Preterm birth continues to be an important public health concern globally. Born only 3 to 6 weeks premature, findings increasingly demonstrate that the late preterm population (34-36 weeks gestational age) is not exempt from long-term risk, as the last few weeks of gestation are important for both physical and cognitive development. This study examined whether late preterm birth was associated with poorer health, development and educational outcomes in the early childhood period, after controlling for a range of medical and social factors. / February 2016

The purpose of this study was to investigate the relationship between residential segregation (the physical separation of Blacks and Whites in residential contexts) and adverse perinatal outcomes (low birth weight, preterm delivery and small for gestational age births) in Florida, Georgia and Louisiana. The study determined the independent effect of the level of residential segregation on the likelihood of adverse perinatal outcomes after controlling for contextual and individual factors. The study also assessed whether the relationship between residential segregation and adverse perinatal outcomes were moderated by ethnicity and median income.The studied employed an observational, cross-sectional study design that utilized secondary data. Live birth certificates between 1999 and 2001 provided information on individual covariates and perinatal outcomes. Structural indicators of residential segregation and contextual covariates were obtained from the U.S. Census Bureau. Th e nested data structure for each birth outcome model was composed of individual, contextual, and structural data. Three-level, hierarchical generalized linear models were used to test research hypotheses.The study population consisted of non-Hispanic White and Black primaparous women between 15 and 49 years of age experiencing singleton live births delivered at less than or equal to 45 weeks gestation. The final sample consisted of 255,548 women nested within 4,360 census tracts and 63 Metropolitan or Micropolitan Statistical Areas. Residential segregation did not have a direct relationship with low birth weight, preterm delivery or small for gestational age, after controlling for other variables in multilevel models. Models testing the moderating effects of ethnicity indicated that increased Isolation decreased the risk of LBW among Black women. Several contextual --level variables and the majority of individual-level variables were significantly associated with perinatal outcome risk .Findings indicate that effects of residential segregation may be birth outcome and ethnic group specific. Relationships between individual factors, contextual factors and adverse perinatal outcomes signal the importance of proximal factors to perinatal outcomes. There is a need for specification of a broader constellation of biological, social and spatial factors and a thorough assessment of residential preferences and experiences in order to better understand the associations between neighborhoods and perinatal outcomes.

This research aims to identify the determinants of the ex-ante risk premium required by Italian private equity funds (PEFs) when valuing privately-held target companies. In theory, perceived risk is a key driver of expected returns and anticipated value, but: "Although PE (private equity) has experienced rapid growth, the risk and return profile of this asset class is not well understood." (Jegadeesh et al., 2009). Some papers have attempted to assess the ex post returns pioneered by Lerner & Gompers (1997). Yet such studies reveal both contradictory conclusions and hitherto inexplicable phenomena: what some authors call the 'private equity premium puzzle' (Moskowitz & Jorgensen, 2000). Such contradictory conclusions include a wide spread of abnormal realized returns ranging from -6% (Phalippou & Gottschalg, 2009) to +32% (Cochrane, 2005). In this research, the perceived risk and expected return drivers refer not to the ex-post realized return that PEF investors actually achieve, but to the required return the PEF hopes to gain from the target investment. At this stage, two important indicators adopted in PEF parlance have to be differentiated: (i) the Expected IRR (E.IRR) and (ii) the Threshold IRR (T.IRR). The first is the IRR as an output of a business plan, and the second assesses the return expected by PEFs according to the risk perceived in the business plan. Put simply, these are respectively, the anticipated return and the (risk-adjusted) required return. The study of the T.IRR is one of the main contributions of this thesis since it has never been studied before by academia as an indicator of the ex-ante perceived risk of a PEF target company. This is partly due to two important reasons. First, most previous papers examine ex-post performance, and only a few (e.g. Manigart et al., 2002), try to assess return expectations and risk perceptions using an ex-ante perspective. Second, most of the prior studies are quantitative and try to measure statistical effects captured by the ex-post IRR. By studying 26 deals (in 13 Italian PEFs) in detail (qualitatively and quantitatively), this research project has been able to observe how PEFs assess risk and estimate the T.IRR. The research project reveals that PEFs apply neither rational-based models nor explicit formulae to assess risk exante. By observing a set of phenomena unique to the PEF sector (fees effect, investment speed effect, persistence effect, money-chasing deal phenomenon, illiquidity effect, etc) whose existence has been suggested by many recent papers, this thesis has been able to propose an adjusted version of the three-factor model of Fama and French (1993, 1995) to assess risk. The application of a quasi-rational-based asset pricing model to guide PEFs assessments is also an important contribution of this thesis. In fact, Franzoni, Nowak and Phalippou (2010), claim to be the first to calculate the PEFs' cost of capital by applying asset pricing models. However, their approaches are not only based on the observations of realized returns, but also consider only one additional factor to the standard Fama & French three-factor model (1993), the liquidity factor. In contrast, the results and the model proposed by this thesis are based on qualitative and quantitative ex-ante information and include not only the classical factors of that model, but also some other factors intended to explain some of the phenomena listed above which might also drive the risk premium in private equity funds. Based, therefore, on explaining the behavior of PEFs, the research develops a framework that can be applied by Italian PEFs and perhaps other PEFs in a more rational manner than their past behavior suggests.

