This study examines the Single Room Occupancy Housing (SRO) stock of the City of Toronto and of the City of Vancouver. The term SROs refers to residential hotels and rooming houses. Rooming houses located in converted single family dwellings constitute the primary SRO form of Toronto. Residential hotels constitute the primary SRO form in Vancouver. This study examines the historical evolution of the SRO stock, the characteristics of the units, the socioeconomic characteristics of the residents, and the provincial and municipal policy relating to the SRO stock. SROs were the first form of accommodation for many immigrants and transient male workers. SRO units in rooming houses also housed couples and families during the first decades of the 1900's in both Toronto and Vancouver. A dire shortage of affordable rental housing forced families to live in overcrowded conditions in single rooms. SROs today house primarily two three of population. Those who live in single rooms permanently, those who live in single rooms because they cannot afford to rent an apartment, and those who live in single rooms temporarily. Contrary to what has been commonly assumed, residents of SROs are not transient. SRO residents, although they might move frequently, they do so because they continually face displacement. Evictions are common because of real estate market pressures. Many SRO units are being converted to other residential uses or demolished. The main group of SRO residents still consists of single older men, however, the percentage of women and of young men has increased among the SRO residents in recent years, especially in the case of the rooming houses of Toronto. The majority of SRO residents live on incomes which are well below of the poverty line (approximately, 50% of the poverty line). These residents pay 50% to 75% of their income on housing. SRO housing is an important component of the rental housing market of Vancouver and Toronto. SROs constitute the last housing resort before homelessness. However, with the exception of SRO units in social housing projects, SROs existing today in Toronto and Vancouver do not constitute an adequate form of accommodation. In most cases, the physical condition of the units is substandard and the rents are still very high for the average SRO resident. In Vancouver, SRO units are not fully recognized as part of the rental housing stock because they are not protected by provincial landlord and tenant regulation. The continued availability of SRO accommodation looks more optimistic in Ontario than it does in British Columbia. The main focuss of the housing policy of Ontario and Toronto towards the SRO stock has been to rehabilitate, to improve and to expand the SRO stock. In addition, Ontario has recently drafted legislation which protects the rental housing stock from demolition and conversion and it has extended security of tenure rights to the residents of rooming houses. On the other hand, the main thrust of the housing policy of the province of British Columbia and of the City of Vancouver towards the SRO stock has been to relocate SRO tenants in social housing units / Applied Science, Faculty of / Community and Regional Planning (SCARP), School of / Graduate

Bakgrund: Idag när nya sjukhus byggs blir designen till större delen enkelrum. Vårdmiljön bör stödja patienternas hälsa och välbefinnande. Att det finns en länk mellan hälsa och miljön som patienterna vistas i fastställs i begreppet evidensbaserad design. När patienter idag vårdas på sjukhus finns olika typer av rum. Dessa är flerbäddsrum, som rymmer två eller flera patienter samt enkelrum, där endast en patient ryms. I denna litteraturöversikt undersöks patienternas upplevelse av att vårdas i enkelrum. Patientens upplevelse av sin vård är viktig för sjuksköterskan att känna till. Den personcentrerade vården är nyckeln till upplevelsen. Syfte: Att beskriva patienters upplevelse av att vårdas på enkelrum. Metod: Studien är en litteraturöversikt baserad på elva vetenskapliga artiklar från två världsdelar. Artiklarna söktes i databaserna Pubmed, Cinahl och Science Direct, inklusionsår var 2000 – 2018. Resultat: Redovisas utifrån studiens syfte och presenteras under fyra kategorier; socialt stöd, autonomi & kontroll, komfort och ensamhet & isolering som i sin tur har underkategorier. Kategorierna har utformats utifrån återkommande begrepp i artiklarna som ligger till grund för resultatet. Resultatet visar både på fördelar och nackdelar med patienternas upplevelse av att vårdas på enkelrum. Slutsats: Patienternas upplevelse av att vårdas på enkelrum är mer komplex än rummets utformning, design och smyckning. Det handlar även om patienternas ålder och personligheter. Mer forskning kring detta ämne kommer att behövas innan generella direktiv om att endast införa enkelrum i byggnationer av nya sjukhus. / Background: Today, when new hospitals are being built, the design becomes mostly single rooms. The healthcare environment should support patients' health and well-being. That there is a link between health and the environment in which patients stay in is established in the concept of evidence-based design. When patients are hospitalized today, there are different types of hospital rooms. These are multibed rooms that accommodate two or more patients as well as single rooms, where only one patient is accommodated. This literature review examines the patient's experience of being cared for in a single room. Patient´s experience of the care is important for the nurse to be aware of and the person-centered care is the key to the experience. Purpose: To describe patients' experience of care in single rooms. Method: The study is a literature review based on eleven scientific articles from two continents. The articles were searched in the databases pubmed, cinahl and science direct, inclusion year were 2000-2018. Results: Reported on the purpose of the study and presented in four categories: social support, autonomy &controll, comfort and lonliness & isolation, which in turn has subcategories. The categories have been designed based on recurring concepts in the articles that underlie the results. The result shows both the advantages and disadvantages of the patient's experience of being cared for in single rooms. Conclusion: Patients' experience of care in single rooms is more complex than the design, and decoration of the room. It is also about the age and personalities of the patients. More research on this subject will be required before general directives to only introduce single rooms in construction of new hospitals.

