Search results for: maternal employment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1477

Search results for: maternal employment

1327 The Impact of Entrepreneur to Develop Economy in Indonesia

Authors: Alif Nur Irvan, M. Varaby Wahyu

Abstract:

Indonesia is a country that have a lot of natural resources and as one of the most populous people in the world. In the last few years, the world economic is growing rapid, and then Indonesia must be able to develop his economy like the other country. The number of graduates in Indonesia always increase every year and the employment in Indonesia is getting decreased, this situation leads to rise unemployment in Indonesia. Limited employment makes people look for the ways to live decently. From this situation, entrepreneurs become an alternative in Indonesia to develop the economy. Being an entrepreneur means being able to find opportunities to utilize existing resources to take advantage of these opportunities. With the increasing number of entrepreneurs in Indonesia can increase employment, improve the quality of life, income distribution, utilize and mobilize resources to improve national productivity, and improve the welfare of government. The main sources for economic growth are the investments that improve the quality of capital or human resources, which in turn managed to increase the quantity of productive resources and can raise the productivity of all resources through new discoveries, innovations, creativity and technological progress. This paper is talking about the topic, discussions, and it offers the solutions to support entrepreneurs in Indonesia, and also talk about entrepreneurial problems that occurred in Indonesia, and the right solution to solve the problems of entrepreneurship in Indonesia and also discusses the role of government to support entrepreneurship to encourage the economy in Indonesia.

Keywords: entrepreneurship, economy, employment, government

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1326 The Challenges of Unemployment Situation and Trends in Nigeria

Authors: Simon Oga Egboja

Abstract:

In Africa, particularly in Nigeria, unemployment is a serious issue of concern to every citizen. Hence, this paper focuses on the employment situation and trends in Nigeria. It also investigated the causes why unemployment persists in the country. Prominent among them is the population explosion and rapid expansion of education opportunities all over the country without a corresponding increase in industrial establishment. The paper also discusses the way of reducing the rate of unemployment by encouraging graduates of tertiary institutions in Nigeria to read professional courses and also to indulge in the habit of establishing small-scale enterprises so that after them school they can be self-employed rather than relying solely on government for employment.

Keywords: causes, population, remedy, unemployment

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1325 An Explorative Research on the Cook and Stewards Employment: Turkish Flagged Ship's Perspective

Authors: Mehmet Yahsi, Ozkan Ugurlu

Abstract:

Cabin department among the stewards and cooks on ships, has an important place in terms of a sufficient and qualified nutrition of seafarers. From this perspective, ships must be employed with a sufficient number of cabin department. In this study, in order to research on the Turkish-flagged ships cook and stewards employment; Our national manning regulation compared with international regulations. The data used in this study were collected via visiting of the ships. 3000 gross tonnage and above engaged in international voyages 181 Turkish-flagged ship’s crew lists were compared with Minimum Safety Manning Certificates. According to the findings; employment rates, %95,6 cook, and %50,8 steward. According to the results of the study; Turkish-flagged ships, although it is not obliged to cook and steward, were employed on ships.

Keywords: manning, cabin department, minimum safety manning certificate, Turkish flag

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1324 Determination of Medians of Biochemical Maternal Serum Markers in Healthy Women Giving Birth to Normal Babies

Authors: Noreen Noreen, Aamir Ijaz, Hamza Akhtar

Abstract:

Background: Screening plays a major role to detect chromosomal abnormalities, Down syndrome, neural tube defects and other inborn diseases of the newborn. Serum biomarkers in the second trimester are useful in determining risk of most common chromosomal anomalies; these test include Alpha-fetoprotein (AFP), Human chorionic gonadotropin (hCG), Unconjugated Oestriol (UEȝ)and inhibin-A. Quadruple biomarkers are worth test in diagnosing the congenital pathology during pregnancy, these procedures does not form a part of routine health care of pregnant women in Pakistan, so the median value is lacking for population in Pakistan. Objective: To determine median values of biochemical maternal serum markers in local population during second trimester maternal screening. Study settings: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) Rawalpindi. Methods: Cross-Sectional study for estimation of reference values. Non-probability consecutive sampling, 155 healthy pregnant women, of 30-40 years of age, will be included. As non-parametric statistics will be used, the minimum sample size is 120. Result: Total 155 women were enrolled into this study. The age of all women enrolled ranged from 30 to39 yrs. Among them, 39 per cent of women were less than 34 years. Mean maternal age 33.46±2.35 SD and maternal body weight were 54.98±2.88. Median value of quadruple markers calculated from 15-18th week of gestation that will be used for calculation of MOM for screening of trisomy21 in this gestational age. Median value at 15 week of gestation were observed hCG 36650 mIU/ml, AFP 23.3 IU/ml, UEȝ 3.5 nmol/L, InhibinA 198 ng/L, at 16 week of gestation hCG 29050 mIU/ml, AFP 35.4 IU/ml, UEȝ 4.1 nmol/L, InhibinA 179 ng/L, at 17 week of gestation hCG 28450 mIU/ml, AFP 36.0 IU/ml, UEȝ 6.7 nmol/L, InhibinA 176 ng/L and at 18 week of gestation hCG 25200 mIU/ml, AFP 38.2 IU/ml, UEȝ 8.2 nmol/L, InhibinA 190 ng/L respectively.All the comparisons were significant (p-Value <0.005) with 95% confidence Interval (CI) and level of significance of study set by going through literature and set at 5%. Conclusion: The median values for these four biomarkers in Pakistani pregnant women can be used to calculate MoM.

