A Avaliação de Impacto Ambiental é um instrumento que auxilia o processo decisório, a elaboração de projetos e propostas de desenvolvimento, e que oferece campo para a integração de valores associados à sustentabilidade e ao desenvolvimento sustentável. Para que a avaliação de impacto ambiental seja efetiva, deve estar embasada na delimitação das questões prioritárias, bem como em respostas adequadas e necessárias aos tomadores de decisão, em um processo conhecido como scoping. A delimitação do escopo de um Estudo de Impacto Ambiental (EIA) tem como principal objetivo definir os estudos considerados adequados para a correta avaliação dos impactos potencialmente significativos relacionados a um projeto, orientado pelo diagnóstico preliminar de suas áreas de influência. Diante da necessidade de avaliar a efetividade dessa etapa dentro do quadro geral da AIA praticada, o objetivo do trabalho foi avaliar a etapa de delimitação do escopo de estudos de impacto ambiental de processos de Avaliação de Impacto Ambiental ocorridos no Estado de São Paulo, utilizando-se como marco referencial a promulgação da Resolução SMA 54/2004. A fim de estudar o processo de scoping no estado de São Paulo, nos termos da regulamentação vigente e com base nas melhores práticas preconizadas para este instrumento, foram analisados 34 processos de licenciamento ambiental que tramitaram na Secretaria de Meio Ambiente do Estado de São Paulo (SMA/CETESB), para diferentes tipologias de empreendimento. Os resultados obtidos demonstram que a estrutura preconizada para o scoping no estado, ainda que seja potencialmente diferenciada em relação aos demais estados do país, não tem assegurado a formulação de Termos de Referências concisos e focados nos impactos significativos dos empreendimentos, pouco contribuindo para a efetividade das avaliações de impacto. / The Environmental Impact Assessment is an instrument which helps in the decision making, the elaboration of projects and development of proposals, also offers a way for the integration of values associated with the sustainability and sustainable development. For the environmental impact assessment to be effective, it should be based on delimitation of priority issues, as well as responses appropriate and necessary to the decision makers, in a process known as scoping. The main objective of the EIA scoping is define the studies considered suitable for the correct evaluation of potentially significant impacts related to a project, directed by the preliminary diagnosis of their areas of influence. Considering the need to evaluate the effectiveness of this step within the overall framework of the EIA carried, the aim of this study was to evaluate de scoping phase in environmental impact statement of Environmental Impact Assessment processes occurred in São Paulo State, under the current regulation and based on best practices recommended for this instrument. The study evaluated 34 environmental licensing process which were proceed through the Secretary of Environment of the São Paulo State (Secretaria de Meio Ambiente do Estado de São Paulo - SMA/CETESB), with different development typologies. The results obtained showed that the structure recommended for the scoping in the São Paulo State, although it is potentially different than the other states in Brazil, it hasnt ensured the elaboration of Terms of Reference concise and focused on significant impacts of the projects, with few contribution to the effectiveness of environmental impact assessment.

Inledning. Den demografiska utvecklingen leder till ett ökat vårdbehov för de äldre. Hemsjukvården idag är en växande del av hälso- och sjukvården i Sverige. Teknisk utveckling leder till att fler sjukvårdsinsatser kan göras i hemmen, av både sjukvårdspersonal, närstående eller patienten själv. Ett avancerat tekniskt hjälpmedel är läkemedelsrobot. Evidensen för effekterna av läkemedelsrobot är mycket liten. Syftet med studien är att sammanställa befintlig forskning om erfarenheter av läkemedelsrobotar i hemsjukvård ur patienters, närståendes och vårdpersonalens perspektiv. Metod En scoping review där16 artiklar inkluderades i studien. Resultat Utifrån syftet identifierades följande teman; Att ha behov av och komma ingång med en läkemedelsrobot, Att använda en robot i vardagen, Att känna sig självständig, Att bli påmind om att ta läkemedel, En ökad adherence, Att lita på en robot och En robot tar över vårdpersonalens arbete. Slutsats Läkemedelsrobotar är ett sätt att förenkla vården och avlasta arbetsbördan för personalen men också öka självständigheten och säkerhet för patienter.

