Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Objective: The objective of this study is to develop a national assessment of the length of stay (LOS), total costs, and in-hospital mortality among patients with chronic obstructive pulmonary disease (COPD), using retrospective data derived from Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). / Mylan School of Pharmacy and the Graduate School of Pharmaceutical Sciences; / Pharmacy Administration / MS; / Thesis;

Background: For most children, being hospitalized is a whole new experience. The care should be safe and meet the children’s needs. In hospital care, children are a large group of patients. It’s important for them to be involved in decisions regarding their care and to get proper information. Working as a nurse, there’s a high possibility to meet with children being ill. In order to get more knowledge about how children experience their hospital stay this study was conducted.Aim: The aim of the study was to describe children’s experiences of being a patient in hospital.Method: The method used was a literature study, based on qualitative research. Eight articles from the databases Cinahl and PsycInfo read, reviewed and analyzed according to the model for analysis of qualitative studies made by Friberg.Results: Four themes and eleven sub themes were found. Children’s experiences of hospital care revolved around the hospital environment, their emotions, not being in control and the nursing staff.Conclusion: The result shows that children’s different experiences related to their hospital stay often is affected by the ability to have their parents close, to have the opportunity to play and to get the proper information from caring health professionals. Children describe both positive and negative experiences.

Thesis (M.P.H.)--University of North Texas Health Science Center at Fort Worth, 2008. / Title from title page display. Bibliography: p. 54-61.

Thesis (Ph. D.)--University of Washington, 1990. / Vita. Includes bibliographical references (leaves [270]-296).

Thesis (M.H.A.)--University of Michigan, 1968.

Thesis (M.H.A.)--University of Michigan, 1968.

Thesis (M.S.)--Boston University

Wastewater surveillance (WWS), included in the field of study of wastewater-based epidemiology (WBE), is the analysis of wastewaters to quantify community disease or use of chemicals by the community, such as pharmaceuticals and illicit drugs. WWS has historically been applied within the context of community public health through monitoring of pathogenic viral outbreaks such as polio and hepatitis A, as well as monitoring of illicit drug consumption. While WWS has been used for several decades, many of its contributions were largely unpopular within the public mainstream prior to the coronavirus disease in 2019 (COVID-19) pandemic. Since the onset of the pandemic, public health resources around the world were significantly afflicted by COVID-19. This elicited a prompt response by researchers to rapidly develop WWS for the application of severe acute respiratory syndrome-2 virus (SARS-CoV-2) WWS as a complementary epidemiological tool for population-wide monitoring of COVID-19 outbreaks. With the novelty of this technology, there are several challenges and gaps of knowledge that remain to be addressed in order to improve the reliability of WWS for SARS-CoV-2. Particularly, the effects of various constituents, endogenous and added, that commonly occur and are applied to wastewaters may result in the significant variability observed in WWS data sets, which in turn results in the uncertainty of the interpretation of WWS data sets of SARS-CoV-2 by various public health agencies throughout the pandemic. This study is aimed to address the critical issue of data variability by investigating the effect of enhanced primary clarification with ferric-based chemical coagulants on the measurements of SARS-CoV-2 and the pepper mild mottle virus (PMMoV) WWS normalizing biomarker. It is believed that the addition of ferric ions via common coagulation treatment of primary sludge would interfere with the quantitative polymerase chain reaction (qPCR) amplification of viral RNA and could cause false-negative results. With 18.1% of the total population in Canada receiving wastewater that undergoes primary treatment including chemical precipitation/flocculation, and with proof of enrichment of SARS-CoV-2 and PMMoV RNA in untreated wastewater and settled primary sludge, it is important to elucidate whether ferric sulfate chemical coagulant is a potential source of data variability for population-wide WWS. With ferric sulfate concentrations ranging from 0 - 60 mg/L as Fe³⁺, the PMMoV-normalized SARS-CoV-2 viral signal measurements were significantly reduced as a result of a significant elevation in the PMMoV viral signal measurements. This is possibly due to the partitioning of PMMoV viral particles from the liquid phase to the solids phase of wastewater samples influenced by ferric sulfate at 60 mg/L as Fe³⁺ compared to the samples that were not treated with ferric sulfate. This thesis also examined the evolving relation of WWS measurements to measurements of public health metrics to improve our current interpretation of SARS-CoV-2 WWS. The statistical correlations between wastewater PMMoV-normalized SARS-CoV-2 viral signal and clinical metrics indicative of disease incidence (laboratory-confirmed COVID-19 positive cases), and metrics indicative of disease burden (hospitalization, intensive care unit (ICU) admissions, and deaths) are investigated from the onset of the wildtype and the Alpha variant of concern (VOC) during limited vaccination immunization, through the onset of the Omicron BA.2 VOC in two strongly characterized sewersheds (Ottawa and Hamilton). WWS demonstrates to be a strong indicator of both disease incidence and disease burden during the period of limited vaccination immunization, and a moderate indicator of disease incidence, while remains a strong indicator of disease burden during the period of peak vaccination immunization (2-4 weeks after reception of 2 doses of the COVID-19 vaccine). Hospitalization-to-wastewater ratio is further shown to be a good indicator of VOC virulence when widespread clinical testing is limited.

