Thesis (M.S.)--University of Michigan, 1981.

Thesis (M.S.)--University of Michigan, 1981.

Existing literature on boarding and rooming establishes the important role of boarding in the housing market. Boarding and rooming have traditionally provided temporary, inexpensive accommodation for those who have come to the city to seek employment. The first half of the twentieth century was a period of dramatic economic and social change and yet there is no study of boarding during this period. This is a study of the declining incidence of boarding and rooming in Hamilton during the period 1900 to 1948. There is a dramatic decline in boarding and rooming during the first fifteen years of the twentieth century. Rates remain low during the 1920's with a slight resurgence seen during the Great Depression and the Second World War. There is a substantial decline in boarding and rooming over the entire period of study 1900 to 1948. Also, there is a decline in the percentage of boarders and roomers that were boarders during the period of study. Changing social tastes demonstrate an increasing preference for the nuclear family. Therefore, individuals residing with the family are no longer encouraged to live as one of the family. The relationship that exists between boarding and rooming and periods of economic prosperity and recession are found to be complex and contradictory in nature. Although periods of prosperity allow individuals to find their own accommodation, this same prosperity attracts increasing numbers of people to the city creating a housing shortage and causing people to have to double up. Similarly, periods of recession create a need for inexpensive accommodation but also, many individuals return to farming during these periods. Finally, the decline that took place in boarding and rooming during this period cannot be explained exclusively by economic changes but also by dramatic social changes that were also taking place during this period. / Thesis / Bachelor of Science (BSc)

Background: Rooming house residents have high rates of morbidity and mortality, yet little is known about why this disparity in health exists. Research Question: How are rooming houses linked to health? Case: Social exclusion of rooming house residents in downtown Ottawa, bounded by the neighborhood, and Ottawa’s political policies at the time of data collection (September 2019-June 2020). Methodology: A single embedded descriptive case study was informed by multiple sources of evidence, and involved a community advisory group (CAG). Rooming house residents took photos, participated in a community walk-about with participant observations and attended a focus group. Two additional focus groups were conducted; one with fellow rooming house residents, another with the CAG. Interviews with rooming house front-line service providers and a secondary data set of homeless service measures also informed the case. Findings: 1. Rooming house residents (n=10) took 112 photos, and (n=8) took part in a focus group where two broad themes emerged: Housing is health care, and just managing today. 2. Interviews with front-line service providers (n=11) focused on two themes: There are many costs to living in a rooming house, and rooming house front-line service providers wear many hats. 3. Between a sample of sheltered homeless (n = 60) and rooming house residents (n=52), there was no difference found for several health indicators, including frequency of care received in the emergency room, hospitalization as an inpatient, and if substance use made it difficult to stay or afford housing. Focus groups with rooming house residents who did not take photos (n=10) and the GAG (n=6) contributed to persona co-creation revealing financial and contextual factors affecting the health of rooming house residents. Conclusion: The shared spaces of rooming houses create a tension between offering community and creating a risk environment. The negative health consequences to living in a rooming house are mitigated by the many roles that rooming house front-line service providers play in filling gaps. This study suggests the need to definitively position rooming house residents on the housing continuum in order to ensure equitable distribution of resources to optimize the health of this vulnerable population.

