Kvinnors upplevelse av planerad hemförlossning i Skandinavien : Women´s experience of planned home birth in the Scandinavian countries

Background: In Sweden and Norway planned home birth is not included in the health care system. In Denmark women with expected low risk birth have the right to choose home birth. Registrations of home births in the Nordic countries are not completed and women’s experiences of planned home birth in Scandinavian context are not earlier described.Objective: The aim of this study was to describe women’s experiences of planned home birth in the Scandinavian countries.Design: Inductive content analysis. Fifty-three Scandinavian women who have experienced planned home birth have replied an open question in a questionnaire. Findings: In the analysis five categories and twelve subcategories emerged. The categories were, to feel secure, experiences of support, being in control, harmony and insecurity. The women felt secure and calm in their own homes. They felt being in control, secure, support and trust in the midwife, relatives and the own body. What worried the women most in presence of the delivery was that the midwife should not be present. Keywords: Home birth, experiences, women.

We did it together : Fathers´ experiences of planned home birth in the Nordic countries

Sammanfattning: Bakgrund: för många pappor kan det vara en av livets största och bästa stund att närvara vid när deras barn föds. Det finns studier som beskriver pappors upplevelse av sjukhusförlossning, däremot finns det få studier som beskriver pappors upplevelse av planerad hemförlossning. Syftet med den här studien är att beskriva pappans upplevelser och erfarenheter av planerad hemförlossning. Metod: i denna studie medverkar 105 pappor från de nordiska länderna som har deltagit i planerad hemförlossning mellan 2009-2011. Materialet från en öppen enkätfråga analyserades med hjälp av deduktiv ansats. Den öppna frågan löd ”beskriv gärna förlossningen med egna ord”. Resultat: papporna upplevde den planerade hemförlossningen som lugn och säker, mycket tack vare den professionella barnmorskan och den välbekanta miljön. Att få vara hemma med sin partner och om så önskades, sin familj var högt skattat. Födelseprocessen hemma beskrevs av papporna som att ”vi gjorde det tillsammans” och ”det var vår egen förlossning”. Papporna uttryckte delaktighet i förlossningsflödet. De kände också att de fick ett barn och var en del av en vacker förlossning full av kärlek. Konklusion: att välkomna ett barn hemma i en lugn miljö där paret känner sig trygga och ostörda, kan underlätta en positiv och meningsfull förlossningsupplevelse.

Heat losses and thermal performance of commercial combined solar and pellet heating systems

Various pellet heating systems are marketed in Sweden, some of them in combination with a solar heating system. Several types of pellet heating units are available and can be used for a combined system. This article compares four typical combined solar and pellet heating systems: System 1 and 2 two with a pellet stove, system 3 with a store integrated pellet burner and system 4 with a pellet boiler. The lower efficiency of pellet heaters compared to oil or gas heaters increases the primary energy demand. Consequently heat losses of the various systems have been studied. The systems have been modeled in TRNSYS and simulated with parameters identified from measurements. For almost all systems the flue gas losses are the main heat losses except for system 3 where store heat losses prevail. Relevant are also the heat losses of the burner and the boiler to the ambient. Significant leakage losses are noticed for system 3 and 4. For buildings with an open internal design system 1 is the most efficient solution. Other buildings should preferably apply system 3. The right choice of the system depends also on whether the heater is placed inside or outside of the heated are. A large potential for system optimization exist for all studied systems, which when applied could alter the relative merits of the different system types.

Design method for solar heating systems in combination with pellet boilers/stoves

In this study an optimization method for the design of combined solar and pellet heating systems is presented and evaluated. The paper describes the steps of the method by applying it for an example of system. The objective of the optimization was to find the design parameters that give the lowest auxiliary energy (pellet fuel + auxiliary electricity) and carbon monoxide (CO) emissions for a system with a typical load, a single family house in Sweden. Weighting factors have been used for the auxiliary energy use and CO emissions to give a combined target function. Different weighting factors were tested. The results show that extreme weighting factors lead to their own minima. However, it was possible to find factors that ensure low values for both auxiliary energy and CO emissions.

