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Describes how a problem-based learning approach is used in a course on general surgery and reports the results in terms of degree of satisfaction of students, teachers, and patients. Employs interviews with a real patient with a real condition. (DDR)

The environmental impact of an extended property close source-separation system for solid household waste (i.e. a systems for collection of recyclables from domestic properties) is investigated in a residential area in southern Sweden. Since 2001, households have been able to source-separate waste into six fractions of dry recyclables and food waste sorting. The current system was evaluated using the EASEWASTE life cycle assessment tool. Current status is compared with an ideal scenario in which households display perfect source-separation behaviour and a scenario without any material recycling. Results show that current recycling provides substantial environmental benefits compared to a non-recycling alternative. The environmental benefit varies greatly between recyclable fractions, and the recyclables currently most frequently source-separated by households are often not the most beneficial from an environmental perspective. With optimal source-separation of all recyclables, the current net contribution to global warming could be changed to a net-avoidance while current avoidance of nutrient enrichment, acidification and photochemical ozone formation could be doubled. Sensitivity analyses show that thetype of energy substituted by incineration of non-recycled waste, as well as energy used in recycling processes and in the production of materials substituted by waste recycling, is of high relevance for the attained results. [ABSTRACT FROM PUBLISHER]

At many large wastewater treatment plants (WWTPs) the increased hydraulic load, caused by combined sewer systems during storm events, results in primary effluent overflow when the capacity of further treatment is exceeded. Due to stringent effluent standards, regulating the total discharge from the WWTPs, the Rya WWTP in Göteborg and the Sjölunda WWTP in Malmö will have to reduce the impact of primary effluent overflow. Separate, high rate, precipitation processes operated only during high flow conditions have been investigated in pilot units at the two WWTPs. Precipitation in existing primary settlers operated at a surface loading of 3.75 m/h removed phosphorus to 0.35 mg/l. The Actiflo process was also shown to remove suspended solids and phosphorus well. BOD was reduced by 50-60%. With such processes the overall effluent concentrations from the plants can be reduced significantly. Key upgrading features are small footprints, short start up time and high efficiency. [ABSTRACT FROM AUTHOR]

Objective . To assess satisfaction and learning accomplishments after communication skills training courses for cancer doctors in the Nordic countries. Method . 155 physicians from the five Nordic countries participated in a communication skills training course. Questionnaires were completed at baseline, at course completion and at follow-up after 2 to 6 years. Results . 94% of the physicians indicated satisfaction with the course. Physicians who had participated in the whole course (as opposed to those who had participated only in parts of the course) and physicians from Denmark and Sweden were most satisfied with the course. Whereas physicians at baseline most frequently reported a need to learn specific aspects of communication, often with emphasis on psychiatric problems, at follow-up they most typically reported that they had learnt basic communication skills (i.e. to listen and to pose open-ended questions). The majority of the physicians reported at follow-up that they applied the learnt skills to patient-related work, in relation to colleagues and on a personal level. Conclusion . Communication skills courses for senior clinicians with no previous formal training in this field should emphasise basic communication skills as well as the handling of difficult situations in doctor–patient interaction. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

National goals regarding sustainable development from the Swedish government were decisive in the planning process when the newly built city district Western Harbour was established in the city of Malmö, Sweden. A systems analysis was used as a tool for evaluating different collection and treatment systems. This type of analysis does not include more subjective factors such as acceptance of organic fertilisers based on human waste and user acceptance of collection schemes. These aspects, however, will often determine the success of a technical solution. When the system for collection and treatment of solid organic waste and wastewater was designed, both subjective and objective factors were considered. This meant that a centralised solution for wastewater treatment was selected. In order to facilitate a more sustainable solution for sludge management a treatment process with recovery of phosphorus will have to be introduced. Organic waste is sorted out and treated in an anaerobic digestion process. Source sorting of solid organic waste has been difficult to implement in Sweden due to inadequate sorting discipline. As a consequence two relatively new systems are tested in the area. A comprehensive evaluation will be carried out during a period of two years. [ABSTRACT FROM AUTHOR]

Objectives There has been little evaluation, by means other than cognitive variables, of medical school curricula that include problem-based learning (PBL). This study aimed to investigate whether medical students’ affect tolerance, an important prerequisite of empathy, was influenced by individual courses. Design The study is pseudo-randomised and cross-sectional, using a test of affect tolerance in students in their first, sixth and eighth term of medical school, during which they were kept together as one group for their pre-clinical studies, but were subsequently separated during the clinical part and were sent to two different university hospitals that used different teaching methods. Subjects Medical students. Setting University of Lund Medical School, Sweden. Results After receiving a short course in communications skills training, students in the sixth term had significantly higher mean scores on the test than students in their first term. In the eighth term, which is the surgery term, the mean scores for students attending the PBL course were still as high as those for students in the sixth term, while students in the course using conventional pedagogical methods had significantly lower mean scores. Discussion Since the content of the courses was similar and the composition of the two groups also fairly similar, we attribute the difference to the differing teaching methods. In the PBL course, the students were given continued and integrated communication skills instruction, in which it was possible for them to learn strategies to counteract the development of rigid psychic defences, which constitute an obstacle to affect tolerance and empathy. [ABSTRACT FROM AUTHOR]

It is argued, that the use of water can no longer be regarded as an almost free commodity. The idea to assess and value the environmentalimpact of the water use represents a true change of paradigm. The key issue is that any future wastewater treatment system has to be evaluated according to a quantitative criterion. This has to consider: hygienic aspects: we believe that nobody will accept a lower hygienic standard than today; -- environmental impact: the wastewater impact on the environment has steadily increased the need for better treatment. We need to be prepared for changes in the society by having a readiness manifested as continuing dynamic research environment in this area. Too often the knowledge buildup has been re-active instead of pro-active; -- economising resources: wastewater treatment looks and probably should look quite different in densely populated urban areas and in rural areas. Considering resource handling one has to consider already invested capital costs, land use, water re-use, organic and nutrient use and re-use, as well as overall use of energy. user aspects: technical functionality, economy and liability in different aspects require profound consideration. A sustainable wastewater treatment has to adapt to a local environment and the total resource demand has to be calculated, including a direct environmental impact on receiving waters, air and soil as well as energy consumption and nutrient recycling. Thus, there is an apparent need for: quantitative performance index: the quest for sustainable development has to be based onobjective reasons as well as subjective ones. An integrated performance index is part of a necessary decision making model for the designand operation of wastewater treatment systems. In this index, it is evident that a trade-off should be made between the pursued quality of the process outputs (liquid, solids, gas) and the associated efforts (investments, operation) required to achieve this considering the inpu [ABSTRACT FROM AUTHOR]

Abstract: Through an agreement with EEE producers, Swedish municipalities are responsible for collection of hazardous waste and waste electrical and electronic equipment (WEEE). In most Swedish municipalities, collection of these waste fractions is concentrated to waste recycling centres where households can source-separate and deposit hazardous waste and WEEE free of charge. However, the centres are often located on the outskirts of city centres and cars are needed in order to use the facilities in most cases. A full-scale experiment was performed in a residential area in southern Sweden to evaluate effects of a system for property-close source separation of hazardous waste and WEEE. After the system was introduced, results show a clear reduction in the amount of hazardous waste and WEEE disposed of incorrectly amongst residual waste or dry recyclables. The systems resulted in a source separation ratio of 70wt% for hazardous waste and 76wt% in the case of WEEE. Results show that households in the study area were willing to increase source separation of hazardous waste and WEEE when accessibility was improved and that this and similar collection systems can play an important role in building up increasingly sustainable solid waste management systems. [Copyright &y& Elsevier]