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Article ; Online: Homecare workers - an untapped resource in preventing emergency department visits among older individuals? A qualitative interview study from Sweden.

Bastholm-Rahmner, Pia / Bergqvist, Monica / Modig, Karin / Gustafsson, Lars L / Schmidt-Mende, Katharina

2024 Volume 24, Issue 1, Page(s) 350

Abstract: Background: Older individuals with functional decline and homecare are frequent visitors to emergency departments (ED). Homecare workers (HCWs) interact regularly with their clients and may play a crucial role in their well-being. Therefore, this study ... ...

Abstract	Background: Older individuals with functional decline and homecare are frequent visitors to emergency departments (ED). Homecare workers (HCWs) interact regularly with their clients and may play a crucial role in their well-being. Therefore, this study explores if and how HCWs perceive they may contribute to the prevention of ED visits among their clients. Methods: In this qualitative study, 12 semi-structured interviews were conducted with HCWs from Sweden between July and November 2022. Inductive thematic analysis was used to identify barriers and facilitators to prevent ED visits in older home-dwelling individuals. Results: HCWs want to actively contribute to the prevention of ED visits among clients but observe many barriers that hinder them from doing so. Barriers refer to care organisation such as availability to primary care staff and information transfer; perceived attitudes towards HCWs as co-workers; and client-related factors. Participants suggest that improved communication and collaboration with primary care and discharge information from the ED to homecare services could overcome barriers. Furthermore, they ask for support and geriatric education from primary care nurses which may result in increased respect towards them as competent staff members. Conclusions: HCWs feel that they have an important role in the health management of older individuals living at home. Still, they feel as an untapped resource in the prevention of ED visits. They deem that improved coordination and communication between primary care, ED, and homecare organisations as well as proactive care would enable them to add significantly to the prevention of ED visits.
MeSH term(s)	Humans ; Aged ; Sweden/epidemiology ; Emergency Room Visits ; Emergency Service, Hospital ; Qualitative Research ; Palliative Care
Language	English
Publishing date	2024-04-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2059865-8
ISSN	1471-2318 ; 1471-2318
ISSN (online)	1471-2318
ISSN	1471-2318
DOI	10.1186/s12877-024-04906-5
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Time-out in prolonged labour: development of a care model to prevent secondary fear of childbirth.

Ringqvist, Anna-Karin / Bergqvist, Liselotte / Brezicka, Thomas / Lundgren, Ingela

BMJ open quality

2022 Volume 11, Issue 4

Abstract: Background: During qualitative improvement work, the statistics at the hospital reveal prolonged labour as one of the major causes of secondary fear of childbirth (FOC). The aim of this improvement work was to develop and implement a care process for ... ...

Abstract	Background: During qualitative improvement work, the statistics at the hospital reveal prolonged labour as one of the major causes of secondary fear of childbirth (FOC). The aim of this improvement work was to develop and implement a care process for prolonged labour to prevent secondary FOC. Materials and methods: To explore the factors behind secondary FOC among multiparous women, a follow-up of referral reasons for 600 women with severe FOC was made between 2015 and 2017 at a Swedish University Hospital. In the group with the most common factor, namely prolonged labour, 41 women were interviewed. From their answers, further research and existing professional knowledge, a care process to prevent secondary FOC was designed, 'Time-out in prolonged labour' (the Time-out). To improve the quality of the care process, the functional resonance analysis method was used. The findings from the interviews were categorised into three themes: lack of involvement; lack of communication and information; and lack of care plan. The women explained that if these areas had been fulfilled, it may have reduced their FOC. Result: To prevent the above-mentioned themes, 'Time-out in prolonged labour' was developed with supporting factors such as gathering the interprofessional team, collecting information, dialogue within the team and the involvement of the women when deciding the care plan. Result after implementation shows a reduction of referral reason due to prolonged labour for women with severe FOC from 28% in 2016 to 8.5% in 2020. Conclusions: The Time-out is a good model to prevent secondary FOC. Central aspects of the model are to ensure women's involvement, good communication and a documented care plan for women in prolonged labour. The supporting factor of interprofessional teamwork is of importance when using the Time-out in practice.
MeSH term(s)	Delivery, Obstetric ; Fear ; Female ; Humans ; Labor, Obstetric ; Parturition ; Pregnancy ; Time Factors
Language	English
Publishing date	2022-10-09
Publishing country	England
Document type	Journal Article
ISSN	2399-6641
ISSN (online)	2399-6641
DOI	10.1136/bmjoq-2022-001853
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Article ; Online: Time-out in prolonged labour

Ingela Lundgren / Thomas Brezicka / Anna-Karin Ringqvist / Liselotte Bergqvist

BMJ Open Quality, Vol 11, Iss

development of a care model to prevent secondary fear of childbirth

2022 Volume 4

Abstract: Background During qualitative improvement work, the statistics at the hospital reveal prolonged labour as one of the major causes of secondary fear of childbirth (FOC). The aim of this improvement work was to develop and implement a care process for ... ...

