Thesis advisor: Christopher S. Lee / Background: Congenital heart disease (CHD) is the most prevalent birth defect in the United States. Advances in treatment have changed CHD from what once was almost always a life-threatening condition to what is commonly a lifelong chronic condition. Up to 60% of adults with CHD experience large gaps in cardiology care during the transition from pediatric to adult specialty care. Effective CHD management in emerging adulthood maximizes lifelong potential, functioning and quality of life. Past research has failed to consider how emerging adults and their parents work together to manage CHD together as an interdependent team. Thus, there remains a dearth of information on how best to support emerging adults and their parents. Since CHD is a life-long diagnosis there is a critical need to understand the ways in which emerging adults and their parents as primary care partners engage in behavior to manage CHD together. This manuscript dissertation had an overarching goal to develop a deeper understanding of emerging adult and parent contributions to the management of CHD. Methods: First, an integrative review summarized and evaluated the evidence of published and peer-reviewed literature regarding parental perspective of the emerging adult with CHD. Next, a cross-sectional quantitative hypothesis-generating pilot study investigating emerging adult and parent contributions to management of CHD was conducted. And finally, an exploratory qualitative study was completed to describe health care team provider perspectives on the experience of emerging adults and their parents in managing CHD. Results: These three manuscripts have the key following results: 1) parents have concerns about their emerging adult children with CHD related to their future, independence in self-care of CHD, including health care system navigation, 2) there was a positive correlation between emerging adult and parent contributions to self-care (management, monitoring and maintenance) of CHD, and in the domain of navigating the health care system, there was a weak and negative correlation (the more an emerging adult does, the less the parent contributes), and 3) providers in health care teams report differences in both emerging adult and parent factors that impact management, and that self-care in emerging adults with CHD is critical with known health care system barriers that need assessment and improvement to support this population. Conclusion: The constellation of these findings from the dissertation and past work help fill critical knowledge and research gaps in emerging adult and parent/care partner contributions to management of CHD. These findings support the much-needed future work to inform clinical care, research, and policy for emerging adults with CHD and parents to further improve health and quality of life for this population. / Thesis (PhD) — Boston College, 2024. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Though the phenomenon of young adults moving in with their parents is not a new one, it is one that has certainly become more common in recent decades. A new life stage of 'emerging adulthood' has become the norm, in which young adults delay marriage and career jobs in order to pursue other goals. This stage is, in part, marked by fluidity in residence. Yet even as a growing number of 'boomerang kids' move back in with their parents, there is a gap in the research regarding this phenomenon's effect on various parts of the family system. This study set out to address this gap by comparing separate interviews from young adult boomerangs and their parents. Findings suggest a disparity between parental and young adult opinions on a variety of topics, most notably: expected household responsibility, parent/child closeness, loss of autonomy, and appreciation. However, similarities emerged regarding the parental home as a safe haven, the arrangement as providing financial security, and the fact that all adult children reported being ready to move out. Ideally, the findings presented here will help illuminate both the similarities and disparities in the experiences of parents and their young adult children who return after launch, in order to increase empathy and promote a healthy family system. / Master of Science

Tennessee has a long history of meteorological hazards that have caused property damage and loss of life. Given climate change and variability, it is imperative to look at trends to ascertain changes spatiotemporally. Space-time cubes, a novel geographic tool, were used to analyze historical heavy precipitation (1-, 2-, and 5-year returns), floods, and flash flood data in Tennessee counties to assess the trends, identify emerging hotspots/cold spots and display changes over space and time. For all return periods, trends analysis revealed that heavy precipitation events are increasing in several counties across the state, with middle Tennessee identified as a hotspot. While floods and flash flood event trends are mixed (with both increases and decreases) across the state counties, related property damages are increasing, especially in middle Tennessee. This study is an important step to understanding spatiotemporal trends and will be useful in federal, state, and county hazard mitigation planning.

Emerging contaminants (ECs) are chemicals such as pharmaceuticals and personal care products that have been detected in various environmental matrices, including drinking water supplies at trace concentrations (ng/L-ug/L or ng/kg-ug/kg). Current wastewater treatment plant technology is largely ineffective at removing ECs. The objectives of this investigation were to: 1) determine the occurrence of ECs in private well water supplies in Montgomery and Roanoke County, VA 2) quantify the concentrations of three ECs in selected private water supplies; 3) examine the relationship between water quality constituents (nitrate, bacteria, pH and total dissolved solids) to EC occurrence in private water supplies; and 4) determine the ability of the MicroEvapTM, a novel wastewater treatment technology, to remove ECs from secondary wastewater effluent. In partnership with the Virginia Household Water Quality Program, 57 private water supplies were sampled and tested for the occurrence of 142 ECs and 43 other water quality constituents. Up to 73 ECs were detected in the sampled private water supplies. Higher numbers of ECs detected in the tested private water supplies were related with nitrate >1 mg/L, total dissolved solids >250 mg/L, and the presence of total coliform bacteria. Results indicate the MicroEvapTM technology had >99% removal effectiveness for all 26 tested ECs from three secondary wastewater effluent. With the increasing detection of ECs in water bodies, it is essential to understand the occurrence of ECs and environmental predictors of EC presence in different water matrices and continue to develop water treatment technology capable of treating wastewater for EC removal. / Master of Science / Emerging contaminants (ECs) are compounds intended to improve human and animal well-being, and include pharmaceuticals, personal care products, and human/veterinary antibiotics. ECs have been frequently detected in water resources worldwide including drinking water. The release of ECs from wastewater treatment plant (WWTP) effluent is their primary route into the environment. The inability of most current wastewater treatment technologies to fully remove ECs necessitates further development of technology that can effectively remove ECs. Emerging contaminants such as pharmaceuticals enter WWTPs because the human body does not fully metabolize the compound and the remainder exits in waste. Private well water is largely unregulated and often untreated and has been relatively less evaluated for EC presence in the literature. The objectives of this study were 1) determine the occurrence of ECs in private well water supplies in Montgomery and Roanoke County, VA 2) quantify the concentrations of three ECs in selected private water supplies; 3) examine the relationship between well age and depth and water quality constituents (nitrate, bacteria, pH and total dissolved solids) to EC occurrence in private water supplies; and 4) determine the ability of the MicroEvap™, a novel wastewater treatment technology, to remove ECs from secondary wastewater effluent. Emerging contaminants were detected in southwest Virginia private well water. Knowing the ECs present in private well water is necessary to allow for eventual human risk assessment of ECs for people consuming the water. The MicroEvap™ was highly effective at EC removal from wastewater with removal rates >99%. The removal of all ECs from wastewater is essential to ensure purified WWTP effluent. The continued detection of ECs and the unknown human health risks from these contaminants in drinking water means ECs are a significant pollution concern that requires continued assessment.

