The impact of humanitarian context conditions and individual characteristics on aid worker retention

High employee turnover rates constitute a major challenge to effective aid provision. This study examines how features of humanitarian work and aid workers' individual characteristics affect retention within one humanitarian organisation, Médecins Sans Frontières (MSF) Holland. The study extends existing research by providing new theoretical explanations of employment opportunities and constraints and by engaging in the first large-scale quantitative analysis of aid worker retention. Using a database of field staff (N=1,955), a logistic regression is performed of the likelihood of reenlistment after a first mission. The findings demonstrate that only 40 per cent of employees reenlist for a second mission with MSF Holland, and that workplace location and security situation, age, and gender have no significant effect. Individuals are less likely to reenlist if they returned early from the first mission for a personal reason, are in a relationship, are medical doctors, or if they come from highly developed countries. The paper reflects on the findings in the light of policy.

Trajectories of Childbearing among HIV Infected Indian Women: A Sequence Analysis Approach

Background

HIV infection closely relates to and deeply affects the reproductive career of those infected. However, little is known about the reproductive career trajectories, specifically the interaction of the timing of HIV diagnosis with the timing and sequencing of reproductive events among HIV infected women. This is the first study to describe and typify this interaction.

Methods

Retrospective calendar data of ever married HIV infected women aged 15-45 attending a HIV clinic in Pune, Maharashtra, Western India (N=622) on reproductive events such as marriage, cohabitation with the partner, use of contraception, pregnancy, childbirth and HIV diagnosis were analyzed using sequence analysis and multinomial logistic regression.

Results

Optimal matching revealed three distinct trajectories: 1) HIV diagnosis concurrent with childbearing (40.7%), 2) HIV diagnosis after childbearing (32.1%), and 3) HIV diagnosis after husband’s death (27.2%). Multinomial logistic regression (trajectory 1 = baseline) showed that women who got married before the age of 21 years and who had no or primary level education had a significantly higher risk of knowing their HIV status either after childbearing or close to their husband’s death. The risk of HIV diagnosis after husband’s death was also higher among rural women and those who were diagnosed before 2005.

Conclusions

Three distinct patterns of interaction of timing of HIV diagnosis with timing and sequencing of events in the reproductive career were observed that have clear implications for (i) understanding of the individual life planning process in the context of HIV, (ii) formulation of assumptions for estimating HIV infected women in need of PMTCT services, and (iii) provision of care services.

Characterizing spatial uncertainty when integrating social data in conservation planning

Recent conservation planning studies have presented approaches for integrating spatially referenced social (SRS) data with a view to improving the feasibility of conservation action. We reviewed the growing conservation literature on SRS data, focusing on elicited or stated preferences derived through social survey methods such as choice experiments and public participation geographic information systems. Elicited SRS data includes the spatial distribution of willingness to sell, willingness to pay, willingness to act, and assessments of social and cultural values. We developed a typology for assessing elicited SRS data uncertainty which describes how social survey uncertainty propagates when projected spatially and the importance of accounting for spatial uncertainty such as scale effects and data quality. These uncertainties will propagate when elicited SRS data is integrated with biophysical data for conservation planning and may have important consequences for assessing the feasibility of conservation actions. To explore this issue further, we conducted a systematic review of the elicited SRS data literature. We found that social survey uncertainty was commonly tested for, but that these uncertainties were ignored when projected spatially. Based on these results we developed a framework which will help researchers and practitioners estimate social survey uncertainty and use these quantitative estimates to systematically address uncertainty within an analysis. This is important when using SRS data in conservation applications because decisions need to be made irrespective of data quality and well characterized uncertainty can be incorporated into decision theoretic approaches.

Non-linear associations between stature and mate choice characteristics for American men and their spouses

OBJECTIVES

Although male height is positively associated with many aspects of mate quality, average height men attain higher reproductive success in US populations. We hypothesize that this is because the advantages associated with taller stature accrue mainly from not being short, rather than from being taller than average. Lower fertility by short men may be a consequence of their and their partner's lower scores on aspects of mate quality. Taller men, although they score higher on mate quality compared to average height men, may have lower fertility because they are more likely to be paired with taller women, who are potentially less fertile.

METHODS

We analyzed data from The Integrated Health Interview Series (IHIS) of the United States (N = 165,606). Segmented regression was used to examine patterns across the height continuum.

RESULTS

On all aspects of own and partner quality, shorter men scored lower than both average height and taller men. Height more strongly predicted these aspects when moving from short to average height, than when moving from average to taller heights. Women of a given height who scored lower on mate quality also had shorter partners.

CONCLUSIONS

Shorter men faced a double disadvantage with respect to both their own mate quality and that of their spouses. Scores of taller men were only marginally higher than those of average height men, suggesting that being tall is less important than not being short. Although effect sizes were small, our results may partly explain why shorter and taller men have lower fertility than those of average stature.

Fertility in Advanced Societies: A Review of Research: La fécondité dans les sociétés avancées: un examen des recherches

This paper provides a review of fertility research in advanced societies, societies in which birth control is the default option. The central aim is to provide a comprehensive review that summarizes how contemporary research has explained ongoing and expected fertility changes across time and space (i.e., cross- and within-country heterogeneity). A secondary aim is to provide an analytical synthesis of the core determinants of fertility, grouping them within the analytical level in which they operate. Determinants are positioned at the individual and/or couple level (micro-level), social relationships and social networks (meso-level); and, by cultural and institutional settings (macro-level). The focus is both on the quantum and on the tempo of fertility, with a particular focus on the postponement of childbearing. The review incorporates both theoretical and empirical contributions, with attention placed on empirically tested research and whether results support or falsify existing theoretical expectations. Attention is also devoted to causality and endogeneity issues. The paper concludes with an outline of the current challenges and opportunities for future research.