Rapport från/Report from IEA Task-14 mötet/meeting on solar heating system, Hameln Tyskland/Germany August 1992

Participation as observer at the meeting of Task 14 of IEA's Solar Heating and Cooling Projects held in Hameln, Germany has led to greater understanding of interesting developments underway in several countries. This will be of use during the development of small scale systems suitable for Swedish conditions. A summary of the work carried out by the working groups within Task 14 is given, with emphasis on the Domestic Hot Water group. Experiences of low-flow systems from several countries are related, and the conclusion is drawn that the maximum theoretical possible increase in performance of 20% has not been achieved due to poor heat exchangers and poor stratification in the storage tanks. Positive developments in connecting tubes and pumps is noted. Further participation as observer in Task 14 meetings is desired, and is looked on favourably by the members of the group. Another conclusion is that SERC should carry on with work on Swedish storage tanks, with emphasis on better stratification and heat exchangers, and possible modelling of system components. Finally a German Do-it-Vourself kit is described and judged in comparison with prefabricated models and Swedish Do-it-Yourself kits.

Competitive Solar Heating Systems for Residential Buildings (REBUS)

Research on solar combisystems for the Nordic and Baltic countries have been carriedout. The aim was to develop competitive solar combisystems which are attractive tobuyers and to educate experts in the solar heating field.The participants of the projects were the universities: Technical University of Denmark,Dalarna University, University of Oslo, Riga Technical University and Lund Institute ofTechnology, as well as the companies: Metro Therm A/S (Denmark), Velux A/S(Denmark), Solentek AB (Sweden), SolarNor (Norway) and SIA Grandeg (Latvia).The project included education, research, development and demonstration. Theactivities started in 2003 and were finished by the end of 2006. A number of Ph.D.studies in Denmark, Sweden and Latvia, and a post-doc. study in Norway were carriedout. Close cooperation between the researchers and the industry partners ensured thatthe results of the projects can be utilized. The industry partners will soon be able tobring the developed systems into the market.In Denmark and Norway the research and development focused on solarheating/natural gas systems, and in Sweden and Latvia the focus was on solarheating/pellet systems. Additionally, Lund Institute of Technology and University ofOslo studied solar collectors of various types being integrated into the building.

Combined solar and pellet heating systems for single-family houses : How to achieve decreased electricity usage, increased system efficiency and increased solar gains

In Sweden, there are about 0.5 million single-family houses that are heated by electricity alone, and rising electricity costs force the conversion to other heating sources such as heat pumps and wood pellet heating systems. Pellet heating systems for single-family houses are currently a strongly growing market. Future lack of wood fuels is possible even in Sweden, and combining wood pellet heating with solar heating will help to save the bio-fuel resources. The objectives of this thesis are to investigate how the electrically heated single-family houses can be converted to pellet and solar heating systems, and how the annual efficiency and solar gains can be increased in such systems. The possible reduction of CO-emissions by combining pellet heating with solar heating has also been investigated. Systems with pellet stoves (both with and without a water jacket), pellet boilers and solar heating have been simulated. Different system concepts have been compared in order to investigate the most promising solutions. Modifications in system design and control strategies have been carried out in order to increase the system efficiency and the solar gains. Possibilities for increasing the solar gains have been limited to investigation of DHW-units for hot water production and the use of hot water for heating of dishwashers and washing machines via a heat exchanger instead of electricity (heat-fed appliances). Computer models of pellet stoves, boilers, DHW-units and heat-fed appliances have been developed and the parameters for the models have been identified from measurements on real components. The conformity between the models and the measurements has been checked. The systems with wood pellet stoves have been simulated in three different multi-zone buildings, simulated in detail with heat distribution through door openings between the zones. For the other simulations, either a single-zone house model or a load file has been used. Simulations were carried out for Stockholm, Sweden, but for the simulations with heat-fed machines also for Miami, USA. The foremost result of this thesis is the increased understanding of the dynamic operation of combined pellet and solar heating systems for single-family houses. The results show that electricity savings and annual system efficiency is strongly affected by the system design and the control strategy. Large reductions in pellet consumption are possible by combining pellet boilers with solar heating (a reduction larger than the solar gains if the system is properly designed). In addition, large reductions in carbon monoxide emissions are possible. To achieve these reductions it is required that the hot water production and the connection of the radiator circuit is moved to a well insulated, solar heated buffer store so that the boiler can be turned off during the periods when the solar collectors cover the heating demand. The amount of electricity replaced using systems with pellet stoves is very dependant on the house plan, the system design, if internal doors are open or closed and the comfort requirements. Proper system design and control strategies are crucial to obtain high electricity savings and high comfort with pellet stove systems. The investigated technologies for increasing the solar gains (DHW-units and heat-fed appliances) significantly increase the solar gains, but for the heat-fed appliances the market introduction is difficult due to the limited financial savings and the need for a new heat distribution system. The applications closest to market introduction could be for communal laundries and for use in sunny climates where the dominating part of the heat can be covered by solar heating. The DHW-unit is economical but competes with the internal finned-tube heat exchanger which is the totally dominating technology for hot water preparation in solar combisystems for single-family houses.