Bakgrund: Barn som föds för tidigt mår i allmänhet bäst av att vårdas av sina föräldrar dygnet runt. Att övergå från öppna rum till familjerum innebär en omställning för personal. Det finns få svenska studier som belyser hur personalen upplever denna förändring. Syfte: Syftet med studien var att beskriva personalens upplevelser av arbete och arbetsmiljö efter en genomförd flytt till nya lokaler och införandet av samvård. Metod: Studien genomfördes med kvalitativ metod med 12 deltagare fördelade på två fokusgruppsintervjuer samt 4 enskilda intervjuer med nyckelpersoner. Dataanalyserades med kvalitativ innehållsanalys. Resultat: I resultatet framkom ett övergripande tema" Realiteten som hinder för att uppleva visionen" med två huvudkategorier som beskrev personalens upplevelser efter den genomförda flytten "Visionen om arbetsmiljön som inte uppfylldes" och "Visionen om föräldrar och barn". Därtill identifierades 12 underkategorier som beskrev personalens upplevelser av förändringsarbetet och processen det inneburit med flytten till en ny vårdbyggnad. Det fanns svårigheter och utmaningar för personalen att gå från öppna rum till enskilda familjerum och införandet av familjecentrerad samvård. Personalen ansåg att lokalerna var dåligt planerade och de hade önskat att deras erfarenheter och åsikter hade vägt tyngre i planeringen. Dock upplevdes vården bättre för barn och familjer efter att familjerum blev tillgängliga. Slutsats: Det finns svårigheter och utmaningar för personalen med att införa samvård som en ny vårdform. Personalen anser ändå att det är det bästa för barnet och familjen. Att involvera personalen och använda deras kunskap och erfarenhet är viktigt vid byggandet av en ny avdelning och införande av samvård eftersom det påverkar deras arbetsmiljö. Nyckelord: Neonatalvård, Familjecentrerad samvård, Samvård, Arbetsmiljö, Anknytning / Bakground: Children born prematurely are in general best cared for by their parents around the clock. The transition from an Open-Bay to a Single-Room unit entails a new way to care for the family and collaboration with staff. There are few studies that illustrates how staff perceive this change. Aim: The aim of the study was to describe staff's experiences of the working environment and working with Family-centered care in a Single-Family-Room unit. The method: The study was conducted with a qualitative design, in which two focus groups with 12 participants and four individual interviews were conducted. Data were analyzed using qualitative content analysis. The result: The result showed an overall theme "Reality as a barrier for experiencing the vision". Two main categories described the staff's experiences after completed the move:"The vision of the work which was not fulfilled" and "The vision of parents and children". In addition, 12 subcategories were identified that described the staff's difficulties and challenges in moving from working in Open-Bay to Single-Room unit. The staff felt that the premises were poorly planned and they had hoped that their opinions had been taken in to account in the planning process. With regard to the care for the family, staff experienced beneficial improvements after introducing Single-Rooms. Conclusion: There are difficulties and challenges for the staff to introduce rooming as a new form of care. The staff believe that it is best for the child and the family. Involving staff and use their knowledge and experience is important in the construction of a new department and the introduction of rooming because it affects their working environment. Nyckelord: Neonatal Nursing, Family Centered Care, Rooming, working environment, Attachment

