At the Nutrition and Physical Activity Research Centre for Optimal Health and Functionality through Life (NUPARC), a research gap was uncovered regarding the concept optimal functionality based on the older adult’s own perspective. The overall aim was to explore the concept of optimal functionality among older adults and the possibility of creating and developing an ICT-platform to measure it. Method: An existing cohort from NUPARC was used for recruitment in studies I-III and to some extent study IV. A scoping study design and framework was adopted for the inclusion of the articles in Study I. Study II had a descriptive design. Six focus group discussions were conducted and analysed using qualitative deductive content analysis to extend the qualitative understanding. Study III used a phenomenological approach describing the experience of mental health and its impact on the ability to function as optimally as possible. Six interviews were analysed using Giorgi’s phenomenological approach. Study IV was a feasibility study and included 8 older adults using an ICTplatform for a period of four weeks. Results: Optimal Functionality comprises three major corner stones: Body-related factors, Self-related factors and External factors (I) accompanied by nine aspects, and according to older adults it is a matter of functioning as optimally as possible (II). The three major cornerstones are intricately linked and all but the mental aspects were included in the discussions (II). Life situations affecting mental health, consequences of mental health and strategies for maintaining good mental health were described by older adults as having an impact on mental health and affecting their ability to function as optimally as possible (III). The older adults managed the usage of an ICT-tool well and it was perceived as meaningful (IV). Conclusion: Optimal functionality is holistic, subjective, dynamic and applicable to all older adults. Identification of the factors involved can help the older adults on their path to health. An ICT-platform can facilitate the identification of the factors for optimal functionality and the eventual measurement of it.

A Avaliação de Impacto Ambiental (AIA) é uma ferramenta com potencial reconhecido para assegurar a proteção da biodiversidade, sendo possível verificar na literatura a existência de uma ampla gama de informação a respeito das melhores formas de integração da biodiversidade na AIA, bem como quanto às principais lacunas existentes. Uma das questões recorrentemente apontadas pela literatura, neste aspecto, diz respeito às deficiências verificadas na determinação do escopo da AIA, com definição de objetivos pouco claros e estudos ambientais demasiadamente abrangentes, o que resulta em estudos de impacto com falta de foco, excessivamente descritivos e repletos de informações irrelevantes para o contexto em que são aplicados. Deste modo, o principal objetivo desta pesquisa foi analisar a inserção das informações sobre a biodiversidade na etapa de escopo da AIA no Brasil, em específico para o estado de São Paulo, levando-se em consideração as solicitações e regulamentações aplicadas pelo órgão ambiental. Em um primeiro momento, foi estabelecido um conjunto de referências de boas práticas para a consideração da biodiversidade na avaliação dos impactos, conforme a literatura. Em seguida, foram analisados 116 Termos de Referência (TRs) elaborados pelo órgão ambiental entre 2005 e 2014 em relação à inclusão das informações sobre a biodiversidade elencadas. Foi analisado, então, o conteúdo sobre a biodiversidade presente no Manual para a Elaboração de Estudos para o Licenciamento com Avaliação de Impacto Ambiental, da Companhia Ambiental do Estado de São Paulo, cujas diretrizes devem ser seguidas para a elaboração e aprovação dos TRs de acordo com a regulamentação aplicada ao estado. Foi constatado que as informações sobre a biodiversidade não foram inseridas de maneira satisfatória nos TRs elaborados no início do período analisado, tendo apresentado um aumento significativo ao longo dos anos, com resultados satisfatórios a partir de 2012. Ainda assim, as solicitações inclusas nos TRs analisados refletem apenas parcialmente as boas práticas identificadas na literatura. O conteúdo dos TRs dá suporte para que sejam realizados levantamentos exaustivos para a elaboração dos estudos ambientais e que sejam apresentadas informações irrelevantes para a avaliação dos impactos. O Manual elaborado pelo órgão ambiental para guiar a etapa de escopo menciona grande parte das informações consideradas relevantes, porém, a falta de orientações específicas para a sua integração é provavelmente um dos fatores que dificultam uma abordagem dirigida dos estudos ambientais, o que contribui para a baixa efetividade da AIA. / Environmental Impact Assessment (EIA) has a recognized potential to ensure the protection of biodiversity, with a wide range of information present in literature about best practice on biodiversity integration in EIA, as well as the existing gaps. Issues recurrently pointed out are related to shortcomings in determining EIA scoping, with unclear objectives and too broad environmental studies, resulting in overly descriptive and non-objective impact studies, with irrelevant information to the context they are applied. Thus, the main objective of this research was to assess biodiversity information inputs in Brazil\'s EIA scoping, specifically in São Paulo state, taking into account requests and regulations applied by the environmental agency. At first, a set of references of good practices for biodiversity consideration in impact assessment was established according to the literature. Then, the inclusion of biodiversity information listed was assessed in 116 Terms of Reference (TRs) prepared by the environmental agency between 2005 and 2014. Biodiversity content presented in the Environmental Impact Assessment Licensing Study Manual of the Environmental Agency of São Paulo State, which guidelines should be followed for elaboration and approval of TRs, was then reviewed. It was found that biodiversity information was not satisfactorily inserted in early TRs, showing a significant increase over the years, with satisfactory results from 2012. Nevertheless, the requests included in TRs only partially reflect the good practices identified in literature. The content of TRs supports exhaustive surveys for environmental studies and the provision of irrelevant information to impact assessment. The Manual developed by the environmental agency to guide scoping mentions much of the information considered relevant, but the lack of specific guidance on its integration into EIA process is probably one of the factors that hinder a targeted approach to environmental studies, which contributes to low effectiveness of EIA.

