Finally, the attitudes of practitioners and the way in which best practices were understood and rewarded needed to be addressed.
We ingest food to meet the energy and nutrient demands of living, but food is also rewarding and therefore meets reward needs as well (Berthoud, 2007).
The conventional MAB problem is a problem in which one gambler facing multiple slot machines, each of which has an unknown probability distribution of rewards, needs to decide (a) which machines to play, (b) the order of play, and (c) the number of times to play each machine, to maximize rewards [15, 16].
However, the role of central versus peripheral ghrelin for alcohol reward needs to be elucidated.
The balance of intrinsic and extrinsic rewards needs to be more fully understood.
To be effective and to prevent undesired behaviour like gaming or tunnel vision, the reward needs to address these additional costs in its design.
In line with standard behavioural design principles, the link between the behaviour and the reward needs to be clear and simple enough for hospital/area to be able to understand [ 62].
In the fasted state, in the presence of hunger, wanting- and liking-related brain signalling coincide and facilitate food intake in agreement with both energy and reward needs (Van Gemert et al., 2000; Westerterp-Plantenga et al., 2002; Westerterp-Plantenga et al., 2003).
"The rewards need to be tied to the goals the state wants to achieve".
Rewards need sharpening, just as poor performers should be edged out more quickly.