O estudo do tempo despendido nas intervenções/atividades de enfermagem tem se mostrado indispensável na identificação da carga de trabalho de enfermagem. O tempo de assistência de enfermagem é a variável mais complexa e difícil de ser avaliada, mas o seu conhecimento possibilita adequar o quantitativo e o qualitativo de profissionais as demandas de cuidado que possibilite segurança aos pacientes e equipe de enfermagem. Particularmente, nas maternidades que adotam o Sistema de Alojamento Conjunto a preocupação com esse tema é oportuna devido a escassez de valores de tempo de assistência de enfermagem ao binômio mãe-filho. Com a finalidade de identificar a carga de trabalho em uma unidade Alojamento Conjunto de um hospital de ensino foi realizada a presente investigação de abordagem quantitativa, tipo estudo de caso, observacional, transversal e descritiva.A metodologia empregada foi dividida em quatro etapas: identificação das atividades ao binômio mãe-filho,por meio do registro no prontuário e da observação das atividades executadas pela equipe de enfermagem; classificação das atividades ao binômio mãe-filho segundo a Classificação de Intervenções de Enfermagem (NIC); validação de conteúdo das intervenções utilizando a técnica de oficina de trabalho e mensuração da quantidade e do tempo despendido nas intervenções de enfermagem adotando-se a técnica de amostragem do trabalho. Foram identificadas e validadas 43 intervenções de enfermagem na assistência ao binômio mãe-filho, referentes a seis dos sete Domínios da NIC. Pela técnica de amostragem do trabalho obteve-se 4.998 mensurações de intervenções realizadas pela equipe de enfermagem da unidade. As enfermeiras despendem 39% de seu tempo em atividades de cuidados diretos, 43% em atividades de cuidados indiretos, 11% em atividades pessoais e 7% em atividades associadas ao trabalho; já as técnicas/auxiliares de enfermagem despenderam 50% em atividades diretas, 28% em indiretas, 18% em pessoal e 4% em associadas ao trabalho. O tempo médio despendido na assistência binômio mãe-filho foi de 5,8h sendo 1,4h de enfermeiras e 4,5h de técnicas/auxiliares de enfermagem. A produtividade da equipe atingiu 85%, considerada alta frente aos dados preconizados na literatura. O Domínio da taxonomia adotada de maior representatividade para a equipe de enfermagem foi o Domínio Sistema de Saúde com a intervenção Documentação a mais frequente. Para as técnicas/auxiliares de enfermagem a intervenção Administração de Medicamentos foi a de maior ocorrência. Ao se comparar o tempo obtido nas intervenções realizadas no Alojamento Conjunto com o tempo estimado na NIC verificou-se que o tempo médio medido está dentro do intervalo do tempo estimado na NIC na maioria das intervenções analisadas. A carga de trabalho do binômio mãe-filho, neste estudo, correspondeu a pacientes de cuidados intermediários, segundo o Sistema de Classificação de Pacientes de Fugulin et al., (1994) e com o tempo médio de assistência intermediária preconizado pela Resolução COFEN nº 293/04 / The study of time expended on nursing interventions/activities has been shown essential to identify nursing workload. Time expended on nursing assistance is the most difficult variable and not easy to be evaluated, but its knowledge allows to adjust the quantitative and qualitative factors of professionals regarding care demand granting safety to the patients and the nursing staff. Specifically, in maternity wards which adopt the rooming-in system, we consider important our concern due to lack of time values for nursing assistance in relation to the mother-child binomial. Aiming to identify the burden of work in a rooming-in unit, in a teaching hospital, a descriptive, quantitative, observational, transversal, case study was carried out. The methodology used was divided into four phases: identification of mother-child binomial, analyzing patient clinical records and through observation of activities performed by the nursing staff; classification of mother-child binomial activities, according to Nursing Intervention Classification (NIC); validation of the intervention content using workshop techniques and measuring the amount of time expended on nursing interventions adopting the work sampling technique. Forty-three nursing interventions regarding the mother-child binomial assistance were identified and validated regarding six out of the seven NIC Domains. By the work sampling technique, we obtained 4,998 interventions measured which were performed by the nurse staff of this unit. The nurses expended 39% of their time in activities regarding direct care, 43% with indirect care, 11% in personal activities and 7% in work related-activities; yet, the nursing technicians/ assistants expended 50% in direct activities, 28% in indirect activities, 18% personal activities and 4% in work related-activities. The mean time used in the mother-child binomial assistance was 5.8 hours, of which 1.4 h for nurses and 4.5h for nursing technicians/ assistants. The staff productivity reached 85%, which was considered high in relation to data stated in the literature. The Domain of the adopted taxonomy of greatest representativeness for the nursing staff was the Health System Domain, being intervention of Documentation as the most frequent. For the nursing technician/assistants, the Medicament Administration intervention was the most mentioned. When comparing time expended on interventions performed in the rooming-in with estimated time on NIC, it was observed that the mean time measured is within the interval of estimated time expended on NIC, which was found in most of the analyzed interventions. The burden of work regarding mother-child binomial, in this study, corresponded to intermediate care patients, according to Fugulin et al. ´s Patient Classification System (1994), and with the mean time of intermediated assistance preconized by the COFEN Resolution n293/4

The old practice of separating the mother-baby-dyad was without measurable benefits to mothers or their infants. Evidence has shown that skin-to-skin care (SSC) prevents hypothermia and hypoglycemia, decreases crying during painful procedures in newborns, and reduces maternal anxiety, stress, and postpartum depression. Rooming-in care (RIC) has been linked to an increase in the rate of breastfeeding and mother-infant interaction, as well as a decrease in the infant morbidity rate. This project assessed the effect of an educational intervention to increase rates of SSC and RIC in an obstetric unit, in addition to measuring nurses' attitudes and barriers in relation to SSC and RIC. The obstetric nurses received educational content related to SSC and RIC based on Kotter's model of change. A pre and postintervention evaluation showed a significant increase in the rates of SSC and RIC from pretest of 10%, to posttest of 96%; and RIC from pretest of 10% to posttest of 92%. Using a Wilcoxon test, a significant difference was found from pretest to posttest for every subscale score of the Mother-Newborn Skin-to-Skin Contact Questionnaire and Nurse Attitudes and Barriers to nonseparation Scale (p < 0.001), with the exception of belief about obstacles for SSC, which yielded a nonsignificant change (p = 0.57). This DNP project led to changes in the organization's culture, including the closure of the well-baby nursery. This project promoted social change across the organization, in that the team health care providers delivered evidence-based, standardized, unbiased, and family-centered care to the mother-baby dyad.

