727 resultados para Home heating
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Background: Perineal injury is a serious complication of vaginal delivery that has a severe impact on the quality of life of healthy women. The prevalence of perineal injuries among women who give birth in hospital has increased over the last decade, while it is lower among women who give birth at home. The aim of this study was to describe the practice of midwives in home birth settings with the focus on the occurrence of perineal injuries. Methods: Twenty midwives who had assisted home births for between one and 29 years were interviewed using an interview guide. The midwives also had experience of working in a hospital delivery ward. All the interviews were tape-recorded and transcribed. Content analysis was used. Results: The overall theme was "No rushing and tearing about", describing the midwives' focus on the natural process taking its time. The subcategories 1) preparing for the birth; 2) going along with the physiological process; 3) creating a sense of security; 4) the critical moment and 5) midwifery skills illuminate the management of labor as experienced by the midwives when assisting births at home. Conclusions: Midwives who assist women who give birth at home take many things into account in order to minimize the risk of complications during birth. Protection of the woman's perineum is an act of awareness that is not limited to the actual moment of the pushing phase but starts earlier, along with the communication between the midwife and the woman.
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Background: British government policy for older people focuses on a vision of active ageing and independent living. In the face of diminishing personal capacities, the use of appropriate home-based technology (HBT) devices could potentially meet a wide range of needs and consequently improve many aspects of older people's quality of life such as physical health, psychosocial well-being, social relationships, and their physical or living environment. This study aimed to examine the use of HBT devices and the correlation between use of such devices and quality of life among older people living in extra-care housing (ECH). Methods: A structured questionnaire was administered for this study. Using purposive sampling 160 older people living in extra-care housing schemes were selected from 23 schemes in England. A face-to-face interview was conducted in each participant's living unit. In order to measure quality of life, the SEIQoL-Adapted and CASP-19 were used. Results: Although most basic appliances and emergency call systems were used in the living units, communally provided facilities such as personal computers, washing machines, and assisted bathing equipment in the schemes were not well utilised. Multiple regression analysis adjusted for confounders including age, sex, marital status, living arrangement and mobility use indicated a coefficient of 1.17 with 95% CI (0.05, 2.29) and p = 0.04 [SEIQoL-Adapted] and 2.83 with 95% CI (1.17, 4.50) and p = 0.001 [CASP-19]. Conclusions: The findings of the present study will be value to those who are developing new form of specialised housing for older people with functional limitations and, in particular, guiding investments in technological aids. The results of the present study also indicate that the home is an essential site for developing residential technologies.
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Objective: For the evaluation of the energetic performance of combined renewable heating systems that supply space heat and domestic hot water for single family houses, dynamic behaviour, component interactions, and control of the system play a crucial role and should be included in test methods. Methods: New dynamic whole system test methods were developed based on “hardware in the loop” concepts. Three similar approaches are described and their differences are discussed. The methods were applied for testing solar thermal systems in combination with fossil fuel boilers (heating oil and natural gas), biomass boilers, and/or heat pumps. Results: All three methods were able to show the performance of combined heating systems under transient operating conditions. The methods often detected unexpected behaviour of the tested system that cannot be detected based on steady state performance tests that are usually applied to single components. Conclusion: Further work will be needed to harmonize the different test methods in order to reach comparable results between the different laboratories. Practice implications: A harmonized approach for whole system tests may lead to new test standards and improve the accuracy of performance prediction as well as reduce the need for field tests.
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Background: Voice processing in real-time is challenging. A drawback of previous work for Hypokinetic Dysarthria (HKD) recognition is the requirement of controlled settings in a laboratory environment. A personal digital assistant (PDA) has been developed for home assessment of PD patients. The PDA offers sound processing capabilities, which allow for developing a module for recognition and quantification HKD. Objective: To compose an algorithm for assessment of PD speech severity in the home environment based on a review synthesis. Methods: A two-tier review methodology is utilized. The first tier focuses on real-time problems in speech detection. In the second tier, acoustics features that are robust to medication changes in Levodopa-responsive patients are investigated for HKD recognition. Keywords such as Hypokinetic Dysarthria , and Speech recognition in real time were used in the search engines. IEEE explorer produced the most useful search hits as compared to Google Scholar, ELIN, EBRARY, PubMed and LIBRIS. Results: Vowel and consonant formants are the most relevant acoustic parameters to reflect PD medication changes. Since relevant speech segments (consonants and vowels) contains minority of speech energy, intelligibility can be improved by amplifying the voice signal using amplitude compression. Pause detection and peak to average power rate calculations for voice segmentation produce rich voice features in real time. Enhancements in voice segmentation can be done by inducing Zero-Crossing rate (ZCR). Consonants have high ZCR whereas vowels have low ZCR. Wavelet transform is found promising for voice analysis since it quantizes non-stationary voice signals over time-series using scale and translation parameters. In this way voice intelligibility in the waveforms can be analyzed in each time frame. Conclusions: This review evaluated HKD recognition algorithms to develop a tool for PD speech home-assessment using modern mobile technology. An algorithm that tackles realtime constraints in HKD recognition based on the review synthesis is proposed. We suggest that speech features may be further processed using wavelet transforms and used with a neural network for detection and quantification of speech anomalies related to PD. Based on this model, patients' speech can be automatically categorized according to UPDRS speech ratings.