Abstract	Background During qualitative improvement work, the statistics at the hospital reveal prolonged labour as one of the major causes of secondary fear of childbirth (FOC). The aim of this improvement work was to develop and implement a care process for prolonged labour to prevent secondary FOC.Materials and methods To explore the factors behind secondary FOC among multiparous women, a follow-up of referral reasons for 600 women with severe FOC was made between 2015 and 2017 at a Swedish University Hospital. In the group with the most common factor, namely prolonged labour, 41 women were interviewed. From their answers, further research and existing professional knowledge, a care process to prevent secondary FOC was designed, ‘Time-out in prolonged labour’ (the Time-out). To improve the quality of the care process, the functional resonance analysis method was used. The findings from the interviews were categorised into three themes: lack of involvement; lack of communication and information; and lack of care plan. The women explained that if these areas had been fulfilled, it may have reduced their FOC.Result To prevent the above-mentioned themes, ‘Time-out in prolonged labour’ was developed with supporting factors such as gathering the interprofessional team, collecting information, dialogue within the team and the involvement of the women when deciding the care plan. Result after implementation shows a reduction of referral reason due to prolonged labour for women with severe FOC from 28% in 2016 to 8.5% in 2020.Conclusions The Time-out is a good model to prevent secondary FOC. Central aspects of the model are to ensure women’s involvement, good communication and a documented care plan for women in prolonged labour. The supporting factor of interprofessional teamwork is of importance when using the Time-out in practice.
Keywords	Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2022-10-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Adipocytes Under Obese-Like Conditions Change Cell Cycle Distribution and Phosphorylation Profiles of Breast Cancer Cells: The Adipokine Receptor CAP1 Matters.

Bergqvist, Malin / Elebro, Karin / Borgquist, Signe / Rosendahl, Ann H

Frontiers in oncology

2021 Volume 11, Page(s) 628653

Abstract: Background: Obesity and associated metabolic conditions impact adipocyte functionality with potential consequences for breast cancer risk and prognosis, but contributing mechanisms remain to be understood. The adipokine receptor adenylyl cyclase- ... ...

Abstract	Background: Obesity and associated metabolic conditions impact adipocyte functionality with potential consequences for breast cancer risk and prognosis, but contributing mechanisms remain to be understood. The adipokine receptor adenylyl cyclase-associated protein-1 (CAP1) has been implicated in the progression of breast cancer, but results are conflicting and the underlying molecular mechanisms are still unknown. In this study, molecular and cellular effects in breast cancer cells by stimulation of adipocytes under normal or obese-like conditions, and potential involvement of CAP1, were assessed. Material and methods: Estrogen receptor (ER)-positive T47D and ER-negative MDA-MB-231 breast cancer cells were exposed to adipocyte-secretome from adipocytes placed under pressures mimicking normal and obese-like metabolic conditions. Changes in phosphorylated kinase proteins and related biological pathways were assessed by phospho-antibody array and PANTHER analysis, cell proliferation were investigated through sulforhodamine B, cell cycle distribution by flow cytometry. Functional effects of CAP1 were subsequently examined following small interfering (si)RNA-mediated knockdown. Results: Protein phosphorylations involved in important biological processes were enriched in T47D breast cancer cells in response to adipocyte secretome from obese-like compared with normal conditions. The obesity-associated adipocyte secretome further stimulated cell proliferation and a shift from cell cycle G1-phase to S- and G2/M-phase was observed. Silencing of CAP1 decreased cell proliferation in both T47D and MDA-MB-231 cells, and reduced the obesity-associated secretome-induction of phosphoproteins involved in cell proliferation pathways. Conclusions: These results indicate that the adipocyte secretome and CAP1 are mechanistically important for the proliferation of both ER-positive and ER-negative breast cancer cells, and potential signaling mediators were identified. These studies provide biological insight into how obesity-associated factors could affect breast cancer.
Language	English
Publishing date	2021-03-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2021.628653
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Article ; Online: A multi-scale in silico mouse model for diet-induced insulin resistance