Keywords: screening, down syndrome, quadruple test, second trimester, serum biomarkers

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1323 International Trade, Manufacturing and Employment: The First Two Decades of South African Democracy

Authors: Phillip F. Blaauw, Anna M. Pretorius

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South Africa re-entered the international economy in the early 1990s, after Apartheid, at a time when globalisation was gathering momentum. Globalisation led to a more open economy, increased export volumes and a changed export mix. Manufacturing goods gained ground relative to mining products. After 21 years of democracy, South African researchers and policymakers need to evaluate the impact of international trade on the level of employment and compensation of employees in the South African manufacturing industry. This is important given the consistent and high levels of unemployment in South Africa. This paper has this evaluation as its aim. Two complimenting approaches are utilised. The 27 sub divisions of the South African manufacturing industry are classified according to capital/labour ratios. Possible trends in employment levels and employee compensation for these categories are then identified when comparing levels in 1995 to those in 2014. The supplementing empirical approach is cross-sectional and panel data regressions for the same period. The aim of the regression analysis is to explain the observed changes in employment and employee compensation levels between 1995 and 2014. The first part of the empirical approach revealed that over the 20-year period the intermediate capital intensive, labour intensive an ultra-labour intensive manufacturing industries all showed massive declines in overall employment. Only three of the 19 industries for these classifications showed marginal overall employment gains. The only meaningful gains were recorded in three of the eight capital intensive manufacturing industries. The overall performance of the South African manufacturing industry is therefore dismal at best. This scenario plays itself out for the skilled section of the intermediate capital intensive, labour intensive an ultra-labour intensive manufacturing industries as well. 18 out of the 19 industries displayed declines even for the skilled section of the labour force. The formal regression analysis supplements the above results. Real production growth is a statistically significant (95 per cent confidence level) explanatory variable of the overall employment level for the period under consideration, albeit with a small positive coefficient. The variables with the most significant negative relationship with changes in overall employment were the dummy variables for intermediate capital intensive and labour intensive manufacturing goods. Disaggregating overall changes in employment further in terms of skill levels revealed that skilled employment in particular responded negatively to increases in the ratio between imported and local inputs for manufacturing. The dummy variable for the labour intensive sectors remained negative and statistically significant, indicating that the labour intensive sectors of South African manufacturing remain vulnerable to the loss of employment opportunities. Whereas the first period (1995 to 2001) after the opening of the South African economy brought positive changes for skilled employment, continued increases in imported inputs displaced some of the skilled labour as well, putting further pressure on the South African economy with already high and persistent unemployment levels. Given the negative for the world commodity cycle and a stagnant local manufacturing sector, the challenge for policymakers is getting even more pronounced after South Africa’s political coming of age.

Keywords: capital/labour ratios, employment, employee compensation, manufacturing

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1322 Spectrum of Acute Kidney Injury in Obstetrics

Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla

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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.

Keywords: AKI, dialysis, hypertension, sepsis, renal parameters

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1321 Phylogenetic Analysis of the Thunnus Tuna Fish Using Cytochrome C Oxidase Subunit I Gene Sequence

Authors: Yijun Lai, Saber Khederzadeh, Lingshaung Han

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Species in Thunnus are organized due to the similarity between them. The closeness between T. maccoyii, T. thynnus, T. Tonggol, T. atlanticus, T. albacares, T. obsesus, T. alalunga, and T. orientails are in different degrees. However, the genetic pattern of differentiation has not been presented based on individuals yet, to the author’s best knowledge. Hence, we aimed to analyze the difference in individuals level of tuna species to identify the factors that contribute to the maternal lineage variety using Cytochrome c oxidase subunit I (COXI) gene sequences. Our analyses provided evidence of sharing lineages in the Thunnus. A phylogenetic analysis revealed that these lineages are basal to the other sequences. We also showed a close connection between the T. tonggol, T. thynnus, and T. albacares populations. Also, the majority of the T. orientalis samples were clustered with the T. alalunga and, then, T. atlanticus populations. Phylogenetic trees and migration modeling revealed high proximity of T. thynnus sequences to a few T. orientalis and suggested possible gene flow with T. tonggol and T. albacares lineages, while all T. obsesus samples indicated unique clustering with each other. Our results support the presence of old maternal lineages in Thunnus, as a legacy of an ancient wave of colonization or migration.

Keywords: Thunnus Tuna, phylogeny, maternal lineage, COXI gene

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1320 Fathers’ Depression and its Relationship with Mothers’ Depression During Postpartum Period

Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.