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In this study the monitoring results of prototype installation of a recently developed solar combisystem have been evaluated. The system, that uses a water jacketed pellet stove as auxiliary heater, was installed in a single family house in Borlänge/Sweden. In order to allow an evaluation under realistic conditions the system has been monitored for a time period of one year. From the measurements of the system it could be seen that it is important that the pellet stove has a sufficient buffer store volume to minimize cycling. The measurements showed also that the stove gives a lower share of the produced heat to the water loop than measured under stationary conditions. The solar system works as expected and covers the heat demand during the summer and a part of the heat demand during spring and autumn. Potential for optimization exists for the parasitic electricity demand. The system consumes 680 kWh per year for pumps, valves and controllers which is more than 4% of the total primary heating energy demand.
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Emissions are an important aspect of a pellet heating system. High carbon monoxide emissions are often caused by unnecessary cycling of the burner when the burner is operated below the lowest combustion power. Combining pellet heating systems with a solar heating system can significantly reduce cycling of the pellet heater and avoid the inefficient summer operation of the pellet heater. The aim of this paper was to study CO-emissions of the different types of systems and to compare the yearly CO-emissions obtained from simulations with the yearly CO-emissions calculated based on the values that are obtained by the standard test methods. The results showed that the yearly CO-emissions obtained from the simulations are significant higher than the yearly CO-emissions calculated based on the standard test methods. It is also shown that for the studied systems the average emissions under these realistic annual conditions were greater than the limit values of two Eco-labels. Furthermore it could be seen that is possible to almost halve the CO-emission if the pellet heater is combined with a solar heating system.
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Dynamic system test methods for heating systems were developed and applied by the institutes SERC and SP from Sweden, INES from France and SPF from Switzerland already before the MacSheep project started. These test methods followed the same principle: a complete heating system – including heat generators, storage, control etc., is installed on the test rig; the test rig software and hardware simulates and emulates the heat load for space heating and domestic hot water of a single family house, while the unit under test has to act autonomously to cover the heat demand during a representative test cycle. Within the work package 2 of the MacSheep project these similar – but different – test methods were harmonized and improved. The work undertaken includes: • Harmonization of the physical boundaries of the unit under test. • Harmonization of the boundary conditions of climate and load. • Definition of an approach to reach identical space heat load in combination with an autonomous control of the space heat distribution by the unit under test. • Derivation and validation of new six day and a twelve day test profiles for direct extrapolation of test results. The new harmonized test method combines the advantages of the different methods that existed before the MacSheep project. The new method is a benchmark test, which means that the load for space heating and domestic hot water preparation will be identical for all tested systems, and that the result is representative for the performance of the system over a whole year. Thus, no modelling and simulation of the tested system is needed in order to obtain the benchmark results for a yearly cycle. The method is thus also applicable to products for which simulation models are not available yet. Some of the advantages of the new whole system test method and performance rating compared to the testing and energy rating of single components are: • Interaction between the different components of a heating system, e.g. storage, solar collector circuit, heat pump, control, etc. are included and evaluated in this test. • Dynamic effects are included and influence the result just as they influence the annual performance in the field. • Heat losses are influencing the results in a more realistic way, since they are evaluated under "real installed" and representative part-load conditions rather than under single component steady state conditions. The described method is also suited for the development process of new systems, where it replaces time-consuming and costly field testing with the advantage of a higher accuracy of the measured data (compared to the typically used measurement equipment in field tests) and identical, thus comparable boundary conditions. Thus, the method can be used for system optimization in the test bench under realistic operative conditions, i.e. under relevant operating environment in the lab. This report describes the physical boundaries of the tested systems, as well as the test procedures and the requirements for both the unit under test and the test facility. The new six day and twelve day test profiles are also described as are the validation results.
