Increasing market opportunities for renewable energy technologies with innovations in aquifer thermal energy storage.

Heating and cooling using aquifer thermal energy storage (ATES) has hardly been applied outside the Netherlands, even though it could make a valuable contribution to the energy transition. The Climate-KIC project "Europe-wide Use of Energy from aquifers" - E-USE(aq) - aimed to pave the way for Europe-wide application of ATES, through the realization and monitoring of six ATES pilot plants across five different EU countries. In a preceding paper, based on preliminary results of E-USE(aq), conclusions were already drawn, demonstrating how the barriers for this form of shallow geothermal energy can be overcome, and sometimes even leveraged as opportunities. Based on final pilot project results, key economic and environmental outcomes are now presented. This paper starts with the analysis of specific technological barriers: unfamiliarity with the subsurface, presumed limited compatibility with existing energy provision systems (especially district heating), energy imbalances and groundwater contamination. The paper then shows how these barriers have been tackled, using improved site investigation and monitoring technologies to map heterogeneous subsoils. In this way ATES can cost-efficiently be included in smart grids and combined with other sources of renewable (especially solar) energy, while at the same time achieving groundwater remediation. A comparative assessment of economic and environmental impacts of the pilots is included, to demonstrate the sustainability of ATES system with different renewables and renewable-based technologies. The paper concludes with an assessment of the market application potential of ATES, including in areas with water scarcity, and a review of climate beneficial impact.

Assessment and documentation of bowel care management in palliative care: incorporating patient preferences into the care regimen.

Nurses in a palliative care unit (PCU) recognized that there were several inconsistencies relating to assessment and documentation of patient preferences in bowel care management. Although bowel care is recognized as of key importance to the wellbeing of palliative care patients, there is little evidence in current literature about accommodation of patient preferences in bowel care management. A questionnaire was developed to assess whether patient preferences were elicited on admission to the PCU, were documented, and were included in the bowel care regimen. Data were collected from 100 patients in two PCUs in Australia. The findings suggested that little was assessed or documented about bowel care management on admission except functional or pharmacological information. According to patients in the study, their preferences were seldom incorporated into the bowel care regimen. Lack of documentation of bowel care preferences was also found following an audit of patient notes. Techniques for eliciting information, awareness of alternative or complementary methods of bowel care and better documentation procedures are all recommended for inclusion in nursing practice in the palliative care setting.

Nurses' use of patient notes to chart bowel care management for the palliative care patient.

Little is known about nurses' knowledge base and practice in the provision of Bowel Care Management (BCM). Recently, a study designed to investigate both factors was conducted in two hospices, one in New South Wales and the other in South Australia. Twenty-four nurses and 100 palliative care patients participated in the study. The audit of patients' medical records, one of several research methods used in the study, will be discussed here. The research identified that in all but two cases, patients' information about their BCM practices used in the home environment was not documented on their admission to the hospice. Further, the considerable number of charts used in each hospice to record BCM generally asked for information related to bowel function and the use of pharmaceutical preparations, to the exclusion of other methods of management.