<p>This major project in Building Engineering has its focus on inquiring into what methods has been used in the planning process of the residential building</p><p>Ljusbojen 1. This project has been conducted in cooperation with Kadesjös Ingenjörsbyrå AB, an engineering contractor firm which also acts as the property developer. Initially several different general methods for planning residential buildings have been presented. After the methods from the process of building Ljusbojen 1 has been analyzed compared to the general methods presented in part 1. This shows what the determining factors are during the planning process; factors such as cost, quality, time management, know-how and environmental issues. Ljusbojen 1 has been a good building to study as it has a quite rare architecture and is meant to be perceived as a luxurious resident. The building has been divided into several different parts as this is how they are in the presented in offers, also the different parts are more easily analyzed; the parts are: foundation preparation, framework, exterior, rooming complements and installations. The basis of information has been extracted from relevant literature, planning project reports and in-person interviews. As the scope of this project covers a large field work has been concentrated on the most interesting methods. As a general result it can be determined that the building industry has been pressured to develop and try new methods mainly because of new and daring architectures. However, many existing and well known methods are still in use as the companies know that they work and can offer lower price from these.</p>

This major project in Building Engineering has its focus on inquiring into what methods has been used in the planning process of the residential building Ljusbojen 1. This project has been conducted in cooperation with Kadesjös Ingenjörsbyrå AB, an engineering contractor firm which also acts as the property developer. Initially several different general methods for planning residential buildings have been presented. After the methods from the process of building Ljusbojen 1 has been analyzed compared to the general methods presented in part 1. This shows what the determining factors are during the planning process; factors such as cost, quality, time management, know-how and environmental issues. Ljusbojen 1 has been a good building to study as it has a quite rare architecture and is meant to be perceived as a luxurious resident. The building has been divided into several different parts as this is how they are in the presented in offers, also the different parts are more easily analyzed; the parts are: foundation preparation, framework, exterior, rooming complements and installations. The basis of information has been extracted from relevant literature, planning project reports and in-person interviews. As the scope of this project covers a large field work has been concentrated on the most interesting methods. As a general result it can be determined that the building industry has been pressured to develop and try new methods mainly because of new and daring architectures. However, many existing and well known methods are still in use as the companies know that they work and can offer lower price from these.

På de flesta svenska sjukhus har samvård av mor och barn efter förlossning eftersträvats eftersom samvård bland annat främjar amning. I samband med kejsarsnitt och då barnet inte mår väl efter födsel separeras dock ofta mor och barn för en kortare eller längre tid, vilket påverkar amningen negativt. Mödrars tillit till sin förmåga att amma har visat sig ha stor betydelse för om de skall lyckas med amning. Mödrar med låg tillit har en högre risk att sluta amma tidigt än de som har hög tillit. Syftet med studien var att jämföra nyblivna mödrars tillit till sin förmåga att amma då mor och barn vårdas tillsammans respektive vårdas separerade efter förlossning. I studien ingick totalt 60 mödrar från fyra olika sjukhus i västra Sverige, varav hälften samvårdats med sitt barn respektive vårdats separerade. Undersökningen gjordes utifrån en kvantitativ ansats genom enkätundersökning med det validerade mätinstrument BSES-SF. Svarsdatan har analyserats med jämförande och förklarande statistik i form av Mann-Whitney U test samt Chi-Square test. Resultatet visade på att numerisk skillnad fanns. Mödrar som separerats hade en lägre tillit till sin förmåga att amma än mödrar som hade samvårdats med sitt barn. Skillnaden var dock ej signifikant. Studien har för litet urval och eventuella störande variabler har ej kunnat uteslutas för att resultatet skall anses tillförlitligt, men tendensen som framkommit stöds i annan forskning. I diskussionen lyfts även att vid initiala amningssvårigheter kan pedagogiska tillitshöjande interventioner vara av betydelse samt undvikande av mjölkersättning i de fall där medicinsk indikation för detta saknas.