Fjärrvärmedrivna vitvaror : Erfarenheter från utveckling, installationer och kostnadsberäkningar

Värmedrivna vitvaror eller HWC-maskiner som de kallas av tillverkaren värms med varmt vatten från en cirkulerande krets via en värmeväxlare inbyggd i maskinen, till skillnad från konventionella maskiner som värms med el. Denna teknik skall inte förväxlas med maskiner som är anslutna till varmvattenledningen och fylls på med varmt vatten och som därmed begränsas till disk- och tvätt. Syftet med fjärrvärmedrivna vitvaror är alltså att använda fjärrvärme, som har lägre kvalitet och pris än elenergi för uppvärmning och torkning och på så sätt spara el och utöka fjärrvärmeunderlaget. En jämförelse av koldioxidutsläpp och primärenergianvändning mellan konventionella vitvaror och fjärrvärmedrivna vitvaror visar att både koldioxidutsläpp och primärenergianvändning blir lägre för fjärrvärmedrivna vitvaror om biobränsle anses koldioxidneutralt och den el som ersätts är producerad i kolkraftverk eller gaskombikraftverk.   Denna rapport beskriver utveckling och kommersialisering av värmedrivna vitvaror (disk- och tvättmaskiner samt torktumlare och torkskåp) och hur de kan anslutas mot fjärrvärmesystem i olika systemlösningar. Dessutom har de energimässiga och ekonomiska förutsättningarna för tekniken undersökts. Erfarenheterna från fältprovning är dock mycket begränsade, eftersom de byggen där fälttesterna skulle ske försenades. Under 2013 färdigställs ett flerbostadshus med värmedrivna vitvaror i 160 lägenheter i Västerås.   De utvecklade maskinernas värmeanvändning som andel av total energianvändning vid 60 graders framledningstemperatur har uppmätts till ca 50 % för diskmaskinen, 67 % för tvättmaskinen, 80 % för torktumlaren och 93 % för torkskåpet. I det studerade flerbostadshuset av passivhusstandard uppgår lasten från värmedrivna vitvaror komfortgolvvärme och handdukstorkar till upp mot 30 % av husets totala värmeanvändning. För småhus är motsvarande siffra upp mot 20 %. Att använda fjärrvärme istället för elvärme till dessa installationer som normalt är elvärmda kan allts minska elbehovet betydligt i lågenergibebyggelse vilket också minskar både koldioxidutsläppen och primärenergianvändningen.   Ekonomiska analyser har genomförts för två olika systemkoncept (separat vitvarukrets och Västeråsmodellen) för nybyggda småhusområden och flerfamiljshus där fjärrvärme inte bara används till vitvaror utan också till handdukstorkar och komfortgolvvärme. De ekonomiska analyserna visar att Västeråsmodellen är den mest ekonomiskt intressanta systemlösningen med värmedrivna vitvaror, handdukstork och komfortgolvvärme. I flerfamiljshus kan den vara konkurrenskraftig mot de elvärmda alternativen (konventionellt system med eldrivna vitvaror, komfortgolvvärme och handdukstorkar) om prisskillnaden mellan el och fjärrvärme är större än 0,7 kr/kWh. En parameterstudie visar att kapitalkostnaden blir ganska hög jämfört med energikostnaden, vilket betyder att lång livslängd och många cykler är viktigt för att förbättra de ekonomiska förutsättningarna för värmedrivna vitvaror. För passiva småhus blir kostnaden för Västeråsmodellen med värmedrivna vitvaror, handdukstork och komfortgolvvärme likvärdig med de elvärmda alternativen vid energiprisskillnader på 0,7 kr/kWh inklusive moms, medan det krävs prisskillnader på 0,9 kr/kWh inklusive moms för normalisolerade småhusområden.   Sammanfattningsvis kan sägas att i kommuner med ett konkurrenskraftigt fjärrvärmepris finns det viss lönsamhet för hela konceptet enligt Västeråsmodellen med värmedrivna vitvaror, komfortgolvvärme, och handdukstorkar. Om man däremot ser på konkurrensen för enskilda vitvaror är det främst torktumlaren som är konkurrenskraftig i bostäder. Målpriset på 1000 kr extra för värmedrift har inte kunnat uppnås inom projektet för diskmaskiner och tvättmaskiner. Det krävs lägre priser och låga anslutningskostnader för att räkna hem diskmaskinen och tvättmaskinen som enskilda komponenter.   Värmedrivna tvättmaskiner och torktumlare är konkurrenskraftiga i flerfamiljstvättstugor. Speciellt i de fall där beläggningen är god och flera maskiner delar på anslutningskostnaden till fjärrvärmecentralen kan värmedrift bli riktigt lönsam. Torkskåpens konkurrenskraft har inte kunnat utvärderas, då priset ännu inte fastställts. Att använda VVC-systemet för värmedistribution till värmedrivna vitvaror kan vara mycket intressant, men det kräver att legionellaproblematiken kan lösas. I nuläget finns ingen lösning som uppfyller formuleringarna i boverkets byggregler. Ett annat distributionssätt som kan vara intressant, men som inte undersökts i studien är att använda VVC för varmvattendistribution och en gemensam radiator- och vitvarukrets med konstant framledningstemperatur. Den aktör som förväntas ha störst ekonomiskt intresse av att tekniken implementeras är sannolikt fjärrvärmebolagen som får sälja mer värme och det ligger därmed främst på deras ansvar att marknadsföra tekniken i mötet med sina kunder.

