Timber has become more popular as a construction material during recent years. Engineered wood products, such as glued laminated timber and cross-laminated timber, have enabled the construction of multi-storey buildings. Tall buildings with many occupants need to resist a disproportional collapse in case of unexpected exposures, e.g. accidents or terrorism. Structural robustness can improve the collapse resistance of a building. The literature about robustness is comprehensive concerning concrete and steel buildings, but it is rather limited regarding timber. A robust building can mobilise alternative load paths in the structure after the removal of bearing building components. Alternative load paths rely primarily on the connections between components. For timber buildings, few investigations exist to evaluate the alternative load paths after a removal. Analyses usually do not take into account non-linear effects which could influence the capacity of alternative load paths, such as damage of single fasteners, friction,  timber crushing and brittle failure. In particular, the alternative load paths in platform-framed cross-laminated timber buildings are not well understood.  The goals of this thesis are to i) review the concept of robustness in general and determine the state of the art concerning timber buildings in particular, ii) develop a method to analyse the alternative load paths in a platform-framed CLT building taking into account relevant non-linearities, iii) use the method to elicit the alternative load paths in a building after a wall removal, and iv) study the effects of probabilistic variations of model parameters.  The thesis first introduces tall timber buildings and then presents a summary of structural robustness in a collapse resistance framework. The summary includes established analysis methods and specific considerations for timber, whereof a detailed review is provided in Paper I. Paper III additionally provides results of a survey on contemporary practices of professionals around the world concerning robustness.  In the subsequent chapter, the studied 8-storey case building made of platform-framed cross-laminated timber is described including the modelling abstractions. Additionally, the setup of a validation experiment for the modelling approach is described. The following chapter introduces the modelling approach for an alternative load path analysis after a wall removal. The approach is based on the finite element method using the commercial software Abaqus. The deterministic part of the approach includes a non-linear static pushdown analysis of single storeys in a bay and elicits the alternative load paths and their capacity. Finite connector elements in the model substitute single fasteners including their elastic, plastic, damage and rupture behaviour. The 3D models of the walls and floors account for timber crushing, brittle failure and contact friction. A simplified non-linear dynamic model of the entire bay uses the pushdown results as inputs and evaluates the collapse progression among storeys after a sudden element removal. The probabilistic part of the approach models the uncertainty of the input parameters of the dynamic model by varying the parameter values in a Monte Carlo simulation, to evaluate the probability of a collapse.  Paper II applies the approach for a simple pushdown of a single storey and Paper IV applies the pushdown and the dynamic analysis to elicit the alternative load paths after a single wall removal. The thesis shows furthermore the results of a double wall removal in the example building and the results of the Monte Carlo analysis for the single and double wall removal.  For the assumed removals, the developed approach could identify the alternative load paths, determine their capacities and estimate the probability of a collapse under probabilistic variations. The approach might be used to classify various removal scenarios in platform-framed multi-storey cross-laminated timber buildings specifically and predetermine design solutions which could provide a desired level of robustness. The approach might be generalised for multi-storey timber buildings of various construction types.

Historically, students from ethnically diverse backgrounds in grades K-12 have been over-represented in special education, yet little research on disproportionate representation has been conducted with preschool-aged children. This study examined if 72,525 preschool-aged children with disabilities from ethnically diverse backgrounds were disproportionately represented in special education within and across five southern states. Data were gathered from the 2006 December 1st Child Count reported by each State Department of Education to the U.S. Department of Education. Chosen states offered state-funded pre-kindergarten programs, which should have provided equal opportunities for inclusion across states. Analyses compared children with disabilities for disproportionate representation across state of residence, across special education eligibilities, across educational placements, and amount of inclusion provided. Data were analyzed for child and placement characteristics. Due to data suppression by individual states, analyses were conducted using children from Black and White backgrounds, and children from Hispanic backgrounds were used when reported by individual states. Child characteristics considered included the child’s: (a) type of disability eligibility category, (b) age, and (c) ethnicity. Placement characteristics included: (a) type of educational placement, (b) state in which child resided, and (c) amount of inclusion received. Indices of disproportionate representation were calculated using: (a) composition index, (b) risk index, (c) odds ratio, and (d) relative risk ratio. A 3 x 5 ANOVA was used to calculate placement differences between states. Factorial analysis was used to calculate determinants of placement status for preschool-aged children with disabilities. Results revealed disproportionate representation does occur at the preschool level, although between state variability was great, and patterns differed from the K-12 literature. Children from American Indian backgrounds were over-represented due to high proportions in states of Alabama and North Carolina, while children from Asian and Hispanic backgrounds were under-represented. Children from Black and White backgrounds were represented in special education at expected rates. The most common eligibility categories were speech/language impairments and developmental delay. Placement results revealed over-representation for White preschoolers and males, although type of state-funded pre-k program was a non-significant factor. Inclusion analyses favored Whites and males. Child demographic factors explained the majority of variability in inclusion status.