Background: Anxiety and depression disorders among adolescents are increasing globally and seriously endanger their health and quality of life. Having anxiety or depressive symptoms in adolescence can have serious consequences and even increase the risk of later adult disorder. Physical activity could be a good way to prevent this. However, an updated review on how and why physical activity interventions may be relevant for reducing and preventing symptoms of depression and anxiety among adolescents is needed. This study aims to study physical activity interventions that focus on the symptoms of depression and anxiety among adolescents. Methods: To bring together previous scientific research, a scoping literature review has been applied. A search was performed in PubMed database to identify studies and meta-analyses meeting the inclusion criteria. Finally references from recent published systematic reviews and meta-analysis were checked. Results: The search yielded a total of 5,091 records with additional 56 records identified through other meta-analyses and reviews. A total of fifteen articles were included for the final review. Most of the included studies showed that there was a significant difference in depressive score after the physical activity intervention. An improvement in anxiety symptoms was identified as well. Overall, 15-60 minutes of aerobics exercise 2-3 times/week, for a minimum of 8 weeks, led to feeling less anxious and depressive. In conclusion, physical activity interventions may be very beneficial for decreasing both depressive and anxiety levels among adolescents.

Förekomsten av övervikt och fetma hos barn ökar i världen trots insatser. Studier visar att förebyggande interventioner för barn och unga har blygsam effekt. Deltagarbaserad forskning har visat sig vara ett sätt att hitta hållbara lösningar inom hälsointerventioner. Övergripande kunskap saknas dock om hur deltagandet för barn och vuxna kan tillämpas inom deltagarbaserade övervikt- och fetmainterventioner riktade till barn. Syftet med denna studie var att kartlägga deltagandet inom deltagarbaserad övervikt- och fetmaprevention riktad till barn. Hur tillämpas deltagande inom deltagarbaserad övervikt- och fetmaprevention? I vilken utsträckning deltar barnen?    En litteraturbaserad design användes enligt Arksey och O’Malley’s ramverk för scoping review, som innebär fem steg; identifiera forskningsfrågan, identifiera relevanta studier, val av studier, kartläggning av data samt samla in, summera och rapportera resultat. Studier till resultatet samlades in från databaserna Medline, Academic Search Elite, Cinahl och Scopus samt via manuella sökningar.  Inklusionkriterier var peer-reviewed, empiriska studier med fokus på interventioner mot förebyggande av övervikt/fetma för barn och unga (0–18 år) samt med en deltagande ansats med föräldrar, barn eller samhälle. Studier på annat språk än engelska eller svenska, som inte fokuserade på förebyggande interventioner mot övervikt/fetma för barn och som inte tydligt definierat studien som deltagarbaserad exkluderades. Sökningen resulterade initialt i 995 artiklar. Urvalsprocessen med vidare granskning resulterade slutligen i 34 studier som inkluderades i denna studie. Graden av delaktighet analyserades vidare med Shier’s Modell, som innebär 5 steg; 1. barn blir lyssnade på, 2. barn stöds i att uttrycka sina åsikter, 3. barns åsikter beaktas, 4. barn är involverade i beslutsprocessen, 5. barn delar makt och ansvar för att ta beslut”.    