Yes / Objectives: General practitioners (GPs) are crucial to improving timely diagnosis, but little is reported about how they perceive dementia, and whether their perceptions display any elements of stigma. The aim of this study was to explore how GPs’ perceptions of dementia map onto current conceptualizations of stigma and whether GPs feel that stigma affects timely diagnosis. Methods: Twenty-three GPs from England were interviewed by telephone. Data were analyzed by means of content analysis. This involved open coding followed by the application of a coding framework derived from the literature to explore how and to what extent their perceptions relate to stigma as well as the unique nature of their perceptions. Results: Three themes emerged from the analysis: (1) ‘making sense of dementia’, (2) ‘relating perceptions of dementia to oneself’ and (3) ‘considering the consequences of dementia’. GPs’ perceptions of dementia mapped onto current conceptualizations of stigma. Perceptions about dementia that were linked to their own existential anxiety and to a perceived similarity between people with dementia and themselves were particularly salient. GPs perceived dementia as a stigma which was gradually being overcome but that stigma still hindered timely diagnosis. They provided examples of structural discrimination within the health service, including lack of time for patients and shortcomings in training that were to the detriment of people with dementia. Conclusion: Measures to involve GPs in tackling stigma should include training and opportunities to explore how they perceive dementia, as well as support to address structural discrimination. / The study was funded by Alzheimer Europe (Luxembourg) in the form of tuition fees for Dianne Gove for her PhD study.

It is well established that adverse childhood experiences (ACEs) are linked to health and emotional outcomes. But less is known about the relationship between ACEs and educational attainment—a potentially important feature of educational stratification in America. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative youth study of 7-12th grade students in the 1994-95 school year, I investigate whether ACEs is linked to post-secondary attainment and examine the role of health and socio-emotional factors as mediators. Results confirm that there is a graded relationship between ACEs and timely bachelor's degree attainment. I find that an additional ACE decreases the odds of timely bachelor's degree attainment by about 17%, even after accounting for other related factors.

archives@tulane.edu / 1 / Ruizhong Zhang

Earnings have numerous properties that can be investigated, including earnings smoothness, abnormal accruals after modelling the accruals process and asymmetric timely loss and gain recognition. In latest decades, as earnings are the main source of firm-specific information for investors, earnings quality has become a significant focus in the financial accounting field. Moreover, high-quality financial reporting helps investors improve decisions and better evaluate firm performance because capital markets depend on the credibility of financial accounting information. The aim of this study investigates the impact of the mandatory adoption of IFRS on earnings quality in term of earnings management and accounting conservatism in consideration of eleven European countries (Germany, France, Italy, The Netherlands, Spain, Sweden, Switzerland, Portugal, Belgium, Norway and the United Kingdom) as a sample study. Then to test whether investors could predict a company's future performance efficiently based on deferred tax expense as one of the accruals components before and after the mandatory adoption of IFRS. Since the mandatory adoption of International Financial Reporting Standards (IFRS) required by the European Union (EU) Parliament, numerous research studies have examined whether earnings management has been reduced due to the mandatory adoption. Chapter two of this study examines whether the board of directors is more effective in constraining earnings management after the mandatory application of IFRS. More specifically, the study explored ways that two board characteristics, board independence and the existence of an audit committee, have impacted earnings management since 2005. The empirical results with eleven European countries (Germany, France, Italy, The Netherlands, Spain, Sweden, Switzerland, Portugal, Belgium, Norway and the United Kingdom) showed evidence of an inverse relationship between the strength of corporate governance and the extent of earnings management. This negative association suggests that firms that apply IFRS with a high level of corporate governance standards are less likely to be involved in earnings management. This study indicates that board independence and the existence of audit committees play important and effective roles in reducing earnings management after the introduction of IFRS. The results also provide evidence that the internationally uniformed accounting regulatory framework significantly contributes to the effectiveness of the two corporate governance mechanisms. Chapter three examines the impact of the mandatory IFRS adoption on the asymmetrically timely gain and loss recognition (accounting conservatism). The findings provide evidence of the importance of the mandatory adoption of IFRS in increasing of accounting conservatism in pooled samples and separate samples. Chapter four investigates whether investors could predict a company's future performance efficiently based on deferred tax expense as one of the accruals components before and after the mandatory adoption of IFRS. Moreover, whether or not the predictions could be generalised to other European countries was examined. The results imply that an accrual anomaly exists in pooled samples before and after mandatory IFRS adoption and the study prove that deferred tax expense as a determinant factor of accounting accruals is overweighed by stocks prices before and after IFRS adoptions.