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Two attitude dimensions which become highly relevant for the person who is admitted to the psychiatric ward of a hospital are acceptance of mental illness and acceptance of mental patients. It is assumed that under the impact of hospitalization acceptance of both mental illness and mental patients and rejection of both mental illness and mental patients tend to become consonant attitude combinations, and it is also assumed that rejection of mental patients and acceptance of mental illness becomes a dissonant attitude combination. Three hypotheses were derived from balance theory and subjected to test. They were first, that people realign attitudes to reduce dissonance, second that people realign attitudes to increase consonance, and third, that people maintain consonant attitude combinations more frequently than dissonant combinations. These hypotheses were tested in the following manner. Ninety-four new admissions to the open psychiatric ward of the Boston Veterans Administration Hospital were administered a questionnaire and interview at time of admission and again after a significant period of hospitalization (approximately ninety days). The questionnaire contained sixteen items measuring acceptance-rejection of mental patients, divided into four subsets each sampling from somewhat different response modes (statement agreement, statement disagreement, adjective ratings, and sentence completion). On the basis of "social distance" score summed across all sixteen items, subjects were divided into accept, neutral, and reject groups of equal frequency. The interview inquired into the patient's perception, belief, and interpretations concerning symptoms, probable cause, and preferred treatment of his own illness. Verbatim interview responses were rated for expression of acceptance and rejection of a psychiatric viewpoint. On the basis of summed ratings, subjects were divided into three groups of equal frequency representing acceptance, neutrality, and rejection at the dimension of mental illness. On the basis of the groupings on the dimension of mental patient and mental illness, subjects were assigned to nine attitude combinations representing varying degrees of consonance, dissonance, and non-consonance. Initial attitude combinations were treated as the independent variable and changes from one combination to another were treated as the dependent variable. Results: There was no special tendency for subjects with dissonant attitude combinations to shift away fran dissonance either in the direction of consonance or merely to non-dissonance. The first hypothesis was thus not confirmed. However, there did appear to be a significant tendency for subjects to shift from non-consonant to consonant attitude combinations, confirming the second hypothesis. Finally, there was no significant indication of greater stability in initially consonant attitude combinations than in non-consonant combinations. The third hypothesis, like the first, was therefore not confirmed. Theoretical Implications: There appears to be some utility in subdividing the omnibus balance hypothesis into three sub-hypotheses: namely, dissonance reduction, consonance increment, and consonance maintenance. Practical Implications: Social integration and acceptance of other mental patients may be a necessary precursor of acceptance of a psychological orientation toward illness in one's self. If psychological insight is the goal, a patient may be more receptive after he has come to perceive mental patients as potential friends and companions and people who are not too much different from himself. If social integration is the principal goal, however, there is no guarantee that acceptance of mental illness in the self will induce greater acceptance of other mental patients. Balance theory, per se, does not appear to be an effective predictor of attitude change in this setting, and it is premature to suggest direct application of the theory to ward management problems. Nevertheless, theoretical analyses are useful in clarifying and sharpening many of the issues confronting the practitioner. / 2031-01-01