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.     

Building sustainable capacity in the public sector: What can be done?

Effective government performance is central to the creation of market-oriented economies, secure and productive populations, and democratic political systems in developing countries. Capacity building to improve public sector performance is thus an important focus of development initiatives. Several implicit assumptions underlie most such efforts: that organizations or training activities are the logical site for capacity-building interventions; that administrative structures and monetary rewards determine organizational and individual performance; that organizations work well when structures and control mechanisms are in place; and that individual performance improves as a result of skill and technology transfer through training activities. Each of these assumptions is called into question by the findings of research carried out in six developing countries and reported in this article. Our studies indicate designing interventions that most constructively address sources of poor performance must follow from an assessment of a relatively broad set of variables, including the action environment in which all such activities take place. We also found that effective public sector performance is more often driven by strong organizational cultures, good management practices, and effective communication networks than it is by rules and regulations or procedures and pay scales. Our case studies further indicate that individual performance is more affected by opportunities for meaningful work, shared professional norms, teamwork, and promotion based on performance rather than it is by training in specific skills. In this article, we describe a framework or conceptual map that emphasizes that training activities, organizational performance and administrative structures are embedded within complex environments that significantly constrain their success and that often account for training or organizational failure. When it was applied in the six case study countries, the framework proved useful in identifying capacity gaps and providing a tool for the strategic design of interventions that are sensitive to the roots of performance deficits. This allows us to conclude that the assumptions underlying many capacity-building initiatives may focus attention on interventions that do not generate the highest payoffs in terms of improved performance.