Background: A recent surge in interest for psychedelic-assisted therapy has manifested itself in exponential increases of subject-related academic publications as well as broad media attention. However, a lot is still to be wished for regarding the question of how the therapy actually works. Objective: To map the current empirical literature regarding “mechanisms of change” and corresponding relevant measures of these mechanisms. Method: The present essay is a scoping review. The process involves systematically acquiring relevant literature by conducting a literature search on two different platforms, Pubmed and PsychInfo, in order to extract and map the data seen as relevant to the research question. Results: Putative “mechanisms of change” and associated measures are successfully mapped and presented in a chart as well as in a basic qualitative content-analysis. The content analysis presents three separate categories used to conceptualize different mechanisms of change: Acute subjective experience, psychological flexibility and neural flexibility. Conclusion: Psychedelic-assisted therapy involves a number of complex mechanisms of change which can be studied both from a psychological as well as neurobiological perspective. These mechanisms can be thought to be dependent on processes in the acute subjective experience and consist in the form of increased psychological flexibility. Relevant measures include psychometric instruments that can be well complemented by FMRI-data. In order to gain a better understanding of these processes regarding the way they relate to one another, what moderates their outcome on depressive symptoms and how clinical application is optimized, further research is warranted. / SammanfattningBakgrund: Ett förhöjt intresse för psykedelisk assisterad terapi har på senare tid visat sig i exponentiella ökningar av ämnesrelaterade akademiska publikationer såväl som bred medieuppmärksamhet. Det finns emellertid mycket att önska när det kommer till frågan om hur terapin faktiskt fungerar. Syfte: Att kartlägga den aktuella empiriska litteraturen angående förmodade ”förändringsmekanismer” och motsvarande relevanta mått på dessa mekanismer. Metod: Föreliggande uppsats är en omfattningsgranskning (scoping review). Processen inbergrep systematisk inhämtning av relevant litteratur genom att genomföra litteratursökningar på två olika plattformar, Pubmed och PsychInfo, för att sedan extrahera och kartlägga den data som ansågs relevant för forskningsfrågan. Resultat: Förmodade "förändringsmekanismer" och tillhörande mått kartläggs framgångsrikt och presenteras i såväl tabell som i en grundläggande kvalitativ innehållsanalys. Innehållsanalysen presenterar tre separata kategorier som används för att konceptualisera olika förmodade förändringsmekanismer: Akut subjektiv upplevelse, psykologisk flexibilitet och neural flexibilitet. Slutsats: Psykedelisk assisterad terapi involverar ett antal komplexa förmodade förändringsmekanismer som kan studeras både ur ett psykologiskt såväl som neurobiologiskt perspektiv. Relevanta mått inkluderar psykometriska instrument som väl kan kompletteras med FMRI-data. För att få en bättre förståelse för dessa processer när det gäller hur de förhåller sig till varandra, vad som dämpar deras resultat vid depressiva symtom och hur klinisk tillämpning optimeras, är ytterligare forskning motiverad.

The Kinaesthetics care conception is a nursing approach for patient handling which aims to prevent work-related complaints and diseases. The evidence about the influence of Kinaesthetics on musculoskeletal disorders among persons who handle patients is unclear to date. The purposes of the scoping review are to gain insight into the current state of research regarding the clinical effectiveness of Kinaesthetics (in terms of perceived exertion and musculoskeletal complaints) among persons who handle patients and to identify potential research gaps. A scoping review was conducted. The search strategy comprised a systematic search in electronic databases (MEDLINE, EMBASE, AMED, CINAHL), a hand search, a fast forward search (Web of Science) and a Google scholar-search. The review process was carried out independently by two reviewers. Methodological quality was assessed for all studies using three methodological main categories (reporting quality, internal validity, external validity). Thirteen studies with different study designs were included. Seven studies investigated musculoskeletal complaints and nine studies the perceived exertion of nursing staff. Most studies were of very low methodology. Most studies reported a decrease of musculoskeletal complaints and perceived exertion due to Kinaesthetics. In conclusion, there is only little evidence of very low quality about the effectiveness of Kinaesthetics. Out of the studies it could be assumed that Kinaesthetics may decrease the patient handling related perceived exertion and musculoskeletal pain of persons who handle patients. But an overestimation of these results is likely, due to inadequate methodology of included studies. As a result, no clear recommendations about the effectiveness of the Kinaesthetics care conception can be made yet. Since a research gap was shown, further high quality intervention studies are necessary for clarifying the effectiveness of Kinaesthetics.

