Inclusive Planning to Evaluate Improved Non-Emergency Medical Transportation Services for Patients With End Stage Renal Disease

The objective of this project is to design a framework that could be used to evaluate the effectiveness and efficiency of non-emergency transportation services (NEMT) for better livability. In addition to the development of the framework, this project aimed to establish connections between Portland State University (PSU) researchers with regional connections involved in public health research, non-emergency medical transportation, medical services, and medical insurance provision. With the rising costs of transportation and medical costs generally in the United States, it is increasingly important to develop new tools and strategies to reduce these costs while maintaining and improving upon the level of care provided. Ultimately, the inability to afford NEMT can lead to missed appointments and reduced access to medical care for vulnerable populations, which in turn can lead to more trips to the emergency room and reduced quality of life. This impacts not only individuals, but the communities that these individuals are a part of. A robust literature review and background research laid the groundwork for this project. This literature review provides an overview of the body of literature that analyzes how non-emergency medical transportation is provided in the United States and also highlights gaps in the existing research. Special attention is paid to the challenges of patients with end-stage renal disease (ESRD), who require routine NEMT service for dialysis appointments. The emerging focus on community-based participatory research (CBPR) is also discussed as a potential tool for better incorporating qualitative data into future analyses of the costs and benefits of providing NEMT. In this process, we identified key strategies for improving NEMT, including better coordination between dialysis clinics and NEMT providers, consideration of fixed-route transportation and improvements in dispatch technology. We developed a framework for evaluating NEMT program changes that centers on a hybrid cost-benefit analysis matrix, modeled on a CBPR approach developed by Stevens et al. for their 2008 evaluation of an Australian childcare strategy. The matrix was refined via feedback from Ride Connection’s advisory committee, and is tailored to many of the unique challenges facing NEMT programs. In conjunction with the hybrid costbenefit analysis framework, a preliminary patient survey instrument was developed to facilitate the collection of data to evaluate transportation policy or program changes for NEMT providers. These tools represent the first steps to researching, evaluating and improving NEMT for healthier and more livable communitie

Bastubadarprincipen - har aggregatet svalnat? - Om rättsutvecklingen av en av svensk arbetsrätts mest välkända principer

Denna uppsats behandlar bastubadarprincipen från AD 1978 nr 89 och innehåller en redogörelse för såväl dess betydelse som utveckling genom tillämpningen i praxis. Som ett led i arbetsgivarens rätt att utöva arbetsledning finns möjlighet till omplacering av arbetstagare, där arbetsgivaren generellt sett är fri att ändra en arbetstagares arbetsuppgifter under förutsättningen att omplaceringen sker inom avtalade gränser och föreliggande arbetsskyldighet. En inskränkning i denna rätt är bastubadarprincipen, som skyddar arbetstagare mot omplaceringar av personliga skäl då omplaceringen leder till särskilt ingripande verkningar och godtagbara skäl ej föreligger för omplaceringsbeslutet. Bastubadarprincipen blev efter dess tillkomst väletablerad och fick en stark påverkan på rättspraxis, men det arbetsrättsliga området som sådant har sedan principens tillkomst utvecklats. Denna uppsats syftar till att undersöka dels vad bastubadarprincipen inneburit för diskussionen kring omplacering av arbetstagare och dels om principen förändrats i något avseende genom åren. Som resultat av uppsatsen kan konstateras att bastubadarprincipen fått stor betydelse som skyddsregel för arbetstagare, men att den endast är tillämplig inom ett begränsat område och därmed inte utgör ett heltäckande skydd mot omplaceringar oavsett dess verkningar. Principen och dess tillämpning har inte genomgått någon väsentlig förändring, utan vad arbetsdomstolen åstadkommit i efterföljande domar är ett förtydligande av dess innebörd och hur bedömningen ska ske.This essay deals with the principle established in AD 1978 nr 89 and contains a discussion of its importance, as well as its development through application in practice. The employers’ wide-ranging rights to organize and manage the workplace includes a possibility to relocate workers to new assignments and positions within the company, if executed within the agreed collective and individual agreements and duty of employment. A limitation of this right is the principle established in AD 1978 nr 89, which protects workers from relocations that has been carried out due to personal reasons, in cases where the result of the relocation is considered to have led to particularly strong effects for the worker, provided there are no acceptable reasons for the decision. Said principle became well established and had a strong impact on the jurisprudence. The area of labor law has, however, since then gone through a noticeable development. This essay therefore aims at determining on the one hand what the principle has meant in situations of relocation of workers, and on the other hand to investigate whether the principle has changed in any aspect over the years. The essay shows that the principle has had a significant impact as a rule of protection of the workers, however not as a protection against all types of relocations since it is only applicable in a narrowly defined area. The principle has not undergone any substantial change over the years, but what the Labor Court has achieved through its application in practice is a clarification of its meaning and of the grounds of the assessment