Psychological biases in the form of sentiment can affect various economic decisions including accounting choices. Broadly defined, the term sentiment refers to unjustified beliefs about the future cash flow prospects of the firm (Baker and Wurgler 2006). Asymmetric timely loss recognition (ATLR) is particularly prone to managerial sentiment because the decision to recognize economic gains and losses is based, in part, on managers’ beliefs about the likelihood of future economic events affecting the firms. In this study, I examine the effect of psychological biases about future performance on current accounting choices via the effect of market-level managerial sentiment on ATLR. I find that ATLR decreases with managerial sentiment and that periods of high managerial sentiment are associated with lower concurrent write-offs but higher subsequent write-offs. This study enhances the implications of sentiment on firms’ accounting choices by identifying a time-varying macroeconomic determinant of ATLR that is based on psychological biases about future performance.

This paper uses the collapse of the junk bond market in the early 1990s as a natural experiment to examine the effect of asymmetric timely loss recognition (ATLR) on speculative-grade (SPG) firms' access to private debt markets and underinvestment. For a sample of 450 firm-years over the period 1988-1991, I find that SPG firms that recognize economic losses in a timelier fashion experience a smaller reduction in debt financing and investment from the pre- to post-collapse period relative to SPG firms that recognize economic losses in a less timely fashion. I also document that the effect of ATLR on debt financing and investment is more pronounced for SPG firms that lack collateral and are not followed by sell-side equity analysts. These findings support the notion that ATLR improves a firm's ability to access private debt markets, thereby attenuating underinvestment. They also suggest that both collateral and sell-side equity analysts serve as substitutes for ATLR to facilitate SPG firms' access to private debt markets. Further analyses reveal that ATLR increases for SPG firms from the pre- to post-collapse period and this increase is more pronounced for SPG firms with net issuance of debt. This evidence suggests that firms adjust ATLR to obtain debt financing in response to private lenders' demand for it.

IFRS allows firms to choose between fair-value accounting and historical cost accounting with impairment testing for property, plant and equipment (PPE). This study examines the effect of firms' accounting choices for this group of non-financial assets on over-investment after IFRS mandatory adoption in the European Union (EU). My results indicate that over-investment in PPE (or capital expenditures) is lower following IFRS adoption among EU firms that used historical cost accounting with impairment testing in the post-IFRS period, consistent with EU firms having more timely loss recognition for PPE under IFRS strict impairment rules. In my analysis of United Kingdom (UK) firms, I find that most UK firms elected to use historical cost accounting with impairment testing for PPE after IFRS mandatory adoption. I also find that UK firms that previously used fair-value accounting under UK GAAP and then switched to historical cost accounting with impairment testing under IFRS exhibit greater reductions in over-investment relative to other EU firms that used historical cost accounting with impairment testing prior to IFRS adoption. Additional analysis suggests that the reductions in over-investment after IFRS mandatory adoption are greater as the severity of agency conflicts increases, consistent with outside shareholders demanding timely loss recognition as a means of addressing agency conflicts with managers.

Timely student completion of undergraduate nursing programs in order to produce practicing registered nurses (RNs) is of concern to students, faculty, governments, employers, and health care consumers across Canada. The shortage of health care professionals in Saskatchewan, particularly in nursing, is an immediate and growing concern. The average age of RNs in Saskatchewan is 44.9 years (CIHI, 2003). With the inevitability of retirement of many RNs, recruitment and retention of new nurses is critical to the quality of health care in this province. The looming shortage creates a further challenge for key stakeholders in academia, government, and health regions who hold a vested interest in the retention of nurses educated in Saskatchewan. Currently, little is known about the impact of barriers to timely completion of students in the Nursing Education Program of Saskatchewan (NEPS). Considering the aging nursing workforce, frequent, substantial numbers of nursing graduates are important to meet the demand for health human resources in the province of Saskatchewan (SRNA, 2004). <p>The purpose of this research was to conduct a secondary analysis of the NEPS Database including exit surveys completed by 363 graduates over a three-year period, 2002-2003; 2003-2004; 2004-2005. Group membership was determined by splitting data between graduates who had taken four academic years (September to April) or less to complete the program (timely completers) and those who took longer than four academic years (delayed completers). Objectives were to examine the differences between the two aforementioned groups in terms of the following variables: employment hours, financial burden, student loan status, dollar amount of bursaries awarded during the NEPS, primary responsibility the year prior to the NEPS, significant life changes during the NEPS, Aboriginal ancestry and core course averages. <p>Results show that 86% of females in the study group completed the NEPS in a timely manner compared with 58% of their male counterparts. There was a trend of higher employment hours per week in every year of the NEPS for delayed completers. However, this difference approached statistical significance only for students in year one, t (360) = 1.81, p < .07. Fifty percent of delayed completers had three or more significant life changes during the NEPS. Seventy-five percent of timely completers had two or fewer significant life changes. Students require various forms of support to ensure timely completion of the NEPS. It is anticipated that results of this research will inform policy decisions to facilitate timely completion of the NEPS.