SAMMANFATTNING Syfte: Att studera föräldrars upplevelse av att kunna tolka sitt barns behov och mående samt upplevda kompetens i föräldrarollen efter att barnet har vårdats på neonatalavdelning. Metod: En jämförande kvantitativ studie med deskriptiv explorativ design som är en del av ett större projekt som genomförts vid två neonatalavdelningar i Sverige. En vecka efter barnets utskrivning från neonatalavdelningen samt vid två månaders korrigerad ålder fick barnets mamma och pappa varsin enkät, innehållande bland annat en föräldra-attitydskala, hemskickad. Insamlade data matades in i Statistical Package for the Social Sciences (SPSS) och redovisades med deskriptiv (md; median och range; minimum och maximum) och jämförande statistik (Chi-2-test och Mann-Whitney U-test). Resultat: En enda signifikant skillnad kunde ses mellan de två neonatalavdelningarna och det gällde föräldrarnas upplevelse att barnet tyckte om kontakt från dem i form av deras doft. På neonatalavdelning 2 svarade föräldrarna i högre grad att detta påstående stämde en vecka efter barnets utskrivning från neonatalavdelningen. Inga andra signifikanta skillnader ses vid jämförelsen av föräldrarnas enkätsvar från de två neonatalavdelningarna. Slutsats: Den enda signifikant skillnad som kunde ses anses av flera orsaker inte vara av särskilt hög betydelse. Följaktligen kan inga väsentliga skillnader ses mellan föräldrarnas upplevelse av sitt barns behov och mående samt upplevda kompetens i föräldrarollen beroende på om barnet vårdats på en neonatalavdelning där föräldrarna fick bo med sitt barn under hela vårdtiden och tidigt involveras i sitt barns vård eller om barnets vårdats på en neonatalavdelning med mindre föräldranärvaro. / ABSTRACT Aim: Studying parents' experience of being able to interpret their child's needs and well-being, and perceived competence in parenting after the child has been cared for in the neonatal unit. Method: A comparative quantitative study with a descriptive exploratory design that is part of a larger project conducted at two neonatal units in Sweden. A week after the child's discharge from the neonatal unit and at two months' corrected age, the child’s mother and father received a questionnaire sent to their home, containing among other things a parental attitude scale. Collected data were fed into the Statistical Package for the Social Sciences (SPSS) and presented with descriptive (md; median and range; minimum and maximum) and comparative statistics (Chi-2 test and Mann-Whitney U test). Results: Only one significant difference was seen between the two neonatal wards and it was regarding the parents' experience that the child enjoyed contact from them in terms of their fragrance. In the neonatal unit 2 parents agreed to a greater extent that this claim was true a week after the child's discharge from the neonatal unit. No other significant differences were seen when comparing the parents' questionnaire responses from the two neonatal wards. Conclusion: The only significant difference that was found was for several reasons not considered to be of very high importance. Consequently, no significant differences was found between the parents perception of their child's needs and well-being, and perceived competence in the parental role, depending on whether the child received care in a neonatal unit where the parents were allowed to stay with their child throughout the whole hospital stay and early get involved in their child's care or if the child was admitted to a neonatal unit with less opportunity for parental presence.