Demonstration of Solar Heating and Cooling System using Sorption Integrated Solar Thermal Collectors
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Producing cost-competitive small and medium-sized solar cooling systems is currently a significant challenge. Due to system complexity, extensive engineering, design and equipment costs; the installation costs of solar thermal cooling systems are prohibitively high. In efforts to overcome these limitations, a novel sorption heat pump module has been developed and directly integrated into a solar thermal collector. The module comprises a fully encapsulated sorption tube containing hygroscopic salt sorbent and water as a refrigerant, sealed under vacuum with no moving parts. A 5.6m2 aperture area outdoor laboratory-scale system of sorption module integrated solar collectors was installed in Stockholm, Sweden and evaluated under constant re-cooling and chilled fluid return temperatures in order to assess collector performance. Measured average solar cooling COP was 0.19 with average cooling powers between 120 and 200 Wm-2 collector aperture area. It was observed that average collector cooling power is constant at daily insolation levels above 3.6 kWhm-2 with the cooling energy produced being proportional to solar insolation. For full evaluation of an integrated sorption collector solar heating and cooling system, under the umbrella of a European Union project for technological innovation, a 180 m2 large-scale demonstration system has been installed in Karlstad, Sweden. Results from the installation commissioned in summer 2014 with non-optimised control strategies showed average electrical COP of 10.6 and average cooling powers between 140 and 250 Wm-2 collector aperture area. Optimisation of control strategies, heat transfer fluid flows through the collectors and electrical COP will be carried out in autumn 2014.
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The core concepts of CA In the theoretical framework of CA, well-being is constituted by a person’s unique way of functioning and capabilities. This means that a person's well-being is personal and involves freedom of choice which in turn means they have a number of options. Although many people may have the same resources, it is of importance to study how these resources are converted into how they function. Thus, wellbeing is about the person's freedom to achieve in general and the capabilities to function in particular (Sen, 1995). Strength of the capability approach The capability approach is a useful tool for matching objective evaluations with subjective metrics. Furthermore, although one’s individual abilities are in focus, contextual factors, and subjective perceptions and experiences, are taken into consideration. Critiques against the CA The capability approach has been criticized for being too individual-centered and not taking sufficient account to social structures in society. It is difficult to know what a person would choose to do if other options were available. Therefore, to operationalize abilities involves uncertainties.
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Addressing building energy use is a pressing issue for building sector decision makers across Europe. In Sweden, some regions have adopted a target of reducing energy use in buildings by 50% until 2050. However, building codes currently do not support as ambitious objectives as these, and novel approaches to addressing energy use in buildings from a regional perspective are called for. The purpose of this licentiate thesis was to provide a deeper understanding of most relevant issues with regard to energy use in buildings from a broad perspective and to suggest pathways towards reaching the long-term savings objective. Current trends in building sector structure and energy use point to detached houses constructed before 1981 playing a key role in the energy transition, especially in the rural areas of Sweden. In the Swedish county of Dalarna, which was used as a study area in this thesis, these houses account for almost 70% of the residential heating demand. Building energy simulations of eight sample houses from county show that there is considerable techno-economic potential for energy savings in these houses, but not quite enough to reach the 50% savings objective. Two case studies from rural Sweden show that savings well beyond 50% are achievable, both when access to capital and use of high technology are granted and when they are not. However, on a broader scale both direct and indirect rebound effects will have to be expected, which calls for more refined approaches to energy savings. Furthermore, research has shown that the techno-economic potential is in fact never realised, not even in the most well-designed intervention programmes, due to the inherent complexity of human behaviour with respect to energy use. This is not taken account of in neither current nor previous Swedish energy use legislation. Therefore an approach that considers the technical prerequisites, economic aspects and the perspective of the many home owners, based on Community-Based Social Marketing methodology, is suggested as a way forward towards reaching the energy savings target.
