Expression and ambivalence over expression of negative emotion:psychometric analysis in the Women's Health Initiative

Inhibition of emotional expression has been associated with the incidence and progression of breast cancer and other chronic illnesses. Others have theorized that it may not be repression itself, but rather ambivalence over the expression of emotions that is the important health-related factor. The Women's Health Initiative (WHI), a long-term, national study focusing on disease prevention among postmenopausal women, is unique in its assessment of expression and ambivalence of negative emotion in a large study sample of multiethnic, older women. Psychological factors such as expression of negative emotion and ambivalence about expression of emotion are also determined by social patterning. The current study examined the psychometric properties of the instruments used to measure each construct and variation across race/ethnicity and age. The analysis suggests that the scales can be used with confidence in diverse ethnic and age groups. Examining ambivalence about expression of negative emotion in future longitudinal research will further elucidate its role in predicting disease incidence and recovery, both important in reducing the public health burden of chronic disease.     

A Peek Inside the Box: How Information Flows Through Substance Abuse Treatment Agencies

This article describes how integrated health information technology affects the collection and flow of client-level intake and assessment data within substance abuse treatment agencies. We combined process mapping and qualitative inquiry methods to analyze staff interviews (N = 54) from eight agencies in four U.S. states. Integrated health information technology was related to expedited and improved flow of information, while nonintegrated health information technology systems were associated with double data entry, multiple eligibility screenings, and different intake processes across levels of care. Process mapping is an effective tool to identify barriers to efficient client-level data management and opportunities to leverage health information technology to streamline the intake process of substance abuse treatment agencies, improve staff productivity, and enhance the accuracy and information flow.     

Significant Others and Gambling Treatment Outcomes

Aims This study investigates the effect of significant others on treatment outcomes among treated pathological gamblers. Design This is a cohort study of individuals who received gambling treatment. Setting Oregon Problem Gambling Services (OPGS) for gamblers and their family members. Participants 4,410 adult gamblers who were discharged from treatment between August, 2001 and April, 2007. Measurements OPGS enrollment forms provided gambler gender, age, ethnicity, education level, employment status, gambling-related debt, and whether the gambler had a significant other at the time of enrollment. Termination forms provided information on the type of discharge (successful/unsuccessful) and treatment length (in days). Participation of the gambler’s significant other in the family treatment program was identified. Findings Results showed that age, ethnicity, gambling debt, and having a significant other are associated with the odds of successful treatment. Education level moderates the effect of having a significant other on treatment success. Age, ethnicity, education, employment, and having a significant other participate in treatment significantly impacted gamblers’ length in treatment. Conclusions These findings indicate that there may be a benefit to integrating significant others in gambling treatment methods. Significant others may act as social supports for gamblers seeking treatment, and involving loved ones in gambling treatment models may positively affect gambler treatment outcomes.     

Expression and ambivalence over expression of negative emotion: cross-sectional associations with psychosocial factors and health-related quality of life in postmenopausal women

Inhibition of emotional expression has been associated with the incidence and progression of breast cancer and other chronic illnesses. The important health-related factor, however, may be ambivalence about the expression of emotions rather than repression itself. This cross-sectional analysis of baseline data from 159,557 participants in the Women's Health Initiative examined the influence of expression of negative emotion and ambivalence about expression of emotion on psychosocial factors and health-related quality of life measured by the Medical Outcomes Study Short-form 36 (SF-36). Overall, observed correlations were modest but in the expected direction; that is, greater ambivalence about negative emotional expression was associated with worse general health and poorer psychosocial risk profile. Ambivalence about expressing negative emotion was more highly correlated with psychosocial factors and health-related quality of life than emotional expression. In general, our analysis supports prior studies suggesting that ambivalence may be more important to consider in studies of health-related outcomes than expression.     

Access to microfinance and intra household business decision making: Implication for efficiency of female owned enterprises in Ghana

Inadequate access to credit contributes to poverty among especially women in developing countries. It is evidenced that in patriarchal societies, males are likely to influence investment decisions when loans are granted to their spouses or female relatives. However the existing literature is inconclusive on whether this influence is positive or negative. This study empirically examines the impact of access to microfinance by women, and male involvement in business decision making on efficiency of small scale enterprises in northern Ghana. We found very low level mean technical efficiency of 40% indicating that output of the enterprises could potentially be more than doubled without employing additional inputs. Moreover access to microfinance increases efficiency by 11%; and enterprises with male spousal influence were less efficient than their counterparts that were independently managed by the women. Furthermore, enterprises owned by women who managed more than one business operated at relatively lower efficiency levels.     

Psychiatric Information Systems: An Analysis of Inpatient and Outpatient Unit Capabilities

This paper describes how a sample of inpatient and out-patient psychiatric treatment units use technology to aid in patient care through scheduling, tracking, billing, and documenting clinical services. We conducted semi-structured interviews (n = 68) at four inpatient and four outpatient psychiatric facilities in Oregon. Results indicate psychiatric facilities are assembling systems for managing information that include a combination of electronic linked clinical records, paper records, and unit-specific, unlinked databases. Barriers remain in (1) improving the sophistication of psychiatric information systems, (2) improving linkages of behavioral health with other medical information systems, and (3) increasing information technology support.     

Enforcement of exogenous environmental regulation, social disapproval and bribery

Many resource users are not directly involved in the formulation and enforcement of resource management rules and regulations in developing countries. As a result, resource users do not generally accept such rules. An enforcement officer who has social ties with the resource users may encounter social disapproval and possible social exclusion from the resource users if he/she enforces the regulation zealously. The officer, however, may avoid this social disapproval by accepting bribes. In this paper, we present a simple model that characterizes this situation and derive results for situations where the officer is passively and actively involved in the bribery.