| 1. |
- Ahl, Caroline, et al.
(författare)
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Making up one's mind : patients' experiences of calling an ambulance
- 2006
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Ingår i: Accident and Emergency Nursing. - : Elsevier. - 0965-2302 .- 1532-9267 .- 1755-599X .- 1878-013X. ; 14:1, s. 11-19
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Tidskriftsartikel (refereegranskat)abstract
- The issue of the inappropriate use of ambulance transport and care has mainly been studied from the professionals' and caregivers' perspective, with few studies focusing on the patient and his/her experiences. To further understand whether patients use ambulance care in an inappropriate manner and, if so, why, it is important to obtain an overall picture of the patients' existential situation at the time they call an ambulance. The aim of this study was to analyse and describe patients' experiences related to the decision to call an ambulance and the wait for it to arrive. The design was explorative, and twenty informants aged between 34 and 82 years were interviewed. Qualitative content analyses were performed. The findings showed that calling for an ambulance is a major decision that is preceded by hesitation and attempts to handle the situation by oneself. Our conclusion is that the definition of inappropriate use of valuable health care resources should not be based solely on the professionals' point of view but also take account of the patients' reactions when they experience a threat to their life and health.
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| 2. |
- Ahl, Caroline, et al.
(författare)
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To Handle the Unexpected : The meaning of caring in pre-hospital emergency care
- 2012
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 20:1, s. 33-41
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Tidskriftsartikel (refereegranskat)abstract
- The patient’s voice has not been present to the same degree as the professional perspective in caring research in a pre-hospital context. In order to further develop and improve pre-hospital care, it is therefore important to explore patients’ situations not only in life threatening but also in non-traumatic situations. This is especially important as these patients might be defined as inappropriate attendees of ambulance services. The aim of this study was to interpret and explain experiences of caring in pre-hospital care situations that are not defined as traumatic or life threatening. Twenty informants aged between 34 and 82 years were interviewed. The design of the study was exploratory, and it used an interpretative approach in order to understand the meaning of pre-hospital caring. The findings show that pre-hospital caring can be understood and explained as a matter of interplay between carer(s) and patient with potentials for positive as well as negative outcomes. Our conclusion is that the initial meeting is of vital importance in how patients experience pre-hospital care. It is suggested that general public information on the development of Swedish pre-hospital care received in turn may facilitate the first encounter between patient and carer(s).
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| 3. |
- Ahl, Matilda, et al.
(författare)
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Immune response in blood before and after epileptic and psychogenic non-epileptic seizures
- 2023
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Ingår i: Heliyon. - : Elsevier. - 2405-8440. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Inflammatory processes may provoke epileptic seizures and seizures may promote an immune reaction. Hence, the systemic immune reaction is a tempting diagnostic and prognostic marker in epilepsy. We explored the immune response before and after epileptic and psychogenic non-epileptic seizures (PNES). Serum samples collected from patients with videoEEG-verified temporal or frontal lobe epilepsy (TLE or FLE) or TLE + PNES showed increased interleukin-6 (IL-6) levels in between seizures (interictally), compared to controls. Patients with PNES had no increase in IL-6. The IL-6 levels increased transiently even further within hours after a seizure (postictally) in TLE but not in FLE patients. The postictal to interictal ratio of additionally five immune factors were also increased in TLE patients only. We conclude that immune factors have the potential to be future biomarkers for epileptic seizures and that the heterogeneity among different epileptic and non-epileptic seizures may be disclosed in peripheral blood sampling independent of co-morbidities.
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| 4. |
- Ahl, Matilda, et al.
(författare)
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Inflammatory reaction in the retina after focal non-convulsive status epilepticus in mice investigated with high resolution magnetic resonance and diffusion tensor imaging
- 2021
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Ingår i: Epilepsy Research. - : Elsevier. - 0920-1211 .- 1872-6844. ; 176
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Tidskriftsartikel (refereegranskat)abstract
- Pathophysiological consequences of focal non-convulsive status epilepticus (fNCSE) have been difficult to demonstrate in humans. In rats fNCSE pathology has been identified in the eyes. Here we evaluated the use of high-resolution 7 T structural T1-weighted magnetic resonance imaging (MRI) and 9.4 T diffusion tensor imaging (DTI) for detecting hippocampal fNCSE-induced retinal pathology ex vivo in mice. Seven weeks post-fNCSE, increased number of Iba1+ microglia were evident in the retina ipsilateral to the hemisphere with fNCSE, and morphologically more activated microglia were found in both ipsi- and contralateral retina compared to non-stimulated control mice. T1-weighted intensity measurements of the contralateral retina showed a minor increase within the outer nuclear and plexiform layers of the lateral retina. T1-weighted measurements were not performed in the ipsilateral retina due to technical difficulties. DTI fractional anisotropy(FA) values were discretely altered in the lateral part of the ipsilateral retina and unaltered in the contralateral retina. No changes were observed in the distal part of the optic nerve. The sensitivity of both imaging techniques for identifying larger retinal alteration was confirmed ex vivo in retinitis pigmentosa mice where a substantial neurodegeneration of the outer retinal layers is evident. With MR imaging a 50 % decrease in DTI FA values and significantly thinner retina in T1-weighted images were detected. We conclude that retinal pathology after fNCSE in mice is subtle and present bilaterally. High-resolution T1-weighted MRI and DTI independently did not detect the entire pathological retinal changes after fNCSE, but the combination of the two techniques indicated minor patchy structural changes.