Keywords: depression, men, postpartum, risk factors, women

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1319 Effect of Islamic Finance on Jobs Generation in Punjab, Pakistan

Authors: B. Ashraf, A. M. Malik

Abstract:

The study was accomplished at the Department of Economics and Agriculture Economics, Pir Mahar Ali Shah ARID Agriculture University, Punjab, Pakistan during 2013-16 with a purpose to discover the effect of Islamic finance/banking on employment in Punjab, Pakistan. Islamic banking system is sub-component of conventional banking system in various countries of the world; however, in Pakistan, it has been established as a separate Islamic banking system. The Islamic banking operates under the doctrine of Shariah. It is claimed that the referred banking is free of interest (Riba) and addresses the philosophy and basic values of Islam in finance that reduces the factors of uncertainty, risk and others speculative activities. Two Islamic bank’s; Meezan Bank Limited (Pakistan) and Al-Baraka Bank Limited (Pakistan) from North Punjab (Bahawalnagar) and central Punjab (Lahore) west Punjab (Gujrat), Pakistan were randomly selected for the conduct of research. A total of 206 samples were collected from the define areas and banks through questionnaire. The data was analyzed by using the Statistical Package for Social Sciences (SPSS) version 21.0. Multiple linear regressions were applied to prove the hypothesis. The results revealed that the assets formation had significant positive; whereas, the technology, length of business (experience) and bossiness size had significant negative impact with employment generation in Islamic finance/banking in Punjab, Pakistan. This concludes that the employment opportunities may be created in the country by extending the finance to business/firms to start new business and increase the Public awareness by the Islamic banks through intensive publicity. However; Islamic financial institutions may be encouraged by Government as it enhances the employment in the country.

Keywords: assets formation, borrowers, employment generation, Islamic banks, Islamic finance

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1318 Exploring Barriers to Quality of Care in South African Midwifery Obstetric Units: The Perspective of Nurses and Midwives

Authors: J. Dutton, L. Knight

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Achieving quality and respectful maternal health care is part of the global agenda to improve reproductive health and achieve universal reproductive rights. Barriers to quality of care in South African maternal health facilities exist at both systemic and individual levels. Addition to this, the normalization of gender violence within South Africa has a large impact on people seeking health care as well as those who provide care within health facilities. The hierarchical environment of South Africa’s public health system penalizes both patients and providers who battle to assume any assessable power. This paper explores how systemic and individual level barriers to quality of care affect the midwifery profession within South African maternal health services and create, at times, an environment of enmity rather than care. This paper analyzes and discusses the data collected from in-depth, semi-structured interviews with nurses and midwives at three maternal health facilities in South Africa. This study has taken a holistic approach to understand the realities of nurses and midwives in order to explore the ways in which experience informs their practice and treatment of pregnant women. Through collecting and analyzing narratives, linkages between nurses and midwives day-to-day and historical experiences and disrespectful care have been made. Findings from this study show that barriers to quality of care take form in complex and interrelated ways. The physical structure of the health facility, human resource shortages, and the current model of maternal health care, which often lacks a person-centered approach, is entangled within personal beliefs and attitudes of what it means to be a midwife to create an environment that is often not conducive to a positive birthing experience. This entanglement sits within a society of high rates of violence, inequality, and poverty. Having teased out the nuances of each of these barriers and the multiple ways they reinforce each other, the findings of this paper demonstrate that birth, and the work of a midwife, are situated in a mode of discipline and punishment within this context. For analytical purposes, this paper has broken down the individual barriers to quality care and discusses the current and historical significance before returning to the interrelated forms in which barriers to quality maternal health care manifest. In conclusion this paper questions the role of agency in the ability to subvert systemic barriers to quality care and ideas around shifting attitudes and beliefs of and about midwives. International and local policies and guidelines have a role to play in realizing such shifts, however, as this paper suggests, when policy does not speak to the local context there is the risk of it contributing to frustrations and impeding the path to quality and respectful maternal health care.

Keywords: disrespect and abuse in childbirth, midwifery, South African maternal health care, quality of care

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1317 Personality Moderates the Relation Between Mother´s Emotional Intelligence and Young Children´s Emotion Situation Knowledge

Authors: Natalia Alonso-Alberca, Ana I. Vergara

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From the very first years of their life, children are confronted with situations in which they need to deal with emotions. The family provides the first emotional experiences, and it is in the family context that children usually take their first steps towards acquiring emotion knowledge. Parents play a key role in this important task, helping their children develop emotional skills that they will need in challenging situations throughout their lives. Specifically, mothers are models imitated by their children. They create specific spatial and temporal contexts in which children learn about emotions, their causes, consequences, and complexity. This occurs not only through what mothers say or do directly to the child. Rather, it occurs, to a large extent, through the example that they set using their own emotional skills. The aim of the current study was to analyze how maternal abilities to perceive and to manage emotions influence children’s emotion knowledge, specifically, their emotion situation knowledge, taking into account the role played by the mother’s personality, the time spent together, and controlling the effect of age, sex and the child’s verbal abilities. Participants were 153 children from 4 schools in Spain, and their mothers. Children (41.8% girls)age range was 35 - 72 months. Mothers (N = 140) age (M = 38.7; R = 27-49). Twelve mothers had more than one child participating in the study. Main variables were the child´s emotion situation knowledge (ESK), measured by the Emotion Matching Task (EMT), and receptive language, using the Picture Vocabulary Test. Also, their mothers´ Emotional Intelligence (EI), through the Mayer, Salovey, Caruso Emotional Intelligence Test (MSCEIT) and personality, with The Big Five Inventory were analyzed. The results showed that the predictive power of maternal emotional skills on ESK was moderated by the mother’s personality, affecting both the direction and size of the relationships detected: low neuroticism and low openness to experience lead to a positive influence of maternal EI on children’s ESK, while high levels in these personality dimensions resulted in a negative influence on child´s ESK. The time that the mother and the child spend together was revealed as a positive predictor of this EK, while it did not moderate the influence of the mother's EI on child’s ESK. In light of the results, we can infer that maternal EI is linked to children’s emotional skills, though high level of maternal EI does not necessarily predict a greater degree of emotionknowledge in children, which seems rather to depend on specific personality profiles. The results of the current study indicate that a good level of maternal EI does not guarantee that children will learn the emotional skills that foster prosocial adaptation. Rather, EI must be accompanied by certain psychological characteristics (personality traits in this case).