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With the building sector accounting for around 40% of the total energy consumption in the EU, energy efficiency in buildings is and continues to be an important issue. Great progress has been made in reducing the energy consumption in new buildings, but the large stock of existing buildings with poor energy performance is probably an even more crucial area of focus. This thesis deals with energy efficiency measures that can be suitable for renovation of existing houses, particularly low-temperature heating systems and ventilation systems with heat recovery. The energy performance, environmental impact and costs are evaluated for a range of system combinations, for small and large houses with various heating demands and for different climates in Europe. The results were derived through simulation with energy calculation tools. Low-temperature heating and air heat recovery were both found to be promising with regard to increasing energy efficiency in European houses. These solutions proved particularly effective in Northern Europe as low-temperature heating and air heat recovery have a greater impact in cold climates and on houses with high heating demands. The performance of heat pumps, both with outdoor air and exhaust air, was seen to improve with low-temperature heating. The choice between an exhaust air heat pump and a ventilation system with heat recovery is likely to depend on case specific conditions, but both choices are more cost-effective and have a lower environmental impact than systems without heat recovery. The advantage of the heat pump is that it can be used all year round, given that it produces DHW. Economic and environmental aspects of energy efficiency measures do not always harmonize. On the one hand, lower costs can sometimes mean larger environmental impact; on the other hand there can be divergence between different environmental aspects. This makes it difficult to define financial subsidies to promote energy efficiency measures.
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The aim of this study was to investigate if a telemetry test battery can be used to measure effects of Parkinson’s disease (PD) treatment intervention and disease progression in patients with fluctuations. Sixty-five patients diagnosed with advanced PD were recruited in an open longitudinal 36-month study; 35 treated with levodopa-carbidopa intestinal gel (LCIG) and 30 were candidates for switching from oral PD treatment to LCIG. They utilized a test battery, consisting of self-assessments of symptoms and fine motor tests (tapping and spiral drawings), four times per day in their homes during week-long test periods. The repeated measurements were summarized into an overall test score (OTS) to represent the global condition of the patient during a test period. Clinical assessments included ratings on Unified PD Rating Scale (UPDRS) and 39-item PD Questionnaire (PDQ-39) scales. In LCIG-naïve patients, mean OTS compared to baseline was significantly improved from the first test period on LCIG treatment until month 24. In LCIG-non-naïve patients, there were no significant changes in mean OTS until month 36. The OTS correlated adequately with total UPDRS (rho = 0.59) and total PDQ-39 (0.59). Responsiveness measured as effect size was 0.696 and 0.536 for OTS and UPDRS respectively. The trends of the test scores were similar to the trends of clinical rating scores but dropout rate was high. Correlations between OTS and clinical rating scales were adequate indicating that the test battery contains important elements of the information of well-established scales. The responsiveness and reproducibility were better for OTS than for total UPDRS.
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Exploiting solar energy technology for both heating and cooling purposes has the potential of meeting an appreciable portion of the energy demand in buildings throughout the year. By developing an integrated, multi-purpose solar energy system, that can operate all twelve months of the year, a high utilisation factor can be achieved which translates to more economical systems. However, there are still some techno-economic barriers to the general commercialisation and market penetration of such technologies. These are associated with high system and installation costs, significant system complexity, and lack of knowledge of system implementation and expected performance. A sorption heat pump module that can be integrated directly into a solar thermal collector has thus been developed in order to tackle the aforementioned market barriers. This has been designed for the development of cost-effective pre-engineered solar energy system kits that can provide both heating and cooling. This thesis summarises the characterisation studies of the operation of individual sorption modules, sorption module integrated solar collectors and a full solar heating and cooling system employing sorption module integrated collectors. Key performance indicators for the individual sorption modules showed cooling delivery for 6 hours at an average power of 40 W and a temperature lift of 21°C. Upon integration of the sorption modules into a solar collector, measured solar radiation energy to cooling energy conversion efficiencies (solar cooling COP) were between 0.10 and 0.25 with average cooling powers between 90 and 200 W/m2 collector aperture area. Further investigations of the sorption module integrated collectors implementation in a full solar heating and cooling system yielded electrical cooling COP ranging from 1.7 to 12.6 with an average of 10.6 for the test period. Additionally, simulations were performed to determine system energy and cost saving potential for various system sizes over a full year of operation for a 140 m2 single-family dwelling located in Madrid, Spain. Simulations yielded an annual solar fraction of 42% and potential cost savings of €386 per annum for a solar heating and cooling installation employing 20m2 of sorption integrated collectors.
