Gender differences in perpetuating factors,experience and management of chronic insomnia

The higher prevalence of insomnia in women has been attributed to biological factors, which are less likely than cognitive and behavioural factors to play a role in perpetuating insomnia. Gender differences in perpetuating factors have not been extensively examined. This study compared men’s and women’s self-reports of factors that perpetuate insomnia; experience of symptoms, perceived severity and impact on daytime functioning; and use of strategies to manage insomnia. Data were collected at baseline, using reliable and valid measures, in a project that evaluated behavioural therapies for insomnia. The sample (N = 739) consisted of women (62.4%) and men (37.6%). Gender differences were found in: (1) perpetuating factors: men took more naps and held more unhelpful beliefs about insomnia, whereas women experienced higher pre-sleep arousal; (2) perception of insomnia severity: higher among women; (3) perceived impact of insomnia: higher fatigue among women; and (4) use of strategies (higher in women) to manage insomnia. Gender differences were of a small size but could be associated with women’s stress, expression of somatic symptoms, and interest in maintaining their own health to meet multiple role demands.     

Signaling virtue: voluntary accountability programs among nonprofit organizations

This article examines the structure of nonprofit voluntary accountability and standard-setting programs, arguing that these programs can be understood as collective action institutions designed to address information asymmetries between nonprofits and their stakeholders. Club theory and the economics of certification suggest that such programs have the potential to provide a signal of quality by setting high standards and fees and rigorously verifying compliance. Such mechanisms can signal quality because higher participation costs may allow only high-quality organizations to join. The article examines the implications of signaling theory using an original dataset on the structure of 32 nonprofit accountability programs across the globe. While many programs set high standards for compliance, the key distinction between strong and weak programs is the use of disclosure or verification mechanisms to enforce compliance. Contrary to theoretical expectations, compliance standards and verification do not appear to be substitutes in creating stronger voluntary programs.

Co-Production and Health System Reform – From Re-Imagining To Re-Making

There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of post-neoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required.     

Attributional style,depressive features,and self-esteem: Adult children of alcoholic and nonalcoholic parents

Undergraduate adult children of alcoholics (ACOAs; N=57) were compared to children of nonalcoholic parents (CONAs; N=100) on measures of the Beck Depression Inventory (BDI), selfesteem, and attributional style. ACOA status was determined using the Children of Alcoholics Screening Test (Jones, 1981). ACOAs were found to have significantly higher scores on the BDI and to have significantly lower self-esteem, as measured by the Index of Self-Esteem, than CONAs. ACOAs were also more likely to have a depressive attributional style, in that they perceived failure as more internal, stable, and global than CONAs. Further, females had significantly higher BDI scores than males.Received B.A. from West Virginia University. Research interests: adult children of alcoholics and human sexual behavior.Received Ph.D. from West Virginia University. Research interests: the impact of popular culture on adolescents and the impact of parental conflict on children.Received Ph.D. from University of Massachusetts. Research interests: adolescent suicide risk.