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  • 1.
    Aceijas, Carmen
    et al.
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium; School of Health Sciences, University of Salford, Salford, Greater Manchester, UK..
    Brall, Caroline
    Department of International Health, School CAPHRI, Maastricht University, The Netherlands.
    Schröder-Bäck, Peter
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium.
    Otok, Robert
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium.
    Maeckelberghe, Els
    Institute for Medical Education, University Medical Center Groningen, The Netherlands.
    Stjernberg, Louise
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium; School of Health Science, Blekinge Institute of Technology.
    Strech, Daniel
    School of Health Science, Blekinge Institute of Technology.
    Tulchinsky, Theodore H
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium; Braun School of Public Health, Hebrew University-Hadassah, Ein Karem, Jerusalem, Israel.
    Teaching Ethics in Schools of Public Health in the European Region: Findings from a Screening Survey2012In: Public Health Reviews, ISSN 0301-0422, E-ISSN 2107-6952, Vol. 34, no 1, p. 1-10Article in journal (Refereed)
    Abstract [en]

    A survey targeting ASPHER members was launched in 2010/11, being a first initiative in improving ethics education in European Schools of Public Health. An 8-items questionnaire collected information on teaching of ethics in public health. A 52% response rate (43/82) revealed that almost all of the schools (95% out of 40 respondents with valid data) included the teaching of ethics in at least one of its programmes. They also expressed the need of support, (e.g.: a model curriculum (n=25), case studies (n=24)), which indicates further work to be met by the ASPHER Working Group on Ethics and Values in Public Health.

  • 2. Aceijas, Carmen
    et al.
    Brall, Caroline
    Schröder-Bäck, Peter
    Otok, Robert
    Maeckelberghe, Els
    Stjernberg, Louise
    Blekinge Institute of Technology, School of Health Science.
    Strech, Daniel
    Tulchinsky, Theodore H
    Teaching Ethics in Schools of Public Health in the European Region: Findings from a Screening Survey2012In: Public Health Reviews, ISSN 0301-0422, E-ISSN 2107-6952, Vol. 34, no 1Article in journal (Refereed)
    Abstract [en]

    A survey targeting ASPHER members was launched in 2010/11, being a first initiative in improving ethics education in European Schools of Public Health. An 8-items questionnaire collected information on teaching of ethics in public health. A 52% response rate (43/82) revealed that almost all of the schools (95% out of 40 respondents with valid data) included the teaching of ethics in at least one of its programmes. They also expressed the need of support, (e.g.: a model curriculum (n=25), case studies (n=24)), which indicates further work to be met by the ASPHER Working Group on Ethics and Values in Public Health.

  • 3.
    Anderberg, Peter
    et al.
    Blekinge Institute of Technology.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institute.
    Stjernberg, Louise
    The Swedish Red Cross University College. Region of Blekinge.
    Bohman, Doris
    Blekinge Institute of Technology.
    Analyzing Nursing Students' Relation to Electronic Health and Technology as Individuals and Students and in Their Future Career (the eNursEd Study): Protocol for a Longitudinal Study2019In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 8, no 10, article id e14643Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students' internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study.

    OBJECTIVE: The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students' knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge?

    METHODS: The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study.

    RESULTS: The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019.

    CONCLUSIONS: This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students' attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students' knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14643.

  • 4.
    Bennet, Louise
    et al.
    Department of Clinical Sciences, University Hospital of Malmö, Lund University; Blekinge Institute of Research and Development.
    Fraenkel, Carl-Johan
    Department of Infectious Diseases, Blekinge County Hospital Karlskrona.
    Garpmo, Ulf
    Department of Clinical Microbiology, Kalmar County Hospital.
    Halling, Anders
    Blekinge Institute of Research and Development, Karlskrona.
    Ingman, Mikael
    Department of Clinical and Experimental Infectious Medicine, University Hospital of Lund.
    Ornstein, Katharina
    Department of Clinical and Experimental Infectious Medicine, University Hospital of Lund.
    Stjernberg, Louise
    Blekinge Institute of Technology, School of Health Science, Karlskrona.
    Berglund, Johan
    Department of Clinical Sciences, University Hospital of Malmö, Lund University; Blekinge Institute of Research and Development, Karlskrona; Blekinge Institute of Technology, School of Health Science, Karlskrona.
    Clinical appearance of erythema migrans caused by Borrelia afzelii and Borrelia garinii: effect of the patient´s sex2006In: Wiener Klinische Wochenschrift, ISSN 0043-5325, E-ISSN 1613-7671, Vol. 118, no 17-18, p. 531-537Article in journal (Refereed)
    Abstract [en]

    Aim: The aim in this survey was to study the clinical characteristics of infections caused by Borrelia genospecies in patients with erythema migrans where Borrelial origin was confirmed by polymerase chain reaction. The aim was also to study factors influencing the clinical appearance of erythema migrans. Methods: The study was conducted in southern Sweden from May 2001 to December 2003 on patients 18 years and older attending with erythema migrans at outpatient clinics. All erythema migrans were verified by polymerase chain reaction, photographed and categorized into “annular” or “non-annular” lesions. A logistic regression model was used to analyze relations between the appearance of the erythema migrans (i.e., annular or non-annular) and factors that influenced its clinical appearances. Results: A total of 118 patients, 54 women (45.8%) and 64 men (54.2%), fulfilled the inclusion criteria. Of these patients, 74% were infected by B. afzelii, 26% by B. garinii ( p < 0.001). A total of 45% (38/85) of the erythema migrans were annular, 46% (39/85) were non-annular and 9.4% (8/85) were atypical. For men infected by B. afzelii the odds ratio of developing non-annular erythema migrans was 0.09 (95% CI: 0.03 - 0.33) in comparison with women with the same infection. Conclusions: In this prospective study of a large series of erythema migrans, where infecting genospecies were confirmed by polymerase chain reaction, the sex of patients infected with B. afzelii had a strong influence on the appearance of the rash. Patients infected by B. garinii more often had non-annular erythema migrans and a more virulent infection with more individuals presenting with fever, raised levels of C-reactive protein and seroreactivity in the convalescence sera.