The United States of America is a country composed of various ethnicities. This country is considered to be a multi-cultural society. There are various cultural traditions values, norms and superstitious practices within each ethnic group. Attitudes toward end of life care are complex and vary differently across each ethnic group. This study explored factors that explained African Americans' disproportionate use of hospice. Access to hospice care was address, experience with hospice was explored, and recommendations were provided. This study conducted non-experimental research. The design of this exploratory study was quantitative in nature. A survey approach was utilized to collect data that was statistically analyzed. The important concept was African American disproportionate use of hospice. The variable willingness to use was employed to try to explain African Americans' disproportionate use of hospice. The independent variables African Americans who mistrust formal healthcare providers and knowledge about hospice services were operationalized using multiple indicators. The independent variable experience with hospice services did not use a scale. The research findings supported all three study hypotheses. This research results recommend that an important focus of the future be to counsel persons on the availability of hospice as an option for end-of-life care. Well-structured programs of training in cultural awareness and cultural competence throughout the ranks of the health care system must be instituted. Such an effort will pay dividends in reducing cultural mistrust and push closer to eliminating health disparities between minority groups and the rest of society.

No description available.

No description available.

No description available.

Medicaid Disproportionate Share Hospital (DSH) payment is one of the major funds supporting health care providers as they treat low-income patients. However, Medicaid DSH payments have been targeted for major budget cuts in many health policy reforms. This study examines the association between the changes in Medicaid DSH payments resulting from the BBA policy changes and hospital outcomes, in terms of hospital provision of uncompensated care and quality of care. Economic theory of non-profit hospital behavior is used as a conceptual framework, and longitudinal data for California short-term, non-federal general acute care hospitals for 1996-2003 are examined. California was especially affected by DSH changes because it is one of the states with highly concentrated DSH payments and high uninsured rate. Economic theory suggests that hospitals would change their uncompensated care provision as well as quality of care when confronted with a reduction in public payments. Hospital uncompensated care costs and percent of operating costs devoted to uncompensated care are used to measure the provision of hospital uncompensated care. Six AHRQ’s Patient safety indicators (PSIs) and one composite measure are selected to measure hospital quality of care provided for Medicaid and uninsured patients as well as privately insured patients. The key independent variable is Medicaid DSH payments received by individual hospitals. This study also includes control variables such as other governmental financial subsidies, market characteristics, and hospital characteristics. The primary data sources include the detailed hospital annual financial data and Medicaid annual report data at the county level from California Office of Statewide Health Planning and Development, Healthcare Cost and Utilization Project (HCUP) state inpatient data (SID), American Hospital Association Annual Survey, Area Resource File, Interstudy HMO Data and Medicare cost report data. After controlling for different factors, the study findings suggest that not-for-profit hospitals may reduce their provision of uncompensated care in response to reductions of Medicaid DSH payments. The results, however, do not support the hypotheses that for-profit hospitals may reduce uncompensated care by a smaller degree than not-for-profit hospitals for a comparable DSH decline. With respect to quality of care model, the overall study findings do not strongly support there is an association between net Medicaid DSH payments and patient adverse events for both Medicaid/uninsured and privately insured.