Cost-of-illness (COI) analysis was the first economic evaluation methodology used in the health field, and it aims to identify and quantify all of the costs incurred due to a particular illness. While cost-of-illness studies attract much interest from healthcare policy makers and public health advocates, inconsistencies in study methodologies and cost inventories have made cost-of-illness estimates difficult to interpret and compare, limiting their usefulness. The purpose of this thesis was to use a scoping review approach to systematically explore cost inventories in the cost of foodborne illness literature, and to investigate the association between study methodologies, component costs, and foodborne illness-related factors to the estimated cost of non-typhoidal Salmonella spp. illness, using studies identified in the scoping review. The results indicated high variability in terms of the depth and breadth of individual and societal level component costs, along with a wide range of data sources being used in the cost of foodborne illness literature. Additionally, the number of direct component cost categories included in an estimate, particularly long-term care costs, and the inclusion of chronic sequelae costs were significantly associated with the cost of non-typhoidal Salmonella spp. illness. Therefore, these may be important factors to consider when initiating a cost of foodborne illness study and when interpreting or comparing existing cost of foodborne illness estimates. The results of this thesis can be used to address issues that are believed to be limiting cost-of-illness studies as decision making tools, and to better understand factors which may impact a cost of foodborne illness estimate. / Scoping review and linear regression analyses in the area of cost of foodborne illness / Canadian Institutes of Health Research/Public Health Agency of Canada (CIHR/PHAC) Applied Public Health Research Chair (awarded to Dr. Jan M. Sargeant)

The Kinaesthetics care conception is a nursing approach for patient handling which aims to prevent work-related complaints and diseases. The evidence about the influence of Kinaesthetics on musculoskeletal disorders among persons who handle patients is unclear to date. The purposes of the scoping review are to gain insight into the current state of research regarding the clinical effectiveness of Kinaesthetics (in terms of perceived exertion and musculoskeletal complaints) among persons who handle patients and to identify potential research gaps. A scoping review was conducted. The search strategy comprised a systematic search in electronic databases (MEDLINE, EMBASE, AMED, CINAHL), a hand search, a fast forward search (Web of Science) and a Google scholar-search. The review process was carried out independently by two reviewers. Methodological quality was assessed for all studies using three methodological main categories (reporting quality, internal validity, external validity). Thirteen studies with different study designs were included. Seven studies investigated musculoskeletal complaints and nine studies the perceived exertion of nursing staff. Most studies were of very low methodology. Most studies reported a decrease of musculoskeletal complaints and perceived exertion due to Kinaesthetics. In conclusion, there is only little evidence of very low quality about the effectiveness of Kinaesthetics. Out of the studies it could be assumed that Kinaesthetics may decrease the patient handling related perceived exertion and musculoskeletal pain of persons who handle patients. But an overestimation of these results is likely, due to inadequate methodology of included studies. As a result, no clear recommendations about the effectiveness of the Kinaesthetics care conception can be made yet. Since a research gap was shown, further high quality intervention studies are necessary for clarifying the effectiveness of Kinaesthetics.