  • 5. Bennet, Louise
    et al.
    Fraenkel, Carl-Johan
    Garpmo, Ulf
    Halling, Anders
    Ingman, Mikael
    Ornstein, Katharina
    Stjernberg, Louise
    Berglund, Johan
    Clinical appearance of erythema migrans caused by Borrelia afzelii and Borrelia garinii: effect of the patient´s sex2006In: Wiener Klinische Wochenschrift, ISSN 0043-5325, E-ISSN 1613-7671, Vol. 118, no 17-18, p. 531-537Article in journal (Refereed)
    Abstract [en]

    Aim: The aim in this survey was to study the clinical characteristics of infections caused by Borrelia genospecies in patients with erythema migrans where Borrelial origin was confirmed by polymerase chain reaction. The aim was also to study factors influencing the clinical appearance of erythema migrans. Methods: The study was conducted in southern Sweden from May 2001 to December 2003 on patients 18 years and older attending with erythema migrans at outpatient clinics. All erythema migrans were verified by polymerase chain reaction, photographed and categorized into “annular” or “non-annular” lesions. A logistic regression model was used to analyze relations between the appearance of the erythema migrans (i.e., annular or non-annular) and factors that influenced its clinical appearances. Results: A total of 118 patients, 54 women (45.8%) and 64 men (54.2%), fulfilled the inclusion criteria. Of these patients, 74% were infected by B. afzelii, 26% by B. garinii ( p < 0.001). A total of 45% (38/85) of the erythema migrans were annular, 46% (39/85) were non-annular and 9.4% (8/85) were atypical. For men infected by B. afzelii the odds ratio of developing non-annular erythema migrans was 0.09 (95% CI: 0.03 - 0.33) in comparison with women with the same infection. Conclusions: In this prospective study of a large series of erythema migrans, where infecting genospecies were confirmed by polymerase chain reaction, the sex of patients infected with B. afzelii had a strong influence on the appearance of the rash. Patients infected by B. garinii more often had non-annular erythema migrans and a more virulent infection with more individuals presenting with fever, raised levels of C-reactive protein and seroreactivity in the convalescence sera.

  • 6. Bennet, Louise
    et al.
    Fraenkel, Carl-Johan
    Stjernberg, Louise
    Garpmo, Ulf
    Ingman, Mikael
    Ornstein, Katharina
    Berglund, Johan
    Clinical Aspects of Erythema Migrans in Southern Sweden2005Conference paper (Refereed)
    Abstract [en]

    Background: The aim of this study was to describe and categorize the different predominant patterns of PCR confirmed erythema migrans (EM) and to study possible correlations according to the clinical pictures and Borrelia substrains. Methods: Patients over 18 years old, seeking care with tick exposure and an EM were consecutively included during a study period of three years. We evaluated clinical and laboratory findings with regard to Borrelia burgdorferi s.l. spirochetes detected with nested Osp A PCR in skin biopsy specimens. Laboratory and serology testing were done acute, after 6 weeks and after 6 months. The patients were clinically evaluated at the initial visit and repeatedly after 14 days unitl recovery. Results: 118 patients (women=54, men=64) with a positive B. Burgdorferi s.l. PCR analysis were included. In this area totally 73.7% of the EM were caused by B. afzelii and 26.3% by B. garinii (p=0.0001). Leisons caused by B. garinii had a shorter duration from tick bite to the initial visit (p= 0.001) but there were no differences between the sizes of the EM, indicating a faster development of lesions caused by B. garinii. Patients with lesions caused by B. garinii to a greater extent had presented with fever at the initial visit (p=0.02). Also patients with B. garinii lesions to a greater extent had elevated levels of CRP at the initial visit (p=0.006). 45% of the EM were categorized as “annular”, 27% as “homogeneous”, 19% as “central erythemas” and 9% as “atypical”. The lesions caused by B. afzelii were predominately “annular” and the lesions caused by B. gaarinii were predominately “homogeneous”. Conclusions: In this study most EM were caused by B. afzelii. Leisons caused by B. garinii developed faster and the patients to a greater extent presented with fever and elevated levels of CRP at the initial visit. Leisons caused by B. garinii were mostly homogenous and by B. afzelii were mostly annular.

  • 7.
    Bennet, Louise
    et al.
    Department of Clinical Sciences, the University Hospital of Malmö, Lund University; Blekinge Institute of Research and Development.
    Stjernberg, Louise
    Blekinge Institute of Research and Development; School of Health Science, Blekinge Institute of Technology.
    Berglund, Johan
    Blekinge Institute of Research and Development; School of Health Science, Blekinge Institute of Technology.
    Effect of Gender on Clinical and Epidemiologic Features of Lyme Borreliosis2007In: Vector Borne and Zoonotic Diseases, ISSN 1530-3667, E-ISSN 1557-7759, Vol. 7, no 1, p. 34-41Article in journal (Refereed)
    Abstract [en]

    The aim is to highlight the influence of patients’ gender on Lyme borreliosis and especially erythema migrans (EM), focusing on exposure to tick bites, epidemiology, and the clinical picture. All studies were conducted in the county of Blekinge, located in southeastern Sweden. A prospective study was conducted in 235 individuals (women, n=110; men, n=125) engaged in recreational or occupational activities focusing on exposure to tick bites. A retrospective epidemiological study evaluating 123,495 electronic patients´ records (women, n=61,712; men, n=61,783) and a prospective clinical study including 118 patients (women, n=54; men, n=64) 18 years or older seeking care for EM > 5 cm in diameter with genospecies verified by polymerase chain reaction were conducted. Results: Women 40 years or older had a 48% higher risk than men 40 years or older and 42% higher risk than women younger than 40 years of attracting tick bites (0.0188 versus 0.0127 and 0.0188 versus 0.0132 tick bites respectively per hour). Additionally they had a 96% higher risk than men younger than 40 years of attracting tick bites (0.0188 versus 0.0096). The annual incidence rate of EM in women was 506 and in men 423 cases per 100,000 inhabitants (p<0.001). Significant differences in incidence rates occurred in those 40 years or older. Odds ratios for males infected with Borrelia afzelii developing nonannular EM were 0.09 (95% confidence interval [CI] 0.03 to 0.33) in comparison with females infected by Borrelia afzelii. Conclusions: Significant gender differences in the risk of contracting tick bites, incidence rates, and clinical picture of EM have been observed. Exposure to tick bites alone may not explain these observations and further studies need to be done to clarify the biologic, immunologic, and sociological mechanisms causing these differences.