Meticillinresistente gule stafylokokker (MRSA)er assosiert med økt risiko for komplikasjoner og død. I Norge anbefales omfattende smitteverntiltak for å forebygge spredning av MRSA i helseinstitusjoner, inklusiv i sykehjem. Tidligere ble det anbefalt å isolere MRSA-positive sykehjemsbeboere på enerom. I nasjonal MRSA-veileder publisert i 2009 frarådes langvarig isolering. Målet med studien var å undersøke om nye anbefalinger om ikke å isolere beboere med MRSA er like effektive som tidligere anbefalinger om å isolere beboere med MRSA, i forhold til å forebygge spredning av MRSA blant beboere i sykehjem. Metode: Studien er en non-inferiority kohortstudie basert på historiske data om registrerte MRSA-tilfeller ved sykehjem i Norge, informasjon om smitteverntiltak ved hvert sykehjem og statistikk om ressursbruk i kommunenes pleie-og omsorgstjenester. Hovedresultat: Insidensratene for sekundærtilfeller av samme MRSA spa-type ved samme sykehjem i løpet av oppfølgingstiden var 6.3 per 1000 beboerår på sykehjem som ikke isolerte og 18.5 per 1000 beboerår på sykehjem som isolerte beboere med MRSA. Insidensrate ratio for nytt MRSA-regime versus tidligere MRSA-regime var på 0.34 (95 % konfidensintervall: 0.17 –0.63). Konklusjon: Studiens resultat tilsier at nytt MRSA-regime uten isolering er like effektivt i å forebygge spredning av MRSA som tidligere MRSA-regime der beboere med MRSA ble isolert. Resultatene i studien bør benyttes aktivt for å få alle sykehjem i Norge til å implementere rutiner som er i tråd med anbefalinger i gjeldende nasjonal MRSA-veileder. / Methicillin-resistant Staphylococcus aureus(MRSA) associates with increased risk of morbidity and mortality. In Norway,public health officials recommend comprehensive infection control measures to prevent the spread of MRSA in healthcare institutions, includingnursing homes. Previous recommendations advisedsingle-room isolation for MRSA-positive nursing home residents. National MRSA-guidelines (2009)recommended avoidinglong-time isolation. Aim: Thisstudy aimed to determine whether the new MRSAregime,which no longer requires isolation ofresidents with MRSA,was equally effective as the former regime,which required isolation ofMRSA-positive patients,in preventing the spread of MRSA among residents in nursing homes. Method: This noninferioritycohort study used historical data on registered MRSA-cases in Norwegian nursing homes, information aboutinfection control measures in each nursing home,and statistics regarding the use of resources in primary health care. Results: The incidence rate for secondary cases of the same MRSA spa-type in the same nursing home was 6.3 per 1,000 person-years in nursing homes thatdid not isolateMRSA-infected residentsversus 18.5 per 1,000 person-years in nursing homes that did isolate such residents. The incidence rate ratio for new versus former MRSAregime was 0.34 (95% CI: 0.17–0.63). Conclusions: Thenonisolating MRSA regimeis equally effective as the isolatingregime in preventing the spread of MRSA. Our results suggest that allNorwegian nursing homes should implement the current national guidelines regarding MRSA / <p>978-91-86739-55-3</p>

Bakgrund: Egenskaperna i en vårdmiljö påverkar patienterna som vårdas i den och ärdärför något som sjuksköterskan måste reflektera över. För att kunna erbjuda enhögkvalitativ personcentrerad vård behöver sjuksköterskors tidigare erfarenheteravseende vård i de olika salstyperna belysas. Syfte: Syftet med litteraturstudien var attbeskriva sjuksköterskors erfarenheter av personcentrerad omvårdnad i en vårdmiljöbestående av enkelsalar och flerbäddssalar. Metod: En allmän litteraturstudie medinduktiv ansats genomfördes med nio vetenskapliga artiklar med kvalitativ metod (5)och mixad metod (4). Data sammanställdes genom en innehållsanalys. Resultat:Innehållsanalysen identifierade två kategorier till resultatet: sjuksköterskorserfarenheter av personcentrerad omvårdnad i enkelsal samt sjuksköterskorserfarenheter av personcentrerad omvårdnad i flerbäddssal. Tre underkategorier perhuvudrubrik uppstod också efter analysen. I resultatet framkom både för- ochnackdelar relaterat till personcentrerad omvårdnad i de båda salstyperna. I enkelsalarvar fördelarna större möjligheter till personcentrering och bibehållen integritet, menmed nackdelar som bland annat känslor av isolering för både sjuksköterskor ochpatienter. I flerbäddssalarna var fördelarna en starkare gemenskap ochsjuksköterskorna kände sig närmare sina patienter, medan kränkt patientintegritet varden stora