Studies in countries across the globe and in Canada show that people from minority communities generally tend to be in poorer health, experience a greater burden of disease and disability than the general population. A 2008 World Health Organization (WHO) report on the Social Determinant of Health stressed that the high burden of disease and disability around the world is due to a great extent, to poor and unequal living conditions which are the consequence of deeper structural conditions such as poor social policies and programmes, inequitable economic structures, and deficient politics. In Canada, there is a growing body of evidence suggesting a negative impact of health disparities on Official Language Minority Communities (OLMCs), especially on Francophones outside of Quebec. In order to better describe and understand the situation of Official Language Minorities (OLMs), especially of Minority Francophone older adults living outside of Quebec, two national surveys were used: The 2006 Canadian post-census Survey on the Vitality of Official Language Minorities (SVOLM) and the 2007 Canadian Community Health Survey (CCHS). Descriptive, and multivariable analyses were conducted, followed by minority Francophone community members’ feedback on the findings. A qualitative analysis of provincial/territorial French-language (English in Quebec) services policies or legislations was subsequently conducted with an in-depth focus on the Government of Saskatchewan French-language Services Policy and an assessment of the potential impact of these policies on the health of OLM older adults. This study showed that minority Francophone older adults consistently rated their health more poorly than their counterparts in the general population but the study failed to demonstrate an association between OLM status and self-rated health, due to low representativity of the OLM population in the sample. However, the sense of belonging to, and vitality of minority community were constructs associated with better self-rated health for minority Francophone older adults while high concentration of minority group was associated with poorer self-rated health. Feedback from Francophone community members emphasized the detrimental role of assimilation, systemic and structural inequities, and unfavourable policies as contributing significantly to the low vitality of their communities and eventually to health disparities. Adopting new sampling approaches for OLMs, addressing minority Francophones’ contextual realities, enhancing access to health services in French, improving the linguistic environment, and developing more supporting policies, would help improve the condition of minority Francophone older adults in Canada.