Simonsson, Christian / Lövfors, William / Bergqvist, Niclas / Nyman, Elin / Gennemark, Peter / Stenkula, Karin G. / Cedersund, Gunnar

Biochemical Engineering Journal. 2023 Feb., v. 191 p.108798-

2023

Abstract: Insulin resistance causes compensatory insulin production, which in humans can eventually progress to β-cell failure and type 2 diabetes (T2D). This disease progression involves multi-scale processes, ranging from intracellular signaling to organ and ... ...

Abstract	Insulin resistance causes compensatory insulin production, which in humans can eventually progress to β-cell failure and type 2 diabetes (T2D). This disease progression involves multi-scale processes, ranging from intracellular signaling to organ and whole-body level regulations, on timescales from minutes to years. T2D progression is commonly studied using overfed and genetically modified rodents. Available multi-scale data from rodents is too complex to fully comprehend using traditional analysis, not based on mathematical modelling. To help resolve these issues, we here present an in silico mouse model, featuring 38 ordinary differential equations and 78 parameters. This is the first mathematical model that simultaneously explains (chi-square cost=28.1 <51 =cut-off, p = 0.05) multi-scale mouse insulin resistance data on all three levels – cells, organs, body – ranging from minutes to months. The model predicts new independent multi-scale simulations, on e.g., weight and meal response changes, which are corroborated by our own new experimental data. The thus validated model provides insights and non-trivial predictions regarding complex non-measured processes, such as the relation between insulin resistance and insulin-dependent glucose uptake for adipose tissue. Finally, we add a β-cell failure module to the in silico mouse model to simulate different human-like scenarios of progression towards T2D. In summary, our in silico mouse model is an extendable and interactive knowledge-base for the study of T2D, which could help simulate treatment scenarios in rodents and translate results to the human situation.
Keywords	adipose tissue ; computer simulation ; disease progression ; glucose ; humans ; insulin ; insulin resistance ; mice ; model validation ; noninsulin-dependent diabetes mellitus ; simulation models ; Systems biology ; Mechanistic and multi-level modelling ; Type 2 diabetes
Language	English
Dates of publication	2023-02
Publishing place	Elsevier B.V.
Document type	Article ; Online
Note	Use and reproduction
ZDB-ID	2012139-8
ISSN	1369-703X
ISSN	1369-703X
DOI	10.1016/j.bej.2022.108798
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Effects of tumor-specific CAP1 expression and body constitution on clinical outcomes in patients with early breast cancer.

Bergqvist, Malin / Elebro, Karin / Sandsveden, Malte / Borgquist, Signe / Rosendahl, Ann H

Breast cancer research : BCR

2020 Volume 22, Issue 1, Page(s) 67

Abstract: Background: Obesity induces molecular changes that may favor tumor progression and metastatic spread, leading to impaired survival outcomes in breast cancer. Adenylate cyclase-associated protein 1 (CAP1), an actin regulatory protein and functional ... ...

