Background:  Heart failure is a multidimensional phenomenon with high mortality. Heart failure is treated with angiotensin converting enzyme (ACE) - inhibitors or angiotensin receptor blockers (ARBs) that counteract neurohormonal stimuli that occur in heart failure, as well as providing vessel dilatation, which reduces symptoms and the need for hospitalization and increases survival. Despite this, only about 50% of heart failure patients survive 6 years after diagnosis with drug therapy, and as heart failure is increasing globally, due to improved care and treatment and increasing life expectancy of the population, there is a great need for new drugs such as LCZ696 that acts by dual inhibition of the renin - angiotensin - aldosterone system and neprilysin inhibition.Objective: The aim of this literature study was to evaluate the efficacy of current treatment and possible future treatments on mortality and morbidity in heart failure patients.Results: The examined articles show that treatment with ACE inhibitors in patients with symptomatic heart failure reduces the risk of total mortality by 16% over 3.5 years, reduces all-cause mortality or hospitalization due to heart failure with NNT (number needed to treat) = 10.4 over 3.5 years and increases median survival by 9.2 months over 12.1 years in patients with asymptomatic heart failure. Treatments with high-dose ACE inhibitors reduce mortality and hospitalization because of cardiovascular causes and hospitalizations from any cause by NNT = 30 over 3 years. Beta-blockers reduce sudden death and total mortality and cardiac death or non - fatal myocardial infarction with NNT = 38 and NNT = 23, respectively, over 12 months.

AbstractThe future of ethanol is depending on good solutions for the production. ENA energy power plant produces electrical power and district heating by heating biofuel. By building an integrated bioenergy plant surplus steam could be used to produce ethanol as fuel to vehicle.This would mean that ethanol is produced renewable energy and the energy for the process derives from the surplus of power.  ENA energy, MDH (the University of Mälardalen) and the energy authority has initiated a research project were different bioenergy combinations integrate with existing power plant.  As a part of the project which size an integrated factory should be to gain the best efficiency for the plant was investigated. Consideration will be taken to the cost of the production in order to be competitive to the price of imported ethanol.  Etanolens framtid vilar på bra lösningar för framställning.  I ENA energi kraftverk i Enköping produceras el och fjärrvärme genom eldning av biobränsle.  Genom att bygga ett integrerat bioenergikraftverk där skulle man kunna använda överskottsånga till att framställa etanol som fordonsbränsle.

This study focuses on small scale hydropower in Sweden. This means plants with a capacity of up to 10 MW. The study has a special focus on plants with a capacity up to 2 MW. The study has three aims. It strives to describe the small-scale hydroelectric industry in Sweden.

The main objective of this study was to investigate the possible design of a horticultural therapy program in Swedish correctional treatment facilities. In the USA the use of horticultural therapy in offender rehabilitation is much more frequent compared with Sweden. The aim of these programs typically contains education for inmates. Research has been made indicating that these programs can have positive effects on psychosocial behavior and on vulnerability to substance abuse among incarcerated offenders. In this study the examples of these programs was categorized and analyzed from three perspectives; Vocational, social and therapeutic horticultural programs.

Eutrophication of the Baltic Sea is a serious problem. A major contributing factor is diffuse losses of phosphorus (P) from agricultural land in surrounding countries. In order to estimate P losses, environmental monitoring of small agriculture-dominated catchments is being carried out in most of these countries. Evaluation of the risk of P leaching to waters is usually based on chemical tests originally developed to quantify the amount of soil P available for plant production. The tests are performed in different ways in the different countries and a number of different extraction agents are in use.

The purpose of this study was to get a client perspective of the different ways to exit from a different role as a drugabuser, and furthermore, how to maintain a drugfree life.The questions of issue were:- What kind of social-psychological conceptions rules the process?- Which motive powers are essential to maintain drug-independence?- Are there any difficulties on the path to social adaptation?Our research was based on interviews with eight persons; five men and three women, from a treatment home in the south of Sweden. The method we used was semi-structured and with a thematic questionnaire. We chose this form due to the fact that we did not want to influence the interviews, as we wanted to know the persons opinions.The result of our study showed that the interviewed persons have some difficulties to adjust in the society and to find new friends especially the interviewed persons with maintenance treatment. Marginal problems as, for example, the lack of not having a work or a home can complicate a further development for the group with maintenance treatment.

This paper intends to show how micro- and small businesses in the tourism and experience industry makes use of social media as a marketing tool. The study also shows the possibilities for businesses to market themselves to customers through social media. Small businesses usually don?t have the same conditions or the same marketing resources that larger companies have. For small businesses that lack marketing resources, social media is a great addition to marketing since the technology around social media is relatively simple.

