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1.	Wising, Jenny, et al. (författare) Certified Registered Nurse Anaesthetists’ and Critical Care Registered Nurses’ perception of knowledge/power in teamwork with Anaesthesiologists in Sweden : a mixed-method study 2024 Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 23 Tidskriftsartikel (refereegranskat)abstract Efficient teamwork is crucial to provide optimal health care. This paper focuses on teamwork between Anaesthesiologists (ANES), Certified Registered Nurse Anaesthetists’ (CRNA) and Critical Care Registered Nurses (CCRN) working in challenging environments such as the intensive care unit (ICU) and the operating room (OR). Conflicts are common between physicians and nurses, negatively impacting teamwork. Social hierarchies based on professional status and power inequalities between nurses and physicians plays a vital role in influencing teamwork. Foucault was a famous thinker especially known for his reasoning regarding power/knowledge. A Foucauldian perspective was therefore incorporated into this paper and the overall aim was to explore CCRN/CRNA perception of knowledge/power in teamwork with ANES.Methods A mixed-method approach was applied in this study. Data was collected using a web-based questionnaire containing both closed-end and open-ended questions. A total of 289 CCRNs and CRNAs completed the questionnaire. Data analysis was then conducted through five stages as outlined by Onwuebugzie and Teddlie; analysing quantitative data in SPSS 27.0 and qualitative data with a directed content analysis, finally merging data together in ATLAS.ti v.23.Results The result reveals a dissonance between quantitative and qualitative data; quantitative data indicates a well-functioning interdisciplinary teamwork between CCRN/CRNA and ANES - qualitative data highlights that there are several barriers and inequalities between the two groups. Medicine was perceived as superior to nursing, which was reinforced by both social and organisational structures at the ICU and OR.Conclusion Unconscious rules underlying current power structures in the ICU and OR works in favour of the ANES and biomedical paradigm, supporting medical knowledge. To achieve a more equal power distribution between CCRN/CRNAs and ANES, the structural hierarchies between nursing and medicine needs to be addressed. A more equal power balance between the two disciplines can improve teamwork and thereby reduce patient mortality and improve patient outcomes.
2.	Abonia, J Pablo, et al. (författare) Alpha-4 integrins and VCAM-1, but not MAdCAM-1, are essential for recruitment of mast cell progenitors to the inflamed lung 2006 Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 108:5, s. 1588-1594 Tidskriftsartikel (refereegranskat)abstract Normal mouse lungs lack appreciable numbers of mast cells (MCs) or MC progenitors (MCp's), yet the appearance of mature MCs in the tracheobronchial epithelial surface is a characteristic of allergic, T-cell-dependent pulmonary inflammation. We hypothesized that pulmonary inflammation would recruit MCp's to inflamed lungs and that this recruitment would be regulated by distinct adhesion pathways. Ovalbumin-sensitized and challenged mice had a greater than 28-fold increase in the number of MCp's in the lungs. In mice lacking endothelial vascular cell adhesion molecule 1 (VCAM-1) and in wild-type mice administered blocking monoclonal antibody (mAb) to VCAM-1 but not to mucosal addressin CAM-1 (MadCAM-1), recruitment of MCp's to the inflamed lung was reduced by greater than 75%. Analysis of the integrin receptors for VCAM-1 showed that in beta7 integrin-deficient mice, recruitment was reduced 73% relative to wild-type controls, and in either BALB/c or C57BL/6 mice, mAb blocking of alpha4, beta1, or beta7 integrins inhibited the recruitment of MCp's to the inflamed lung. Thus, VCAM-1 interactions with both alpha4beta1 and alpha4beta7 integrins are essential for the recruitment and expansion of the MCp populations in the lung during antigen-induced pulmonary inflammation. Furthermore, the MCp is currently unique among inflammatory cells in its partial dependence on alpha4beta7 integrins for lung recruitment.
3.	Ahlstrand, Inger, et al. (författare) Health-promoting factors among students in higher education within health care and social work : a cross-sectional analysis of baseline data in a multicentre longitudinal study 2022 Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 22:1 Tidskriftsartikel (refereegranskat)abstract Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.
4.	Ahnström, Johan, et al. (författare) Farmers and nature conservation: What is known about attitudes, context factors and actions affecting conservation? 2009 Ingår i: Renewable Agriculture and Food Systems. - 1742-1705 .- 1742-1713. ; 24, s. 38-47 Tidskriftsartikel (refereegranskat)abstract Farmers' attitudes towards viability of specific conservation practices or actions strongly impact their decisions on adoption and change. This review of 'attitude' information reveals a wide range of perceptions about what conservation means and what the impacts of adoption will mean in economic and environmental terms. Farmers operate in a tight financial situation, and in parts of the world they are highly dependent on government subsidies, and cannot afford to risk losing that support. Use of conservation practices is most effective when these are understood in the context of the individual farm, and decisions are rooted in land and resource stewardship and long-term concerns about health of the farm and the soil. The attitudes of farmers entering agri-environmental schemes decide the quality of the result. A model is developed to show how attitudes of the farmer, the farming context and agri-environmental schemes interact and thus influence how the farming community affects nature and biodiversity. As new agri-environmental schemes are planned, agricultural development specialists need to recognize the complexity of farmer attitudes, the importance of location and individual farmer circumstances, and the multiple factors that influence decisions. We provide these insights and the model to conservation biologists conducting research in farming areas, decision makers who develop future agri-environmental schemes, educators training tomorrow's extension officers and nature conservationists, and researchers dealing with nature conservation issues through a combination of scientific disciplines.
5.	Ahumada, Sofía, et al. (författare) Calibration of SO2 and NO2 Electrochemical Sensors via a Training and Testing Method in an Industrial Coastal Environment 2022 Ingår i: Sensors. - : IVL Svenska Miljöinstitutet. - 1424-8220. ; 22:19, s. 7281-7281 Tidskriftsartikel (refereegranskat)abstract Low-cost sensors can provide inaccurate data as temperature and humidity affect sensoraccuracy. Therefore, calibration and data correction are essential to obtain reliable measurements.This article presents a training and testing method used to calibrate a sensor module assembledfrom SO2 and NO2 electrochemical sensors (Alphasense B4 and B43F) alongside air temperature (T)and humidity (RH) sensors.Field training and testing were conducted in the industrialized coastalarea of Quintero Bay, Chile. The raw responses of the electrochemical (mV) and T-RH sensors weresubjected to multiple linear regression (MLR) using three data segments, based on either voltage(SO2 sensor) or temperature (NO2). The resulting MLR equations were used to estimate the referenceconcentration. In the field test, calibration improved the performance of the sensors after addingT and RH in a linear model.The most robust models for NO2 were associated with data collectedat T < 10 C (R2 = 0.85), while SO2 robust models (R2 = 0.97) were associated with data segmentscontaining higher voltages. Overall, this training and testing method reduced the bias due to T andHR in the evaluated sensors and could be replicated in similar environments to correct raw data fromlow-cost electrochemical sensors. A calibration method based on training and sensor testing afterrelocation is presented. The results show that the SO2 sensor performed better when modeled fordifferent segments of voltage data, and the NO2 sensor model performed better when calibrated fordifferent temperature data segments.
6.	Alcaide, Pilar, et al. (författare) Dendritic cell expression of the transcription factor T-bet regulates mast cell progenitor homing to mucosal tissue 2007 Ingår i: Journal of Experimental Medicine. - : Rockefeller University Press. - 0022-1007 .- 1540-9538. ; 204:2, s. 431-439 Tidskriftsartikel (refereegranskat)abstract The transcription factor T-bet was identified in CD4(+) T cells, and it controls interferon gamma production and T helper type 1 cell differentiation. T-bet is expressed in certain other leukocytes, and we recently showed (Lord, G.M., R.M. Rao, H. Choe, B.M. Sullivan, A.H. Lichtman, F.W. Luscinskas, and L.H. Glimcher. 2005. Blood. 106:3432-3439) that it regulates T cell trafficking. We examined whether T-bet influences homing of mast cell progenitors (MCp) to peripheral tissues. Surprisingly, we found that MCp homing to the lung or small intestine in T-bet(-/-) mice is reduced. This is reproduced in adhesion studies using bone marrow-derived MCs (BMMCs) from T-bet(-/-) mice, which showed diminished adhesion to mucosal addresin cellular adhesion molecule-1 (MAdCAM-1) and vascular cell adhesion molecule-1 (VCAM-1), endothelial ligands required for MCp intestinal homing. MCp, their precursors, and BMMCs do not express T-bet, suggesting that T-bet plays an indirect role in homing. However, adoptive transfer experiments revealed that T-bet expression by BM cells is required for MCp homing to the intestine. Furthermore, transfer of WT BM-derived dendritic cells (DCs) to T-bet(-/-) mice restores normal MCp intestinal homing in vivo and MCp adhesion to MAdCAM-1 and VCAM-1 in vitro. Nonetheless, T-bet(-/-) mice respond vigorously to intestinal infection with Trichinella spiralis, eliminating a role for T-bet in MC recruitment to sites of infection and their activation and function. Therefore, remarkably, T-bet expression by DCs indirectly controls MCp homing to mucosal tissues.
