on government by collusive behavior. Keywords: Political economy; Incentives; Collusion