Keywords: emotional intelligence, emotion situation knowledge, mothers, personality, young children

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1316 Perception of Health Care Providers: A Need to Introduce Screening of Maternal Mental Health at Primary Health Care in Nepal

Authors: Manisha Singh, Padam Simkhada

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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

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1315 Employment of Persons with Disabilities in Georgia: Challenges and Perspectives

Authors: Tamar Makharadze, Anastasia Kitiashvili, Irine Zhvania, Tamar Abashidze

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After ratification of UN Convention on the Rights of Persons with Disabilities (UN CRPD) by the Parliament of Georgia in 2013, ensuring equal access to education and employment for people with disabilities has become one of the priorities of the government. The current research has analyzed the attitudes of people with disabilities, employers and society towards various challenges that employment of persons with disabilities faces in Georgia. The study has been carried out in the capital city and three towns in West and East Georgia. Both quantitative and qualitative research methods have been used. Employers’ attitudes have been studied by analyzing research data from six focus groups and 12 in-depth interviews. Views of persons with disabilities have been analyzed relied on data from eight focus groups and 14 in-depth interviews. The quantitative study covered 490 surveyed respondents from four cities in Georgia. The research was carried out with the employees of companies selected based on the Simple Random Sample; in each company, based on the size of the company 7–10 employees were surveyed. A survey was conducted using a specially developed structured questionnaire. Data analysis was carried out using SPSS (21.0). The research was carried out during June-August 2015. The research data shows that both qualitative and quantitative research participants view employment of persons with disabilities positively; however persons with severe intellectual disabilities and mental problems are viewed as less workable and desired at workplaces. The respondents support the idea of employment of persons with disabilities at an open labour market; at the same time idea of a development of sheltered workshops is also supported. The vast majority of research participants believe that employers should be rather encouraged to hire persons with disabilities than force them to do so. For employers it is important to have the state assistance in adjusting working place to the needs of employee with disabilities. Some tax benefits for employers having employees with disabilities also are seen as encouraging employment of persons with disabilities. Both employers and persons with disabilities believe that development of job coaching will help persons with disabilities to find and maintain a job at the open market. Majority of survey respondents think that the main reasons discouraging employment of persons with disabilities in Georgia are: poor socioeconomic background and high level of unemployment in the country, absence of related state programs and existed stigma towards persons with disabilities within the society. To conclude it can be said that both employers and persons with disabilities expect initiative from the government – development of the programs and services focusing on employment of persons with disabilities that will be rather encouraging and supporting than punishing and forcing. Relied on survey data it can be said that people have positive attitudes to see persons with disabilities at workplaces, educational institutions and public places. This creates a good background for extensive and consistent work towards social inclusion of persons with disabilities in Georgia.

Keywords: supported employment, job coaching, employment of persons with disabilities in Georgia, social inclusion

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1314 An Explorative Research on the Electric and Electronic Officers Employment: Turkish Flagged Ship's Perspective

Authors: Mehmet Yahsi, Ozkan Ugurlu, Ercan Yuksekyildiz

Abstract:

Assistant department among the electric and electronic officers on ships, has an important place for the maintenance of electric and electronic devices. From this perspective, ships must be employed with a sufficient number of assistant department. In this study, in order to research on the Turkish-flagged ships electric and electronic officers employment; Our national manning regulation compared with international regulations. The data used in this study were collected via visiting of the ships. 3000 gross tonnage and above engaged in international voyages 181 Turkish-flagged ship’s crew lists were compared with Minimum Safety Manning Certificates. According to the findings; employment rate, %54 electric and electronic officers. According to the results of the study; Turkish-flagged ships, although it is not obliged to electric and electronic officers, were employed on ships.

Keywords: manning, electric officer, electronic officer, minimum safety manning certificate

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1313 Towards Inclusive Learning Society: Learning for Work in the Swedish Context

Authors: Irina Rönnqvist

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The world is constantly changing; therefore previous views or cultural patterns and programs formed by the “old world” cannot be suitable for solving actual problems. Indeed, reformation of an education system is unlikely to be effective without understanding of the processes that emerge in the field of employment. There is a problem in overcoming of the negative trends that determine imbalance of needs of the qualified work force and preparation of professionals by an education system. At the contemporary stage of economics the processes occurring in the field of labor and employment reproduce the picture of economic development of the country that cannot be imagined without the factor of labor mobility (e.g. migration). On the one hand, adult education has a significant impact on multifaceted development of economy. On the other hand, Sweden has one of the world's most generous asylum reception systems and the most liberal labor migration policy among the OECD countries. This effect affects the increased productivity. The focus of this essay is on problems of education and employment concerning social inclusion of migrants in working life in Sweden.

