Retrospective reports of parental partner abuse: Relationships to depression,trauma symptoms and self-esteem among college students

This study tested whether retrospective reports of childhood exposure to parental partner abuse were associated with internalizing aspects of adult adjustment. Participants were 550 men and women college students. Among women, childhood exposure to partner abuse was related to depression, trauma-related symptoms, and low self-esteem; among men, exposure was associated with trauma-related symptoms. These relationships were statistically independent of reported parental alcohol abuse and divorce. Relationships of parental partner abuse to low self-esteem and depression among women were also independent of variation in retrospective reports of child sexual and physical abuse. However, the relationship of partner abuse to trauma-related symptoms depended, in part, on the co-occurrence of child abuse. The discussion addressed implications of the findings for future research and for clinical practice.     

WOMEN, LABOR MARKETS. AND COMPARABLE WORTH

This article reviews various theories about labor markets in the United States and traces the arguments that accompany each theory concerning why women earn less than men. To test some of these arguments, the paper uses aggregate statistics on the sex composition of occupations and industries during the decade 1970–1980 t o identify trends. Findings show that the sex segregation of occupations decreased slightly while the sex segregation of industries increased. The earnings differential between men and women remained substantially the same. The paper offers an explanation using labor market theories for these empirical findings and, in light of this explanation, assesses the implications for the effectiveness of comparable worth policies.     

Comparative lobbying strategies in influencing health care policy

Abstract: This paper explores the proposition that the lobbying behaviour of pressure groups is strongly influenced by whether they are output-oriented or process-oriented. We argue that where a group focuses its lobbying efforts on obtaining economic gains for its members, a more confrontational approach will be used. If an interest group does not bargain directly with government for economic gains, but rather tries to foster a positive political climate, it will practice the art of quiet diplomacy. We analyse the behaviour of the medical and hospital associations in British Columbia as interest groups and seek to identify the determinants of their different lobbying strategies, styles and techniques. We also try to assess the impact of these lobbying styles and strategies on the public policies that the groups have sought to influence, recognizing that government is also trying to influence the group's behaviour. We conclude that there are six crucial factors, some exogenous and some endogenous, that strongly influence the lobbying behaviour of health case organizations. These are the nature of the groups' membership, the focus of their lobbying activities, the cycle of group-government interaction, the length of experience with government as the principal paymaster, the presence or absence of factions within the group, and the values and attitudes of various members stemming from their socialization. Sommaire: Ce document analyse l'idée selon laquelle le comportement d'un groupe de pression est fortement influence par l'orientation de ce groupe et varie selon qu'il s'intéresse davantage aux résultats ou aux processus. Nous montrons ici qu'un groupe de pression qui s'efforce d'obtenir des gains économiques pour ses membres a tendance à adopter une attitude de confrontation. Par contre, un groupe qui ne négocie pas directement avec le gouvernement en vue d'obtenir des gains économiques, mais qui essaie plutôt d‘établir un climat politique favorable, a tendance à agir avec “diplomatie”. Nous analysons le comportement des associations médicales et hospitalières de la Colombie-Britannique et cherchons à définir les facteurs caractérisant leurs divers styles, stratégies et techniques de pression. Nous tentons également d'évaher I'effet de ces styles et stratégies de pression sur les politiques publiques queles groupes ont cherchéà influencer, tout en sachant que le gouvernement essaie également d'influencer le comportement des groupes. Nous en venons à la conclusion qu'il existe six facteurs critiques, certains exogènes, d'autres endogènes, qui influencent fortement le comportement des organismes de santé en tant que groupes de pression. Ces facteurs sont les suivants: nature des membres du groupe, orientation de leurs activités au sein du groupe, cycle des interactions groupe-gouvernement, durée de I'expérience du groupe avec le gouvernement comme principal bailleur de fonds, présence ou absence de relations harmonieuses au sein du groupe, et enfin valeurs et attitudes des divers membres en fonction de leur intégration sociale.     

Ethics Consultation

As part of the journal's effort to give readers practical applications in health care, we present the following regular feature. We hope that all readers will find something of interest in this and subsequent case studies, and, with the authors, we welcome your feedback. Ed.     

Disbursement,decentralization and development: Lessons from the first rural health services project in Papua New Guinea

In 1983 the Department of Health in Papua New Guinea decentralized the control of health services to provincial governments. In the same year a major rural health development project commenced in six of the nineteen provinces. Conflict arose between the centralized control required by the project and the decentralized health system. This article reviews the experience of the project implementators in trying to reconcile the philosophy and reality of decentralization with the centralized project design. Lessons point to the need for closer collaboration with beneficiaries during project design, formal clarification of responsibilities of national and provincial governments in implementation, institutional strengthening as a project input and the development of mechanisms for review and change during the course of implementation.