  • 8. Bennet, Louise
    et al.
    Stjernberg, Louise
    Berglund, Johan
    Effect of Gender on Clinical and Epidemiologic Features of Lyme Borreliosis2007In: Vector Borne and Zoonotic Diseases, ISSN 1530-3667, E-ISSN 1557-7759, Vol. 7, no 1, p. 34-41Article in journal (Refereed)
    Abstract [en]

    The aim is to highlight the influence of patients’ gender on Lyme borreliosis and especially erythema migrans (EM), focusing on exposure to tick bites, epidemiology, and the clinical picture. All studies were conducted in the county of Blekinge, located in southeastern Sweden. A prospective study was conducted in 235 individuals (women, n=110; men, n=125) engaged in recreational or occupational activities focusing on exposure to tick bites. A retrospective epidemiological study evaluating 123,495 electronic patients´ records (women, n=61,712; men, n=61,783) and a prospective clinical study including 118 patients (women, n=54; men, n=64) 18 years or older seeking care for EM > 5 cm in diameter with genospecies verified by polymerase chain reaction were conducted. Results: Women 40 years or older had a 48% higher risk than men 40 years or older and 42% higher risk than women younger than 40 years of attracting tick bites (0.0188 versus 0.0127 and 0.0188 versus 0.0132 tick bites respectively per hour). Additionally they had a 96% higher risk than men younger than 40 years of attracting tick bites (0.0188 versus 0.0096). The annual incidence rate of EM in women was 506 and in men 423 cases per 100,000 inhabitants (p<0.001). Significant differences in incidence rates occurred in those 40 years or older. Odds ratios for males infected with Borrelia afzelii developing nonannular EM were 0.09 (95% confidence interval [CI] 0.03 to 0.33) in comparison with females infected by Borrelia afzelii. Conclusions: Significant gender differences in the risk of contracting tick bites, incidence rates, and clinical picture of EM have been observed. Exposure to tick bites alone may not explain these observations and further studies need to be done to clarify the biologic, immunologic, and sociological mechanisms causing these differences.

  • 9.
    Berggren, M
    et al.
    Blekinge Institute of Technology.
    Stjernberg, Louise
    Blekinge Institute of Technology.
    Lindström, F
    Blekinge Institute of Technology.
    Claesson, I
    Blekinge Institute of Technology.
    Audio processing solution for video conference based aerobics2010In: 2010 Digest of Technical Papers, International Conference on Consumer Electronics: (ICCE 2010) : Las Vegas, Nevada, USA : 9-13 January, 2010, Piscataway, N.J.: IEEE conference proceedings, 2010, p. 407-408Conference paper (Refereed)
    Abstract [en]

    In this paper an audio processing solution for video conference based aerobics is presented. The proposed solution leaves the workout music unaltered by separating it from the speech and processing each signal separately. The speech signal processing is also performed at a lower sample rate, which saves computational power. Real time evaluation of the system shows that high quality music as well as a good two-way communication is maintained during the aerobic session.

  • 10. Berggren, Magnus
    et al.
    Stjernberg, Louise
    Lindström, Fredric
    Claesson, Ingvar
    Audio Processing Solution for Video Conference Based Aerobics2010Conference paper (Refereed)
    Abstract [en]

    In this paper an audio processing solution for video conference based aerobics is presented. The proposed solution leaves the workout music unaltered by separating it from the speech and processing each signal separately. The speech signal processing is also performed at a lower sample rate, which saves computational power. Real time evaluation of the system shows that high quality music as well as a good two-way communication is maintained during the aerobic session.

  • 11. Berglund, Johan
    et al.
    Stjernberg, Louise
    Ornstein, Katharina
    Tykesson/Joelsson, Katarina
    Walter, Hallstein
    5-y follow-up study of patients with neuroborreliosis2002In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, no 6, p. 421-425Article in journal (Refereed)
    Abstract [en]

    The objective of this follow-up study was to determine the long-term outcome of strictly classified cases of neuroborreliosis treated with antibiotics. A one-year prospective population-based survey of Lyme borreliosis was conducted in southern Sweden, between 1992 and 1993. A total of 349 identified cases with suspected neuroborreliosis were followed up 5 years later. Medical records were reviewed and all participants filled in a questionnaire. Of those classified with definite neuroborreliosis 114/130 completed the follow-up, of whom 111 had completed the initial antibiotic treatment. Of the 114 patients followed up, 86 (75%) had recovered completely and 70 (61%) had recovered within 6 months. Residual neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy were reported by 28/114. No significant differences between different antibiotic treatments were observed in terms of occurrence of sequelae. To conclude, we found that 25% (95% confidence interval 17-33%) of the patients suffered from residual neurological symptoms 5 years post-treatment. However, the clinical outcome of treated neuroborreliosis is favourable as only 14/114 (12%) of the patients had sequelae that influenced their daily activity post-treatment. Early diagnosis and treatment would seem to be of great importance in order to avoid such sequelae.