Resultatet visade att de flesta interventioner skedde i skolan. Både föräldrar, barn, lärare och samhället involverades i olika grad och inom olika metoder. Flera studier rapporterade dock deltagandet bristfälligt. I 12 studier exkluderades barn som deltagare. När barn deltog var det ofta äldre barn i tonåren. Vid analys av barns deltagande med Shier’s Modell var flest studier inom steg 4 (deltagande i beslut, n= 7) och steg 3(konsultation, n=7) följt av steg 5 (delat ansvar och makt, n=6). Framtida forskning bör fokusera på att mer utförligt beskriva den deltagande processen, involvera yngre barn samt undersöka hur barn upplever sitt deltagande, för att skapa ett meningsfullt deltagande. Prevention för övervikt och fetma kräver innovativa lösningar och fokus inom framtida studier bör vara på att öppna upp för deltagande genom en deltagande utgångspunkt, att skapa möjligheter genom tillräckliga resurser och passande metoder samt att inkludera deltagandet som en inbyggd policy genom arbetsprocessen. / The prevalence of overweigth and obesity in children is increasing in the world despite efforts. Studies show that preventive interventions for children and young people have a modest effect. Participatory research has proven to be a way to find sustainable solutions in health interventions. However, there is no comprehensive  knowledge on how participation for children and adults can be applied within participant-based obesity interventions targeting children.The purpose of this study was to map participation in participant-based obesity prevention targeting children. How is participation in participant-based obesity prevention applied? To what extent do the children participate?   A literature-based design was used according to Arksey and O’Malley’s scoping review framework, which involves five steps; identifying the research issue, identifying relevant studies, selecting studies, charting data, and collecting, summarizing and reporting results. Studies for the results were collected from the databases Medline, Academic Search Elite, Cinahl and Scopus as well as through manual searches. Inclusion criteria were peer-reviewed, empirical studies focusing on interventions to prevent obesity for children and adolescents (0–18 years) and with a participatory approach with parents, children or society. Studies in languages ​​other than English or Swedish, studies which did not focus on preventive interventions against obesity for children and studies that did not clearly define the study as participant-based, were excluded. The search initially resulted in 995 articles. The selection process with further examination finally resulted in 34 studies that are included in this study. The degree of participation was further analyzed with Shier's Model, which involves 5 steps; 1. children are listened to, 2. children are supported in expressing their opinions, 3. children's opinions are taken into account, 4. children are involved in the decision-making process, 5. children share power and responsibility in making decisions.    The result showed that most interventions took place in school. Both parents, children, teachers and society were involved to varying degrees and within different methods. Several studies reported the participation poorly. In 12 studies, children were excluded as participants. When children participated, they were often older, in their teens. When analyzing children´s participation with Shiers’s Model, most studies were in step 4 (participation in decisions, n=7) and step 3 (consultation, n= 7) followed by step 5 (shared responsibility and power, n=6).   Future research should focus on more fully describing the participatory process, involving younger children and examining how children experience their participation, in order to create meaningful participation. Prevention for obesity requires innovative solutions and the focus of future studies should be on opening up for participation through a participatory starting point, creating opportunities through adequate resources and appropriate methods, and including participation as an embedded policy through the work process.

