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The aim of this study was to clarify the possibilities to increase the amount of soluble chemical oxygen demand (SCOD) and methane production of sludge using ultrasound technologies with and without oxidising agents. The study was done using multivariate data analyses. The most important factors affected were discovered. Ultrasonically assisted disintegration increased clearly the amount of SCOD of sludge. Also more methane was produced from treated sludge in anaerobic batch assays compared to the sludge with no ultrasonic treatment. Multivariate data analysis showed that ultrasonic power, dry solid content of sludge (DS), sludge temperature and ultrasonic treatment time have the most significant effect on the disintegration. It was also observed that in the reactor studied energy efficiency with high ultrasound power together with short treatment time was higher than with low ultrasound power with long treatment time. When oxidising agents were used together with ultrasound no increase in SCOD was achieved compared the ultrasonic treatment alone and only a slight increase in total organic carbon of sludge was observed. However, no enhancement in methane production was observed when using oxidising agents together with ultrasound compared the ultrasonic treatment alone. Ultrasound propagation is an important factor in ultrasonic reactor scale up. Ultrasound efficiency rose linearly with input power in sludge at small distances from the transducer. Instead, ultrasound efficiency started even to decrease with input power at long distances from the transducer.

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AimWe quantitatively analysed the effect of a course in communication on the content of nurse–parent encounters and the ability of nurses to respond to the empathic needs of parents in a level III neonatal intensive care unit.MethodsWe evaluated 36 and 45 nurse–parent encounters audio recorded before and after 13 neonatal nurses attended a communication course. The number of empathic opportunities, the nurses' responses to these and the ways they involved parents in their infants' care were studied.ResultsBoth before and after the course, the nurses talked more than the parents during the conversations. This nurse‐centredness decreased after the course. The use of empathic or exploring responses to empathic opportunities increased from 19.9 ± 9.0% to 53.8 ± 8.9% (p = 0.027), whereas ignoring the feelings of the parents or giving inadequate advice decreased from 63.0 ± 10.0% to 27.5 ± 8.4% (p = 0.043) after the course. Use of statements expressing caring for the parents and encouragement for parents to participate in the care of their infant increased after the course (p = 0.0034 and p = 0.043, respectively). The nurses felt the course was very useful for their profession.ConclusionA course in communication techniques improved nurses' ability to respond to parents' feelings with empathy.