Keywords: migration, adaptation, formal learning, informal learning, Sweden

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1312 To Corelate Thyroid Dysfunction in Pregnancy with Preterm Labor

Authors: Pushp Lata Sankhwar

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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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1311 Maternal Health Care Utilization and Its Effect on Pregnancy Outcome in Nepal

Authors: Adrita Banerjee, Ajeet Kumar Singh

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Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy and delivery. The quality of antenatal care can be monitored through the content of services received and the kind of information mothers are given during their visit. Objective: The paper tries to examine the association between ANC check-ups and size/ birth weight. It also focuses on investigating the relationship between utilization of recommended prenatal care for mothers and its effect on infant survival in Nepal. Data and methods: This paper uses data from Nepal demographic Health Survey 2011. To understand the relationship bi-variate statistical analysis and logistic regressions has been done. Maternal health care utilization include ANC check-ups i.e. the type of ante-natal care providers, the number and timing of the visit. The various components of the check-ups include intake of iron tablets/syrups, intestinal parasitic drugs, etc. Results: The results show that women who had no antenatal care visits about 40% had small sized babies at the time of birth compared to women to had at least 3 ANC check up. Women who had at least 3 check-ups 17% of the babies have a small size. It has also been found that about 50 % of the women prefer ANC check-ups during pregnancies which have resulted in lowering the infant mortality by about 40% during 1996-2011. Conclusion: Ante natal care check is care and monitoring of the pregnant woman and her foetus throughout pregnancy. ANC checks have an effect on the infant health and child survival. A woman who had at least three check-ups the possibilities of adverse effect on infant health and infant survival was significantly lower. The findings argue for a more enhanced focus on ANC check-ups for improving the maternal and child health in Nepal.

Keywords: maternal, health, pregnancy, outcome

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1310 Gender Stereotypes in Reproductive Medicine with Regard to Parental Age

Authors: Monika Michałowska, Anna Alichniewicz

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Detrimental outcomes of advanced maternal age on the chances of fertilization, pregnancy as well as mother and fetus health have been recognized for several decades. It seemed interesting to investigate whether there is a comparable awareness of the detrimental influence on the reproductive outcomes of late fatherhood, given that it has been already ten years since an intense and growing interest concerning later-age fatherhood commenced in medical research. To address that issue a two-step research was done. First, we performed a review of the subject literature to answer the following questions: 1) What age is defined as advanced?; 2) Is the same age defined as advanced in both genders?; 3) What terminology concerning age issues is used?; 4) Is the same age terminology used regarding both genders? The second part of our studies was devoted to the views of medical students. This part of our research comprised both quantitative and qualitative studies. Opinions of medical students in one of the Polish medical universities on several issues connected with assisted reproduction technology (ART) were gathered: 1) students’ attitude to in vitro fertilization (IVF) for women over 40 and for postmenopausal women; 2) students’ attitude to late fatherhood; 3) students’ reasoning given against acceptability of IVF procedure for all of these group of patients involved in an IVF procedure. Our analyses revealed that: First, there is no universal definition of the term ‘advanced age’; secondly, there is a general tendency to adopt different age limits depending on whether they refer to maternal or paternal age, but no justification is provided by the researchers explaining why they set different age limits for women and men; thirdly, the image of postponed fatherhood stands in stark contrast to postponed motherhood - while postponed fatherhood is frequently portrayed as a reasonable and conscious decision enabling a stable family environment for a child, the reasonableness of postponed motherhood is often questioned; finally, the bias regarding maternal versus paternal age is deeply embedded in medical students’ attitude to IVF for women over 40 and for postmenopausal women.

Keywords: gender stereotypes, reproductive medicine, maternal age, paternal age

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1309 Assessing the Quality of Maternity Care in Sub-Saharan Africa Using the Donabedian Quality of Care Framework: A Systematic Scoping Review

Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

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1308 Youth NEET in Albania: Current Situation and Outreach Mechanisms

Authors: Emiljan Karma

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One of the major problems of the present is young people who are not concerned with employment, education, or training (NEETs). Unfortunately, this group of people in Albania is a considerable part of working-age people, and despite the measures taken, they remain a major problem. NEETs in Albania are very heterogeneous. This is since youth unemployment and inactivity rate are at a very high level (Albania has the highest NEET rate among EU candidates/potential candidates’ countries and EU countries); the high level of NEET rate in Albania means that government agencies responsible for labour market regulation and other social actors interested in the phenomenon (representatives of employees, representatives of employers, non-governmental organizations, etc.) did not effectively materialize the policies in the field of youth employment promotion. The National Agency for Employment and Skills (NAES) delivers measures specifically designed to target unemployed youth, being the key stakeholder in the implementation of employment policies and skills development in Albania. In the context of identifying and assisting NEETs, this role becomes even stronger. The experience of different EU countries (e.g., Youth Guarantee) indicates that there are different policy-making structures and various outreach mechanisms for constraining the youth NEET phenomenon. The purpose of this research is to highlight: (1) The identification of NEETs feature in Albania; (2) The identification of tailored and efficient outreach mechanisms to assist vulnerable NEETs; (3) The fundamental importance of stakeholders’ partnership at central and regional level.