Abstract	Background: Obesity induces molecular changes that may favor tumor progression and metastatic spread, leading to impaired survival outcomes in breast cancer. Adenylate cyclase-associated protein 1 (CAP1), an actin regulatory protein and functional receptor for the obesity-associated adipokine resistin, has been implicated with inferior cancer prognosis. Here, the objective was to investigate the interplay between body composition and CAP1 tumor expression regarding breast cancer outcome through long-term survival analyses. Methods: Among 718 women with primary invasive breast cancer within the large population-based prospective Malmö Diet and Cancer Study, tumor-specific CAP1 levels were assessed following thorough antibody validation and immunohistochemical staining of tumor tissue microarrays. Antibody specificity and functional application validity were determined by CAP1 gene silencing, qRT-PCR, Western immunoblotting, and cell microarray immunostaining. Kaplan-Meier and multivariable Cox proportional hazard models were used to assess survival differences in terms of breast cancer-specific survival (BCSS) and overall survival (OS) according to body composition and CAP1 expression. Results: Study participants were followed for up to 25 years (median 10.9 years), during which 239 deaths were observed. Patients with low CAP1 tumor expression were older at diagnosis, displayed anthropometric measurements indicating a higher adiposity status (wider waist and hip, higher body mass index and body fat percentage), and were more prone to have unfavorable tumor characteristics (higher histological grade, higher Ki67, and estrogen receptor (ER) negativity). Overall, patients with CAP1-low tumors had impaired BCSS (adjusted hazard ratio: HR Conclusions: Low CAP1 tumor expression was associated with higher body fatness and worse survival outcomes in breast cancer patients with effect modification by adiposity and ER status. CAP1 could be a novel marker for poorer survival outcome in leaner or ER-positive breast cancer patients, highlighting the need for considering body constitution in clinical decision making.
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Biomarkers, Tumor/metabolism ; Body Constitution ; Breast Neoplasms/drug therapy ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Cell Cycle Proteins/genetics ; Cell Cycle Proteins/metabolism ; Cytoskeletal Proteins/genetics ; Cytoskeletal Proteins/metabolism ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Obesity/metabolism ; Obesity/physiopathology ; Prognosis ; Prospective Studies ; Receptor, ErbB-2/metabolism ; Receptors, Estrogen/metabolism ; Receptors, Progesterone/metabolism ; Survival Rate
Chemical Substances	Biomarkers, Tumor ; CAP1 protein, human ; Cell Cycle Proteins ; Cytoskeletal Proteins ; Receptors, Estrogen ; Receptors, Progesterone ; ERBB2 protein, human (EC 2.7.10.1) ; Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2020-06-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2015059-3
ISSN	1465-542X ; 1465-5411
ISSN (online)	1465-542X
ISSN	1465-5411
DOI	10.1186/s13058-020-01307-5
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Article ; Online: Biosynthesis of prostaglandin 15dPGJ

Steinmetz-Späh, Julia / Liu, Jianyang / Singh, Rajkumar / Ekoff, Maria / Boddul, Sanjaykumar / Tang, Xiao / Bergqvist, Filip / Idborg, Helena / Heitel, Pascal / Rönnberg, Elin / Merk, Daniel / Wermeling, Fredrik / Haeggström, Jesper Z / Nilsson, Gunnar / Steinhilber, Dieter / Larsson, Karin / Korotkova, Marina / Jakobsson, Per-Johan

Journal of lipid research

2022 , Page(s) 100310

Abstract: Inhibition of microsomal prostaglandin E synthase-1 (mPGES-1) results in decreased production of pro-inflammatory ... ...

Abstract	Inhibition of microsomal prostaglandin E synthase-1 (mPGES-1) results in decreased production of pro-inflammatory PGE
Language	English
Publishing date	2022-11-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	80154-9
ISSN	1539-7262 ; 0022-2275
ISSN (online)	1539-7262
ISSN	0022-2275
DOI	10.1016/j.jlr.2022.100310
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Article: The role of chloramines in treatment of diabetic foot ulcers: an exploratory multicentre randomised controlled trial.

Bergqvist, Karin / Almhöjd, Ulrica / Herrmann, Irene / Eliasson, Björn

Clinical diabetes and endocrinology

2016 Volume 2, Page(s) 6

Abstract: Background: Chronic foot ulcers in diabetes are serious, costly and frequently difficult to heal. Recent guidelines conclude that new dressings and treatments generally fail to show superiority compared with standard of care. Several mechanisms are ... ...

Abstract	Background: Chronic foot ulcers in diabetes are serious, costly and frequently difficult to heal. Recent guidelines conclude that new dressings and treatments generally fail to show superiority compared with standard of care. Several mechanisms are probably responsible for impaired healing of chronic foot ulcers, including inflammation and infection. Chloramines have presumed antiseptic and antibacterial properties, and have shown to be a useful treatment in odontology. Methods: In an explorative open randomised controlled multi-centre study, we compared chloramine-based treatment with current standard of care for 12 weeks and follow-up for 24 weeks. Seventeen patients in each group, mean age about 70, duration of diabetes > 20 years and foot ulcers about 1.5 years, completed the 12 weeks study. Results: After 5 weeks, the difference between the groups in relative reduction in ulcer area was statistically significant (p=0.016). Absolute change in ulcer area was first statistically significant within the chloraminetreated group after 2 weeks (p=0.026), after 8 weeks in the control group (p=0.0023), with significant difference between groups after 5 weeks (p=0.024). The approximate relative decrease per week was 19.4% (95%CI 12.2, 26.0; p<0.0001) in the chloramine-treated group and 11.7% (95%CI 6.4, 16.7; p<0.0001; between-group difference p=0.083). After 9 weeks 7 patients had healed in the chloraminetreated group, but only one in the control group (p=0.039). There were no statistically significant differences in wound healing at 12 or 24 weeks, and no marked differences in signs of infection, pain, quality of life (EQ-5D), or incidence of adverse events. Conclusions: Chloramine-based treatment seems to be efficacious, particularly in the early phase of the care of infected diabetic foot ulcers. It is safe and easy to use, and could prove to be a valuable addition in the treatment arsenal, providing non-surgical debridement. Future studies will evaluate its role in wound care.
Language	English
Publishing date	2016-03-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2834859-X
ISSN	2055-8260
ISSN	2055-8260
DOI	10.1186/s40842-016-0026-8
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Article ; Online: A systems biology analysis connects insulin receptor signaling with glucose transporter translocation in rat adipocytes.