Avtalsrättslig ställningsfullmakt och aktiebolagsrättslig behörighet - En utredning om utvecklingen inom ställningsfullmakten och dess förhållande till de aktiebolagsrättsliga behörighetsreglerna

Inom fullmaktsinstitutet finns olika fullmaktstyper som möjliggör rättshandlande genom att en huvudman delegerar behörighet till en fullmäktig att rättshandla för huvudmannens räkning. En sådan fullmaktstyp är ställningsfullmakten som regleras i 10 § 2 st. avtalslagen. Ställningsfullmakten innebär att en person genom sin ställning får en viss behörighet att rättshandla för sin huvudman till följd av lag eller sedvänja. Behörighetsregler att rättshandla för en huvudman finns även inom aktiebolagsrätten där ett aktiebolags företagsledning ges en behörighet att rättshandla för bolaget. Denna behörighet tillkommer via reglerna inom aktiebolagsrätten och anses inte vara en ställningsfullmakt utan ett legalt ställföreträdarskap. Det finns dock likheter som gör det intressant att undersöka förhållandet mellan de aktiebolagsrättsliga reglerna och reglerna för ställningsfullmakt och dess nuvarande tillämpning. Uppsatsen syftar till att redogöra för utvecklingen som skett inom ställningsfullmaktens område och den rättsliga ställning och tillämpbarhet en sådan fullmakt har idag. Detta görs via en genomgång av dess bakomliggande regler och en redogörelse för den utveckling som skett i rättspraxis, med fokus på de två rättsfallen NJA 2013 s. 659 och NJA 2014 s. 684. HD införde genom de avgörandena den tillitsgrundade fullmakten. Uppsatsen syftar även till att undersöka hur behörighet bestäms inom aktiebolagsrätten, med fokus på den verkställande direktören, samt om de principer som kommer till uttryck i den tillitsgrundade fullmakten bör tillåtas påverka en sådan behörighetsbedömning. Detta möjliggörs genom en undersökning av gällande rätt och av syftena bakom det aktiebolagsrättsliga regelverket. Sammanfattningsvis kan konstateras att förändringar inom ställningsfullmaktens område, med framväxten av kompletterande fullmaktstyper och tillitsprincipens allt mer framträdande betydelse, har inneburit att ställningsfullmakten erhållit en ökad tillämpbarhet. En del av denna utveckling utgörs av introduktionen av den tillitsgrundade fullmakten. HD bekräftade genom införandet av den att tredje mans befogade tillit kan ligga till grund för en fullmakt. Vid tillitsbedömningen ska dock huvudmannens insikt till tillitens uppkomst beaktas, vilket innebär att tillitsaspekten inte får ett sådant genomslag som benämningen av fullmakten antyder. Bedömningen avseende hur långt en verkställande direktörs behörighet sträcker sig görs med beaktande av arten och omfattningen av bolagets verksamhet och den aktuella rättshandlingen. Av avgörande betydelse är rättshandlings art, dess värde och tidsomfång samt avtalsinnehåll. Avslutningsvis dras slutsatsen att de principer som kommer till uttryck i den tillitsgrundade fullmakten inte bör tillämpas vid behörighetsbedömningen för en verkställande direktör enligt ABL. Ett skäl är de skillnader i den bakomliggande viljeförklaringen från huvudmannen som kommer till uttryck vid anställandet av en VD, jämfört med vid en anställning som föranleder en ställningsfullmakt. Därutöver talar syftena bakom det aktiebolagsrättsliga regelverket, samt det faktum att tredje man redan tillförsäkras ett visst godtrosskydd i aktiebolagslagen, emot en sådan tillämpning.There are different types of powers of attorney that enables legal actions, where a principal delegates authority to a representative to act on behalf of the principal. One of these is the power of attorney based on position which is regulated in article 10 paragraph 2 of the Swedish Contract Law. In this type of power of attorney, the right to act on behalf of the principal is derived from the position that the person holds, and the limits of authority are defined by law or custom. The right to act for a principal also exists within company law where the management of a limited liability company is given authority to act on behalf of the company. This authority is not considered to be a power of attorney based on position but a right to act given directly by law. There are, however, similarities which makes it interesting to examine the relationship between the rules of company law and the rules governing the power of attorney based on position and its current application. The thesis aims to explain the development that has taken place within the field of the power of attorney based on position, and the legal status and present applicability of such power of attorney. This is done through a review of its underlying rules and by explaining the developments of recent case law, focusing on the two cases NJA 2013 p. 659 and NJA 2014 p. 684. The Swedish Supreme Court hereby introduced a power of attorney based on trust. The thesis also aims to examine how authority is determined within company law, with focus on the CEO, and whether such an assessment should be influenced by the principles expressed in the power of attorney based on trust. This is made possible by examining existing law and the purposes behind the legal framework of company law. In conclusion, changes within the field of the power of attorney based on position, with the emergence of additional types of powers of attorney and the increasing use of trust as a base to decide authority, has resulted in that the power of attorney based on position has been given a wider scope. One part of this development is the introduction of the power of attorney based on trust. By its introduction, The Swedish Supreme Court confirmed that the legitimate trust of third parties can in itself form the basis of a power of attorney. However, in assessing the trust, the principal's insight of the emergence of trust must be taken into account, which means that the aspect of trust will have a lower impact than what the name of the power of attorney suggests. The assessment of to what extent a CEO has authority to act on behalf of the company is made based on the nature and scope of the company's activities and the current legal action. In such assessment, the nature of the legal act, its value, scope in time and the content of the contract is of decisive importance. Finally it is concluded that the principles expressed in the power of attorney based on trust should not be applied in the assessment of the authority of a CEO under the Swedish Companies Act. One reason is the differences in the underlying will of the principal that is expressed in the principal's employment of a CEO compared to an employment that gives rise to a power of attorney based on position. Further reasons against such an application are the objectives behind the legal framework for limited liability companies, and the fact that third parties are already guaranteed a certain level of protection of good faith in the Swedish Companies Act