Keywords: labor market, NEETs, non-registered NEETs, unemployment

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1307 A Clinical Study of Placenta Previa and Its Effect on Fetomaternal Outcome in Scarred and Unscarred Uterus at a Tertiary Care Hospital

Authors: Sharadha G., Suresh Kanakkanavar

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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

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1306 Thinking Differently about Diversity: A Literature Review

Authors: Natalie Rinfret, Francine Tougas, Ann Beaton

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Conventions No. 100 and 111 of the International Labor Organization, passed in 1951 and 1958 respectively, established the principles of equal pay for men and women for work of equal value and freedom from discrimination in employment. Governments of different countries followed suit. For example, in 1964, the Civil Rights Act was passed in the United States and in 1972, Canada ratified Convention 100. Thus, laws were enacted and programs were implemented to combat discrimination in the workplace and, over time, more than 90% of the member countries of the International Labour Organization have ratified these conventions by implementing programs such as employment equity in Canada aimed at groups recognized as being discriminated against in the labor market, including women. Although legislation has been in place for several decades, employment discrimination has not gone away. In this study, we pay particular attention to the hidden side of the effects of employment discrimination. This is the emergence of subtle forms of discrimination that often fly under the radar but nevertheless, have adverse effects on the attitudes and behaviors of members of targeted groups. Researchers have identified two forms of racial and gender bias. On the one hand, there are traditional prejudices referring to beliefs about the inferiority and innate differences of women and racial minorities compared to White men. They have the effect of confining these two groups to job categories suited to their perceived limited abilities and can result in degrading, if not violent and hateful, language and actions. On the other hand, more subtle prejudices are more suited to current social norms. However, this subtlety harbors a conflict between values of equality and remnants of negative beliefs and feelings toward women and racial minorities. Our literature review also takes into account an overlooked part of the groups targeted by the programs in place, senior workers, and highlights the quantifiable and observable effects of prejudice and discriminatory behaviors in employment. The study proposes a hybrid model of interventions, taking into account the organizational system (employment equity practices), discriminatory attitudes and behaviors, and the type of leadership to be advocated. This hybrid model includes, in the first instance, the implementation of initiatives aimed at both promoting employment equity and combating discrimination and, in the second instance, the establishment of practices that foster inclusion, the full and complete participation of all, including seniors, in the mission of their organization.

Keywords: employment discrimination, gender bias, the hybrid model of interventions, senior workers

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1305 Review of Influential Factors on the Personnel Interview for Employment from Point of View of Human Resources Management

Authors: Abbas Ghahremani

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One of the most fundamental management issues in organizations and companies is the recruiting of efficient staff and compiling exact and perfect criteria for testing the applicants,which is guided and practiced by the manager of human resources of the organization. Obviously, each part of the organization seeks special features and abilities in the people apart from common features among all the staff in all units,which are called principal duties and abilities,and we will study them more. This article is trying to find out how we can identify the most efficient people among the applicants of employment by using proper methods of testing appropriate for the needs of different of employment by using proper methods of testing appropriate for the needs of different units of the organization and recruit efficient staff. Acceptable method for recruiting is to closely identify their characters from various aspects such as ability to communicate, flexibility, stress management, risk acceptance, tolerance, vision to future, familiarity with the art, amount of creativity and different thinking and by raising proper questions related with the above named features and presenting a questionnaire, evaluate them from various aspect in order to gain the proper result. According to the above explanations, it can be concluded which aspects of abilities and characteristics of a person must be evaluated in order to reduce any mistake in recruitment and approach an ideal result and ultimately gain an organized system according to the standards and avoid waste of energy for unprofessional personnel which is a marginal issue in the organizations.

Keywords: human resources management, staff recuiting, employment factors, efficient staff

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1304 Maternal and Child Health Care: A Study among the Rongmeis of Manipur, India

Authors: Lorho Mary Maheo, Arundhati Maibam Devi

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Background: Maternal and child health (MCH) cares are the health services provided to mothers and children. It includes the health promotion, preventive, curative and rehabilitation health care for mothers and children. Materials and method: The present study sample comprises of 208 women within the age range 15-69 years from two remote villages of Tamenglong District in Manipur. They were randomly chosen for assessing their health as well as the child’s health adopting an interview schedule method. Results: The findings of the study revealed that majority (80%) of the women have their first conception in their first year of married life. A decadal change has been observed with regard to the last pregnancy i.e., antenatal check-up, place of delivery as well as the service provider. However, irrespective of age of the women, home delivery is still preferred though very few are locally trained. Pre- and post-delivery resting period vary depending on the busy schedule of the agricultural works as the population under study is basically agriculturist. Postnatal care remains to be traditional as they are strongly associated with cultural beliefs and practices that continue to prevail in the studied community. Breast feeding practices such as colostrums given, initiation of breastfeeding, weaning was all taken into account.  Immunization of children has not reached the expected target owing to a variety of reasons. Maternal health care also includes use of birth control measures. The health status of women would invariably improve if family planning is meaningfully adopted. Only 10.1% of the women adopted the modern birth control implying its deep-rooted value attached to the children. Based on the self-assessment report on their health treatment a good number of the respondents resorted to self-medication even to the extent of buying allopathic medicine without a doctor’s prescription. One important finding from the study is the importance attributed to the traditional health care system which is easily affordable and accessible to the villagers. Conclusion: The overall condition of maternal and child care is way behind till now as no adequate/proper health services are available.