Using a panel data analysis of a sample of 80 listed non-financial Jordanian firms during the period from 2000 to 2011, we investigated the corporate cash-holding decision. The firm’s decision to hold cash has come to the fore in last two or three years as a result of the recent global financial crisis, and the impact that this has had on the firms’ ability to raise funds from external sources. There is evidence in the US, for example, that firms have increased their holdings of cash as a result of increasing constraints from external sources. This current study therefore examines this issue from the point of view of a developing economy. We started by investigating the empirical determinants of corporate cash holdings; the results showed that firm size and growth opportunities have no significant effect on corporate cash-holding decisions, while firm’s cash flow, leverage, and liquid assets substitute have a significant negative effect on cash-holding decisions, and profitability and cash dividends have a positive effect on cash-holding decisions. Then we investigated empirically how cash-holding affects the value of corporate firms. Based on Fama and French’s (1998) valuation model and Faulkender and Wang’s (2006) model, the results showed that the marginal value of each Jordanian Dinar (JD) is valued at a discounted value of 0.41 JD; with higher leverage the marginal value of cash is declining, with a higher level of cash the marginal value of cash is increasing and, finally, cash dividends have no significant effect on shareholders’ value. We also investigated empirically how a group of explanatory variables affect a firm’s debt ratio by focusing on the liquidity variable. Results showed that the total debt ratio is positively affected by firm size and is negatively affected by growth opportunities, profitability, assets tangibility and total liquidity, cash, and non-cash liquidity. The long-term debt ratio is positively affected by firm size, non-debt tax shield, asset tangibility, total liquidity, cash, and non-cash liquidity, while the long-term debt ratio is negatively affected by growth opportunities and profitability. For the short-term debt models, the debt ratio is negatively affected by firm size, asset tangibility, and liquidity in its different forms. An investigation into the speed of adjustment showed that Jordanian firms quickly adjusted the total and long-term debt ratio, while they do not have an optimal or target short-term debt ratio.

This study examines the determinants of economic growth at sub-national level in South Africa, and investigates cross-locality medium-term (five-year) growth rate differentials between 354 magisterial districts. The period in question is 1998 to 2002. A dynamic panel data regression model is used that includes measures of geography (distance and natural resources) as well as recent estimates of physical and human capital. It is found that the significant determinants of local economic growth are distance from internal markets, human capital, export propensity, and the capital stock of municipalities (reflecting institutional quality and governance on local government level). Distance from international harbours, as a measure of transport costs, and urban agglomeration (or density) affects growth indirectly through its significant effect on the ability of a region to export. Overall, these results indicate that geography is important for economic growth, independent of its effects in institutions. Bearing in mind the medium-term focus of the work, no evidence of absolute convergence could be found over a five-year period, rather the tentative evidence suggests slow beta convergence. / Thesis (Ph.D. (Economics))--North-West University, Potchefstroom Campus, 2005.

In Canada and internationally, increases in Home Care (HC) services for the elderly have been a policy priority in recent decades. HC services include Home Health Care (HHC) and Homemaking/Personal Support (HM). The primary objectives of this study were to explore the interrelationship among publicly funded, privately funded, and informal HC services in terms of potential for substitution, and between publicly funded HHC and HM services; and the determinants of the receipt of each type of HC services. Stabile, Laporte, and Coyte’s family home care decision model (2006) was extended, to develop an understanding of the demand for HHC and HM services separately and to include different household arrangements. The consequential hypotheses were tested in two empirical studies. Individual panel data for those aged 65 and over were derived from 8 biannual waves of the Canadian National Population Health Survey (1994-95 to 2008-09). A Panel Two-Stage Residual Inclusion method was used to estimate the likelihood of the receipt of HC services, adjusting for socio-demographic, health status, disability, dependence on help with Activities of Daily Living (ADLs), and regional characteristics. The results showed that receipt of publicly funded HM is complementary with receipt of publicly funded HHC services after adjusting for functional and health status. Receipt of publicly funded and privately funded HM services did not show an effect on each other. Receipt of publicly funded HM did not affect the receipt of informal HM services. The availability of informal care from a partner or other adult sharing the household reduced the likelihood of publicly funded HM receipt. Age, dependence on help with ADLs, health status and income are determinants of the propensity to receive publicly funded HHC and HM services as well as privately funded and informal HM. Findings in this study suggest that changes in the availability of publicly funded HC services may not greatly affect the provision of informal care in Canada. The complementary effect between publicly funded HHC and HM services and the income effect in the receipt of publicly and privately funded HC services may raise concerns about equitable access to HC services in Canadian jurisdictions.