  • 12.
    Berglund, Johan
    et al.
    Lund University / Blekinge Institute of Technology / Research Centre for Zoonotic Ecology and Epidemiology.
    Stjernberg, Louise
    Lund University / Blekinge Institute of Technology.
    Ornstein, Katharina
    Lund University.
    Tykesson-Joelsson, Katarina
    Båstad Health Center.
    Walter, Hallstein
    Örkelljunga Health Center.
    5-y follow-up study of patients with neuroborreliosis2002In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, no 6, p. 421-425Article in journal (Refereed)
    Abstract [en]

    The objective of this follow-up study was to determine the long-term outcome of strictly classified cases of neuroborreliosis treated with antibiotics. A one-year prospective population-based survey of Lyme borreliosis was conducted in southern Sweden, between 1992 and 1993. A total of 349 identified cases with suspected neuroborreliosis were followed up 5 years later. Medical records were reviewed and all participants filled in a questionnaire. Of those classified with definite neuroborreliosis 114/130 completed the follow-up, of whom 111 had completed the initial antibiotic treatment. Of the 114 patients followed up, 86 (75%) had recovered completely and 70 (61%) had recovered within 6 months. Residual neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy were reported by 28/114. No significant differences between different antibiotic treatments were observed in terms of occurrence of sequelae. To conclude, we found that 25% (95% confidence interval 17-33%) of the patients suffered from residual neurological symptoms 5 years post-treatment. However, the clinical outcome of treated neuroborreliosis is favourable as only 14/114 (12%) of the patients had sequelae that influenced their daily activity post-treatment. Early diagnosis and treatment would seem to be of great importance in order to avoid such sequelae.

  • 13. Berglund, Johan
    et al.
    Stjernberg, Louise
    Ornstein, Katharina
    Tykesson/Joelsson, Katarina
    Walter, Hallstein
    A 5-years follow-up of patients with neuroborreliosis.2002Conference paper (Refereed)
    Abstract [en]

    The objective of this follow-up study was to determine the long-term outcome in patients treated with antibiotics for strictly classified cases of neuroborreliosis. A one-year prospective population-based survey of Lyme borreliosis was conducted in southern Sweden, 1992-1993. Totally 349 identified cases with suspected neuroborreliosis were registered. Of those, 130 were classified as definitively neuroborreliosis and followed up five years later. Medical records were reviewed and all participants filled in a questionnaire. Totally, 114/130 (88%) completed the follow-up of whom 111/114 (97%) had fulfilled the initial antibiotic treatment. Of these, 86/114 (75%) had recovered completely and 70 (61%) recovered within six months. However 28/114 (25%) suffered from remaining neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy. The longer the duration from the neurological symptoms onset to antibiotic treatment the higher was the rate of sequelae. Of those who were treated within 30 days 5/32 (16%) and of those who were treated after 30 days 16/41 (39%) respectively, reported sequelae. Women suffered significantly more from sequelae compared to men, this difference was not seen among the children. No significant differences between the different antibiotic treatments given and experience of sequelae were seen. To conclude, we found that 25% (95% CI 17% to 33%) of the patients suffered from remaining neurological symptoms five years post treatment. However, the clinical outcome of treated neuroborreliosis is favourable as only 14/114 (12%) of the patients had sequelae that influenced their daily activity post treatment and early diagnosis and treatment seems to be of great importance to possibly avoid also these cases.

  • 14.
    Bjegovic-Mikanovic, Vesna
    et al.
    Belgrade University, Belgrade, Serbia.
    Foldspang, Anders
    Aarhus University, Aarhus, Denmark.
    Jakubowski, Elke
    WHO Regional Office for Europe, Copenhagen, Denmark.
    Müller-Nordhorn, Jaqueline
    Berlin School of Public Health – Charité, Berlin, Germany.
    Otok, Robert
    ASPHER Office, Brussels, Belgium.
    Stjernberg, Louise
    Blekinge Institute of Technology.
    Developing The Publichealth Workforce2015In: Eurohealth, ISSN 1356-1030, Vol. 21, no 1, p. 24-27Article in journal (Other academic)
    Abstract [en]

    The development of the public health workforce is acornerstone in WHO's Action Plan for Strengthening Public HealthServices and Capacities. Public health education shall combineEssential Public Health Operations – surveillance; monitoring; healthprotection and promotion; disease prevention; service delivery;communication and research – with the competences needed within:public health methods; population health and its social, economicand environmental determinants; and man-made systems andinterventions to improve population health. An authorised publichealth profession founded on graduation from comprehensive publichealth education is needed. The capacity and standards of Schoolsof Public Health should accordingly be continuously developed.

  • 15. Bjegovic-Mikanovic, Vesna
    et al.
    Laaser, Ulrich
    Vukovic, Dejana
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Otok, Robert
    Czabanowska, Katarzyna
    The way forward in partnerships for education and training in public health2014Conference paper (Refereed)
    Abstract [en]

    Today schools and departments of public health (SDPHs), as well as public health professionals are searching for interface and synergies between public health science and practice. They are increasingly relying on partnerships in order to achieve common goals. To collect more information on the fragmented institutional landscape the Association of Schools of Public Health in the European Region (ASPHER) organised a survey among its full institutional 81 members with the core objective to assess the exit competences of master of public health graduates according to the new Essential Public Health Operations (EPHO) of WHO-EURO. The survey results indicate that usually European SDPHs are small units, funded from tax money. A total of 130 academic programmes released 3035 graduates per last year All selected competences within each EPHO showed high reliability and high internal consistency (alpha>0.75, p<0.01). SDPH assess their best teaching output to be in the field of health promotion, followed by disease prevention and identification of priority health problems and health hazards in the community, while they see the least success regarding preparedness and planning for public health emergencies. Given the fragmentation of the institutional infrastructure, the harmonization of programme content and thinking is impressive. Even more surprising is the observation that the determination of the desired performance by employers of public health professionals for most EPHOs (6 out of 10) is almost congruent with the estimated output of SDPHs. The main objective of the workshop was to continue with permanent dialogue on innovation and good practice in public health education, continuing training and lifelong learning and to strengthen everlasting collaboration of European schools in efforts to improve public health performance.