Bergqvist, Niclas / Nyman, Elin / Cedersund, Gunnar / Stenkula, Karin G

The Journal of biological chemistry

2017 Volume 292, Issue 27, Page(s) 11206–11217

Abstract: Type 2 diabetes is characterized by insulin resistance, which arises from malfunctions in the intracellular insulin signaling network. Knowledge of the insulin signaling network is fragmented, and because of the complexity of this network, little ... ...

Abstract	Type 2 diabetes is characterized by insulin resistance, which arises from malfunctions in the intracellular insulin signaling network. Knowledge of the insulin signaling network is fragmented, and because of the complexity of this network, little consensus has emerged for the structure and importance of the different branches of the network. To help overcome this complexity, systems biology mathematical models have been generated for predicting both the activation of the insulin receptor (IR) and the redistribution of glucose transporter 4 (GLUT4) to the plasma membrane. Although the insulin signal transduction between IR and GLUT4 has been thoroughly studied with modeling and time-resolved data in human cells, comparable analyses in cells from commonly used model organisms such as rats and mice are lacking. Here, we combined existing data and models for rat adipocytes with new data collected for the signaling network between IR and GLUT4 to create a model also for their interconnections. To describe all data (>140 data points), the model needed three distinct pathways from IR to GLUT4: (i) via protein kinase B (PKB) and Akt substrate of 160 kDa (AS160), (ii) via an AS160-independent pathway from PKB, and (iii) via an additional pathway from IR,
MeSH term(s)	Adipocytes/cytology ; Adipocytes/metabolism ; Animals ; GTPase-Activating Proteins/genetics ; GTPase-Activating Proteins/metabolism ; Glucose Transporter Type 4/genetics ; Glucose Transporter Type 4/metabolism ; Protein Transport/physiology ; Proto-Oncogene Proteins c-akt/genetics ; Proto-Oncogene Proteins c-akt/metabolism ; Rats ; Receptor, Insulin/genetics ; Receptor, Insulin/metabolism ; Signal Transduction/physiology ; Systems Biology/methods
Chemical Substances	GTPase-Activating Proteins ; Glucose Transporter Type 4 ; Slc2a4 protein, rat ; TBC1D4 protein, rat ; Receptor, Insulin (EC 2.7.10.1) ; Proto-Oncogene Proteins c-akt (EC 2.7.11.1)
Language	English
Publishing date	2017-05-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2997-x
ISSN	1083-351X ; 0021-9258
ISSN (online)	1083-351X
ISSN	0021-9258
DOI	10.1074/jbc.M117.787515
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Article: Inhibition of mPGES-1 or COX-2 Results in Different Proteomic and Lipidomic Profiles in A549 Lung Cancer Cells.

Bergqvist, Filip / Ossipova, Elena / Idborg, Helena / Raouf, Joan / Checa, Antonio / Englund, Karin / Englund, Petter / Khoonsari, Payam Emami / Kultima, Kim / Wheelock, Craig E / Larsson, Karin / Korotkova, Marina / Jakobsson, Per-Johan

Frontiers in pharmacology

2019 Volume 10, Page(s) 636

Abstract: Pharmacological inhibition of microsomal prostaglandin E synthase (mPGES)-1 for selective reduction in prostaglandin ... ...

Abstract	Pharmacological inhibition of microsomal prostaglandin E synthase (mPGES)-1 for selective reduction in prostaglandin E
Language	English
Publishing date	2019-06-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587355-6
ISSN	1663-9812
ISSN	1663-9812
DOI	10.3389/fphar.2019.00636
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