7.	Alvarado-Vazquez, Perla Abigail, et al. (författare) Circulating mast cell progenitors increase in frequency during natural birch pollen exposure in allergic asthma patients 2023 Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 78:11, s. 2959-2968 Tidskriftsartikel (refereegranskat)abstract Background: Mast cells (MCs) develop from a rare population of peripheral blood circulating MC progenitors (MCps). Here, we investigated whether the frequency of circulating MCps is altered in asthma patients sensitized to birch pollen during pollen season, compared to out of season.Methods: Asthma patients were examined during birch pollen season in late April to early June (May), and out of season in November–January. Spirometry measurements, asthma and allergy-related symptoms, asthma control questionnaire (ACQ), and asthma control test (ACT) scores were assessed at both time points. The MCp frequency was determined by flow cytometry in ficoll-separated blood samples from patients with positive birch pollen-specific IgE, and analyzed in relation to basic and disease parameters.Results: The frequency of MCps per liter of blood was higher in May than in November (p = .004), particularly in women (p = .009). Patients that reported moderate to severe asthma symptoms (<.0001), nose or eye symptoms (p = .02; p = .01), or reduced asthma control (higher ACQ, p = .01) had higher MCp frequency in May than those that did not report this. These associations remained significant after adjusting for sex and BMI. The change in asthma control to a lower ACT score in May correlated with an increase in MCp frequency in May (p = .006, rho = 0.46).Conclusions: The data suggest that the frequency of MCps increases in symptomatic patients with allergic asthma. Our results unravel a link between asthma symptoms and circulating MCps, and bring new insight into the impact of natural allergen exposure on the expansion of MCs.
8.	Alvarado-Vazquez, Perla Abigail, et al. (författare) Depletion of Mcpt8‐expressing cells reduces lung mast cells in mice with experimental asthma 2022 Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 78:5, s. 1363-1366 Tidskriftsartikel (refereegranskat)
9.	Alvarado-Vazquez, P. Abigail, et al. (författare) Mast cell-derived CXCL1 promotes bronchoalveolar CXCR2+ T-cells in mice with IL-33-induced airway inflammation Annan publikation (övrigt vetenskapligt/konstnärligt)
10.	Alvarado-Vazquez, P. Abigail (författare) Mast cells and their progenitors in respiratory diseases : Understanding their connection to lung function and airway inflammation 2023 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Mast cells are rare immune cells involved in allergic diseases, including asthma. These cells are derived from mast cell progenitors (MCps) that migrate to the peripheral tissues via the blood in response to allergic or non-allergic stimuli. The main purpose of this thesis was to investigate the role of mast cells and MCps in the lung function decline observed in mouse models of airway inflammation. We also investigated the MCp frequency during natural allergen exposure using patient samples. Our aim in paper I was to investigate the effect of age and weight on lung function parameters in naïve mice using a pulmonary function test (PFT). We showed that age and weight positively correlated with lung function and successfully used the PFT to monitor asthma outcomes and distinguish between treated and untreated experimental asthma.In paper II, we investigated the specificity of a basophil-deficient mouse model that relies on the deletion of the mast cell protease 8 (mMCP-8), a classical basophil marker. We found that lung mast cells expressed mMCP-8, and deleting this protease reduced lung mast cells in mice with allergic airway inflammation.Mast cells express ST2 and thus can be activated by interleukin-33 (IL-33). Hence, in paper III, we used Cpa3cre/+ mast cell-deficient mice to investigate the role of mast cells in airway inflammation induced by intranasal IL-33 administration. We identified a new mechanism in which mast cells participate in T-cells mobilization into the alveolar space via the CXCL1/CXCR2 axis. We have previously described increased circulating MCps in subjects with reduced lung function. However, if and how MCps change upon allergen exposure is unknown. Therefore, in paper IV, we investigated the frequency of blood MCps in birch pollen-sensitized asthma patients in and out of the birch pollen season. We demonstrated that in allergic asthma patients, circulating MCps were increased during natural pollen exposure and were associated with more asthma symptoms and less asthma control.This thesis involves both basic and translational research and provides new insights into the role of mast cells and their progenitors in type 2 inflammation.
11.	Alvarado-Vazquez, Perla A., et al. (författare) Use of spirometry-like measurements to monitor house dust mite-induced experimental asthma in mice 2021 Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 76:7, s. 2204-2207 Tidskriftsartikel (refereegranskat)abstract Weight and age correlated positively with FEV 0.1 and PEF among other lung function parameters in naïve mice. Lung function parameters decline in a model of experimental asthma induced by intranasal HDM administrations. Systemic injections of dexamethasone improved lung function, decreased mast cell populations and BAL levels of mast cell protease-1 in the HDM model.
12.	Andersson Sjöland, Annika, et al. (författare) Versican in inflammation and tissue remodelling: the impact on lung disorders. 2015 Ingår i: Glycobiology. - : Oxford University Press (OUP). - 1460-2423 .- 0959-6658. ; 25:3, s. 243-251 Forskningsöversikt (refereegranskat)abstract Versican is a proteoglycan that has many different roles in tissue homeostasis and inflammation. The biochemical structure is comprised of four different types of the core protein with attached glycosaminoglycans that can be sulphated to various extents and has the capacity to regulate differentiation of different cell types, migration, cell adhesion, proliferation, tissue stabilization and inflammation. Versican's regulatory properties are of importance during both homeostasis and changes that lead to disease progression. The glycosaminoglycans that are attached to the core protein are of the chondroitin sulfate/dermatan sulfate type and are known to be important in inflammation through interactions with cytokines and growth factors. For a more complex understanding of versican it is of importance to study the tissue niche, where the wound healing process in both healthy and diseased conditions take place. In previous studies our group has identified changes in the amount of the multifaceted versican in chronic lung disorders such as asthma, chronic obstructive pulmonary disease and bronchiolitis obliterans syndrome, which could be a result of pathologic, transforming growth factor β driven, on-going remodelling processes. Reversely, the context of versican in its niche is of great importance since versican has been reported to have a beneficial role in other contexts e.g. emphysema. Here we explore the vast mechanisms of versican in healthy lung and in lung disorders.
13.	Arm, Maria, et al. (författare) Pulp mill fly ash for stabilization of low-volume unpaved forest roads — field performance 2014 Ingår i: Canadian journal of civil engineering (Print). - : Canadian Science Publishing. - 0315-1468 .- 1208-6029. ; 41:11, s. 955-963 Tidskriftsartikel (refereegranskat)abstract Increased temperatures and rainfalls will give more settlements and less bearing capacity in gravel roads, which will have implications for the forestry. Pulp mill fly ash without additives was used for stabilizing the road base of a low-volume gravel road. A two-year monitoring of the road was conducted, including measurements of achieved ash content, density, water infiltration capacity, and load bearing capacity. The results showed that the ash-stabilized sections performed better than conventionally upgraded sections and also achieved increased bearing capacity over time. Hydration of the fly ash increased the stiffness and decreased the permeability of the road base. The differences were more pronounced during spring thaw. Best performance was achieved in the section with thicker ash stabilized layer.