Keywords: antenatal, breastfeeding, child health, maternal, Tamenglong District

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1303 Tale of Massive Distressed Migration from Rural to Urban Areas: A Study of Mumbai City

Authors: Vidya Yadav

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Migration is the demographic process that links rural to urban areas, generating or spurring the growth of cities. Evidence shows the role of the city as a production processes. It looks the city as a power of centre, and a centre of change. It has been observed that not only the professionals want to settle down in an urban area but rural labourers are also coming to cities for employment. These are the people who are compelled to migrate to metropolises because of lack of employment opportunities in their place of residence. However, the cities also fail to provide adequate employment because of limited job opportunity creation and capital-intensive industrialization. So these masses of incoming migrants are force to take up whatever employment absorption is available to them particularly in urban informal activities. Ultimately with this informal job they are compelled to stay in the slum areas, which is another form of deprived housing colonies. The paper seeks to examine the evidences of poverty induced migration from rural to urban areas (particularly in urban agglomeration). The present paper utilizes an abundant rich source of census migration data (D-Series) of 1991-2001. Result shows that Mumbai remain as the most attractive place to migrate. The migrants are mainly from the major states like Uttar Pradesh, Bihar, West Bengal, Jharkhand, Odisha, and Rajasthan. Male dominated migration is related mostly for employment and females due to marriages. The picture of occupational absorption of migrants who moved for employment, cross classified with educational status. Result shows that illiterate males are primarily engaged in low grade production processing work. Illiterate’s females engaged in service sectors; but these are actually very low grade services in urban informal sectors in India like maid servants, domestic help, hawkers, vendors or vegetables sellers. Among the higher educational level, a small percentage of males and females got absorbed in professional or clerical work but the percentage has been increased in the period 1991-2001.

Keywords: informal, job, migration, urban

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1302 Maternal and Neonatal Outcome Analysis in Preterm Abdominal Delivery Underwent Umbilical Cord Milking Compared to Early Cord Clamping

Authors: Herlangga Pramaditya, Agus Sulistyono, Risa Etika, Budiono Budiono, Alvin Saputra

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Preterm birth and anemia of prematurity are the most common cause of morbidity and mortality in neonates, and anemia of the preterm neonates has become a major issue. The timing of umbilical cord clamping after a baby is born determines the amount of blood transferred from the placenta to fetus, Delayed Cord Clamping (DCC) has proven to prevent anemia in the neonates but it is constrained concern regarding the delayed in neonatal resuscitation. Umbilical Cord Milking (UCM) could be an alternative method for clamping the umbilical cord due to the active blood transfer from the placenta to the fetus. The aim of this study was to analyze the difference between maternal and neonatal outcome in preterm abdominal delivery who underwent UCM compared to ECC. This was an experimental study with randomized post-test only control design. Analyzed maternal and neonatal outcomes, significant P values (P <0.05). Statistical comparison was carried out using Paired Samples t-test (α two tailed 0,05). The result was the mean of preoperative mother’s hemoglobin in UCM group compared to ECC (10,9 + 0,9 g/dL vs 10,4 + 0,9 g/dL) and postoperative (11,1 + 1,1 g/dL vs 10,5 + 0,7 g/dL), the delta was (0,2 + 0,7 vs 0,1 + 0,6.). It showed no significant difference (P=0,395 vs 0,627). The mean of 3rd phase labor duration in UCM group vs ECC was (20,5 + 3,5 second vs 21,1 + 3,3 second), showed insignificant difference (P=0,634). The amount of bleeding after delivery in UCM group compared to ECC has the median of 190 cc (100-280cc) vs 210 cc (150-330 cc) showed insignificant difference (P=0,083) so the incidence of post-partum bleeding was not found. The mean of the neonates hemoglobin, hematocrit and erythrocytes of UCM group compared to ECC was (19,3 + 0,7 vs 15,9 + 0,8 g/dl), (57,1 + 3,6 % vs 47,2 + 2,8 %), and (5,4 + 0,4 g/dl vs 4,5 + 0,3 g/dl) showed significant difference (P<0,0001). There was no baby in UCM group received blood transfusion and one baby in the control ECC group received blood transfusion was found. Umbilical Cord Milking has shown to increase the baby’s blood component such as hemoglobin, hematocrit, and erythrocytes 6 hours after birth as well as lowering the incidence of blood transfusions. Maternal and neonatal morbidity were not found. Umbilical Cord Milking was the act of clamping the umbilical cord that was more beneficial to the baby and no adverse or negative effects on the mother.

Keywords: umbilical cord milking, early cord clamping, maternal and neonatal outcome, preterm, abdominal delivery

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1301 The Most Effective Interventions to Prevent Childhood Obesity

Authors: Sarah-Anne Schumann, Chintan Shah, Sandeep Ponniah, Syeachia Dennis

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Effective interventions to prevent childhood obesity include limiting sugar-sweetened beverage intake (SOR: B, longitudinal study), school and home based strategies to reduce total screen time and increase physical activity, behavioral and dietary counseling, and support for parents and families (SOR: A, meta-analysis of randomized and non-randomized controlled trials). Risk factors for childhood obesity include maternal pre-pregnancy weight, high infant birth weight, early infant rapid weight gain and maternal smoking during pregnancy which may provide opportunities to intervene and prevent childhood obesity (SOR: B, meta-analysis of observational studies).

