Identifiering av parametrar till ackumulatortanken Solus1050 från consolar - en metodbeskrivning

This report describes the work done creating a computer model of a kombi tank from Consolar. The model was created with Presim/Trnsys and Fittrn and DF were used to identify the parameters. Measurements were carried out and were used to identify the values of the parameters in the model. The identifications were first done for every circuit separately. After that, all parameters are normally identified together using all the measurements. Finally the model should be compared with other measurements, preferable realistic ones. The two last steps have not yet been carried out, because of problems finding a good model for the domestic hot water circuit.The model of the domestic hot water circuit give relatively good results for low flows at 5 l/min, but is not good for higher flows. In the report suggestions for improving the model are given. However, there was not enough time to test this within the project as much time was spent trying to solve problems with the model crashing. Suggestions for improving the model for the domestic circuit are given in chapter 4.4. The improved equations that are to be used in the improved model are given by equation 4.18, 4.19 and 4.22.Also for the boiler circuit and the solar circuit there are improvements that can be done. The model presented here has a few shortcomings, but with some extra work, an improved model can be created. In the attachment (Bilaga 1) is a description of the used model and all the identified parameters.A qualitative assessment of the store was also performed based on the measurements and the modelling carried out. The following summary of this can be given: Hot Water PreparationThe principle for controlling the flow on the primary side seems to work well in order to achieve good stratification. Temperatures in the bottom of the store after a short use of hot water, at a coldwater temperature of 12°C, was around 28-30°C. This was almost independent of the temperature in the store and the DHW-flow.The measured UA-values of the heat exchangers are not very reliable, but indicates that the heat transfer rates are much better than for the Conus 500, and in the same range as for other stores tested at SERC.The function of the mixing valve is not perfect (see diagram 4.3, where Tout1 is the outlet hot water temperature, and Tdhwo and Tdhw1 is the inlet temperature to the hot and cold side of the valve respectively). The outlet temperature varies a lot with different temperatures in the storage and is going down from 61°C to 47°C before the cold port is fully closed. This gives a problem to find a suitable temperature setting and gives also a risk that the auxiliary heating is increased instead of the set temperature of the valve, when the hot water temperature is to low.Collector circuitThe UA-value of the collector heat exchanger is much higher than the value for Conus 500, and in the same range as the heat exchangers in other stores tested at SERC.Boiler circuitThe valve in the boiler circuit is used to supply water from the boiler at two different heights, depending on the temperature of the water. At temperatures from the boiler above 58.2°C, all the water is injected to the upper inlet. At temperatures below 53.9°C all the water is injected to the lower inlet. At 56°C the water flow is equally divided between the two inlets. Detailed studies of the behaviour at the upper inlet shows that better accuracy of the model would have been achieved using three double ports in the model instead of two. The shape of the upper inlet makes turbulence, that could be modelled using two different inlets. Heat lossesThe heat losses per m3 are much smaller for the Solus 1050, than for the Conus 500 Storage. However, they are higher than those for some good stores tested at SERC. The pipes that are penetrating the insulation give air leakage and cold bridges, which could be a major part of the losses from the storage. The identified losses from the bottom of the storage are exceptionally high, but have less importance for the heat losses, due to the lower temperatures in the bottom. High losses from the bottom can be caused by air leakage through the insulation at the pipe connections of the storage.

Improving continence services for older people from the service-providers’ perspective : a qualitative interview study

Objective: To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design: Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting: 3 acute and 13 primary care National Health Service Trusts in England. Participants: 16 continence service leads in England actively treating and managing older people with UI. Results: In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and highquality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions: Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.

Assessing the physical environment of older people’s residential care facilities: development of the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM)

Background There is emerging evidence that the physical environment is important for health, quality of life and care, but there is a lack of valid instruments to assess health care environments. The Sheffield Care Environment Assessment Matrix (SCEAM), developed in the United Kingdom, provides a comprehensive assessment of the physical environment of residential care facilities for older people. This paper reports on the translation and adaptation of SCEAM for use in Swedish residential care facilities for older people, including information on its validity and reliability. Methods SCEAM was translated into Swedish and back-translated into English, and assessed for its relevance by experts using content validity index (CVI) together with qualitative data. After modification, the validity assessments were repeated and followed by test-retest and inter-rater reliability tests in six units within a Swedish residential care facility that varied in terms of their environmental characteristics. Results Translation and back translation identified linguistic and semantic related issues. The results of the first content validity analysis showed that more than one third of the items had item-CVI (I-CVI) values less than the critical value of 0.78.  After modifying the instrument, the second content validation analysis resulted in I-CVI scores above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ= 0.903 and 0.869) and inter-rater reliability (κ= 0.851 and 0.832). Conclusions Adapting an instrument to a domestic context is a complex and time-consuming process, requiring an understanding of the culture where the instrument was developed and where it is to be used. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation and adaption. This study showed preliminary validity and reliability evidence for the Swedish version (S-SCEAM) when used in a Swedish context. Further, we believe that the S-SCEAM has improved compared to the original instrument and suggest that it can be used as a foundation for future developments of the SCEAM model.

"An on-going individual adjustment" : a qualitative study of midwives' experiences counselling pregnant women on physical activity in Sweden

Background: In Sweden, midwives play prominent supportive role in antenatal care by counselling and promoting healthy lifestyles. This study aimed to explore how Swedish midwives experience the counselling of pregnant women on physical activity, specifically focusing on facilitators and barriers during pregnancy. Also, addressing whether the midwives perceive that their own lifestyle and body shape may influence the content of the counselling they provide. Methods: Eight focus group discussions (FGD) were conducted with 41 midwives working in antenatal care clinics in different parts of Sweden between September 2013 and January 2014. Purposive sampling was applied to ensure a variation in age, work experience, and geographical location. The FGD were digitally recorded, transcribed verbatim, and analyzed using manifest and latent content analysis. Results: The main theme- "An on-going individual adjustment" was built on three categories: "Counselling as a challenge"; "Counselling as walking the thin ice" and "Counselling as an opportunity" reflecting the midwives on-going need to adjust their counselling depending on each woman's specific situation. Furthermore, counselling pregnant women on physical activity was experienced as complex and ambiguous, presenting challenges as well as opportunities. When midwives challenged barriers to physical activity, they risked being rejected by the pregnant women. Despite risking rejection, the midwives tried to promote increased physical activity based on their assessment of individual needs of the pregnant woman. Some participants felt that their own lifestyle and body shape might negatively influence the counselling; however, the majority of participants did not agree with this perspective. Conclusions: Counselling on physical activity during pregnancy may be a challenging task for midwives, characterized by on-going adjustments based on a pregnant woman's individual needs. Midwives strive to find individual solutions to encourage physical activity. However, to improve their counselling, midwives may benefit from further training, also organizational and financial barriers need to be addressed. Such efforts might result in improved opportunities to further support pregnant women's motivation for performance of physical activity.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.