14.	Aybay, Erdem, et al. (författare) Extended cleavage specificities of human granzymes A and K, two closely related enzymes with conserved but still poorly defined functions in T and NK cell-mediated immunity 2023 Ingår i: Frontiers in Immunology. - : Frontiers Media S.A.. - 1664-3224. ; 14 Tidskriftsartikel (refereegranskat)abstract Granzymes A and K are two highly homologous serine proteases expressed by mammalian cytotoxic T cells (CTL) and natural killer cells (NK). Granzyme A is the most abundant of the different granzymes (gzms) expressed by these two cell types. Gzms A and K are found in all jawed vertebrates and are the most well conserved of all hematopoietic serine proteases. Their potential functions have been studied extensively for many years, however, without clear conclusions. Gzm A was for many years thought to serve as a key component in the defense against viral infection by the induction of apoptosis in virus-infected cells, similar to gzm B. However, later studies have questioned this role and instead indicated that gzm A may act as a potent inducer of inflammatory cytokines and chemokines. Gzms A and K form clearly separate branches in a phylogenetic tree indicating separate functions. Transcriptional analyses presented here demonstrate the presence of gzm A and K transcripts in both CD4+ and CD8+ T cells. To enable screening for their primary biological targets we have made a detailed analysis of their extended cleavage specificities. Phage display analysis of the cleavage specificity of the recombinant enzymes showed that both gzms A and K are strict tryptases with high selectivity for Arg over Lys in the P1 position. The major differences in the specificities of these two enzymes are located N-terminally of the cleavage site, where gzm A prefers small amino acids such as Gly in the P3 position and shows a relatively relaxed selectivity in the P2 position. In contrast, gzm K prefers large amino acids such as Phe, Tyr, and Trp in both the P2 and P3 positions and does not tolerate negatively charged residues in the P2 position. This major distinction in extended specificities is likely reflected also in preferred in vivo targets of these two enzymes. This information can now be utilized for high-precision screening of primary targets for gzms A and K in search of their highly conserved but still poorly defined functions in vertebrate immunity.
15.	Bergström, Joakim, 1987- (författare) A Search for the Masked Mechanism Behind IgG-Mediated Suppression of Antibody Responses 2017 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Antibodies passively administered together with their specific antigen can enhance or suppress the specific antibody response. This phenomenon is known as antibody feedback regulation. Whether this modulation causes up- or downregulation of the antibody response depends both on the antibody isotype and the antigen used. IgG antibodies passively administered together with particulate antigens, e.g. erythrocytes, can completely prevent the induction of an antibody response to the antigen. The suppressive capacity of IgG has been routinely used in the clinic since the 1960’s in RhD-prophylaxis to prevent hemolytic disease of the fetus and newborn. Although studied for decades, the underlying mechanism of IgG-suppression has remained elusive. The main focus of this thesis has been to elucidate the mechanism behind IgG-suppression of antibody responses in vivo in mouse models using intravenous immunization with specific IgG together with native or haptenated sheep red blood cells, SRBC. We show that IgG-suppression of IgM and long-term serum IgG-responses operates independently of activating FcγRI, III, IV, or the inhibitory FcγRIIB, thus confirming and extending previous findings. Moreover, we demonstrate for the first time that C1q, C3 and CR1/2 are dispensable for IgG-suppression of antibody responses. These findings strongly argue against the involvement of Fc-dependent mechanisms as the explanation for IgG-suppression. Interestingly, GC formation occurs in IgG-suppressed mice although the antibody response to surface SRBC epitopes are completely suppressed. The data suggests that these GCs develop in response to intracellular SRBC epitopes as well as to the passively administered suppressive IgG. Moreover, we demonstrate that passively administered IgG suppresses several parameters of an antibody/B cell response including antigen specific GC and non-GC B cells, extra-follicular antibody secreting cells, long-lived plasma cells and induction of immunological memory. Before the onset of the present study, two mechanisms appeared compatible with the majority of experimental findings: IgG-mediated antigen clearance and epitope masking. Herein we show that the contribution of IgG-mediated antigen clearance is negligible and that suppression of IgG-responses is strictly epitope specific. This provides compelling evidence that a very important mechanism underlying IgG-suppression is epitope masking.
16.	Blöndal, Viiu, et al. (författare) Asthma in combination with rhinitis and eczema is associated with a higher degree of type-2 inflammation and symptom burden than asthma alone 2021 Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 76:12, s. 3827-3829 Tidskriftsartikel (refereegranskat)
17.	Bouwmeester Stjernetun, Björn, doktorand, 1983-, et al. (författare) Effects of an age suit simulation on nursing students’ perspectives on providing care to older persons - an education intervention study 2024 Ingår i: Educational gerontology. - : Taylor & Francis Group. - 0360-1277 .- 1521-0472. ; 50:3, s. 240-253 Tidskriftsartikel (refereegranskat)abstract Nursing students are important future health care providers to the growing number of older persons in society. However, two barriers are their common ageist attitudes and lack of interest in geriatrics. This is a concern in light of the global demand for nurses and a challenge that need to be addressed in nurse education. Age suit simulation has been shown to affect the attitudes of students toward older persons, but the important context of home is often missing from studies. Accordingly, the present study employed a quantitative approach with the goal of investigating the effects of aging simulation with an age suit in a home context as a part of experiential learning among second-year nursing students. The age simulation allowed the students to experience both specific and common health problems from the patient’s point of view in a controlled environment and a relevant context: the home. Data were collected using a questionnaire in a quasi-experimental pretest – posttest design with a control group. Results showed that the intervention had a positive effect on various aspects of the nursing students’ perspectives on caring for older persons. Work experience was associated with more positive attitudes. The control group was more negative toward geriatrics as a career choice than the intervention group. In conclusion, age suit simulation can be an innovative part of nurse education because it raises awareness and understanding of the health challenges of older persons, which are important in combating ageism among future nurses.
18.	Bouwmeester Stjernetun, Björn, doktorand, 1983-, et al. (författare) ”It´s like walking in a bubble”, nursing students´ perspectives on age suit simulation in a home environment – group interviews from reflection seminars 2024 Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 23:1 Tidskriftsartikel (refereegranskat)abstract BackgroundOlder persons with age-related and complex health problems will increasingly depend on care provision from nurses in their own homes. However, a barrier to quality care is ageism and nursing students´ disinterest in geriatrics. In addition, nurse education often falls short in preparing students for the complexity of geriatric care. Welfare technology (WT) is progressively implemented in home care to help older persons live at home despite their health problems. However, this process is intricate and requires acceptance and digital literacy among caregivers and older persons. Despite these challenges, nurse education can address and change negative attitudes through innovative teaching methods such as age suit simulation. Therefore, the study aims to describe nursing students´ experiences of age suit simulation in a home-like environment with WT and technical aids, and will reveal their perspective on ageing and providing care to older adults.MethodsA qualitative explorative design using semi-structured group interviews (n=39) among nursing students. Data was analysed through reflexive thematic analysis.ResultsThe analysis generated three main themes; “It’s like walking in a bubble”, “An eye opener” and “Concerns about ageing and the current structure of geriatric care”. The main themes included eight subthemes. Adapting to the sensory and physical limitations of the age suit was an immersive experience and caused feelings of frustration, loneliness and disconnection. A prominent result was a raised awareness of cognitive loss, especially impaired vision, and students felt the simulations had made them aware of the everyday challenges older persons faced. Students highlighted the importance of patience and giving enough time in care situations by being present and having a critical perspective of WT. The students were mostly negative towards their own ageing and could better relate to older persons´ vulnerability.ConclusionsAge suit simulation was described as an embodied and eye-opening experience, raising nursing students´ awareness of older persons´ functional limitations and the consequences for dignity and independence. Coping with cognitive loss was especially difficult. Students were motivated to apply their new knowledge to clinical practice. Age suit simulation can complement geriatric education, preparing students for the complex care needs of older persons.
19.	Calvén, Jenny, et al. (författare) Viral Stimuli Trigger Exaggerated Thymic Stromal Lymphopoietin Expression by Chronic Obstructive Pulmonary Disease Epithelium: Role of Endosomal TLR3 and Cytosolic RIG-I-Like Helicases. 2012 Ingår i: Journal of Innate Immunity. - : S. Karger AG. - 1662-811X .- 1662-8128. ; 4, s. 86-99 Tidskriftsartikel (refereegranskat)abstract Background: Rhinovirus (RV)-induced chronic obstructive pulmonary disease (COPD) exacerbations exhibit TH(2)-like inflammation. We hypothesized that RV-infected bronchial epithelial cells (BEC) overproduce TH(2)-switching hub cytokine, thymic stromal lymphopoietin (TSLP) in COPD. Methods: Primary BEC from healthy (HBEC) and from COPD donors (COPD-BEC) were grown in 12-well plates, infected with RV16 (0.5-5 MOI) or stimulated with agonists for either toll-like receptor (TLR) 3 (dsRNA, 0.1-10 Î¼g/ml) or RIG-I-like helicases (dsRNA-LyoVec, 0.1-10 Î¼g/ml). Cytokine mRNA and protein were determined (RTqPCR; ELISA). Results: dsRNA dose-dependently evoked cytokine gene overproduction of TSLP, CXCL8 and TNF-Î± in COPD-BEC compared to HBEC. This was confirmed using RV16 infection. IFN-Î² induction did not differ between COPD-BEC and HBEC. Endosomal TLR3 inhibition by chloroquine dose-dependently inhibited dsRNA-induced TSLP generation and reduced generation of CXCL8, TNF-Î±, and IFN-Î². Stimulation of cytosolic viral sensors (RIG-I-like helicases) with dsRNA-LyoVec increased production of CXCL8, TNF-Î±, and IFN-Î², but not TSLP. Conclusions: Endosomal TLR3-stimulation, by dsRNA or RV16, induces overproduction of TSLP in COPD-BEC. dsRNA- and RV-induced overproduction of TNF-Î± and CXCL8 involves endosomal TLR3 and cytosolic RIG-I-like helicases and so does the generation of IFN-Î² in COPD-BEC. RV16 and dsRNA-induced epithelial TSLP may contribute to pathogenic effects at exacerbations and development of COPD.