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| 5. |
- Ahl, Matilda, et al.
(författare)
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Physical Activity Reduces Epilepsy Incidence : a Retrospective Cohort Study in Swedish Cross-Country Skiers and an Experimental Study in Seizure-Prone Synapsin II Knockout Mice
- 2019
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Ingår i: Sports medicine - open. - : Springer. - 2199-1170 .- 2198-9761. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Epilepsy patients commonly exercise less than the general population. Animal studies indicate beneficial effects of physical activity in established epilepsy, while its effect on the development is currently less known.METHODS: Here, we investigated the incidence of epilepsy during 20 years in a cohort of participants from the long-distance Swedish cross-country ski race Vasaloppet (n = 197,685) and compared it to the incidence of non-participating-matched controls included in the Swedish population register (n = 197,684). Individuals diagnosed with diseases such as stroke and epilepsy before entering the race were excluded from both groups. Experimentally, we also determined how physical activity could affect the development of epilepsy in epilepsy-prone synapsin II knockout mice (SynIIKO), with and without free access to a running wheel.RESULTS: We identified up to 40-50% lower incidence of epilepsy in the Vasaloppet participants of all ages before retirement. A lower incidence of epilepsy in Vasaloppet participants was seen regardless of gender, education and occupation level compared to controls. The participants included both elite and recreational skiers, and in a previous survey, they have reported a higher exercise rate than the general Swedish population. Sub-analyses revealed a significantly lower incidence of epilepsy in participants with a faster compared to slower finishing time. Dividing participants according to specified epilepsy diagnoses revealed 40-50% decrease in focal and unspecified epilepsy, respectively, but no differences in generalized epilepsy. Voluntary exercise in seizure-prone SynIIKO mice for 1 month before predicted epilepsy development decreased seizure manifestation from > 70 to 40%. Brain tissue analyses following 1 month of exercise showed increased hippocampal neurogenesis (DCX-positive cells), while microglial (Iba1) and astrocytic activation (GFAP), neuronal Map2, brain-derived neurotrophic factor and its receptor tyrosine receptor kinase B intensity were unaltered. Continued exercise for additionally 2 months after predicted seizure onset in SynIIKO mice resulted in a 5-fold reduction in seizure manifestation (from 90 to 20%), while 2 months of exercise initiated at the time of predicted seizure development gave no seizure relief, suggesting exercise-induced anti-epileptogenic rather than anti-convulsive effect.CONCLUSION: The clinical study and the experimental findings in mice indicate that physical activity may prevent or delay the development of epilepsy.
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| 6. |
- Ahl, Maria, et al.
(författare)
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Working with home birth - Swedish midwives´experiences
- 2018
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756. ; :18, s. 24-29
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to describe Swedish midwives’ experiences of working with home birth. Methods: Two focus group interviews were conducted with eight home birth-attending midwives. Data were analysed with qualitative content analysis. Results: Four main categories were identified: the birth as a meaningful moment; to fully focus on the birth; to practise the craft; and not to be part of the health care system. The midwives viewed childbirth as a significant moment that should be conducted on the woman’s terms. Working with home birth enabled them to work at their own pace and focus fully on the woman. During home births, they learned more about normal birth, and developed their practical skills and professional knowledge with little reliance on technology. They did, however, not feel fully accepted in the maternity care system. Conclusion: This study contributes to the discussion about midwives’ experiences of working with home birth in contexts where home birth is not covered by public health care. The study shows that the work environment influences how midwives perform their craft, how they follow and support normal birth, and how the birth setting influence valuing their work.
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| 7. |
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| 8. |
- Avdic, Una, et al.