The incidence of adverse birth outcomes, such as low birth weight and preterm births, has steadily risen in recent years in Canada. Despite the fact that numerous individual and neighbourhood risk factors for low birth weight and preterm births have been identified and various person-oriented intervention strategies have been implemented, uncertainties still exist concerning the role that place and space play in determining adverse birth outcomes. In order to succeed in producing community-oriented health policy and planning guidelines to reduce both the occurrence and inequalities of adverse birth outcomes, the research presented in this thesis provides an approach to examining the pathways of various socio-economic, environmental, and psycho-social risks to LBW and preterm births. Using a modified multilevel binary-outcome mediational analysis method, case studies are conducted within three public health units in Ontario, namely the Wellington-Dufferin-Guelph Health Unit, the Windsor-Essex County Health Unit, and the Halton Region Health Unit. Different pathways are investigated given the available data and the theoretical assumptions of three health inequality pathway models, namely the behavioural model, the psycho-social model, and the materialist model, and the geographical and planning perspectives of health inequalities. A local spatial analysis process is also used to identify spatial clusters of incidence and to assess possible associated reasons in order to support public health polices and planning in community-oriented health interventions. Using Bayesian spatial hierarchical analysis and spatial clustering analysis, local clustering of high risks of adverse birth outcomes and spatial variations of associated individual risks within the study areas are identified. The analysis is framed around five hypotheses that examine personal vs. spatial, compositional vs. contextual, psycho-social vs. material, personal vs. cultural, and global vs. local effects on the determinants of adverse birth outcomes. The results of testing these hypotheses provide evidence to assist with multi-component multi-level community-oriented interventions. Possible improvements of current prenatal care policies and programs to reduce the spatial and social inequalities of adverse birth outcomes are suggested. Potential improvements, including early stage prenatal health education, local healthy food provision, and cross-sector interventions such as the combination of social mixing strategies with bottom-up community-based health promotion programs, are also suggested.

Introduction: Adolescents in the United States use alcohol more than any other substance, including tobacco and marijuana. Continuing alcohol misuse has numerous adverse health effects and is linked to liver disease, cancer, cardiovascular disease and neurological damage. Furthermore, alcohol consumption is a significant risk factor for unsafe sexual behaviors, unintentional injuries, physical and sexual assaults, various types of illegal activities, and suicide (USDHHS, 2007). Aim: The purpose of this study is to compare the individual social indicators from 4 categories that have been identified within the literature as being particularly associated with alcohol consumption in general, and underage alcohol consumption in particular. The categories used were: drinking consequences, urbanicity, poverty, and alcohol outlet density. The social indicators in these categories will be compared in the 10 most-at-risk counties (MAR) and the 10 least-at-risk counties (LAR), and the 20 MAR counties and the 20 LAR counties, as they relate to underage alcohol consumption. Methods: The counties were identified in and data was obtained from Governor’s Cooperative Agreement State Incentive Planning and Development Grant: Social Indicator Study to Assess Substance Use Prevention Needs at the State and County Levels in Georgia. An independent 2-tailed t-test was conducted to compare the means of groups in both the 10 MAR/LAR counties and the 20 MAR/LAR counties. Results: Significant differences were observed in all of the individual indicators in the poverty and alcohol outlet density categories for both the 10 MAR/LAR counties and the 20 MAR/LAR counties. Discussion: There needs to be a more accurate, specific and efficient methods of data surveillance concerning underage drinking behavior. Further research should focus on urbanicity, poverty, and alcohol outlet density as they relate to underage alcohol consumption. There were differences observed between the MAR and LAR counties in all of the poverty alcohol outlet density indicators, and researchers and policy makers should pay special attention to these two areas when designing further research and prevention policies.

In this thesis, we explore determinants of Canadian workers’ job-related education and training take-ups by using the 2008 Access and Support to Education and Training Survey (ASETS). We implement three models, OLS, probit and logit. Regression results show that the three models produce similar and generally consistent estimates. We find systematic patterns across demographic groups in relation to job-related education and training. Most of our findings, such as the e?ect of age and education, are consistent with previous research. We also find two new influential factors, namely, individuals’ computer ability and their information search behavior, which are critical in determining job-related education and training take-ups. This new finding not only further completes the image of job-related education or training take-ups, but also suggests that government, educational institutions and employers invest more resources into internet to e?ectively promote job-related education and training.