The aim of this thesis has been to investigate women's experience of the Methadone maintenance treatment and what help they believe they need to be able to recover and to improve their social life and whether the medical- and social workers share the similar view.Our method of investigation has been qualitative interviews with four women in the program, two nurses and a counsellor at the methadone clinic and two social workers, who have female clients in the program.The questions at issue were:* how did the women describe their life situation during treatment, compared to the situation they had while they were addicted to narcotics,* did the women experience that the treatment they get in the methadone maintenance program is giving them a better social life situation,* did the employees at the clinic and at the social office share the similar view about the treatments as the female patients?Main problems seemed to be; meeting new non-addictive friends and finding something to do. We could se that, in different ways, they need more support. It wasn't always clear to the people who work with them whose responsibility it was, depending on workplace and/or personality..

Aim/Objective: The purpose of this paper is to investigate and analyze the early effects that could arise between entrepreneurs and lenders in connection with the auditing requirement, which has now been abolished. Through, empirical data identify the impact from the credit provider?s perspective and small business perspective and then make an overall assessment.Method:The authors are to achieve the purpose for this thesis through the use of both primary and secondary data. Primary data gathered through interviews and secondary data in the form of earlier thesis as well as articles.Result and conclusion: Banks have not prepared for the change in connection with the abolition of the audit requirement. Lenders look at repayment ability as the most important aspect of giving credit.

Hungary?s share of renewable energy in 2010 was 7.9 %, and their renewable energy goal for 2020 is 14.65 %. Geothermal energy is one option that could help to achieve the goal, since Hungary has favorable bedrock, the temperature gradient is above average and thepermeability is high. Today Hungary is importing just over half of its primary energy supply. Because of political conflicts between nations Hungary wants to expand its own production of energy.

Sewer trenches usually contain material with a higher hydraulic conductivity then the adjacent soil. Thus they can serve as paths of preferential flow in a polluted area. Wastewater from factories can also leak from wastewater pipes and pollute the soil in the sewer trenches.The purpose of this project was to investigate pollutions in sewer trenches and in sewer pipes in the industrial area of Köpmanholmen, 20 km south of Örnsköldsvik in the north of Sweden. To make an estimation concerning the potential of transport of pollutions in sewer trenches, hydrological calculations were performed.Leakage to any greater extent did not seem to be a problem in the area. This is the case both for the concrete and the wooden pipes that have served as factory wastewater pipes.

Continuously grazed grasslands have remarkably high plant species diversity. In Sweden this type of habitat has declined for the last two centuries. Changed land use has caused habitat fragmentation and loss of habitat quality. This has caused a great number of plant species to end up on the verge of extinction. To try to save this unique habitat and the species that are tied to it, lots of resources are laid on restoration of abandoned grasslands. In this study, plant species richness of continuously grazed, abandoned and restored grasslands were related to degree of overgrowth, time since overgrowth started and rate of overgrowth.

This study uses qualitative research consisting of six semi-structural interviews of treatment workers who, in various capacities, have worked with men who use violence against their female partners. The purpose has been to show what the treatment counselor understand to be the reasons behind the men?s violence, what kind of backgrounds and problems they believe these abusers have and, lastly, how they view the male abusers as clients. The empirical data was analyzed through four perspectives and explanatory models derived from the past thirty years of Scandinavian research on the reasons behind men?s violence against women.

Title: The nurse's dilemma in psychiatric inpatient care - a balancing act between good and evil Objective: To describe the nurse's experience of relieving patient suffering caused by coercive measures on a closed psychiatric ward . Frame of reference : The results are discussed in light of Eriksson´s theory of suffering and caring relationships Method: A qualitative analysis based on focus group discussions Results: The analysis resulted in six categories, to protect the patient , to involve the patient , not to lose control , to remain , to justify compulsion , and to be touched . The results showed that nurses had the experience of being able to relieve the suffering of patients caused by coercive measures. It was also found that the nurses had a tendency to justify coercive measures , the more experience they had of performing these . Conclusion: The results describe that nurses have the experience and knowledge of how to relieve patients' suffering caused by coercion but also their experiences of performing these .

Introduction: Anxiety and depression are common among patients enrolled in psychiatric outpatient care. Ear Acupuncture is an alternative form of treatment that has been shown to relieve anxiety and depression in previous studies.Aim: To evaluate ear acupuncture as a group treatment for depression and anxietyMethod: A psychiatric outpatient clinic has been offering group treatments with ear acupuncture for anxiety and depression for 5 weeks. Participants of the study have answered self-rating scales Montgomery Åsberg Depression Rating Scale, Beck Anxiety Inventory and Sheehan Disability scale before and after the treatment period. Material was collected in the period 2008-2012 and has been analyzed in SPSS.Results: Data from 31 patients were included in the study. The results from the study showed a significant difference, between the measurements before and after treatment, with a reduction of the average values in the three different scales.Summary: From this study, it is difficult to draw any conclusions about the effect of ear acupuncture.