  • 16. Czabanowska, Katarzyna
    et al.
    Laaser, Ulrich
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Shaping and Authorising a Public Health Profession2014Conference paper (Refereed)
    Abstract [en]

    The aim of the presentation and the following paper was to stimulate debate on the state of a public health profession in Europe and measures and actions which need to be taken to authorise public health professionals based on their competencies.

  • 17.
    Czabanowska, Katarzyna
    et al.
    Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
    Laaser, Ulrich
    Faculty of Health Sciences, University of Bielefeld, Germany; Centre School of Public Health, Faculty of Medicine, University of Belgrade, Serbia.
    Stjernberg, Louise
    Department of Health, Blekinge Institute of Technology.
    Shaping and Authorising a Public Health Profession2014In: The South Eastern European Journal of Public Health, ISSN 2197-5248, Vol. 2Article in journal (Refereed)
    Abstract [en]

    The aim of this short communication is to stimulate a discussion on the state of a public health profession in Europe and actions which need to be taken to authorise public health professionals based on their competencies. While regulated professions such as medical doctors, nurses, lawyers, and architects can enjoy the benefits of the 2005/ 36/EC Directive amended by 2013/55/EU Directive on the recognition of professional qualifications, public health professionals are left out from these elite. Firstly, we use the profession traits theory as a framework in arguing whether public health can be a legitimate profession in itself, second, we explain who public health professionals are and what usually is required for shaping the public health profession, and thirdly, we attempt to sketch the road to the authorisation or licencing of public health professionals. Finally, we will propose some recommendation.

  • 18. Czabanowska, Katarzyna
    et al.
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Laaser, Ulrich
    Shaping and Authorising a Public Health Profession.2014In: The South Eastern European Journal of Public Health, ISSN 2197-5248, Vol. 31 MayArticle in journal (Refereed)
    Abstract [en]

    The aim of this short communication is to stimulate a discussion on the state of a public health profession in Europe and actions which need to be taken to authorise public health professionals based on their competencies. While regulated professions such as medical doctors, nurses, lawyers, and architects can enjoy the benefits of the 2005/ 36/EC Directive amended by 2013/55/EU Directive on the recognition of professional qualifications, public health professionals are left out from these elite. Firstly, we use the profession traits theory as a framework in arguing whether public health can be a legitimate profession in itself, second, we explain who public health professionals are and what usually is required for shaping the public health profession, and thirdly, we attempt to sketch the road to the authorisation or licencing of public health professionals. Finally, we will propose some recommendation.

  • 19. Jakubowski, Elke
    et al.
    Bjegovic-Mikanovic, Vesna
    Müller-Nordhorn, Jaqueline
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Foldspang, Anders
    Equity across the European region: the European action plan for strengthening Public Health Services and Capacity2014Conference paper (Refereed)
    Abstract [en]

    Plenary: After key note presentation by Elke Jakubowski, the plenary session continued as panel discussion dedicated to innovation and good-practice in public health education based on interface between public health operations, competences and performance.

  • 20.
    Karlsson, E
    et al.
    Karolinska Institute.
    Sjögren Forss, K
    Blekinge Institute of Technology.
    Jorgréus, C
    Blekinge Institute of Technology.
    Stjernberg, Louise
    Blekinge Institute of Technology.
    Exercise and factors associated with active commuting2014In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 24, no S2, p. 312-Article in journal (Other academic)
  • 21. Martin-Moreno, J.M.
    et al.
    Ricciardi, W.
    Bjegovic-Mikanovic, V.
    Maguire, P.
    McKee, M.
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Ebola: an open letter to European governments2014In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 384, no 9950Article in journal (Refereed)
    Abstract [en]

    After months of inaction and neglect from the international community, the Ebola epidemic in west Africa has now spiralled utterly out of control. Today, the virus is a threat not only to the countries where the outbreak has overwhelmed the capacity of national health systems, but also to the entire world. We urge our governments to mobilise all possible resources to assist west Africa in controlling this horrific epidemic. Based on our expertise in public health and emergency response, this open letter describes believes and measures particularly effective to take into actions.

  • 22.
    Otok, R
    et al.
    ASPHER, Brussels, Belgium.
    Stjernberg, Louise
    Blekinge Institute of Technology.
    Undergraduate education in public health in Europe: The positioning of bachelor programmes for public health2014In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 24, no S2, p. 301-Article in journal (Other academic)
    Abstract [en]

    In response to the increased demand from the public health labour market, various bachelor and master programmes have been developed in recent years throughout Europe. As an example, in the European ASPHER survey 18 Schools and Departments of Public Health delivered 977 bachelor degrees per year (2011/12) with a median of 55 per institution. The expectations of – present and potential - employers of professionals, trained in public health, are largely unknown. However, in comparison to the attention paid and the knowledge generated around postgraduate/master education in public health, still relatively little is known about the provision of bachelor degrees. Furthermore, while real efforts have and are made to define professional and academic frameworks, including accreditation schemes for master programmes, the roles, practices and competences for bachelor programmes are somehow blur. This presentation will report on the work of the ASPHER's Working Group on Undergraduate Public Health Education in Europe aiming to promote collaboration initiatives on bachelor programmes across Europe among academic institutions, share best practices and generate knowledge on employability and career progression of public health bachelor graduates. In particular, the results of the survey carried out by ASPHER across over 100 schools of public health in early 2014 will be presented bringing up the current and full picture as regards the undergraduate education in Public Health in Europe.

