Wastewater sludge as a resource: sludge disposal strategies and corresponding treatment technologies aimed at sustainable handling of wastewater sludge.

The paper discusses different strategies for the disposal of wastewater sludge, particularly the "use on land" strategy and the "productification" strategy. In the "use on land" strategy the new regulations in Europe call for stabilization as well as disinfection of sludge to be used on land. The paper discusses the design and operation experiences with stabilization/disinfection methods in Norway where such treatment has been compulsory since 1995. In the "productification" strategy it is differentiated between the production of "bio-soils" and production of specific products (energy, nutrients, coagulants etc) and the "marketability" of these products is evaluated. An example of a sludge treatment concept aimed at recycling--the KREPRO process--is presented.

[Inventory of geriatric psychiatry in Sweden. In short supply where demand does not determine resource allocation]. / Aldrepsykiatrin inventerad i Sverige. En bristvara där efterfrågan inte styr resurstilldelningen.

In 1999 The Swedish Society for Old Age Psychiatry conducted an investigation in all Swedish counties in order to survey existing organizations and resources for medical services intended for elderly people with psychiatric complaints. In some counties there were no out-patient units specifically aimed at elderly people with psychiatric diseases, while more than half had no out-patient units for the large group of elderly with psychiatric ailments other than dementia. The total number of beds was far less than international recommendations. Less than 5 per cent of the total number of Swedish psychiatrists and geriatricians hold positions exclusively for geriatric psychiatry. Access to geriatric psychiatry resources appears to be unevenly distributed, and may be found mainly in or near university cities.

Assessment of rehabilitation technologies in stroke. Outcomes and costs.

Initial functional ability (Barthel Index, mean 57) was found to be an important predictor of functional ability 1 year after stroke (mean 80) and for costs during the period. On average the total cost for a stroke patient was about SEK 200,000; the main expense, accommodation, averaged about SEK 140,000, while assistive devices amounted to SEK 2,600. Those who use assistive devices, although having achieved a high functional ability, perceive and rate their life situation (Nottingham Health Profile) considerably more impaired than those without assistive devices.

Toward a model for quality assessment in heart transplantation.

A model for quality assessment of heart transplantation that combines a scientific method for studying the recipients' quality of life and a basis for a method of clinical work by nurses and other health care professionals is discussed. Besides its use as a research method, this model also may serve as an instrument for documenting patients' biopsychosocial status, including coping capacity, and for evaluating nursing interventions.