This thesis presents a case study of an open pit mine proposal in Kamloops, BC. During an integrated Environmental (Impact) Assessment (EA) process mandated by the Provincial and Federal governments, stakeholders addressed the mine’s environmental, social, heritage, economic, and health-related impacts. At the end of a 7-year process, the application was denied. My research sought to examine how health was conceptualized in the EA, and, specifically, had the mine been approved, how would the permit conditions have protected the public from adverse health effects. To that end, I conducted a review of health-related documents incorporated in the EA and studied the results through a Health Impact Assessment (HIA) lens based on guidance from the International Finance Corporation (IFC). As well as reviewing and analyzing the EA documents, I conducted interviews with participants in and outside the formal stakeholder group, as prescribed by the IFC HIA Guidance. Specifically, my analysis was based on the scoping phase of the assessment, and the baseline health profile that was included, using this internationally recognized HIA framework. My results show that the social determinants of health were not factored into the EA as per HIA best practice. Many in the formal stakeholder group, and outside of it, felt that institutional barriers prevented inclusion of the social determinants of health in the assessment. That finding raises questions about the reality of EA processes to protect public health. / Graduate

Background: The COVID-19 pandemic calls attention to the importance of sustainable healthcare systems. Frail healthcare systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Significant work has been done to describe the general attribute of sustainability and resilience in healthcare systems during crises. The next step would be to identify the research domains that has been highlighted during COVID-19 pandemic in order to reflect and achieve further sustainability in healthcare systems.  Methods: A scoping review of the literature was conducted to identify recurring themes, research domains and capacities needed to maintain healthcare systems’ sustainability in COVID-19 outbreak. Until 13 December 2020, six electronic databases were searched using specific keywords such as ‘sustainability,’ ‘resilience,’ and ‘surge capacity’ in ‘healthcare systems.’ Peer-reviewed articles went through a scientometric analysis mapping research fields, domains, study destinations and keywords.  Results: 104 studies met the inclusion criteria – majority (75%) focused on medical research followed by interdisciplinary (12%), social science (5%), and environment studies (5%). Originally identified domains of healthcare systems’ sustainability research included ‘capacity calculation,’ ‘telehealth,’ ‘environment,’ ‘inequity,’ ‘data,’ ‘holistic nexus planning,’ ‘social & environmental risk factor,’ ‘transport connectivity,’ and ‘vulnerability.’  Conclusion: This scoping review represents a systematic assessment of the research domains of healthcare systems’ sustainability during COVID-19 pandemic. Further refined and broadened sustainability framework is required so that healthcare systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

This thesis by article contains three chapters. The first chapter provides an overview of recent developments in global refugee education policy to situate Refugee Education 2030, the United Nations High Commissioner for Refugees’ current international refugee education strategy, within global policy initiatives. It then reviews the literature on refugee education policy that informed the development of a methodology of vertical policy coherence analysis with Refugee Education 2030 to answer the research questions of the thesis. Finally, it addresses my researcher positionality and journey leading to the thesis. The second chapter contains the manuscript for an article. The purpose of the article is to analyze the vertical coherence of Canadian policy regimes towards the primary and secondary education of refugee children and youth with Refugee Education 2030. The article presents a theoretical framework for policy coherence analysis that combines policy coherence theory, policy attributes theory, and policy behaviour theory, as well as a tri-phasic methodology for vertical policy coherence analysis with an international framework designed to be adapted to different contexts to guide the development of country-specific education policies. The theoretical framework and methodology are applied to determine the categories of needs underpinning Enabling Activities of a Strategic Objective of Refugee Education 2030, to assess these needs as presented by refugee children and youth in Canada, and to analyze the coherence of Canadian education policy responses to these needs with Refugee Education 2030. The findings indicate that there are five categories of needs inherent in the Enabling Activities of the selected Strategic Objective, specifically access to education, accelerated education, language education, mental health and psychosocial support, and special education; that all of these categories of needs are present in refugee claimant and/or refugee children and youth in all of Canada’s educational jurisdictions; and that there are significant gaps in policy responses to these needs. Taken together, the findings permitted a discussion on priorities for the revision and development of refugee education policy across Canadian jurisdictions to ensure greater coherence with Refugee Education 2030. The third chapter summarizes the findings of the contextualized analysis of the vertical coherence of Canadian refugee education policy regimes with Refugee Education 2030. Additional findings that could not be incorporated in the article due to the manuscript submission guidelines Schutte iv of the intended journal of publication are then presented and discussed. The thesis concludes with reflections on my research journey.

