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Undervisning i global hälsa förekommer i olika former vid samtliga läkarutbildningar i Sverige, och på vissa håll har kursmoment med fokus på internationell hälsa funnits i över trettio år. I denna artikel presenteras utvecklingenav global hälsa vid Sveriges läkarutbildningar – från dåtid till nutid och framtid. Textbidrag har inkommit från respektive lärosäte och sammanställts av Helena Nordenstedt och Hampus Holmer. Global health education exists in different forms in all medical programs in Sweden, and in some places parts of courses with a focus on international health has existed for more than 30 years. In this article we the development of global health education in the medical programs in Sweden is presented – from then to now and into the future. Each university has contributed texts, and these contributions have then been compiled by Helena Nordenstedt and Hampus Holmer.

Flowchart of participants in the study. (DOCX 27 kb)

Distillery wastewater in the form of spent wash is a complex and strong industrial effluent, with high load of organic pollutants that may deplete dissolved oxygen on being discharged into aquatic systems and contaminate groundwater by leaching of pollutants, while untreated spent wash disposed on land acidifies the soil. Stringent legislative measures have therefore been framed in different countries for discharge standards of distillery effluent. Utilising the organic pollutants present in various types of wastes as food by mixed microbial populations is emerging as an eco-friendly approach in the recent years, in which complex organic matter is converted into simpler forms, and simultaneously useful gases are produced as renewable and clean energy sources. In the present study, wastewater from a rice bran based distillery has been used as the substrate in a dark fermenter, and native microbial consortium from the digester sludge has been used as the inoculum to treat the wastewater and produce hydrogen. After optimising the operational conditions in batch reactors, sequential batch mode and continuous flow stirred tank reactors were used to study the best operational conditions for enhanced and sustained hydrogen production and removal of pollutants. Since the rate of hydrogen production by the microbial consortium during dark fermentation is influenced by concentration of organic matter, pH and temperature, these operational conditions were optimised in batch mode studies. Maximum hydrogen production rate (347.87ml/L/d) was attained in 32h dark fermentation while a good proportion of COD also got removed from the wastewater. Slightly acidic initial pH seemed to favor biohydrogen production. In continuous stirred tank reactor, high H2 production from distillery wastewater was obtained from a relatively shorter substrate retention time (SRT) of 48h and a moderate organic loading rate (OLR) of 172 g/l/d COD., {"references":["Kaushik, A. Mona, S., Kaushik, C. P, \" Integrating photobiological hydrogen production with dye–metal bioremoval from simulated textile wastewater\" Bioresource Technology vol. 102 no. 21, pp 9957-9964, Aug. 2011.","Fan, K. S., Chen, Y. Y., \"H2 production through anaerobic mixed culture: effect of batch S0/X0 and shock loading in CSTR\" Chemosphere vol. 57, pp 1059-68, Jan. 2004.","Chu, C. F., Li, Y. Y., Xu, K. Q., Ebie, Y., Inamori, Y., Kong, H. N., \"A pH-and temperature-phased two stage process for hydrogen and methane production from food waste. Int J Hydrogen Energy,\" vol. 33, pp. 4739-46, July, 2008.","Luo, G., Xie, L., Zou, Z., Zhou, Q., Wang, J. Y., \"Fermentative hydrogen production from cassava tillage by mixed anaerobic microflora: effects of temperature and pH\", Appl. Energy, vol. 87, no. 12, pp. 3710-17, Sept. 2010.","Valdez-Vazquez, I., Poggi-Varaldo, H. M., \"Hydrogen production by fermentative consortia\", Renew. Sust Energy Review. Vol. 13, no. 5, pp. 1000-1013, June, 2009.","Noike, T., \"Biological hydrogen production of organic wastes—Development of the two-phase hydrogen production process, Proceedings International Symposium on Hydrogen and Methane\", Fermentation of Organic Waste, Tokyo, March, 2002, pp. 31–39.","Li, D., Chen, H., \"Biological hydrogen production from steam-exploded straw by simultaneous saccharification and fermentation\", Int J Hydrogen Energy, vol. 32, no. 12, pp. 1742-48, Aug., 2007.","Doi, T., Matsumoto, H., Abe, J., Morita, S., \"Feasibility study on the application of rhizosphere microflora of rice for the biohydrogen production from wasted bread\", Int J Hydrogen Energy, vol. 34, no.4, pp. 1735-43, May, 2009.","Argun, H., Kargi, F., Kapdan, I. K., Oztekin, R., \"Batch dark fermentation of powdered wheat starch in to hydrogen gas: effects of initial substrate and biomass concentration\", Int J Hydrogen Energy, vol. 33, pp. 6109-15, Nov., 2008.\n[10]\tKumar, G., Lin, C. Y., \"Bioconversion of de-oiled Jatropha waste (DJW) to hydrogen and methane gas by anaerobic fermentation: influence of substrate concentration, temperature and pH\", Int J Hydrogen Energy vol. 38, pp. 63-72, Jan., 2013.\n[11]\tSkonieczny, M. T., Yargeau, V., \"Biohydrogen production from wastewater by Clostridium beijerinckii: effect of pH and substrate concentration\", Int J Hydrogen Energy, vol. 34, no. 8, 3288-94, May, 2009.\n[12]\tMohammadi, P., Ibrahim, S., Annuar, M. S. M., Ghafari, S., Vikineswary, S., Zinatizadeh, A. A. \"Influence of environmental and operational factors on dark fermentative hydrogen production: A Review\", Clean- Soil, Air, Water, vol. 40 no. 11, pp. 1297-1305, Nov., 2012."]}