(författare)
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Immune profile in blood following non-convulsive epileptic seizures in rats
- 2019
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Ingår i: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 10:JUL
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Tidskriftsartikel (refereegranskat)abstract
- Non-convulsive status epilepticus (NCSE) is a prolonged epileptic seizure with subtle symptoms that may delay clinical diagnosis. Emerging experimental evidence shows brain pathology and epilepsy development following NCSE. New diagnostic/prognostic tools are therefore needed for earlier and better stratification of treatment. Here we examined whether NCSE initiates a peripheral immune response in blood serum from rats that experienced electrically-induced NCSE. ELISA analysis showed an acute transient increase in serum protein levels including interleukin-6 6 h post-NCSE, similar to the immune reaction in the brain. At 4 weeks post-NCSE, when 75% of rats subjected to NCSE had also developed spontaneous seizures, several immune proteins were altered. In particular, markers associated with microglia, macrophages and antigen presenting cells, such as CD68, MHCII, and galectin-3, were increased and the T-cell marker CD4 was decreased in serum compared to both non-stimulated controls and NCSE rats without spontaneous seizures, without correlation to interictal epileptiform activity. Analyses of serum following intracerebral injection of lipopolysaccharide (LPS) showed an acute increase in interleukin-6, but at 4 weeks unaltered levels of MHCII and galectin-3, an increase in CD8 and CD11b and a decrease in CD68. None of the increased serum protein levels after NCSE or LPS could be confirmed in spleen tissue. Our data identifies the possibility to detect peripheral changes in serum protein levels following NCSE, which may be related to the development of subsequent spontaneous seizures.
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| 9. |
- Bjursell, Cecilia, 1970-, et al.
(författare)
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Lifelong Learning Through Context Collapse : Higher education Teachers’ Narratives About Online education During The Pandemic
- 2022
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Ingår i: Proceedings of INTED2022 Conference 7th-8th March 2022. - : IATED. - 9788409377589 ; , s. 2632-2641
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Konferensbidrag (refereegranskat)abstract
- The COVID-19 pandemic has elicited a shift from campus classrooms to distance education in higher education worldwide, shaping not only students’ experiences, but also those of teachers, especially those who never have taught online. In addition, the pandemic created a meta-context that has positioned distance education as something different from previous efforts. This study aimed to investigate higher education teachers’ experiences during the transition from classroom to online teaching by using a collective auto-ethnography method based on 13 personal stories from Swedish faculty. For the abductive approach in the analysis, a framework that combines lifelong learning theory with the context collapse concept has been applied. The disjuncture that the pandemic has elicited created a situation in which teachers had to make sense of the fact that their previous experiences did not completely fit the new situation. Context collapse, a term used to describe encounters with many audiences in social media, has been introduced to highlight the clash between professional and private contexts in online educational platforms. Based on lifelong learning theories, we suggest that context collapse should be examined in terms of how it can help improve higher education, as it holds the potential to include the entire person – body and mind – in education.
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| 10. |
- Geiser, Petra, et al.
(författare)
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Salmonella enterica Serovar Typhimurium Exploits Cycling through Epithelial Cells To Colonize Human and Murine Enteroids
- 2021
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Ingår i: mBio. - : American Society for Microbiology. - 2161-2129 .- 2150-7511. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Enterobacterial pathogens infect the gut by a multistep process, resulting in colonization of both the lumen and the mucosal epithelium. Due to experimental constraints, it remains challenging to address how luminal and epithelium-lodged pathogen populations cross-feed each other in vivo. Enteroids are cultured three-dimensional miniature intestinal organs with a single layer of primary intestinal epithelial cells (IECs) surrounding a central lumen. They offer new opportunities to study enterobacterial infection under near-physiological conditions, at a temporal and spatial resolution not attainable in animal models, but remain poorly explored in this context. We employed microinjection, time-lapse microscopy, bacterial genetics, and barcoded consortium infections to describe the complete infection cycle of Salmonella enterica serovar Typhimurium in both human and murine enteroids. Flagellar motility and type III secretion system 1 (TTSS-1) promoted Salmonella Typhimurium targeting of the intraepithelial compartment and breaching of the epithelial barrier. Strikingly, however, TTSS-1 also potently boosted colonization of the enteroid lumen. By tracing the infection over time, we identified a cycle(s) of TTSS-1-driven IEC invasion, intraepithelial replication, and reemergence through infected IEC expulsion as a key mechanism for Salmonella Typhimurium luminal colonization. These findings suggest a positive feed-forward loop, through which IEC invasion by planktonic bacteria fuels further luminal population expansion, thereby ensuring efficient colonization of both the intraepithelial and luminal niches.IMPORTANCE Pathogenic gut bacteria are common causes of intestinal disease. Enteroids—cultured three-dimensional replicas of the mammalian gut—offer an emerging model system to study disease mechanisms under conditions that recapitulate key features of the intestinal tract. In this study, we describe the full life cycle of the prototype gut pathogen Salmonella enterica serovar Typhimurium within human and mouse enteroids. We map the consecutive steps and define the bacterial virulence factors that drive colonization of luminal and epithelial compartments, as well as breaching of the epithelial barrier. Strikingly, our work reveals how bacterial colonization of the epithelium potently fuels expansion also in the luminal compartment, through a mechanism involving the death and expulsion of bacterium-infected epithelial cells. These findings have repercussions for our understanding of the Salmonella infection cycle. Moreover, our work provides a comprehensive foundation for the use of microinjected enteroids to model gut bacterial diseases.
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