Denna studie undersöker hur forskningsområdet “skäl att personer stannar i ett våldsamt förhållande” ser ut, vilka kunskapsluckor det finns i området och beskriver vilka samhällsgrupper det behövs mer forskning om. Genom en scoping review kartlägger denna studie hur långt forskningen kommit och vad vi idag vet om anledningar till att heterosexuella män och kvinnor, HBTQI-personer, unga och äldre stannar i en våldsam relation. I studien presenteras internationell forskning som är avgränsad till en västerländsk kontext. Studien använder sig av en tematisk analys för att undersöka om det finns likheter och skillnader i forskningen kring de utvalda grupperna. Socialkonstruktionism, paradigm och fält används som teoretiska begrepp i syfte att undersöka potentiella förklaringar till varför forskningsområdet ser ut som det gör. Analysen kommer fram till att samhällsdiskursen kring våld, sättet som forskningen utformas samt forskningens aktörer och finansiering påverkar hur forskningsområdet ser ut och den kunskap vi idag har om anledningar att olika grupper stannar i en våldsam relation. Resultatet av studien visar att det finns en kunskapslucka i forskningen och att det saknas forskning om varför andra grupper än heterosexuella kvinnor stannar i en våldsam relation. Forskningen som beskriver anledningar att män i heterosexuella förhållande, HBTQI-personer, unga och äldre stannar i ett våldsamt förhållande är knapp och behöver utvecklas för att samhället ska kunna förstå och hjälpa dessa personer på ett adekvat sätt.

[pt] A COVID-19 foi declarada como uma pandemia em março de 2020 pela OMS (Organização Mundial da Saúde) e até abril de 2022 infectou aproximadamente 490,7 milhões de pessoas, com pelo menos 6,17 milhões de mortes. A pandemia desafiou a segurança alimentar, agricultura e cadeias de alimentos frescos. Pesquisas sobre a análise de cadeias de suprimentos agroalimentares durante a COVID-19 indicam um maior impacto em pequenos fornecedores destas cadeias, principalmente as cadeias mais curtas, que são aquelas que possuem poucos elos. Neste contexto, esse trabalho analisa os efeitos da COVID-19 em cadeias de alimentos frescos. É desenvolvido, assim, um estudo de caso em uma organização de produtores do Rio de Janeiro. Esse estudo cobre uma revisão de escopo que identifica na literatura os principais impactos e políticas da pandemia nessa cadeia. Em seguida, os resultados são avaliados através de uma pesquisa de levantamento (survey) na organização para avaliar se as variáveis encontradas na literatura possuem aderência com as variáveis identificadas pelos respondentes da survey, que são pequenos produtores no estado do Rio de Janeiro. Por fim, o problema é modelado por meio de uma simulação por dinâmica de sistemas. Os resultados mostraram que a cadeia de suprimentos da organização é sensível a variáveis de impacto como aumento do custo de produção e não entrega de produtos, pois ao aumentar o custo de produção e a não entregar produtos, a taxa de vendas é impactada negativamente. A política de investimento em logística mostra que a taxa de vendas é impactada positivamente quando se aumenta o investimento. / [en] COVID-19 was declared a pandemic in March 2020 by the WHO (World Health Organization), and at the beginning of April 2022, it had infected approximately 490.7 million people, with at least 6.17 million deaths. The pandemic has challenged food security, agriculture, and fresh food chains. Research on the analysis of agri-food supply chains during COVID-19 indicates a more significant impact on small suppliers of these chains, especially the shorter chains, which are those with few links. In this context, this work analyzes the effects of COVID-19 on fresh food chains. Thus, a case study is developed in a producer organization in Rio de Janeiro. This study covers a scoping review that identifies in the literature the main impacts and policies of the pandemic in this chain. Then, the results are evaluated through a survey in the organization to assess whether the variables found in the literature match the variables identified by the survey respondents, who are small producers in the state of Rio de Janeiro. Finally, the problem is modeled through a system dynamics simulation. The results showed that the organization s supply chain is sensitive to impact variables such as increased production cost and non-delivery of products. As increasing production cost and not delivering products, the sales rate is negatively impacted. The investment policy in logistics shows that the sales rate is positively impacted when investment increases.

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