  • 23.
    Schröder-Bäck, Peter
    et al.
    Department of International Health, School CAPHRI, Maastricht University, The Netherlands; Working Group ‘‘Ethics and Values in PublicHealth’’, Association of Schools of Public Health in the European Region(ASPHER), Brussels, Belgium; Section ‘‘Ethics in Public Health’’, EuropeanPublic Health Association (EUPHA), Utrecht, The Netherlands.
    Stjernberg, Louise
    Working Group ‘‘Ethics and Values in Public Health’’, Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium; School of Health Science, Blekinge Institute of Technology.
    Borg, Ann Marie
    Department of International Health, School CAPHRI, Maastricht University, The Netherlands.
    Values and ethics amidst the economic crisis2013In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no 5, p. 723-724Article in journal (Refereed)
    Abstract [en]

    The current protracted economic crisis is giving rise to the scarcity of public health resources across Europe. In response to budgetary pressures and the Eurozone public debt crisis, decision-makers resort to a short-term solution: the introduction of austerity measures in diverse policy fields. Health and social policy tend to be easy targets in this regard and budget cuts often include a reduction of healthcare expenditure or social welfare benefits. We suggest incorporating discussions from the field of ethics in policy making processes and in the academic debate on austerity. This includes recognising procedural justice as a social value. On the road to economic recovery, governments are compelled to resort to fiscal consolidation and austerity packages but decisions taken to save our European ships in crisis should be anchored in values such as (procedural) justice, equity and solidarity.

  • 24. Schröder-Bäck, Peter
    et al.
    Stjernberg, Louise
    Blekinge Institute of Technology, School of Health Science.
    Borg, Ann Marie
    Values and ethics amidst the economic crisis2013In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no 5Article in journal (Refereed)
    Abstract [en]

    The current protracted economic crisis is giving rise to the scarcity of public health resources across Europe. In response to budgetary pressures and the Eurozone public debt crisis, decision-makers resort to a short-term solution: the introduction of austerity measures in diverse policy fields. Health and social policy tend to be easy targets in this regard and budget cuts often include a reduction of healthcare expenditure or social welfare benefits. We suggest incorporating discussions from the field of ethics in policy making processes and in the academic debate on austerity. This includes recognising procedural justice as a social value. On the road to economic recovery, governments are compelled to resort to fiscal consolidation and austerity packages but decisions taken to save our European ships in crisis should be anchored in values such as (procedural) justice, equity and solidarity.

  • 25.
    Sjögren Forss, Katarina
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Ekvall Hansson, Eva
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Outdoor recreational physical activity and parenthood in a gender perspective: a study from the south eastern part of Sweden2010In: European Journal of Public Health, 2010, Vol. 20Conference paper (Refereed)
    Abstract [en]

    The participation in physical activity (PA) can change during the life time. Parenthood has been found to be a life event that is associated with decreased PA, especially among women, but studies in the field are sparse. The aim of this study was to investigate performance in outdoor recreational PA, and factors influencing participation among parents and non-parents from a gender perspective. Methods This study included 432 individuals, 224 women and 208 men from Karlskrona municipality in the south eastern part of Sweden. Data collection was carried out during the years 2008-09. We measured the self-reported amount of outdoor recreational PA performed during the last year and analysed the dependency of the probability of performing this PA on 25 variables covering individual and socio-economic factors. Results A total of 76% of the women and 65% of the men had performed outdoor recreational PA during the last 12 months before one month prior to pregnancy. Men were affected by a greater number of factors than women. Performing PA indoors and dog or horse ownership emerged as the most important factors associated with the probability of performing outdoor recreational PA. Conclusions Those active in PA were active independent of indoor or outdoor activities, i.e. to be physical active seems to have a special connection to the personality and lifestyle. Becoming a parent is a life-changing event that affects participation in PA. By offering family-oriented PA choices that involve both parfents and children, midwives and health promoters can courage parents to be active and to support each other. The promotion of outdoor recreational PA, which also has restorative effects on well-being, needs to focus on activities which are attractive and affordable for the majority of both women and men.

  • 26.
    Sjögren Forss, Katarina
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Ekvall Hansson, Eva
    Troein, Margareta
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Patterns of physical activity among women and men before and during pregnancy2014In: Public Health, ISSN 0033-3506, Vol. 128, no 9, p. 814-816Article in journal (Refereed)
    Abstract [en]

    Objectives: Follow changing physical activity (PA) patterns among women and men during pregnancy compared to before pregnancy. Study design: Longitudinal study. Methods: The study involved 280 individuals, 145 women and 135 men (who were partners to the women), from the municipality of Karlskrona, Sweden. Data were collected during 2008–2009. We measured the self-reported amount of PA performed outdoors and indoors during the 12 months before pregnancy and throughout the entire pregnancy. Results: Among both women and men, we found changes in PA patterns during pregnancy compared to before pregnancy. Women and men were more physically active before pregnancy than during pregnancy. Similar patterns were found among women and men with regard to the type of activity, with both groups taking more exercise and pursuing aquatic sports, indoor PA and non-strenuous activities before pregnancy and more strolling/walking during pregnancy. Conclusions: Our findings contribute new knowledge about changes in men’s PA patterns from pre-pregnancy to pregnancy that is an unexplored field. Changes in the women’s activity patterns during pregnancy also affect the men. Women seem to adjust their activity patterns during the pregnancy. The changes in activity patterns among the men are more tentative but follow the pattern for the women, which could be explained by the couples sharing their everyday lives. Midwives should consider providing information to men about the importance of being physically active during pregnancy and informing them about their role in encouraging women to be physically active.

  • 27.
    Sjögren Forss, Katarina
    et al.
    Faculty of Medicine, Department of Clinical Sciences in Malmö, General Practice, Lund University; School of Health Science, Blekinge Institute of Technology.
    Ekvall Hansson, Eva
    Faculty of Medicine, Department of Clinical Sciences in Malmö, General Practice, Lund University.
    Troein, Margareta
    Faculty of Medicine, Department of Clinical Sciences in Malmö, General Practice, Lund University.
    Stjernberg, Louise
    School of Health Science, Blekinge Institute of Technology.
    Patterns of physical activity among women and men before and during pregnancy2014In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 128, no 9, p. 814-816Article in journal (Refereed)
    Abstract [en]