nackdelen. Konklusion: Sjuksköterskan ska arbeta för en hållbar vårdmiljöoch därför behöver vårdmiljöns påverkan på patienter belysas, diskuteras ochreflekteras över av blivande och legitimerade sjuksköterskor. / Background: The characteristics of the environment affects the patients and shouldbe considered by the nursing staff. To enable a person-centered care in the differentpatient rooms, nurses’ experiences must be considered. Aim: The aim with thisliterature study was to describe nurses’ experiences of person-centered care in anenvironment with single rooms and shared rooms. Method: A literature study with aninductive approach was used with nine articles using qualitative method (5) andmixed method (4). Data was conducted through a content analysis. Results: Theanalysis identified two main categories: nurses’ experiences of person-centered carein a single room and nurses’ experiences of person-centered care in a shared roomand a total of six sub-categories. The results showed advantages and disadvantageswith the different types of rooms. Single rooms had advantages as opportunities forperson-centered care and maintained privacy, but patient and nurse isolation asdisadvantages. Shared rooms implied a sense of community, while privacy violationwas the major disadvantage. Conclusion: A nurse is tasked to work for a sustainableenvironment and because of that the importance of the environments’ impact onpatient well-being must be enlightened. The phenomenon must be addressed by bothnursing students and registered nurses.

I Sverige finns 36 neonatalavdelningar, där vårdas spädbarn som kräver högspecialiserad vård. Sjuksköterskor som arbetar inom neonatalvården behöver därför ha adekvat utbildning och vara kunniga inom sitt område. I nuläget bedriver inte alla neonatalavdelningar familjecentrerad enkelrumsvård. Familjecentrerad enkelrumsvård innebär att föräldrarna tar hand om sitt barn under hela dygnet med stöd av sjuksköterskor. Syftet med studien var att beskriva sjuksköterskors erfarenhet av familjecentrerad enkelrumsvård på en neonatalavdelning. Semistrukturerade intervjuer genomfördes med sju sjukskörskor och analyserades med kvalitativ innehållsanalys. Ur resultatet kom tre kategorier att växa fram; sjuksköterskan och familjecentrerad enkelrumsvård, föräldrarna och familjecentrerad enkelrumsvård samt barnet och familjecentrerad enkelrumsvård. I resultatet beskriver sjuksköterskor att familjecentrerad enkelrumsvård är att föredra, både för sjuksköterskor och familjer. Erfarenhet visar på att sjuksköterskors roll förändrats, från att vara den som står barnet närmast och utför omvårdnaden till att lämna över ansvaret till föräldrarna och istället inta en undervisande roll, vilket tillåter föräldrarna att växa i sina roller och stärker anknytningen till barnet. Kommunikationen mellan sjuksköterskor och familjer är en viktig del för att vårdformen ska lyckas och behöver därför belysas, samt lyftas upp i kommande specialistsjuksköterskeutbildningar mot barn och ungdom. Dessutom behövs det på neonatalavdelningar diskuteras och struktureras upp hur kommunikationen på arbetsplatsen bör fungera. / There are 36 neonatal wards in Sweden, which demands a highly specialized healthcare. Therefore, neonatal nurses need to have adequate education and have good knowledge within their field. Not every ward in Sweden conducts family centered single-room care. This care-model means that parents take care of their child throughout the day with the support from nurses. The aim of this study was to highlight nurses’ experience of family-centered single-room care in a neonatal ward. Semi-structured interviews were conducted and were analyzed using qualitative content analysis. From the result three categories emerged; nurses and family-centered single-rooms care, parents and family-centered single rooms care and children and family-centered single room. The result showed that family-centered single-room care is preferred from both nurses and families. Experience shows that nurses’ role has changed from being the one closest to the child and performs nursing care, to leave that responsibility to the parents and instead assume a teaching role. This allows parents to grow in their roles and strengthens the connection with the child. Communication between nurses and families is important for this form of care to succeed, and therefore needs to be highlighted in future educations. Neonatal wards need to discussed communication and structured up how it should be carried out on the workplace.