20.	Cardenas, Eduardo, I, et al. (författare) Elastase- and LPS-Exposed Cpa3(Cre/+) and ST2(-/-) Mice Develop Unimpaired Obstructive Pulmonary Disease 2022 Ingår i: Frontiers in Immunology. - : Frontiers Media S.A.. - 1664-3224. ; 13 Tidskriftsartikel (refereegranskat)abstract IL-33 and its receptor ST2, as well as mast cells and their mediators, have been implicated in the development of chronic obstructive pulmonary disease (COPD). However, whether mast cells and the ST2 receptor play a critical role in COPD pathophysiology remains unclear. Here, we performed repeated intranasal administrations of porcine pancreatic elastase and LPS for four weeks to study COPD-like disease in wildtype, ST2-deficient, and Cpa3(Cre/+) mice, which lack mast cells and have a partial reduction in basophils. Alveolar enlargement and changes in spirometry-like parameters, e.g. increased dynamic compliance and decreased expiratory capacity, were evident one day after the final LPS challenge and worsened over time. The elastase/LPS model also induced mild COPD-like airway inflammation, which encompassed a transient increase in lung mast cell progenitors, but not in mature mast cells. While ST2-deficient and Cpa3(Cre/+) mice developed reduced pulmonary function uninterruptedly, they had a defective inflammatory response. Importantly, both ST2-deficient and Cpa3(Cre/+) mice had fewer alveolar macrophages, known effector cells in COPD. Elastase/LPS instillation in vivo also caused increased bronchiole contraction in precision cut lung slices challenged with methacholine ex vivo, which occurred in a mast cell-independent fashion. Taken together, our data suggest that the ST2 receptor and mast cells play a minor role in COPD pathophysiology by sustaining alveolar macrophages.
21.	Collington, Sarah J, et al. (författare) The role of the CCL2/CCR2 axis in mouse mast cell migration in vitro and in vivo 2010 Ingår i: Journal of Immunology. - : The American Association of Immunologists. - 0022-1767 .- 1550-6606. ; 184:11, s. 6114-6123 Tidskriftsartikel (refereegranskat)abstract Tissue-resident mast cells (MCs) are important in allergic diseases. In a mouse model of allergic airways inflammation, an increase in peribronchiolar MCs was associated with increased concentrations of the chemokine CCL2 in lung lavage. MC progenitors (MCps) arising in bone marrow (BM) are recruited to tissues by transendothelial migration, and we found that CCL2 is chemotactic for MCps in freshly isolated BM in vitro. Immature, but not mature, BM-derived MCs migrated in response to CCL2 when cultured in IL-3+stem cell factor (SCF) but not when cultured in IL-3 alone. However, the cells under both culture conditions expressed mRNA for CCR2, the receptor for CCL2, and bound the radiolabeled chemokine with similar affinities, highlighting SCF as a key mediator in coupling CCR2 to downstream events, culminating in chemotaxis. Immature BM-derived MCs from IL-3 +SCF cultures, when administered i.v., accumulated at skin sites injected with CCL2 in vivo. MCp recruitment to the allergen-sensitized/challenged lung was significantly reduced in CCR2(-/-) and CCL2(-/-) mouse strains. However, reconstitution studies of sublethally irradiated and BM-reconstituted mice indicated that BM cells and stromal elements could provide CCL2, whereas the CCR2 function resided with stromal elements rather than BM cells. These experiments revealed a new function of SCF in chemokine receptor coupling, but they suggest a complex role of the CCL2/CCR2 axis in recruiting MCps during pulmonary inflammation.
22.	Cui, Yue, et al. (författare) Mouse Mast Cell Protease-6 and MHC Are Involved in the Development of Experimental Asthma 2014 Ingår i: Journal of Immunology. - 0022-1767 .- 1550-6606. ; 193:10, s. 4783-4789 Tidskriftsartikel (refereegranskat)
23.	Cui, Yue, et al. (författare) Mouse Mast Cell Protease-6 and MHC Are Involved in the Development of Experimental Asthma 2014 Ingår i: Journal of Immunology. - : The American Association of Immunologists. - 0022-1767 .- 1550-6606. ; 193:10, s. 4783-4789 Tidskriftsartikel (refereegranskat)abstract Allergic asthma is a complex disease with a strong genetic component where mast cells play a major role by the release of proinflammatory mediators. In the mouse, mast cell protease-6 (mMCP-6) closely resembles the human version of mast cell tryptase, beta-tryptase. The gene that encodes mMCP-6, Tpsb2, resides close by the H-2 complex (MHC gene) on chromosome 17. Thus, when the original mMCP-6 knockout mice were backcrossed to the BALB/c strain, these mice were carrying the 129/Sv haplotype of MHC (mMCP-6(-/-)/H-2bc). Further backcrossing yielded mMCP-6(-/-) mice with the BALB/c MHC locus. BALB/c mice were compared with mMCP-6(-/-) and mMCP-6(-/-)/H-2bc mice in a mouse model of experimental asthma. Although OVA-sensitized and challenged wild type mice displayed a striking airway hyperresponsiveness (AHR), mMCP-6(-/-) mice had less AHR that was comparable with that of mMCP-6(-/-)/H-2bc mice, suggesting that mMCP-6 is required for a full-blown AHR. The mMCP-6(-/-)/H-2bc mice had strikingly reduced lung inflammation, IgE responses, and Th2 cell responses upon sensitization and challenge, whereas the mMCP-6(-/-) mice responded similarly to the wild type mice but with a minor decrease in bronchoalveolar lavage eosinophils. These findings suggest that inflammatory Th2 responses are highly dependent on the MHC-haplotype and that they can develop essentially independently of mMCP-6, whereas mMCP-6 plays a key role in the development of AHR.
24.	Dahlin, Joakim (författare) Mast Cell Progenitor Trafficking in Allergic Airway Inflammation 2013 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Mast cell progenitors originate from the bone marrow and migrate to the lungs via the blood. During maturation, these cells acquire granules that contain a potent array of bronchoconstrictive mediators. The number of pulmonary mast cells is augmented in asthmatic patients and in mice with allergic airway inflammation, possibly contributing to airway hyperreactivity. An increase in mast cells is likely due to an increased recruitment of committed mast cell progenitors from the blood. However, until now a committed mast cell progenitor population has not been found in adult peripheral blood. We isolated Lin- c-kithi ST2+ integrin β7hi CD16/32hi progenitors from murine blood and showed that these cells were committed to the mast cell lineage. Based on the expression of FcεRI, these cells were less mature in Th1-prone C57BL/6 mice than in Th2-prone BALB/c mice.Asthma is associated with elevated levels of IgE. Upon exposure to allergens, IgE immune complexes are formed. In a mouse model of allergic airway inflammation, we showed that intranasal administration of IgE immune complexes to antigen-sensitized mice resulted in an increased number of mast cell progenitors compared with antigen administration alone. The increase in mast cell progenitors was independent of the low-affinity IgE receptor CD23. Rather, signaling through the common FcRγ-chain was required to enhance the number of lung mast cell progenitors. Signaling through FcεRI was likely responsible for the increase. However a role for FcγRIV could not be excluded.CD11c+ cells, such as dendritic cells, are important for antigen sensitization. In a mouse model of allergic airway inflammation, these cells are also important for the development of airway hyperreactivity, eosinophilia and Th2 cytokine production in response to antigen challenge. We showed that CD11c+ cells are critical for the recruitment of lung mast cell progenitors and the subsequent increase in mast cells. These CD11c+ cells were needed for the upregulation of endothelial vascular cell adhesion molecule-1 (VCAM-1), which is a prerequisite for the antigen-induced recruitment of lung mast cell progenitors.