Economic Evaluation of a Solar Charged Thermal Energy Store for Space Heating

A thermal energy store corrects the misalignment of heating demand in the winter relative to solar thermal energy gathered in the summer. This thesis reviews the viability of a solar charged hot water tank thermal energy store for a school at latitude 56.25N, longitude -120.85W

Passive solar options for reducing heating demand and maintain indoor climate in a multifamily house in Sweden

This research was carried out by studying possible renovation of a two-storey detached multifamily building by using passive solar design options in a cold climate in Borlänge, Sweden where the heating Degree Days are 4451 (base 20°C). Borlänge`s housing company, Tunabyggen, plans to renovate the project house located inthe multicultural district, Jakobsgårdarna. The goal of the thesis was to suggest a redesign of the current building, decrease the heating energy use, by applying passive solar design and control strategies, in a most reasonable way. In addition ensure a better thermal comfort for the tenants in the dwellings. Literatures have been studied, from which can be inferred that passive design should be abasic design consideration for all housing constructions, because it has advantages to ensure thermal comfort, and reduce the energy use. In addition further savings can be achieved applying different types of control strategies, from which the house will be more personalized, and better adapted to the user’s needs.The proposed method is based on simulations by using TRNSYS software. First a proper building model was set up, which represents the current state of the project building. Then the thermal insulation and the windows were upgraded, based on today's building regulations. The developments of the passive solar options were accomplished in two steps. First of all the relevant basic passive design elements were considered, then those advantages were compared to the advantages of applying new conventional thermostat, and shading control strategies.The results show that there is significant potential with the different types of passive solar design; their usage depends primarily on the location of the site as well as the orientation of the project building. Applying the control strategies, such as thermostat, and shading control, along the thermal insulation upgrade, may lead to significant energy savings (around 40 %), by comparison to the reference building without any upgrade.

A home environment test battery for status assessment in patients with motor fluctuations

Background and aims Evaluating status in patients with motor fluctuations is complex and occasional observations/measurements do not give an adequate picture as to the time spent in different states. We developed a test battery to assess advanced Parkinson patients' status consisting of diary assessments and motor tests. This battery was constructed and implemented on a handheld computer with built-in mobile communication. In fluctuating patients, it should typically be used several times daily in the home environment, over periods of about one week. The aim of this battery is to provide status information in order to evaluate treatment effects in clinical practice and research, follow up treatments and disease progression and predict outcome to optimize treatment strategy. Methods Selection of diary questions was based on a previous study with Duodopa® (DIREQT). Tapping tests (with and without visual cueing) and a spiral drawing test were added. Rapid prototyping was used in development of the user interface. An evaluation with two pilot patients was performed before and after receiving new treatments for advanced disease (one received Duodopa® and one received DBS). Speed and proportion missed taps were calculated for the tapping tests and entropy of the radial drawing velocity was calculated for the spiral tests. Test variables were evaluated using non-parametric statistics. Results Post-treatment improvement was detected in both patients in many of the test variables. Conclusions Although validation work remains, preliminary results are promising and the test battery is currently being evaluated in a long-term health economics study with Duodopa® (DAPHNE).