Introduktion: Det finns allt fler studier inom området “Aktivitetsbalans” inom Arbetsterapin. Studier lyfter associationer till aktivitetsbalans inom olika livsområden men än finns få studier som sammanställer Forskningsläget kring dessa associationer. Samlad kunskap behövs kring arbetsterapeutens förebyggande, återställande och bibehållande insatser gentemot sina klienter. Syfte: Syftet var att beskriva forskningsläget kring vad som är associerat till aktivitetsbalans i kvantitativa studier. Metod: Designen för examensarbete var scoping review. Datainsamling genomfördes i databaserna Cinahl och Medline. Tjugo artiklar inkluderades och analyserades med numerisk och tematisk analys. Resultat: Examensarbetet resulterade i teman och underteman som beskriver associationer till aktivitetsbalans. Följande fem teman skapades: Hälsa och välbefinnande, Sociodemografi, Aktivitet, Interpersonella faktorer och Omgivningsfaktorer. Dessa utmynnade i elva underteman som associerar till aktivitetsbalans: Hälsa, livskvalitet och livstillfredsställelse, personfaktorer, variabla personfaktorer, sysselsättning, tillfredsställelse med aktivitetsutförande, problematiskt internetanvändande, familj och sociala relationer, barn med särskilda behov, samhällsinformation och isolering. Slutsats: En persons hälsa, relationer och dagliga aktiviteter har genom arbetet visat sig ha ett samband med aktivitetsbalans. Även personliga egenskaper och delar av den omgivningen där personen befinner sig i förefaller vara associerat till aktivitetsbalansen. Aktivitetsbalans har i examensarbetet visat sig ha associationer till flera olika delar av en människas tillvaro. / Introduction: More research is getting produced regarding ”occupational balance” (OB) in the field of occupational therapy. Studies lifts associations to occupational balance in different areas of life but there’s still few studies that conclude these associations. Congregated knowledge is needed in the occupational therapist daily preventive, restorative and maintaining work. Aim: To describe the current research about associations to OB in quantitative studies. Method: The study design was a scoping review. Data was collected from Cinahl and Medline. Twenty articles were included and analysed through numerical and thematical analysis. Results: The thesis resulted in five themes and eleven sub-themes describing associations to OB. Following five themes were created: Health and wellbeing, sociodemographic, activity, interpersonal factors, environmental factors. These themes resulted in eleven sub-themes with associations to OB: Health, life quality and life satisfaction, personal factors, variating personfactors, employment, family and social relationships, children with special needs, problematic internet use, social information, isolation, and satisfaction with occupational performance. Conclusions: A persons health, relations and daily activities have shown a relationship to occupational balance. Personal characteristics and surrounding environment of which the person belongs seems to relate to occupational balance. Occupational balance has shown associations to many parts of the human life.

Children who grow up with one or both parents who substance misuse are at an elevated risk of being harmed. This study aimed to compile current knowledge on directed interventions intended to improve the outcomes of children who live in environments where adults misuse substances, and to analyze children’s influence and participation in interventions. The method used was a systematically undertaken scoping review. Despite a comprehensive searching strategy only ten relevant studies were found. There was a low geographical spread indicating the lack of intervention studies, including within Scandinavian settings. The result showed that nine out of ten interventions were group support. Interventions were manualised and primarily focused on changing children’s behaviour or increasing children’s general knowledge about misuse. Hart’s participation ladder was used to assess children’s degree of participation and influence in both intervention and research setting. Results indicated that children had low to mediocre degrees of participation. An implication for the future is that support groups showed positive effects on children’s attitudes towards misuse by increased knowledge about parental substance misuse. There is still a need for more intervention studies before it is possible to identify the best types of support for children affected by parental substance misuse. / Barn som växer upp med en eller båda föräldrar med missbruk har en ökad risk för att fara illa. Denna studie syftade till att sammanställa tillgänglig kunskap om interventioner riktade mot barn med målet att stödja barn som växer upp i miljöer där vuxna har ett missbruk samt att analysera barns delaktighet och påverkan i interventioner. Metoden som användes var en systematiskt genomförd scoping review. Trots omfattande litteratursökningar bedömdes endast tio effektutvärderingar som relevanta för inklusion. Studierna hade låg geografisk spridning vilket visade på avsaknaden av effektutvärderingar, bland annat inom skandinavisk forskning. Resultatet visade att nio av tio interventioner var gruppstöd. Interventionerna var manualbaserade och fokuserade på att förändra barns beteende eller öka barns generella kunskap om missbruk. Harts delaktighetstrappa användes för att undersöka barns delaktighet och påverkan i interventioner och forskning. Resultatet indikerade att barn hade låg- till medelgrad av delaktighet. Ett fynd för framtiden är att stödgrupper visade på positiva effekter på barns attityd till missbruk genom ökad kunskap om vuxnas missbruk. Det finns fortsatt ett stort behov av att genomföra fler effektutvärderingar innan det är möjligt att konstatera vilken eller vilka interventioner för barn som fungerar bäst.

No description available.