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Emissions from residential combustion appliances vary significantly depending on the firing behaviours and combustion conditions, in addition to combustion technologies and fuel quality. Although wood pellet combustion in residential heating boilers is efficient, the combustion conditions during start-up and stop phases are not optimal and produce significantly high emissions such as carbon monoxide and hydrocarbon from incomplete combustion. The emissions from the start-up and stop phases of the pellet boilers are not fully taken into account in test methods for ecolabels which primarily focus on emissions during operation on full load and part load. The objective of the thesis is to investigate the emission characteristics during realistic operation of residential wood pellet boilers in order to identify when the major part of the annual emissions occur. Emissions from four residential wood pellet boilers were measured and characterized for three operating phases (start-up, steady and stop). Emissions from realistic operation of combined solar and wood pellet heating systems was continuously measured to investigate the influence of start-up and stop phases on total annual emissions. Measured emission data from the pellet devices were used to build an emission model to predict the annual emission factors from the dynamic operation of the heating system using the simulation software TRNSYS. Start-up emissions are found to vary with ignition type, supply of air and fuel, and time to complete the phase. Stop emissions are influenced by fan operation characteristics and the cleaning routine. Start-up and stop phases under realistic operation conditions contribute 80 – 95% of annual carbon monoxide (CO) emission, 60 – 90% total hydrocarbon (TOC), 10 – 20% of nitrogen oxides (NO), and 30 – 40% particles emissions. Annual emission factors from realistic operation of tested residential heating system with a top fed wood pelt boiler can be between 190 and 400 mg/MJ for the CO emissions, between 60 and 95 mg/MJ for the NO, between 6 and 25 mg/MJ for the TOC, between 30 and 116 mg/MJ for the particulate matter and between 2x10-13 /MJ and 4x10-13 /MJ for the number of particles. If the boiler has the cleaning sequence with compressed air such as in boiler B2, annual CO emission factor can be up to 550 mg/MJ. Average CO, TOC and particles emissions under realistic annual condition were greater than the limits values of two eco labels. These results highlight the importance of start-up and stop phases in annual emission factors (especially CO and TOC). Since a large or dominating part of the annual emissions in real operation arise from the start-up and stop sequences, test methods required by the ecolabels should take these emissions into account. In this way it will encourage the boiler manufacturers to minimize annual emissions. The annual emissions of residential pellet heating system can be reduced by optimizing the number of start-ups of the pellet boiler. It is possible to reduce up to 85% of the number of start-ups by optimizing the system design and its controller such as switching of the boiler pump after it stops, using two temperature sensors for boiler ON/OFF control, optimizing of the positions of the connections to the storage tank, increasing the mixing valve temperature in the boiler circuit and decreasing the pump flow rate. For 85 % reduction of start-ups, 75 % of CO and TOC emission factors were reduced while 13% increase in NO and 15 % increase in particle emissions was observed.
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Background: Studies evaluating acceptability of simplified follow-up after medical abortion have focused on high-resource or urban settings where telephones, road connections, and modes of transport are available and where women have formal education. Objective: To investigate women's acceptability of home-assessment of abortion and whether acceptability of medical abortion differs by in-clinic or home-assessment of abortion outcome in a low-resource setting in India. Design: Secondary outcome of a randomised, controlled, non-inferiority trial. Setting Outpatient primary health care clinics in rural and urban Rajasthan, India. Population: Women were eligible if they sought abortion with a gestation up to 9 weeks, lived within defined study area and agreed to follow-up. Women were ineligible if they had known contraindications to medical abortion, haemoglobin < 85mg/l and were below 18 years. Methods: Abortion outcome assessment through routine clinic follow-up by a doctor was compared with home-assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet. A computerized random number generator generated the randomisation sequence (1: 1) in blocks of six. Research assistants randomly allocated eligible women who opted for medical abortion (mifepristone and misoprostol), using opaque sealed envelopes. Blinding during outcome assessment was not possible. Main outcome measures: Women's acceptability of home-assessment was measured as future preference of follow-up. Overall satisfaction, expectations, and comparison with previous abortion experiences were compared between study groups. Results: 731 women were randomized to the clinic follow-up group (n = 353) or home-assessment group (n = 378). 623 (85%) women were successfully followed up, of those 597 (96%) were satisfied and 592 (95%) found the abortion better or as expected, with no difference between study groups. The majority, 355 (57%) women, preferred home-assessment in the event of a future abortion. Significantly more women, 284 (82%), in the home-assessment group preferred home-assessment in the future, as compared with 188 (70%) of women in the clinic follow-up group, who preferred clinic follow-up in the future (p < 0.001). Conclusion: Home-assessment is highly acceptable among women in low-resource, and rural, settings. The choice to follow-up an early medical abortion according to women's preference should be offered to foster women's reproductive autonomy.