25.	Dahlin, Joakim, et al. (författare) Prospective Isolation of Committed Mast Cell Progenitors from Mouse Blood 2014 Ingår i: Scandinavian Journal of Immunology. - 0300-9475 .- 1365-3083. ; 79:6, s. 436-436 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
26.	Dahlin, Joakim S, et al. (författare) CD11c(+) Cells Are Required for Antigen-Induced Increase of Mast Cells in the Lung 2012 Ingår i: Journal of Immunology. - : The American Association of Immunologists. - 0022-1767 .- 1550-6606. ; 189:8, s. 3869-3877 Tidskriftsartikel (refereegranskat)abstract Patients with allergic asthma have more lung mast cells, which likely worsens the symptoms. In experimental asthma, CD11c(+) cells have to be present during the challenge phase for several features of allergic inflammation to occur. Whether CD11c(+) cells play a role for Ag-induced increases of lung mast cells is unknown. In this study, we used diphtheria toxin treatment of sensitized CD11c-diphtheria toxin receptor transgenic mice to deplete CD11c(+) cells. We demonstrate that recruitment of mast cell progenitors to the lung is substantially reduced when CD11c(+) cells are depleted during the challenge phase. This correlated with an impaired induction of endothelial VCAM-1 and led to a significantly reduced number of mature mast cells 1 wk after challenge. Collectively, these data suggest that Ag challenge stimulates CD11c(+) cells to produce cytokines and/or chemokines required for VCAM-1 upregulation on the lung endothelium, which in turn is crucial for the Ag-induced mast cell progenitor recruitment and the increase in mast cell numbers.
27.	Dahlin, Joakim S, et al. (författare) Committed mast cell progenitors in mouse blood differ in maturity between Th1 and Th2 strains 2013 Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : Wiley. - 0105-4538 .- 1398-9995. ; 68:10, s. 1333-1337 Tidskriftsartikel (refereegranskat)abstract Mast cell progenitors (MCp) leave the bone marrow and migrate to peripheral tissues where they mature. Although the existence of committed MCp in adult mouse and human blood has been postulated, they have never been found. We have isolated a rare population of cells in adult mouse blood, committed to the mast cell lineage. These were identified as lineage− c-kithi ST2+ integrin β7hi CD16/32hi cells. Moreover, a major difference in maturity of these cells based on FcεRI expression was observed between the Th2-prone BALB/c strain and the Th1-prone C57BL/6 strain (66% vs 25% FcεRI+, respectively). Therefore, the choice of mouse strain is critical when studying disease models such as experimental asthma where mast cells and their progenitors are involved.
28.	Dahlin, Joakim S., et al. (författare) Distinguishing Mast Cell Progenitors from Mature Mast Cells in Mice 2015 Ingår i: Stem Cells and Development. - : Mary Ann Liebert Inc. - 1547-3287 .- 1557-8534. ; 24:14, s. 1703-1711 Tidskriftsartikel (refereegranskat)abstract Mast cells originate from the bone marrow and develop into c-kit(+) FcRI(+) cells. Both mast cell progenitors (MCp) and mature mast cells express these cell surface markers, and ways validated to distinguish between the two maturation forms with flow cytometry have been lacking. Here, we show that primary peritoneal MCp from naive mice expressed high levels of integrin 7 and had a low side scatter (SSC) light profile; whereas mature mast cells expressed lower levels of integrin 7 and had a high SSC light profile. The maturation statuses of the cells were confirmed using three main strategies: (1) MCp, but not mature mast cells, were shown to be depleted by sublethal whole-body -irradiation. (2) The MCp were small and immature in terms of granule formation, whereas the mature mast cells were larger and had fully developed metachromatic granules. (3) The MCp had fewer transcripts of mast cell-specific proteases and the enzyme responsible for sulfation of heparin than mature mast cells. Moreover, isolated peritoneal MCp gave rise to mast cells when cultured in vitro. To summarize, we have defined MCp and mature mast cells in naive mice by flow cytometry. Using this strategy, mast cell maturation can be studied in vivo.
29.	Dahlin, Joakim S., et al. (författare) Identification of committed mast cell progenitors in mouse blood 2013 Ingår i: Immunology. - 0019-2805 .- 1365-2567. ; 140:S1, s. 175-176 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
30.	Dahlin, Joakim S., et al. (författare) IgE Immune Complexes Stimulate an Increase in Lung Mast Cell Progenitors in a Mouse Model of Allergic Airway Inflammation 2011 Ingår i: PLoS One. - : Public Library of Science (PLoS). - 1932-6203. ; 6:5, s. e20261- Tidskriftsartikel (refereegranskat)abstract Mast cell numbers and allergen specific IgE are increased in the lungs of patients with allergic asthma and this can be reproduced in mouse models. The increased number of mast cells is likely due to recruitment of mast cell progenitors that mature in situ. We hypothesized that formation of IgE immune complexes in the lungs of sensitized mice increase the migration of mast cell progenitors to this organ. To study this, a model of allergic airway inflammation where mice were immunized with ovalbumin (OVA) in alum twice followed by three daily intranasal challenges of either OVA coupled to trinitrophenyl (TNP) alone or as immune complexes with IgE-anti-TNP, was used. Mast cell progenitors were quantified by a limiting dilution assay. IgE immune complex challenge of sensitized mice elicited three times more mast cell progenitors per lung than challenge with the same dose of antigen alone. This dose of antigen challenge alone did not increase the levels of mast cell progenitors compared to unchallenged mice. IgE immune complex challenge of sensitized mice also enhanced the frequency of mast cell progenitors per 10 6 mononuclear cells by 2.1-fold. The enhancement of lung mast cell progenitors by IgE immune complex challenge was lost in FcR gamma deficient mice but not in CD23 deficient mice. Our data show that IgE immune complex challenge enhances the number of mast cell progenitors in the lung through activation of an Fc receptor associated with the FcR gamma chain. This most likely takes place via activation of Fc epsilon RI, although activation via Fc gamma RIV or a combination of the two receptors cannot be excluded. IgE immune complex-mediated enhancement of lung MCp numbers is a new reason to target IgE in therapies against allergic asthma.
31.	Dahlin, Joakim S, et al. (författare) Lineage- CD34hi CD117int/hi FcϵRI+ cells in human blood constitute a rare population of mast cell progenitors 2016 Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 127:4, s. 383-391 Tidskriftsartikel (refereegranskat)abstract Mast cells are rare tissue-resident immune cells that are involved in allergic reactions, and their numbers are increased in the lungs of asthmatics. Murine lung mast cells arise from committed bone marrow-derived progenitors that enter the blood circulation, migrate through the pulmonary endothelium, and mature in the tissue. In humans, mast cells can be cultured from multipotent CD34(+) progenitor cells. However, a population of distinct precursor cells that give rise to mast cells has remained undiscovered. To our knowledge, this is the first report of human lineage(-) CD34(hi) CD117(int/hi) FcϵRI(+) progenitor cells, which represented only 0.0053% of the isolated blood cells in healthy individuals. These cells expressed integrin β7 and developed a mast cell-like phenotype, although with a slow cell division capacity in vitro. Isolated lineage(-) CD34(hi) CD117(int/hi) FcϵRI(+) blood cells had an immature mast cell-like appearance and expressed high levels of many mast cell-related genes as compared with human blood basophils in whole-transcriptome microarray analyses. Furthermore, serglycin, tryptase, and carboxypeptidase A mRNA transcripts were detected by quantitative RT-PCR. Altogether, we propose that the lineage(-) CD34(hi) CD117(int/hi) FcϵRI(+) blood cells are closely related to human tissue mast cells and likely constitute an immediate precursor population, which can give rise to predominantly mast cells. Furthermore, asthmatics with reduced lung function had a higher frequency of lineage(-) CD34(hi) CD117(int/hi) FcϵRI(+) blood mast cell progenitors than asthmatics with normal lung function.
32.	Dahlin, Joakim S, et al. (författare) Mast cell progenitors : Origin, development and migration to tissues 2015 Ingår i: Molecular Immunology. - : Elsevier BV. - 0161-5890 .- 1872-9142. ; 63:1, s. 9-17 Forskningsöversikt (refereegranskat)abstract Mast cells in tissues are developed from mast cell progenitors emerging from the bone marrow in a process highly regulated by transcription factors. Through the advancement of the multicolor flow cytometry technique, the mast cell progenitor population in the mouse has been characterized in terms of surface markers. However, only cell populations with enriched mast cell capability have been described in human. In naïve mice, the peripheral tissues have a constitutive pool of mast cell progenitors. Upon infections in the gut and in allergic inflammation in the lung, the local mast cell progenitor numbers increase tremendously. This review focuses on the origin and development of mast cell progenitors. Furthermore, the evidences for cells and molecules that govern the migration of these cells in mice in vivo are described.
