The impact of single and shared rooms on family centred care in children's hospitals

Aim: To explore whether and how spatial aspects of children’s hospital wards (single and shared rooms) impact upon family centred care. Background: Family centred care has been widely adopted in paediatric hospitals internationally. Recent hospital building programmes in many countries have prioritised the provision of single rooms over shared rooms. Limited attention has, however, been paid to the potential impact of spatial aspects of paediatric wards on family centred care. Design: Qualitative, ethnographic. Methods: Phase 1; observation within 4 wards of a specialist children’s hospital. Phase 2; interviews with 17 children aged 5-16 years and 60 parents/carers. Sixty nursing and support staff also took part in interviews and focus group discussions. All data were subjected to thematic analysis. Results: Two themes emerged from the data analysis: ‘role expectations’ and ‘family-nurse interactions’. The latter theme comprised 3 sub-themes: ‘family support needs’, ‘monitoring children’s wellbeing’ and ‘survey-assess-interact within spatial contexts’. Conclusion: Spatial configurations within hospital wards significantly impacted upon the relationships and interactions between children, parents and nurses, which played out differently in single and shared rooms. Increasing the provision of single rooms within wards is therefore likely to directly affect how family centred care manifests in practice. Relevance to clinical practice: Nurses need to be sensitive to the impact of spatial characteristics, and particularly of single and shared rooms, on families’ experiences of children’s hospital wards. Nurses’ contribution to and experience of family centred care can be expected to change significantly when spatial characteristics of wards change and, as is currently the vogue, hospitals maximise the provision of single rather than shared rooms

Interim research assessment 2003-2005 - Computer Science

This report primarily serves as a source of information for the 2007 Interim Research Assessment Committee for Computer Science at the three technical universities in the Netherlands. The report also provides information for others interested in our research activities

1995 BRAC Commission

Defense Logistics Agency, Defense Systems Design Center - Data Call 1994. Tabular data, memos, charts, graphs, documents. Box 144, L-072

Housing quality and lost (public) space in Croatia

IN ENGLISH: In the post-socialist period and within the current social transition context, urban and rural Croatia has, just like other transition countries, experienced many changes in the social structure and space. One example is the housing quality which is a replica of the situation in the Croatian society and has also undergone some major changes. Socially oriented housing construction co-financed by the state and the cities is in an unfavourable position compared to private housing construction. In the last twenty years the amount of the social housing construction has been only a minor part of the total contruction work in the country. For instance, out of nine newly planned residential housing developments in Zagreb, the capital city, only three have been completed and the work on the rest of them has stopped and is unlikely to continue. Private construction work prevails especially on the edge of the city and is characterised by high density housing. This type of housing construction doesn't benefit the majority of citizens in search of accommodation (price per square meter is too high, low-quality building). There is also a big problem of the community facilities (primary and secondary infrastructure, schools, kindergartens, playgrounds, green areas, sidewalks, public transport etc.). The existing globalisation-transition circumstances of the Croatian society corroborate the fact which experts of various profiles often point out: ignoring the process of (urban) planning will irreparably damage the space. The city transformation shows the absence of comprehensive urban planning which results in an ever increasing number of random buildings which do not fit in the surroundings. This leads up to yet another important issue – the shrinking and, in some cases, disappearance of public space which becomes the “lost space“. In recent years there has been a lot of building in the city core and on the edge which does not quite fit in the existing urban structure, image or the skyline of the city. The current situation in the process of planning can be characterized as a conflict and imbalance between the powerful actors (mostly political and economic) and less powerful actors (mostly professional and civil). The actors who have the political power and influence and the ones who possess the capital are forming an “alliance” between two important layers of the social structure. The lack of civil and professional actors, “lost spatial actors”, and therefore of civic aggregation is also present and that is also the cause of public space “disappearance” and undermined process of public participation. --------------- IN CROATIAN: U postsocijalističkom razdoblju i trenutnom tranzicijskom kontekstu urbana i ruralna Hrvatska su, kao i ostale tranzicijske zemlje, doživjele mnoge promjene u društvenoj strukturi i samom prostoru. Na primjeru kvalitete stanovanja kao replike stanja u hrvatskom društvu mogu se vidjeti značajne promjene. Društveno usmjerena stambena izgradnja sufinancirana od strane države i gradova je stoga rjeđa i u nepovoljnijoj je situaciji prema privatnoj stanogradnji. Zadnjih dvadeset godina udjel socijalne stambene gradnje je zanemariv u ukupnoj izgradnji na razini zemlje. Primjerice, od devet planiranih stambenih naselja izgrađenih po modelu POS-a u Zagrebu samo su tri i završena. Na ostalima je proces gradnje zastao i ne čini se da će se privesti kraju. Privatna je gradnje prisutnija, posebno na rubovima grada, a obilježava je visoka gustoća gradnje. Ovakav tip gradnje ne odgovara većini stanovnika koji su u procesu potražnje stambene nekretnine (visoka cijena kvadratnog metra, a slaba kvaliteta gradnje). Postoji također i problem nedostatne opremljenosti susjedstva (primarna i sekundarna infrastruktura, škole, vrtići, igrališta, zelene površine, pješačke staze, javni transport itd.). Navedene globalizacijsko-tranzicijske okolnosti hrvatskog društva potvrđuju ono što eksperti različitih profila ističu, a to je da će ignoriranje procesa (urbanog) planiranja nepovratno uništiti prostor gradova. Ovakve transformacije pokazuju nedostatak sustavnog urbanog planiranja što rezultira sve većim brojem zgrada koje se ne uklapaju u neposrednu okolinu. To nadalje dovodi do drugog važnog aspekta – smanjivanja i u nekim slučajevima, nestanka javnog prostora koji postaje „izgubljeni prostor“. Posljednjih je godina izgrađen velik broj zgrada, i u središtu i na rubovima grada, koje se ne uklapaju u postojeću urbanu strukturu, izgled ili vizuru grada. Ovakvu situaciju obilježavaju sukob i neravnoteža između moćnijih društvenih aktera (većinom političkih i ekonomskih) i onih manje moćnih (većinom profesionalnih i civilnih). Politički i ekonomski akteri se često povezuju u „savez“ dvaju najjačih u društvenoj strukturi. S druge strane nedostatak utjecaja civilnih i profesionalnih aktera kao „izgubljenih prostornih aktera“ dovodi do „nestanka“ javnih prostora te smanjenja važnosti procesa participacije (sudjelovanja javnosti)