Innovation in Ireland's 'high-technology' businesses: the roles of interaction and proximity

This thesis explores the drivers of innovation in Irish high-technology businesses and estimates, in particular, the relative importance of interaction with external businesses and other organisations as a source of knowledge for innovation at the business-level. The thesis also examines the extent to which interaction for innovation in these businesses occurs on a local or regional basis. The study uses original survey data of 184 businesses in the Chemical and Pharmaceutical, Information and Communications Technology and Engineering and Electronic Devices sectors. The study considers both product and process innovation at the level of the business and develops new measures of innovation output. For the first time in an Irish study, the incidence and frequency of interaction is measured for each of a range of agents, other group companies, suppliers, customers, competitors, academic-based researchers and innovation-supporting agencies. The geographic proximity between the business and each of the most important of each of each category of agent is measured using average one-way driving distance, which is the first time such a measure has been used in an Irish study of innovation. Utilising econometric estimation techniques, it is found that interaction with customers, suppliers and innovation-supporting agencies is positively associated with innovation in Irish high-technology businesses. Surprisingly, however, interaction with academic-based researchers is found to have a negative effect on innovation output at the business-level. While interaction generally emerges as a positive influence on business innovation, there is little evidence that this occurs at a local or regional level. Furthermore, there is little support for the presence of localisation economies for high-technology sectors, though some tentative evidence of urbanisation economies. This has important implications for Irish regional, enterprise and innovation policy, which has emphasised the development of clusters of internationally competitive businesses. The thesis brings into question the suitability of a cluster-driven network based approach to business development and competitiveness in an Irish context.

Cesarean section and rate of subsequent stillbirth, miscarriage and ectopic pregnancy: a Danish register-based cohort study

Background: With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. Methods and Findings: We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996), with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy) or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28) was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI) of 0.03% for stillbirth, and a number needed to harm (NNH) of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31) and elective cesarean (HR 1.11, 95% CI 0.91, 1.35), although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15) and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21), yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85). Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment, causes of stillbirth, and maternally requested cesarean section, as well as lack of data on antepartum/intrapartum stillbirth and gestational age for stillbirth and miscarriage. Conclusions: This study found that cesarean section is associated with a small increased rate of subsequent stillbirth and ectopic pregnancy. Underlying medical conditions, however, and confounding by indication for the primary cesarean delivery account for at least part of this increased rate. These findings will assist women and health-care providers to reach more informed decisions regarding mode of delivery.