Keywords: childhood, obesity, prevent obesity, interventions to prevent obesity

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1300 Employment Mobility and the Effects of Wage Level and Tenure

Authors: Idit Kalisher, Israel Luski

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One result of the growing dynamicity of labor markets in recent decades is a wider scope of employment mobility – i.e., transitions between employers, either within or between careers. Employment mobility decisions are primarily affected by the current employment status of the worker, which is reflected in wage and tenure. Using 34,328 observations from the National Longitudinal Survey of Youth 1979 (NLS79), which were derived from the USA population between 1990 and 2012, this paper aims to investigate the effects of wage and tenure over employment mobility choices, and additionally to examine the effects of other personal characteristics, individual labor market characteristics and macroeconomic factors. The estimation strategy was designed to address two challenges that arise from the combination of the model and the data: (a) endogeneity of the wage and the tenure in the choice equation; and (b) unobserved heterogeneity, as the data of this research is longitudinal. To address (a), estimation was performed using two-stage limited dependent variable procedure (2SLDV); and to address (b), the second stage was estimated using femlogit – an implementation of the multinomial logit model with fixed effects. Among workers who have experienced at least one turnover, the wage was found to have a main effect on career turnover likelihood of all workers, whereas the wage effect on job turnover likelihood was found to be dependent on individual characteristics. The wage was found to negatively affect the turnover likelihood and the effect was found to vary across wage level: high-wage workers were more affected compared to low-wage workers. Tenure was found to have a main positive effect on both turnover types’ likelihoods, though the effect was moderated by the wage. The findings also reveal that as their wage increases, women are more likely to turnover than men, and academically educated workers are more likely to turnover within careers. Minorities were found to be as likely as Caucasians to turnover post wage-increase, but less likely to turnover with each additional tenure year. The wage and the tenure effects were found to vary also between careers. The difference in attitude towards money, labor market opportunities and risk aversion could explain these findings. Additionally, the likelihood of a turnover was found to be affected by previous unemployment spells, age, and other labor market and personal characteristics. The results of this research could assist policymakers as well as business owners and employers. The former may be able to encourage women and older workers’ employment by considering the effects of gender and age on the probability of a turnover, and the latter may be able to assess their employees’ likelihood of a turnover by considering the effects of their personal characteristics.

Keywords: employment mobility, endogeneity, femlogit, turnover

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1299 The Effect of Vertical Integration on Operational Performance: Evaluating Physician Employment in Hospitals

Authors: Gary Young, David Zepeda, Gilbert Nyaga

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This study investigated whether vertical integration of hospitals and physicians is associated with better care for patients with cardiac conditions. A dramatic change in the U.S. hospital industry is the integration of hospital and physicians through hospital acquisition of physician practices. Yet, there is little evidence regarding whether this form of vertical integration leads to better operational performance of hospitals. The study was conducted as an observational investigation based on a pooled, cross-sectional database. The study sample comprised over hospitals in the State of California. The time frame for the study was 2010 to 2012. The key performance measure was hospitals’ degree of compliance with performance criteria set out by the federal government for managing patients with cardiac conditions. These criteria relate to the types of clinical tests and medications that hospitals should follow for cardiac patients but hospital compliance requires the cooperation of a hospital’s physicians. Data for this measure was obtained from a federal website that presents performance scores for U.S. hospitals. The key independent variable was the percentage of cardiologists that a hospital employs (versus cardiologists who are affiliated but not employed by the hospital). Data for this measure was obtained from the State of California which requires hospitals to report financial and operation data each year including numbers of employed physicians. Other characteristics of hospitals (e.g., information technology for cardiac care, volume of cardiac patients) were also evaluated as possible complements or substitutes for physician employment by hospitals. Additional sources of data included the American Hospital Association and the U.S. Census. Empirical models were estimated with generalized estimating equations (GEE). Findings suggest that physician employment is positively associated with better hospital performance for cardiac care. However, findings also suggest that information technology is a substitute for physician employment.

Keywords: physician employment, hospitals, verical integration, cardiac care

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1298 Bayesian Semiparametric Geoadditive Modelling of Underweight Malnutrition of Children under 5 Years in Ethiopia

Authors: Endeshaw Assefa Derso, Maria Gabriella Campolo, Angela Alibrandi

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Objectives:Early childhood malnutrition can have long-term and irreversible effects on a child's health and development. This study uses the Bayesian method with spatial variation to investigate the flexible trends of metrical covariates and to identify communities at high risk of injury. Methods: Cross-sectional data on underweight are collected from the 2016 Ethiopian Demographic and Health Survey (EDHS). The Bayesian geo-additive model is performed. Appropriate prior distributions were provided for scall parameters in the models, and the inference is entirely Bayesian, using Monte Carlo Markov chain (MCMC) stimulation. Results: The results show that metrical covariates like child age, maternal body mass index (BMI), and maternal age affect a child's underweight non-linearly. Lower and higher maternal BMI seem to have a significant impact on the child’s high underweight. There was also a significant spatial heterogeneity, and based on IDW interpolation of predictive values, the western, central, and eastern parts of the country are hotspot areas. Conclusion: Socio-demographic and community- based programs development should be considered compressively in Ethiopian policy to combat childhood underweight malnutrition.

Keywords: bayesX, Ethiopia, malnutrition, MCMC, semi-parametric bayesian analysis, spatial distribution, P- splines

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