33.	Dondalska, Aleksandra, 1985- (författare) Harnessing the immunoregulatory capacity of single-stranded oligonucleotides to modulate innate immunity 2020 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract As the first line of defense, the innate immune system is exceptionally efficacious against invading pathogens but must be tightly regulated to avoid immune-related pathogenesis. Accordingly, the innate immune system recognizes highly conserved components associated with infections and damaged cells using a limited number of pattern-recognition receptors (PRRs), which are differentially expressed across cell types. Importantly, tissue damage and viral infections can induce the release and production of nucleic acids, which can be sensed by nucleic-acid sensing Toll-like-receptors (TLRs), a subset of PRRs located in cellular endosomes that encompass the receptors TLR3,7,8 or 9. It is imperative that these receptors can differentiate “self” nucleic acids from “non-self” in order to avoid autoimmune reactions. However, increasing data has shown that over-active signaling from these receptors can contribute to TLR-mediated inflammatory and auto-immune consequences. Previously, a 35 bases long single-stranded oligonucleotide (ssON) was revealed to inhibit TLR3 activation in dendritic cells (DCs). Hence, the research presented in this thesis aims to harness the capacity of certain immunosuppressive oligonucleotides to modulate the innate immune response to inflammation and viral infection. In Paper I we demonstrated that ssON inhibits certain receptor-mediated endocytosis, thereby preventing activation from TLR3/4/7 signaling endosomes Additionally, ssON modulated TLR3-mediated activation in vivo in the skin. Therefore, in Paper II, we further assessed ssON’s effect on prominent symptoms of inflammatory skin disorders. We demonstrated that ssON inhibits non-IgE-mediated degranulation of mast cells induced by certain ligands of the pseudo-allergic receptor MRGPRX2, thereby alleviating the respective downstream itch and inflammation. There is currently an urgent need to develop new broad-spectrum antivirals against acute respiratory tract infections, which at present remain the deadliest communicable diseases. Since ssON inhibits clathrin-mediated and caveolin-dependent endocytosis, which are cellular entry pathways utilized by many viruses, we investigated ssON’s potential as an anti-viral agent against two major respiratory viruses. In Paper III we aimed to assess the effect of ssON on influenza A virus (IAV) infection. We demonstrated that ssON inhibits the infection of IAV, and more specifically the pandemic H1N1, in vitro in DCs and reduces viral load and disease in murine models of IAV infection. In Paper IV we aimed to assess the anti-viral capacity of ssON on respiratory syncytial virus (RSV) infection. We discovered that ssON acts as an efficient antiviral agent against RSV in vitro, seemingly by competing with the virus for binding to the entry receptor nucleolin. Additionally, ssON inhibits viral infection in vivo in a murine model of RSV infection, and the combination of ssON treatment and RSV infection leads to an upregulation of immune-related genes in the lungs, which most likely aid in viral clearance.In summary, the research presented in this thesis uncovers novel immunomodulatory functions of synthetic, noncoding ssONs to modulate the innate immune responses in the context pseudo- allergic itch and inflammation as well as in IAV and RSV infection. Furthermore, these studies unveil prospective therapeutic possibilities for ssON as an antiviral agent or as a treatment for certain inflammatory dermatoses.
34.	Düringer, Caroline, et al. (författare) HAMLET; a novel tool to identify apoptotic pathways in tumor cells. 2005 Ingår i: Application of apoptosis to cancer treatment.. - Berlin/Heidelberg : Springer-Verlag. - 9781402033032 ; , s. 223-245 Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract Tumor cells often carry mutations in genes that control cell survival, and become resistant to signals that trigger cell death. Yet, some cell death pathways remain intact in tumor cells. If identified, these pathways might be exploited to selectively remove tumor cells. HAMLET (human α-lactalbumin made lethal to tumor cells) is a protein-lipid complex derived from human milk that activates cell death programs in tumor cells but not in healthy differentiated cells. We use HAMLET as a tool to identify apoptosis and apoptosis-like cell death mechanisms in tumor cells and to understand if these mechanisms differ between tumor and healthy cells. HAMLET interacts with the cell surface, translocates into the cytoplasm and accumulates in cell nuclei, where it disrupts the chromatin. Recent in vivo studies have shown that HAMLET maintains the tumoricidal activity in glioblastoma, papilloma and bladder cancer models, with no significant side effects. The results suggest that HAMLET should be explored as a new therapeutic agent with selectivity for the tumor and with little toxicity for adjacent healthy tissue. Such therapies are a much-needed complement to conventional treatments, to reduce the side effects and improve the selectivity.
35.	Emmesjö, Lina, et al. (författare) Home health care professionals’ experiences of working in integrated teams during the COVID-19 pandemic : a qualitative thematic study 2022 Ingår i: BMC Primary Care. - : BioMed Central (BMC). - 2731-4553. ; 23:1 Tidskriftsartikel (refereegranskat)abstract Background: Since COVID-19 emerged, over 514 million COVID-19 cases and 6 million COVID-19-related deaths have been reported worldwide. Older persons receiving home health care often have co-morbidities that require advanced medical care, and are at risk of becoming severely ill or dying from COVID-19. In Sweden, over 10,000 COVID-19-related deaths have been reported among persons receiving municipal home health and social care. Home health care professionals have been working with the patients most at risk if infected. Most research has focused on the experiences of professionals in hospitals and assistant nurses in a home care setting. It is therefore valuable to study the experiences of the registered nurses and physicians working in home health care during the COVID-19 pandemic to learn lessons to inform future work.Method: A thematic qualitative study design using a semi-structured interview guide.Results: The health care professionals experienced being forced into changed ways of working, which disrupted building and maintaining relationships with other health care professionals, and interrupted home health care. The health care professionals described being forced into digital and phone communication instead of in-person meetings, which negatively influenced the quality of care. The COVID-19 pandemic brought worry about illness for the health care professionals, including worrying about infecting patients, co-workers, and themselves, as well as worry about upholding the provision of health care because of increasing sick leave. The health care professionals felt powerless in the face of their patients’ declining health. They also faced worry and guilt from the patients’ next of kin.Conclusion: Home health care professionals have faced the COVID-19 pandemic while working across organizational borders, caring for older patients who have been isolated during the pandemic and trying to prevent declining health and feelings of isolation. Due to the forced use of digital and phone communication instead of in-person visits, the home health care professionals experienced a reduction in the patients’ quality of care and difficulty maintaining good communication between the professions.
36.	Emmesjö, Lina, et al. (författare) Patients’ and next of kin’s expectations and experiences of a mobile integrated care model with a home health care physician : a qualitative thematic study 2023 Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1 Tidskriftsartikel (refereegranskat)abstract Background: The organizational principle of remaining at home has offset care from the hospital to the home of the older person where care from formal and informal caregivers is needed. Globally, formal care is often organized to handle singular and sporadic health problems, leading to the need for several health care providers. The need for an integrated care model was therefore recognized by health care authorities in one county in Sweden, who created a cross-organisational integrated care model to meet these challenges. The Mobile integrated care model with a home health care physician (MICM) is a collaboration between regional and municipal health care. Descriptions of patients’ and next of kin’s experiences of integrated care is however lacking, motivating exploration.Method: A qualitative thematic study. Data collection was done before the patients met the MICM physician, and again six months later.Results: The participants expected a sense of relief when admitted to MICM, and hoped for shared responsibility, building a personal contact and continuity but experienced lack of information about what MICM was. At the follow-up interview, participants described having an easier daily life. The increased access to the health care personnel (HCP) allowed participants to let go of responsibility, and created a sense of safety through the personalised contact and continuity. However, some felt ignored and that the personnel teamed up against the patient. The MICM structure was experienced as hierarchical, which influenced the possibility to participate. However, the home visits opened up the possibility for shared decision making.Conclusion: Participants had an expectation of receiving safe and coherent health care, to share responsibility, personal contact and continuity. After six months, the participants expressed that MICM had provided an easier daily life. The direct access to HCP reduced their responsibility and they had created a personalised contact with the HCP and that the individual HCP mattered to them, which could be perceived as in line with the goals in the shift to local health care. The MICM was experienced as a hierarchic structure with impact on participation, indicating that all dimensions of person-centred care were not fulfilled.