Bakgrund: Ett barn kan behöva vård på NVA av olika anledningar. För att familjen ska känna trygghet inför transitionen till hemmet krävs god planering och samverkan i hela vårdkedjan, från NVA till BHV. Det skapar förutsättning för att främja hälsa hos familjen. Föräldrar är med stöd av specialistsjuksköterskan viktiga för barnets utveckling och välbefinnande. Tidigare forskning visar att föräldrar som är delaktiga i sitt barns omvårdnad blir trygga att själva vårda barnet vilket stärker anknytningen och kan leda till en kortare vårdtid på NVA. Specialistsjuksköterskan är den som har kunskap om transitionens innebördoch kan anpassa stöd efter familjens behov för att bibehålla hälsa. Syfte: Syftet var att beskriva föräldrars erfarenheter av transition från neonatal vårdavdelning till hemmet. Metod: En scoping review som analyserades med kvalitativ innehållsanalys. Resultat: Tre huvudteman framkom; Utskrivningens betydelse för framtiden, En förändrad livsvärld och Föräldrars behov. Det första temat består av tre subteman; Att känna glädje och oro inför hemgång som belyser föräldrars ambivalenta känslor kopplade till transition till hemmet och vikten av kompetent vårdpersonal för att föräldrar ska känna trygghet. Att inte känna sig inkluderad som pappa visar på pappors känslor av att inte bli inkluderade i sitt barns vård som gör att de upplever en svårighet att stötta sin partner och barn. Att förbättra transitionen till hemmet belyser föräldrars olika perspektiv av förberedelse inför transition. Det andra temat innehåller tre subteman; Att vara i sin hemmiljö beskriver föräldrars erfarenheter av att komma hem med sitt barn. Att få nya perspektiv på livet belyser föräldrars upplevelse av att bli föräldrar först när barnet kommer hem men också upplevelser av att kunna leva vidare efter transitionen. Att vilja skydda barnet innehåller upplevelser och erfarenheter av att skapa en vardag med barnet. I det tredje temat framkom två subteman; Att få stöd i sin föräldraroll beskriver olika former av stöd som föräldrar upplever i transitionen och Strategier för att hantera situationen tar upp metoder som föräldrar fann stöd genom. Slutsats: Det kan innebära en stor utmaning för föräldrar att få ett barn som behöver vård på NVA. Transitionen till hemmet behöver förberedelse. Föräldrar upplevde trygghet och kände mindre ambivalens när de fick stöd och vägledning från vårdpersonal. Föräldrar som gjorts delaktiga i sitt barns omvård på NVA kunde uppleva transitionen mer glädjefylld än de som inte fått den erfarenheten. Specialistsjuksköterskan har en viktig roll i att underlätta transitionen för föräldrar för att de ska känna sig trygga och säkra i att själva vårda barnet hemma. Ytterligare kompetens och stöd från specialistsjuksköterskan behövs för att transitionen ska upplevas trygg och säker för föräldrar. / Background: There can be various reasons for a child needing care in neonatal care unit. Forthe family to feel secure before the transition to home, good planning and cooperation is required throughout the continuity of patientcare, from neonatal care unit to children healthcare services. It creates conditions for promoting health in the family. Parents, with the support of the nurse specialist, are important for the child’s development and well-being. Previous research shows that parents who are involved in their child’s care become confident in caring for the child themselves, which strengthens the connection and can lead to a shorter period of care at the neonatal care unit. The nurse specialist is the one who has knowledge of the meaning of the transition and can adapt support to the family’s needs to maintain health. Aim: The aim was to describe parents’ experiences of the transition from neonatal care unit to home. Method: A scoping review that was analysed with qualitative content analysis. Results: Three main themes emerged in the result; The importance of the transition, A changed life world and Parents’needs. The first theme consists of three subthemes; Feeling joy and anxiety before going homewhich highlights parent’s ambivalent feelings connected to the transition home and the importance of competent healthcare professionals for parents to feel security. Not feeling included as a father shows fathers’ feelings of not being included in their child’s care, which makes them experience difficulty in supporting their partners and child. Improving the transition to the home highlights parents’ different perspectives of preparation for transition.The second theme contains three subthemes; Being in their home environment describes parents’ experiences of coming home with their child. Gaining new perspectives in lifehighlights parents’ experiences of becoming parents when the child comes home, but also experiences of being able to continue living after the transition. Wanting to protect the childincludes experiences and perspectives of creating a daily life with the child. In the third theme, two subthemes emerged; Getting support in the parental role describes different types of support that parents experience during the transition and Strategies to handle the situationexplain methods that parents found support through. Conclusion: It might imply a great challenge when parents get a child in need of care at neonatal care unit. The transition to home needs preparation. Parents experienced security and felt less ambivalence when they get through nursing staff got support and guidance. Parents who been involved in their child’s care in the neonatal care unit experienced the transition more joyous than parents who was not involved. The nurse specialist has an important role in facilitating the transition. To make the parents secure and safe taking care of their child at home. Further competence of parents’experiences requires in both neonatal care units and in child health services.