Sexual abuse and sexual functioning in a chronic pelvic pain sample

Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index of the extent of sexual abuse experiences in childhood and adolescence/adulthood, higher scores were related to lower rates of sexual activity, less satisfaction with orgasm and feelings of closeness with sexual partners, and greater severity of and interference from pain. Findings point to the importance of controlling for relationship status in analyses of long-term effects of sexual abuse and of assessing chronic pelvic pain patients for histories of sexual abuse using measures that address the extent or severity of abuse.     

The dream: Mechanisms and clinical applications

The clinician's use of client dream reports to promote self-discovery and foster a therapeutic alliance is examined in the context of borderline personality psychodynamics. The mechanisms and operations central to understanding dream processes are explained, using both Freudian and information processing models. This paper's thesis is that the effective, differential use of dream material hinges on the assessment of the client's ego functioning in the object relations sphere and relative to level of cognitive development.     

Risk-Based Zoning for Toxic-Gas Pipelines

Implicit in the operation of a toxic-gas pipeline is the possibility of an accidental release, which could have serious consequences if upwind of a nearby populated area. Concern for public safety leads to the establishment of isolation corridors or buffer zones to reduce and control the hazard to human settlements. Although "worst case" or "average case" are often used in the determination of safe distances, a probabilistic approach (risk analysis) is superior because it identifies important factors, it makes maximum use of available data, it allows comparison of alternatives, and it quantifies intuitive risk considerations. To illustrate the method, a risk model developed for sour gas pipelines in the Province of Alberta, Canada is outlined and an actual risk-distance curve is presented. The current zoning regulations in Alberta are summarized.     

Predicting the effect of disability on employment status and income

Research shows that participation in employment contributes to life satisfaction for persons with disabilities [18]. Title I of the Americans with Disabilities Act (ADA) sought to prohibit discrimination against persons with disabilities in the workplace, however, the ADA's effectiveness remains controversial. This research utilizes data from the disability supplement of the 2000 Behavioral Risk Factor Surveillance System to examine the impact of disability status on predicting employment status and income. Confounding variables such as gender, age, educational level, race and marital/parental status are examined regarding their influence on results. Results from analysis utilizing zero-order correlation, linear and logistic regression analysis techniques revealed that disability status has a significant predictive effect on inability to work. Furthermore, results continue to show that despite legislation, the higher the level of disability, the lower the employment status (those employed for wages) and income. Finally, disability status, coupled with being female or decreased educational level, consistently shows significance in predicting lower employment status and income than men or non-minorities with disabilities. Future research opportunities and policy implications are discussed with regard to the results presented.     

Leading beyond the bottom line: organizational assets for the new economy. 2

Organizations are created to aggregate resources to accomplish some purpose, be it to provide health care, raise a family, or build cars. These resources are assets. A manager has a fiduciary responsibility, by practice, and, in many cases, by law, to make the best use of those assets. Traditionally, we've evaluated the use of assets through financial statements. The troublesome aspect of these financial statements is that they were designed to measure only those things that can be counted simply--financial and physical assets. But our world has moved from an industrial, manufacturing age to an information, service economy and we are learning that intangible assets are as powerful--potentially more powerful--in creating value as are tangible assets. Recognizing the intangible asset value of employees, customers, and the community is the challenge in this new service economy. Effective health care leaders need to leverage and manage all of an organization's assets.     

Mental Health of Transgender People in Hong Kong: A Community-Driven,Large-Scale Quantitative Study Documenting Demographics and Correlates of Quality of Life and Suicidality

A community-driven survey of 106 transgender people (the first such survey in Hong Kong) showed that: (1) more than half the sample (50.9%) had a university degree or higher qualification; (2) despite this, 43.4% had a monthly income below HK$6,000 (about USD$775); (3) 66% reported “fair” or “poor” quality of life; (4) 67% of the sample (87.1% of respondents aged 15–24 years) had contemplated suicide; and (5) 20.8% of the sample (35.5% of respondents aged 15–24 years) had attempted suicide. It was found that (1) those who were single, had a lower monthly income, and identified as transgender women reported lower quality of life; and (2) those who were younger and on a lower income expressed higher suicidality. The findings suggest that service providers and policy makers urgently need to address the mental health needs of transgender people, particular younger transgender people.     

Coordinated Replenishments from a Common Supplier

Coordinated replenishment strategies may be implemented by jointly ordering multiple items from a common supplier. A major benefit of coordinated replenishment is that it increases the size of shipments, permitting the buyer to enjoy transportation economies without a major increase in average inventory levels. The coordinated replenishment problem is complex because side constraints govern the attainment of transportation rate breaks. The problem is further complicated by the presence of purchase quantity discount opportunities. Thus, the buyer must decide which items to order independently, which items to include in a group order, and the order quantities of each item, governed by the frequency of independent or group orders. We present a mathematical model and a heuristic solution procedure that provide analytical support to the buyer seeking to minimize total costs of replenishing multiple items from a common supplier. The relevant costs are purchase prices, ordering costs, holding costs, and transportation costs. Coordinated replenishment provides nearly a 30 percent reduction in controllable costs relative to independent control. Experimentation with the heuristic has yielded optimal solutions over 88 percent of the time. When optimality was not obtained, the mean penalty was much less than one percent. The average heuristic search was more than two orders of magnitude faster than branch and bound, even for small problems, and possessed a much tighter distribution around the mean search time.     

Who should invest in specific training?

We study experimentally whether employers or workers should invest in specific training. Workers have an alternative trading opportunity that takes the form of either an outside option or a threat point. Theory predicts that with outside options, employers have (weakly) better investment incentives than workers do and should therefore be the investing party. With threat points, employers and workers are predicted to invest the same. Our results are, by and large, in line with these predictions. Due to offsetting inefficiencies in the bargaining stage, however, realized inefficiencies are remarkably similar across the different situations considered.

Measures of economic well-being as predictors of psychological well-being

This research indicates that a comprehensive measure of economic well-being based on permanent income, annuitized net worth, and household economic demands, performs better as a predictor of psychological well-being than conventional measures of economic well-being, particularly current reported income. Statistically, the results are significant yet the percentage of psychological well-being variance explained by the measures of economic well-being is very small. The average level of happiness varied only a small amount across quintile categories of each of the measures of economic well-being. That is to say, a substantial number of respondents in the lowest and next lowest quintiles of the measures of economic well-being expressed as high a level of happiness as respondents in the upper two quintiles of economic well-being.This research was funded by a grant from the National Institutes of Health/Mental Health #MH41783-02.