37.	Emmesjö, Lina (författare) Within an integrated home health care model : Registered nurses’, physicians’, patients’ and their next of kin’s perspectives 2024 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Many older patients receive health care from several different healthcare organizations, which may lead uncertainty about the responsibility for their healthcare needs. Integrated care has been argued to aid the healthcare system by addressing the challenge of the complex care needs of older patients with multiple health problems. Previous research has stated that integrated care models often have been developed with a focus on a single diagnosis, which risks overlooking the extensive and complex care needs of older patients. Prior research has also expressed the need to deepen knowledge about how integrated care models influence health care professionals, patients and their next of kin. Moreover, it is important to understand how the COVID-19 pandemic affected integrated care models which may expand knowledge about integrated home health care in crisis situations.The overall aim is to study expectations, perceptions and experiences of integrated home health care through the perspective of registered nurses, physicians, patients and their next of kin.Inductive qualitative designs where data was collected through interviews and field notes in the setting of the mobile integrated care model with a home health care physician (MICM) with registered nurses, physicians and patients and next of kin. Analysis was conducted using qualitative content analysis, phenomenography, and thematic analysis.The emphasis on person-centered care in the MICM was evident in the perceptions of the healthcare professionals about the patients and their next of kin, whom they viewed as persons, not simply recipients of health care. Differences were found in the health care provided in the MICM and in comparison, to other healthcare organizations which did not align with the person-centered care ethics. However, providing health care to patients in their own home benefited the provision of person-centered care – the value base of the MICM. The MICM was created with the goal of implementing individually tailored and coherent health care with increased continuity. The healthcare professionals viewed individual medical healthcare plans as co-created with each patient, and yet no patient could recall participating in this co-creation. The coherency of the MICM was regarded as having been improved by teamwork between the registered nurse and the home healthcare physician. Collaborations with other healthcare professionals rarely occurred and should be improved in the future. Participants reported varying experiences of continuity in the MICM, which influenced the possibility of building relationships. Providing continuity with a home healthcare physician for patients is therefore preferable. The work described in this thesis was conducted during the COVID-19 pandemic. The thesis provides unique insights into an integrated care model during a crisis situation, which the healthcare system may face in similar or different ways in the future. The MICM was upheld as the best way to work in home health care, especially as patients and their next of kin regarded the model as making their daily lives easier.
38.	Ernsth Bravell, Marie, et al. (författare) Motor functioning differentially predicts mortality in men and women 2017 Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 72, s. 6-11 Tidskriftsartikel (refereegranskat)abstract IntroductionResearch indicates gender differences in functional performance at advanced ages, but little is known about their impact on longevity for men and women.ObjectiveTo derive a set of motor function factors from a battery of functional performance measures and examine their associations with mortality, incorporating possible gender interactions.MethodAnalyses were performed on the longitudinal Swedish Adoption/Twin Study of Aging (SATSA) including twenty-four assessments of motor function up to six times over a 19-year period. Three motor factors were derived from several factor analyses; fine motor, balance/upper strength, and flexibility. A latent growth curve model was used to capture longitudinal age changes in the motor factors and generated estimates of intercept at age 70 (I), rates of change before (S1) and after age 70 (S2) for each factor. Cox regression models were used to determine how gender in interaction with the motor factors was related to mortality.ResultsFemales demonstrated lower functional performance in all motor functions relative to men. Cox regression survival analyses demonstrated that both balance/upper strength, and fine motor function were significantly related to mortality. Gender specific analyses revealed that this was true for women only. For men, none of the motor factors were related to mortality.ConclusionWomen demonstrated more difficulties in all functioning facets, and only among women were motor functioning (balance/upper strength and fine motor function) associated with mortality. These results provide evidence for the importance of considering motor functioning, and foremost observed gender differences when planning for individualized treatment and rehabilitation.
39.	Gamgam Leanderz, Åsa, et al. (författare) Parental-couple separation during the transition to parenthood 2021 Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 8:5, s. 2622-2636 Tidskriftsartikel (refereegranskat)abstract AIM: To evaluate factors associated with parental separation during the parenthood transition.DESIGN: Prospective, longitudinal and explorative.METHODS: This is a quantitative longitudinal study of N784 subjects throughout the pregnancy journey with multivariate regression analysis of survey data derived from three validated measurement scales; the Sense of Coherence scale, the Multidimensional Scale of Perceived Social Support and the Perceived Quality of the Dyadic Relationship scale conducted 2014-2016.RESULTS: N17 participants separated at 2 years. Parental separation was significantly greater for those women and partners with low or changing sense of coherence, perceived social support and perceived quality of the parental-couple relationship indexes. Partners with a change in sense of coherence (p: .003) and perceived quality of the parental-couple relationship (p: .020) between 1 week and 2 years were at greater risk for separation. Attending professional preparatory support with a partner for women (p: .013) and attending the "Inspirational Lecture" for partners (p: .046) were, to a lesser extent, associated with a risk of parental separation.
40.	Gillsjö, Catharina, Senior Lecturer, 1963-, et al. (författare) En utbildnings-intervention med simulering i äldredräkt i Skaraborgs Hälsoteknikcentrum för ökad insikt och förståelse för att åldras och leva med åldersrelaterade hälsoproblem 2021 Ingår i: DAL-21 Det akademiska lärarskapet. - Skövde : Högskolan i Skövde. - 9789198366785 ; , s. 30-31 Konferensbidrag (refereegranskat)abstract Världshälsoorganisationen, [1] belyser utmaningen att ge en vård som stödjer ett hälsosamt åldrande. Ett centralt hinder är den höga förekomsten av negativa attityder gentemot åldrandet, äldre personer och vård av äldre, särskilt bland vårdpersonal [2-4]. Vidare påvisas att sjuksköterskestudenter kan bära på negativa attityder till att vårda äldre och därför inte ser arbete inom äldrevård som ett önskvärt och framtida arbetsfält [5, 6]. Otillräcklig forskning avseende ålderism tillsammans med bristande utbildning inom området äldre, det normala åldrandet samt åldrandets hälsoproblem beskrivs som en bidragande faktor till ålderism [4]. Trots att interventioner kontinuerligt genomförs för att ändra attityder och minska ålderism i vården kvarstår dessa i betydande omfattning [3]. Det finns således ett behov av att skapa innovativa lösningar som bidrar till en ökad och hållbar förståelse för åldrandet, äldre och åldersrelaterade hälsoproblem. Detta adresseras i en ny utbildningsintervention med simulering i äldredräkt som utformats och genomförs i Skaraborgs Hälsoteknikcentrum (SHC), Högskolan i Skövde. Forskning [7] lyfter fram att simulering i utbildning, särskilt genom användande av utrustning som äldredräkt, är en framgångsrik väg att ändra studenters attityder gentemot äldre. Simulering i SHC ger även möjlighet att testa hälso- och välfärdsteknik vilket ytterligare kan inverka positivt på uppfattningar om dess nytta vid implementering av teknik i vården [8].Pågående utbildningsmoment i utbildning till sjuksköterska och distriktssköterskaUnder läsåret 2019-2020 har grupper av studerande inom omvårdnad deltagit i simulering i SHC. Vid denna simulering har äldredräkt använts för att återspegla upplevelsen av normalt åldrande och vanligt förekommande hälsoproblem. De studerande tilldelas en personas och genomför olika scenarier i SHC. I samband med detta besvaras enkät [9], före simulering samt efter simulering för att ta del av synen på åldrandet och att vårda äldre samt eventuell förändring efter genomgången simulering. Efter simuleringen reflekterar studenterna i grupp över upplevelsen av simuleringen, åldrandet och den vård som ges. Reflektionerna relateras sedan till centrala begrepp i omvårdnad samt sjuksköterskans kärnkompetenser. Vidare reflekterar de studerande över hur simuleringen påverkat deras insikt och förståelse samt hur det kommer att visa sig i den vård som ges.ForskningsprojektUtbildningsinterventionen beforskas som en del i ett longitudinellt projekt med övergripande syfte att studera hur en utbildningsintervention med simulering i äldredräkt inverkar på insikt och förståelse för åldrandet, att vara äldre och att leva med åldersrelaterade hälsoproblem i kontexten samt vård av äldre personer. Vidare är syftet att longitudinellt studera studenters syn på åldrandet, äldre och att vårda äldre personer. De hittills genomförda simuleringarna visar tecken på att studenters insikt och förståelse avseende åldrandet, att åldras och att leva med åldersrelaterade hälsoproblem förändras på ett positivt sätt. Det finns därför ett behov av att systematiskt utvärdera effekten och nyttan av den intervention som nu genomförs i SHC. Externa medel söktes hos Familjen Kamprads stiftelse och 3,5 miljoner erhölls för att genomföra projektet och att anställa en doktorand.Referenser1. WHO, Integrated care for older people (ICOPE) implementation framework: guidance for systems and services. 2019, Geneva: World Health Organization.2. Wyman, M.F., S. Shiovitz-Ezra, and J. Bengel, Ageism in the Health Care System: Providers, Patients, and Systems, in Contemporary Perspectives on Ageism, L. Ayalon and C. Tesch-Römer, Editors. 2018, Springer International Publishing: Cham. p. 193-212.3. Burnes, D., et al., Interventions to Reduce Ageism Against Older Adults: A Systematic Review and Meta-Analysis.American Journal of Public Health, 2019. 109(8): p. e1-e9.4. Wilson, D.M., et al., A critical review of published research literature reviews on nursing and healthcare ageism. Journal of Clinical Nursing, 2017. 26(23-24): p. 3881-3892.5. Szadowska-Szlachetka, Z., et al., Attitudes of students of nursing major towards people of geriatric age. Polish Journal of Public Health, 2019. 129(3): p. 95.6. Naughton, C., K.L. O’Shea, and N. Hayes, Incentivising a career in older adult nursing: The views of student nurses. International Journal of Older People Nursing, 2019. 14(4): p. e12256.7. Giner Perot, J., et al., Aging-simulation experience: impact on health professionals’ social representations. BMC Geriatrics, 2020. 20(1): p. 14.8. Frennert, S. and K. Baudin, The concept of welfare technology in Swedish municipal eldercare. Disability and Rehabilitation, 2019: p. 1-8.9. Burbank, P.M., G.J. Burkholder, and J. Dugas, Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses. Applied Nursing Research, 2018. 43: p. 98-104
41.	Gustafsson, Lotta, et al. (författare) HAMLET kills tumor cells by apoptosis: Structure, cellular mechanisms, and therapy 2005 Ingår i: Journal of Nutrition. - 1541-6100. ; 135:5, s. 1299-1303 Tidskriftsartikel (refereegranskat)abstract New cancer treatments should aim to destroy tumor cells without disturbing normal tissue. HAMLET (human a-lactalbumin made lethal to tumor cells) offers a new molecular approach to solving this problem, because it induces apoptosis in tumor cells but leaves normal differentiated cells unaffected. After partial unfolding and binding to oleic acid, α-lactalbumin forms the HAMLET complex, which enters tumor cells and freezes their metabolic machinery. The cells proceed to fragment their DNA, and they disintegrate with apoptosis-like characteristics. HAMLET kills a wide range of malignant cells in vitro and maintains this activity in vivo in patients with skin papillomas. In addition, HAMLET has striking effects on human glioblastomas in a rat xenograft model. After convection-enhanced delivery, HAMLET diffuses throughout the brain, selectively killing tumor cells and controlling tumor progression without apparent tissue toxicity. HAMLET thus shows great promise as a new therapeutic with the advantage of selectivity for tumor cells and lack of toxicity.