Det här examensarbetet går ut på att jämföra EKS 11 och SS-EN 1991-1-7 olika beräkningsmodeller för olyckslaster. Ifall en byggnad endast har ett trapphus som enda nödutgång krävs det att den dimensioneras för olyckslaster. Dessa olyckslaster delas upp i två olika grupper, kända- och okända olyckslaster. Kända olyckslaster är exempelvis påkörning när byggnaden ligger nära en väg och explosion ifall det finns exempelvis gasledningar i byggnaden. Okända olyckslaster är de laster där man inte kan dimensionera för ett exakt värde. Istället dimensionerar man för att minska konsekvenserna av lasten där främsta alternativet är att använda de krav som ställs på väsentliga bärverksdelar och applicera dem på de bärande konstruktionsdelarna. Alternativt när byggnaden inte har gasledningar så kan man beräkna för okända laster genom att dimensionera via värdet som uppkommer från en gasexplosion, 34 kN/m2. Dimensioneringen anpassas efter ett verkligt projekt konstruerat av Structor. Tidigare problem har uppstått vid tolkning av eurokodens beräkningsgång och därför har eks 11 kommit med förtydliganden och med mer triviala lösningar kring olyckslaster. Beräkningsgången för de olika olyckslasterna ser olika ut beroende på om man följer eks 11:s metod eller eurokodens metod. Målet med arbetet är att förtydliga skillnaderna mellan de olika beräkningsgångarna och se vad som ligger till grund för dom. För att kunna skapa en bredare förståelse kring olyckslaster har eurokoden, EKS 11, litteratur och Structor varit till stor hjälp. Examensarbetet är avgränsat till olyckslaster när det bara finns ett trapphus som enda utrymningsväg där det sker en jämförelse mellan EKS 11 och SS-EN 19911-7. Resultatet visar att de två olika beräkningsgångarna ger två olika svar vid beräkning av både kända- och okända laster. Ekvationerna för att räkna fram olyckslaster i de olika standarderna tar hänsyn till olika saker vilket leder till olika resultat. Slutsatsen som går att dra är att det alltid finns olika förutsättningar för varje projekt. Därför bör det göras en riskanalys i projekteringsskedet för att avgöra vilken standard som ska användas för det aktuella projektet. / This dissertation is based on a comparison between the two different procedures on accidental actions in the Swedish norm EKS 11 and SS-EN 1991-1-7. If a construction only has a stairwell as the only emergency exit it requires that accidental actions determines. These accidental actions are categorized mainly to known and unknown accidental actions. Known accidental actions are for example collision by a vehicle or a gas leak from a gas pipe in the building. Unknown accidental actions are those loads that cannot be completely determined. Instead an analyze how to decrease the damage by accidental actions are used. The main approach is to value members as key elements, in effect making them strong enough to withstand a prescribed hazard loading. An alternative if the construction does not have any gas pipes is to use the pressure of 34 kN/m2 to represent the static equivalent from a notional gas explosion. The values in the work are based from a project constructed by the Swedish company Structor. Previously difficulties have occurred while comprehending the Eurocode’s calculation procedures therefore the new Swedish norm EKS have clarified a lot about accidental actions. The calculation procedures results in two different answers between the Eurocode and the Swedish norm EKS. The aim with this dissertation is too clarify the differences between them and perceive the reasons behind it. To be able to have a wider understanding of the subject accidental actions a screening has occurred of the Eurocode, the Swedish norm EKS and literature. The Swedish company Structor has also shared a lot of knowledge on the subject. The dissertation has been limited to accidental actions on stairwells as the only emergency exit and a comparison between the Swedish norm EKS 11 and SS-EN1-7. The outcome of the two different calculations shows two different results of the known and unknown accidental actions. The equations for calculating accidental action in the different standards considerate different things which leads to different results. The conclusion is that there always are different conditions in every project. Therefor a risk assessment should be done before the construction begins to determine which standard is the most suitable for the project.

The EU Water Framework Directive (Directive 2000/60 EC) provides numerous requirements, including achievement of good status of all water bodies by 2015. However, meeting this environmental target brings substantial costs. In justified cases, member states may request an extension of the deadline based on disproportionality of costs of meeting the WFD requirements. Definition of disproportionate costs must be based on economic analysis and on the WFD general requirements. This thesis provides a review of proportionate costs in the context of the WFD, identifies main requirements for its practical definition as an exemption and provides a review of foreign methodical approaches to define cost proportionality. It is clear that the Cost-effectiveness analysis (CEA) and the Cost-benefit analysis (CBA) are most commonly used methods to determine the cost proportionality treshold. This thesis discuss the relevance of these methods to define cost proportionality to reach good status of water bodies. The thesis also provides methodology to assess cost proportionality based on modified CBA and analyses ecosystem services of water bodies. In addition, the thesis points out the methodological complications and uncertainties of suggested methodology. Main methodological issues are connected with definition of right scale of analysis and synergy effects of measures, analysis of costs and definition of suitable measures and analysis of benefits and quantification of ecosystem services of water bodies.

Past research has revealed that African American/Black boys are referred for special education evaluation at disproportionately higher rates than boys of other racial/ethnic groups. This correlational study used survey methodology to examine whether student and teacher demographic variables predicted how likely a teacher would refer boy students for special education evaluation. The following questions guided this research: 1) To what degree does student race/ethnicity, teacher gender, teacher race/ethnicity, and teacher attitude toward inclusion predict how likely a teacher would refer boys' to special education after controlling for teacher's years of experience in general and special education? 2) What are the differences in teacher ratings regarding the severity of classroom behaviors based on the students' race/ethnicity? Cultural theory and social exclusion theory were used to guide this research. Data were collected through the researcher developed Teacher Rating Form from 110 teachers. Results from a multiple linear regression revealed that years of teaching experience, race of teacher, race the student, and teacher attitude toward inclusion were statistically significant predictors of teacher referral to special education. However, the effect size was small. Results from the ANOVA procedure revealed no statistically significant differences in teacher ratings for severity of described classroom behaviors based on the students' race/ethnicity. Findings form this study could be used to promote social change by increasing teacher awareness of how certain teacher demographics affect teacher referral of boys to special education. Findings can be used to advocate for training and seminars that could promote cultural understanding among teachers that may lead to and reduce the number of referrals.