Allen Boulevard Corridor Plan

The Allen Boulevard corridor, home to diverse populations and a vibrant commercial district, is a community in transition and a community with potential. While Allen Boulevard possesses unique assets in its present state, it has seen little in the way of localized planning or City programs tailored to the area’s needs. As such, the City of Beaverton partnered with the Portland State University Master of Urban and Regional Planning program to produce a detailed corridor study and planning guide for the area. From that partnership, six graduate students formed a consulting group, InSite Planning, to produce this plan. This project was conducted under the supervision of Sy Adler, Marisa A. Zapata, Andree Tremoulet, Lisa Bates, Matthew Gebhardt and Gregory Schrock

Instability of CAG-trinucleotide repeats in chronic lymphocytic leukemia

Instability of CAG-trinucleotide Repeats in Chronic Lymphocytic Leukemia Anticipation--earlier onset and more severe disease in the offspring generation--is a well documented feature of familial chronic lymphocytic leukaemia (CLL). In a number of Mendelian diseases, anticipation is caused by expansion of contiguous triplets of nucleotides. The severity of disease expression and penetrance is related to the extent of the triplet expansion. To investigate whether repeat nucleotide repeat expansion is a feature of CLL, the repeat expansion detection (RED) technique was applied to samples from 17 patients with familial disease and 32 patients with early-onset CLL disease. No potentially pathological CAG expansions were detected. We conclude that unstable CAG repeat expansion is not a feature of CLL and that other processes are likely to be involved in generating anticipation in familial forms of the disease