42.	Hadrévi, Jenny, et al. (författare) Systemic differences in serum metabolome : a cross sectional comparison of women with localised and widespread pain and controls 2015 Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 5 Tidskriftsartikel (refereegranskat)abstract Chronic musculoskeletal pain exists either as localised to a single region or as widespread to multiple sites in several quadrants of the body. Prospective studies indicate that widespread pain could act as a far end of a continuum of musculoskeletal pain that started with chronic localised pain. The mechanism by which the transition from localised pain to widespread occurs is not clear, although many studies suggest it to be an altered metabolism. In this study, systemic metabolic differences between women with chronic localised neck-shoulder pain (NP), women with chronic widespread pain (CWP) and women who were healthy (CON) were assessed. Blood samples were analysed taking a metabolomics approach using gas chromatography mass spectrometry (GC-MS) and orthogonal partial least square discriminant analysis (OPLS-DA). The metabolomics analysis showed a clear systematic difference in the metabolic profiles between the subjects with NP and the CON but only a weak systematic difference between the subjects with CWP and the CON. This most likely reflects a difference in the portion of the metabolome influenced by the two pain conditions. In the NP group, the overall metabolic profile suggests that processes related to energy utilisation and lipid metabolism could be central aspects of mechanisms maintaining disorder.
43.	Hallgren, Hanna, 1972-, et al. (författare) Being each others dog : or the figure wanders on alone 2014 Ingår i: A Valentine for Gertrud Stein: The Reception of Getrud Stein in the Arts and Humanities. 8-10 april 2014. Hosted by the Ubiversity of Copenhagen, Denmark and co-organized with Ghent Univeristy and Linköping Univeristy. - : University of Copenhagen. Konferensbidrag (refereegranskat)
44.	Hallgren, Hanna, 1972-, et al. (författare) Gränslösa hundar 2010 Ingår i: Omslag. - Stockholm : Rosenlarv förlag. - 9789197793520 ; , s. 103-121 Bokkapitel (populärvet., debatt m.m.)
45.	Hallgren, Hanna, 1972, et al. (författare) Queer & Form 2008 Ingår i: Trikster – Nordic Queer Journal #1 2008. Annan publikation (övrigt vetenskapligt/konstnärligt)
46.	Hallgren, Hanna, 1972-, et al. (författare) Queer & Form 2008 Ingår i: Trikster. - Köpenhamn : Trikster. - 1890-596X. ; :1 Tidskriftsartikel (populärvet., debatt m.m.)
47.	Hallgren, Hanna, 1972-, et al. (författare) Translating 51 days 2015 Ingår i: PARSE Conference, Nov 4-6, 2015 The 1st PARSE Biennial Research Conference on TIME, Göteborgs Universitet & Platform for Artistic Research Sweden An international initiative based at the University of Gothenburg, Sweden, aimed at supporting a multidisciplinary research culture – exploring the contemporary challenges of artistic research and the dialogue between research in the arts and research in other disciplines and domains.. Konferensbidrag (refereegranskat)abstract In the summer of 2014 poets Somaya El-Sousi, Hanna Hallgren and Jenny Tunedal were working together in a translation workshop via skype that had been ongoing for more than a year. When war broke out in Gaza, where El-Sousi lives and works, this translation workshop transformed into a daily conversation on war, despair, food, rooms, objects, women, children, mothers, intimacy, fear, news, weather and writing.The differences and distances always present in translation work became enhanced and acute, as did a sense of closeness. The circumstances of war cut into our work and somehow into the everyday quotidian life of Sweden; as a shock, as a difference, as an acute experience of a lack of experience. The computer screen became, in El-Sousis words: “a blue window of hope”; the hope of continuing, linearity, future.Continuity is complicated for anyone living in Gaza. Life is a secluded incarceration not only in space but maybe even more so in time. Future as well as political and personal history are constantly being cut off from and / or conditioned by a claustrophobic present. The disaster that war is adds enormous pressure and fear to this present, to the extend were chronological time seems almost entirely dissolved.We would like to examine this sense of time and how it conditions the work of female writers in Gaza. We have gathered literary texts by women living in Gaza that were written during the 51 days of war and aim to perform a reading of how the temporality of war becomes readable, and possibly shareable, in these texts; as structure, as experience, as knowledge, as the unanswerable question: ”How long is that night, how hard is that darkness?” (from Somaya El-Sousis “It does not end”, written in late July 2014)Our work and our friendship takes place on skype. During the conference we would like to use skype and together, yet apart, perform a poetic conversation piece on the temporality of war, of literature, of translation and of friendship.
48.	Hallgren, Hanna, 1972, et al. (författare) Translating 51 Days: These Texts are not Memories 2016 Ingår i: Parse Journal Issue 4 Times Autumn 2016. Konstnärligt arbete (övrigt vetenskapligt/konstnärligt)
49.	Hallgren, Hanna, 1972-, et al. (författare) Writing during war : Keynote 2014 Ingår i: Exitable Writing, 8-10 December 2014, Linköpings University. - : Linköpings Universitet. Konferensbidrag (övrigt vetenskapligt/konstnärligt)
50.	Hallgren, Jenny, 1978-, et al. (författare) A prospective cross-sectional study of child healthcare competence among nurses within primary healthcare in Sweden 2023 Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-11 Tidskriftsartikel (refereegranskat)abstract Child-centered care is based on the fact that children are individuals with their own rights. Since January 2020, The United Nations Convention on the Rights of the Child (CRC) is law in Sweden. Children's meeting with professionals is important because it becomes the children's impression of healthcare that may reflect the children's future image of and feelings about the whole healthcare system. This prospective cross-sectional study aimed to explore child healthcare competence among nurses within primary healthcare. Data were collected through a web-based questionnaire among 101 primary healthcare district nurses, specialist nurses, and registered nurses. The study was compliant with the STROBE checklist. The results showed that the nurses have a good ability to apply child-centered care during children's visits to primary healthcare. To further implement a child-centered approach in primary healthcare, nurses need to have access to workplace educational opportunities continually, to enhance their child competence throughout their nursing careers.

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