TU-F-213AB-01: Diagnostic Workforce and Manpower Survey

Since AAPM Report No. 33 on Diagnostic Radiology Physics staffing is more than 20 years old, the Diagnostic Work and Workforce Study Subcommittee (DWWSS) of the Professional Council was formed to conduct a new study and update the data. The intent of the DWWSS study has two goals. First, it wanted to assess the number of FTE diagnostic physicists needed to support the QC, acceptance tests, radiation safety and other clinical functions for various imaging modalities, such as: CT scanners, MRI units, angiography rooms, ultrasound units, nuclear medicine imagers and other equipment. For example, the preliminary results indicate that the median annual physics support for one CT scanner is 0.007 FTE or 12.6 hours per unit. Second, the study wanted to provide an estimate of the cost of these physics services in terms of a fraction of a dollar per patient examination performed. For example, the cost for physics support of CT would be $0.27 for each CT procedure. This information would be similar to the Abt study conducted in Radiation Oncology. Radiation therapy physicists have utilized the Abt studies to generate re-imbursement for physics services and to justify financially the cost of their work efforts. Appropriate recognition for physics efforts in Diagnostic Radiology has never been properly quantified nor appreciated. With all the current and future changes occurring in healthcare, the information from the DWWSS survey could be important to the future of diagnostic physicists. Although diagnostic physicists are involved with many other activities such as teaching of residents and research, information about the clinical equipment support effort could be used to assess diagnostic physics staffing needs. The goals of the DWWSS study and the preliminary findings will be presented.

OBJECTIVE

1. Present the goals of the DWWSS Diagnostic Physicist Survey.2. Present potential benefits to the AAPM members from this survey.3. Present findings from the preliminary analysis of the survey.

TU-G-211-01: New Member Symposium

As a new member of the AAPM, it's easy to feel overwhelmed by the size and complexity of the association and to be unaware of the benefits and opportunities available to members. At this year's AAPM national meeting in Charlotte, we will host a New Member Symposium, where you can learn more about the organization, member resources, opportunities to get involved, and about topics of particular interest to new professionals. We encourage you to take advantage of this great opportunity to learn valuable information and to grow your professional network. Following an introduction from Dr. Gary A. Ezzell, the AAPM President; Michael Woodward of the AAPM staff will provide a crash course on the AAPM structure and organization, as well as some pointers on navigating the website. Next will be Dr. Michael Mills presenting on the current state of the U.S. Medical Physics Workforce, Staffing, Supply & Demand, and Limited Residency slots. Registered attendees will receive a raffle ticket for entry in a drawing to win a complimentary registration for the 2013 Annual Meeting in Indianapolis. In addition, all new members who register for the Symposium will receive a drink ticket good for one complimentary beer served after the New Member Symposium during the social with committee chairs from 4 AAPM Councils: Science, Education, Professional, and Administrative.

Why do people postpone parenthood? Reasons and social policy incentives

BACKGROUND

Never before have parents in most Western societies had their first children as late as in recent decades. What are the central reasons for postponement? What is known about the link between the delay of childbearing and social policy incentives to counter these trends? This review engages in a systematic analysis of existing evidence to extract the maximum amount of knowledge about the reasons for birth postponement and the effectiveness of social policy incentives.

METHODS

The review followed the PRISMA procedure, with literature searches conducted in relevant demographic, social science and medical science databases (SocINDEX, Econlit, PopLine, Medline) and located via other sources. The search focused on subjects related to childbearing behaviour, postponement and family policies. National, international and individual-level data sources were also used to present summary statistics.

RESULTS

There is clear empirical evidence of the postponement of the first child. Central reasons are the rise of effective contraception, increases in women's education and labour market participation, value changes, gender equity, partnership changes, housing conditions, economic uncertainty and the absence of supportive family policies. Evidence shows that some social policies can be effective in countering postponement.

CONCLUSIONS

The postponement of first births has implications on the ability of women to conceive and parents to produce additional offspring. Massive postponement is attributed to the clash between the optimal biological period for women to have children with obtaining additional education and building a career. A growing body of literature shows that female employment and childrearing can be combined when the reduction in work-family conflict is facilitated by policy intervention.

The Impact of Subjective Work Control, Job Strain and Work-Family Conflict on Fertility Intentions: a European Comparison

The link between employment and fertility is often only examined by focussing on women's labour market status or the impact of part- versus full-time employment. This study introduces a new explanation by extending research to examine how women's subjective perceptions of control or autonomy over work, job strain and work-family conflict influence fertility intentions. National-level measures of childcare enrolment under the age of three and the occurrence of part-time work are also included to examine their relation to fertility intentions and their interplay with perceptions of work. Using data from 23 countries from the 2004/5 European Social Survey (ESS), multilevel logistic regression models of fertility intentions are estimated separately for women without children and women with one child. Women with higher levels of work control are significantly more likely to intend to have a second child. Higher levels of job strain (time pressure) significantly lower fertility intentions for mothers in contexts where childcare availability is low. The prevalence of part-time work amongst the female work force significantly predicts the intention to become a mother but has different effects for women who work part-time themselves compared with full-time employees.