Timely student completion of undergraduate nursing programs in order to produce practicing registered nurses (RNs) is of concern to students, faculty, governments, employers, and health care consumers across Canada. The shortage of health care professionals in Saskatchewan, particularly in nursing, is an immediate and growing concern. The average age of RNs in Saskatchewan is 44.9 years (CIHI, 2003). With the inevitability of retirement of many RNs, recruitment and retention of new nurses is critical to the quality of health care in this province. The looming shortage creates a further challenge for key stakeholders in academia, government, and health regions who hold a vested interest in the retention of nurses educated in Saskatchewan. Currently, little is known about the impact of barriers to timely completion of students in the Nursing Education Program of Saskatchewan (NEPS). Considering the aging nursing workforce, frequent, substantial numbers of nursing graduates are important to meet the demand for health human resources in the province of Saskatchewan (SRNA, 2004). <p>The purpose of this research was to conduct a secondary analysis of the NEPS Database including exit surveys completed by 363 graduates over a three-year period, 2002-2003; 2003-2004; 2004-2005. Group membership was determined by splitting data between graduates who had taken four academic years (September to April) or less to complete the program (timely completers) and those who took longer than four academic years (delayed completers). Objectives were to examine the differences between the two aforementioned groups in terms of the following variables: employment hours, financial burden, student loan status, dollar amount of bursaries awarded during the NEPS, primary responsibility the year prior to the NEPS, significant life changes during the NEPS, Aboriginal ancestry and core course averages. <p>Results show that 86% of females in the study group completed the NEPS in a timely manner compared with 58% of their male counterparts. There was a trend of higher employment hours per week in every year of the NEPS for delayed completers. However, this difference approached statistical significance only for students in year one, t (360) = 1.81, p < .07. Fifty percent of delayed completers had three or more significant life changes during the NEPS. Seventy-five percent of timely completers had two or fewer significant life changes. Students require various forms of support to ensure timely completion of the NEPS. It is anticipated that results of this research will inform policy decisions to facilitate timely completion of the NEPS.

Background: The focus of this study is on how far GPs' perceptions of dementia map onto the components and contributing factors to stigma as described by Link and Phelan (2001; 2006) and Jones et al. (1984). Aim: The study explores GPs' perceptions of dementia as a stigma, develops a specific conceptualization of the stigma of dementia and considers implications for timely diagnosis. Methods: Data from twenty-three GPs in northern England were collected by semistructured telephone interviews. Within the context of a qualitative design, a combined process of grounded theory and framework analysis was adopted to collect and analyse data. Results: The findings reveal that GPs' perceptions of dementia map onto Link and Phelan and Jones' identification of contributing factors and components of stigma and may hinder timely diagnosis. Three themes emerged reflecting a dynamic process of making sense of dementia, relating perceptions to oneself and considering the consequences of dementia. Within those themes, certain categories had particular salience for GPs, namely the characteristics of the attribute, existential anxiety and discrimination. The themes and categories are inter-related and can be considered as parts of a system. Perceived lack of reciprocity could be detected in most categories which suggests that it is influential in the social construction of the stigma of dementia. Conclusion: The data suggest that current conceptualizations of stigma are insufficient to fully account for the stigma of dementia. A specific conceptualization of the stigma of dementia is proposed and the implications of GPs' perceptions for timely diagnosis are discussed.