Yes / Sourcing healthcare practice placements continues to present a challenge for higher education institutions. Equally, the provision of clinical placements by healthcare providers is not at the forefront of their agenda. In view of this, the historic and traditional models of clinical placements is becoming more difficult to provide. In light of this, new models of clinical placements are being explored. Aims: This literature review explores the differing models of clinical placements in use and examines the merits and limitation of each. Methods: A mixed-methods literature review with a pragmatic approach has been used. Findings: Several placement models were described, including the traditional 1:1 model as well as 2:1, 3:1. The hub and spoke, capacity development facilitator, collaborative learning in practice and role emerging placement models were also discussed. Conclusion: There is a considerable paucity of high-quality evidence evaluating differing placement modules. Further research is required to evaluate the differing placement models from a students, clinical educators and service user’s perspective.

Yes / From a perspective of the resource-based view, this paper analyses the inter-connection between technology adoption and creation in affiliates of multinational enterprises (MNEs) in an emerging economy. Operating below the international technological frontier, multinational affiliates are more motivated to adopt technologies already existent from their MNEs than create new technologies, as the former already gives them competitive advantages over local firms. When technology creation is required, multinational affiliates will adopt further technology-based resources from their MNEs as they are unavailable in an emerging economy. As a result, technology adoption is a necessary but not sufficient condition for multinational affiliates to conduct technology creation. Given that networks are particularly important for working around institutional voids in the context of an emerging economy, this paper also investigates the different roles of R&D support from internal and external networks of multinational affiliates in technology adoption and creation. Hypotheses are tested and partially supported based on unique data from 465 multinational affiliates in China.

Yes / This study seeks to investigate the effectiveness of Cloud Computing Utilization (CCU) in the mitigation of informational and marketing barriers for SMEs from the Emerging Market-Countries (EM-SMEs). A quantitative-research methodology was applied to collect data by using self-administered questionnaires from top managers of 227 SMEs based in Iran and Turkey. The study contributes theoretically to both small business and international business literature by developing a new classification of the internationalization barriers that EM-SMEs face, and proposing a series of cloud computing (CC) solutions for mitigating these barriers, resulting in the creation and testing of a new model. The empirical findings confirm that CCU can help EM-SMEs to mitigate a series of informational and marketing barriers. The key practical contributions of the study offer insights to both EM-SMEs and Cloud-Service-Providers (CSPs) on the extent to which CCU is effective in mitigating the internationalization barriers faced by EM-SMEs.

Yes / This study examines the effects of firm performance and corporate governance on chief executive officer (CEO) compensation in an emerging market, Pakistan. Using a more robust Generalized Method of Moments (GMM) estimation approach for a sample of non-financial firms listed at Karachi Stock Exchange (KSE) over the period 2005 to 2012, we find that both current and previous year accounting performance has positive influence on CEO compensation. However, stock market performance does not appear to have a positive impact on executive compensation. We further find that ownership concentration is positively related with CEO compensation, indicating some kind of collusion between management and largest shareholder to get personal benefits. Inconsistent with agency theory, CEO duality appears to have a negative influence, while board size and board independence have no convincing relationship with CEO compensation, indicating board ineffectiveness in reducing CEO entrenchment. The results of dynamic GMM model suggest that CEO pay is highly persistent and takes time to adjust to long-run equilibrium.

Yes / Circular Economy (CE) and the adoption of its principles globally are more important than ever to sustain the rate of production of goods and services to meet the ever-increasing consumer demand that is burdening the environment and society. This study investigates the adoption of CE principles amongst emerging economies as the challenges faced by these economies are generally different in terms of resource availability, varying government policies and consumer behaviour from those of developed economies. This research presents an empirically validated CE adoption model using a sample of 183 consumer responses. The study highlights the strong influence of factors such as consumer behaviour on the acceptance of remanufactured products and using products as a service to encourage the adoption of CE practices in emerging economies. This research offers businesses, consumers and policy makers insights into measures that have been taken by emerging economies that are in line with CE principles.

Yes / This paper undertakes a comparison between five multifactor variants of the capital asset pricing model. These include additional factors based on size, book to market value, momentum, liquidity and a new investor protection metric based on the product of institutional quality in a country and the proportion of free float shares, which captures the impact of controlling block holders. Using monthly returns of 909 blue chip firms from 18 Middle East & North African equity markets for 16 years, we show that a two factor CAPM augmented with a factor mimicking portfolio based on the investor protection metric yields the highest explanatory power. Analysis of Kalman filter time varying investor protection betas reveals investor protection premiums in Egypt, Iraq, Lebanon and Tunisia and corresponding discounts in Israel, Saudi Arabia, Kuwait, Oman, Dubai and Abu Dhabi.