    Objectives: Follow changing physical activity (PA) patterns among women and men during pregnancy compared to before pregnancy. Study design: Longitudinal study. Methods: The study involved 280 individuals, 145 women and 135 men (who were partners to the women), from the municipality of Karlskrona, Sweden. Data were collected during 2008–2009. We measured the self-reported amount of PA performed outdoors and indoors during the 12 months before pregnancy and throughout the entire pregnancy. Results: Among both women and men, we found changes in PA patterns during pregnancy compared to before pregnancy. Women and men were more physically active before pregnancy than during pregnancy. Similar patterns were found among women and men with regard to the type of activity, with both groups taking more exercise and pursuing aquatic sports, indoor PA and non-strenuous activities before pregnancy and more strolling/walking during pregnancy. Conclusions: Our findings contribute new knowledge about changes in men’s PA patterns from pre-pregnancy to pregnancy that is an unexplored field. Changes in the women’s activity patterns during pregnancy also affect the men. Women seem to adjust their activity patterns during the pregnancy. The changes in activity patterns among the men are more tentative but follow the pattern for the women, which could be explained by the couples sharing their everyday lives. Midwives should consider providing information to men about the importance of being physically active during pregnancy and informing them about their role in encouraging women to be physically active.

  • 28.
    Sjögren Forss, Katarina
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Differences in physical activity patterns among women and men with and without children2012In: European Journal of Public Health, 2012, Vol. 22, no Supl 22Conference paper (Refereed)
    Abstract [en]

    Background Due to health effects from participating in physical activity (PA) it is from a public health perspective important to study how participation PA may change over a lifetime and how different life events impact on the participation. Although studies in the field are sparse, parenthood has been found to be a life event associated with decreased PA, especially among women. We studied physical activities performed among women and men with and without children. Methods This study includes data for from parents-to-be, 224 women and 208 men, from Karlskrona municipality, situated in the south eastern part of Sweden. Data collection was carried out during 2008–2009. When contacting the antenatal clinics in the municipality all expectant parents were asked by the midwife about participation in the study. Respondents completed a questionnaire about age, socioeconomic status, level of education, previous children, smoking and alcohol habits, Body Mass Index, self estimated health, and participation in different kinds of outdoor and indoor recreational PA. We measured the self-reported amount of outdoor recreational PA undertaken during the last year. Results Both women and men without children performed more outdoor and indoor PA compared to those who had children. Women walked significantly more (p = 0.017) than men irrespective of whether or not they had children. Women with children participated in significantly more gardening (p = 0.009) and winter sports (p = 0.013) than women without children, and women without children participated in significantly more PA indoors (p = 0.001) than women with children. Men with children participated in significantly more gardening (p = 0.001) than men without children, and men without children participated in significantly more PA indoors (p = 0.006). Conclusions Becoming a parent is a life event that affects participation in PA, both concerning duration and the kind of activities performed. To gain deeper understanding and more insight about reasons for these changed patterns of PA as well as the effects on the outcome of the parents health in a short- and long term would be important to follow prospectively.

  • 29.
    Sjögren Forss, Katarina
    et al.
    Department of Health, Blekinge Institute of Technology; Jönkoping University .
    Stjernberg, Louise
    Department of Health, Blekinge Institute of Technology; Jönkoping University .
    Differences in physical activity patterns among women and men with and without children2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no suppl. 2, p. 133-133Article in journal (Refereed)
    Abstract [en]

    Background Due to health effects from participating in physical activity (PA) it is from a public health perspective important to study how participation PA may change over a lifetime and how different life events impact on the participation. Although studies in the field are sparse, parenthood has been found to be a life event associated with decreased PA, especially among women. We studied physical activities performed among women and men with and without children. Methods This study includes data for from parents-to-be, 224 women and 208 men, from Karlskrona municipality, situated in the south eastern part of Sweden. Data collection was carried out during 2008–2009. When contacting the antenatal clinics in the municipality all expectant parents were asked by the midwife about participation in the study. Respondents completed a questionnaire about age, socioeconomic status, level of education, previous children, smoking and alcohol habits, Body Mass Index, self estimated health, and participation in different kinds of outdoor and indoor recreational PA. We measured the self-reported amount of outdoor recreational PA undertaken during the last year. Results Both women and men without children performed more outdoor and indoor PA compared to those who had children. Women walked significantly more (p = 0.017) than men irrespective of whether or not they had children. Women with children participated in significantly more gardening (p = 0.009) and winter sports (p = 0.013) than women without children, and women without children participated in significantly more PA indoors (p = 0.001) than women with children. Men with children participated in significantly more gardening (p = 0.001) than men without children, and men without children participated in significantly more PA indoors (p = 0.006). Conclusions Becoming a parent is a life event that affects participation in PA, both concerning duration and the kind of activities performed. To gain deeper understanding and more insight about reasons for these changed patterns of PA as well as the effects on the outcome of the parents health in a short- and long term would be important to follow prospectively.

  • 30.
    Sjögren Forss, Katarina
    et al.
    Malmö University.
    Stjernberg, Louise
    The Swedish Red Cross University College.
    Physical Activity Patterns Among Women and Men During Pregnancy and 8 Months Postpartum Compared to Pre-pregnancy: A Longitudinal Study2019In: Frontiers In Public Health, ISSN 2296-2565, Vol. 7, article id 294Article in journal (Refereed)
    Abstract [en]

    Background: Realizing the essential prerequisite of regular physical activity (PA) it is essential to have knowledge about how different life change events may influence individual's participation. Many studies have documented that pregnancy and the transition to parenthood are life change events associated with decreased PA among women however, the examination of changes of PA in the male parent during this major life change event has been largely neglected in scientific literature and a significant research gap can be found. In the light of this, this longitudinal study aimed to follow changing PA patterns among women and men during pregnancy and 8 months postpartum compared to pre-pregnancy. Methods: In this study, 123 women and 112 men (partners of the women) that lived in the municipality of Karlskrona, Sweden, were included. Data were collected between 2008 and 2010. The self-reported amount of PA performed outdoors and indoors before pregnancy throughout the entire pregnancy, and 8 months postpartum, were measured. Results: We found similar changes in PA patterns among both women and men during pregnancy and 8 months postpartum when compared to pre-pregnancy. In almost all the activities studied except for walking/strolling, a significant decline was found. Conclusions: Our findings contribute new knowledge about changes in men's PA patterns from pre-pregnancy to pregnancy and postpartum. As couples seem to change activity patterns similarly, it is important to promote family-based PA initiatives and encourage couples to be active together during pregnancy and postpartum.

  • 31.
    Sjögren Forss, Katarina
    et al.
    Malmö Högskola.
    Stjernberg, Louise
    The Swedish Red Cross University College.
    Ekvall Hansson, Eva
    Lunds universitet.
    Osteoarthritis and fear of physical activity-The effect of patient education2017In: Cogent Medicine, ISSN 2331-205X, no 4, p. 1-5, article id 1328820Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the current study was twofold. The first aim was to investigate, from the aspects of gender, age and Body Mass Index, the prevalence of fear among individuals with osteoarthritis that their joints would be harmed if they performed physical activity. The second aim was to determine if a patient education programme might lessen this fear.

    Method: A total of 100 participants were enrolled in a randomised controlled study and completed measures on two occasions over the course of six months. The participants were randomised to either an intervention group or to a control group.

    Results: More than a quarter of the participants feared that their joints would be harmed if they performed physical activity. This was reported by significantly more men than women. Age and Body Mass Index did not seem to have any significant impact on the fear. The patient education programme for osteoarthritis reduced fear significantly (p = 0.010).

    Conclusions: A patient education programme appear to be one way of reducing the fear among individuals with osteoarthritis, that the joints would be harmed by physical activity.

  • 32.
    Sjögren, Katarina
    et al.
    School of Health Science, Blekinge Institute of Technology; Lund University.
    Hansson, Eva Ekvall
    Lund University.
    Stjernberg, Louise
    School of Health Science, Blekinge Institute of Technology.
    Outdoor recreational physical activity and parenthood in a gender perspective-a study from south eastern part of Sweden2010In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 20, no Suppl. 1, p. 182-182Article in journal (Refereed)
  • 33.
    Sjögren, Katarina
    et al.
    Faculty of Medicine, Department of Clinical Sciences in Malmö, General Practice, Lund University; School of Health Science, Blekinge Institute of Technology.
    Hansson, Eva Ekvall
    Faculty of Medicine, Department of Clinical Sciences in Malmö, General Practice, Lund University.
    Stjernberg, Louise
    School of Health Science, Blekinge Institute of Technology.
    Parenthood and factors that influence outdoor recreational physical activity from a gender perspective2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, no 93Article in journal (Refereed)
    Abstract [en]

    Background: A physically active life promotes both physical and mental health, increasing well-being and quality of life. Physical activity (PA) performed outdoors has been found to be particularly good for promoting well-being. However, participation in PA can change during the course of a lifetime. Parenthood has been found to be a life event associated with decreased PA, especially among women, although studies in the field are sparse. The aim of this study was to investigate participation in outdoor recreational PA, and factors influencing participation among parents-to-be, with and without previous children, from a gender perspective. Methods: This study included baseline data from parents-to-be, 224 women and 208 men, from the municipality of Karlskrona in south-east Sweden. Data collection was carried out during 2008-2009. We measured the self-reported amount of outdoor recreational PA undertaken during the last year and analysed the probability of participating in this PA using 25 variables covering individual and socioeconomic factors. Results: Seventy-six per cent of the women and 65% of the men had participated in outdoor recreational PA, varying from several times per month to every day, over a 12-month period prior to one month before pregnancy. Participation in PA indoors and owning a dog or a horse emerged as the most important factors associated with the probability of participation in outdoor recreational PA. Men were affected by a greater number of factors than women, for example men who had a family situation that permitted outdoor recreational PA participated in activities to a greater extent than men without such a family situation. The physical aspect, i.e. improved physical condition, staying power and vigour, also played a significant role with regard to participation among men. Conclusions: Becoming a parent is a life-changing event that affects participation in PA. By offering family-oriented PA choices that involve both parents and children, midwives and health promoters can encourage parents to be active and to support each other. The promotion of outdoor recreational PA, which also has restorative effects on well-being, needs to focus on activities which are attractive and affordable for the majority of both women and men.

  • 34. Sjögren, Katarina
    et al.
    Hansson, Eva Ekvall
    Stjernberg, Louise
    Parenthood and factors that influence outdoor recreational physical activity from a gender perspective2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, no 93Article in journal (Refereed)
    Abstract [en]

    Background: A physically active life promotes both physical and mental health, increasing well-being and quality of life. Physical activity (PA) performed outdoors has been found to be particularly good for promoting well-being. However, participation in PA can change during the course of a lifetime. Parenthood has been found to be a life event associated with decreased PA, especially among women, although studies in the field are sparse. The aim of this study was to investigate participation in outdoor recreational PA, and factors influencing participation among parents-to-be, with and without previous children, from a gender perspective. Methods: This study included baseline data from parents-to-be, 224 women and 208 men, from the municipality of Karlskrona in south-east Sweden. Data collection was carried out during 2008-2009. We measured the self-reported amount of outdoor recreational PA undertaken during the last year and analysed the probability of participating in this PA using 25 variables covering individual and socioeconomic factors. Results: Seventy-six per cent of the women and 65% of the men had participated in outdoor recreational PA, varying from several times per month to every day, over a 12-month period prior to one month before pregnancy. Participation in PA indoors and owning a dog or a horse emerged as the most important factors associated with the probability of participation in outdoor recreational PA. Men were affected by a greater number of factors than women, for example men who had a family situation that permitted outdoor recreational PA participated in activities to a greater extent than men without such a family situation. The physical aspect, i.e. improved physical condition, staying power and vigour, also played a significant role with regard to participation among men. Conclusions: Becoming a parent is a life-changing event that affects participation in PA. By offering family-oriented PA choices that involve both parents and children, midwives and health promoters can encourage parents to be active and to support each other. The promotion of outdoor recreational PA, which also has restorative effects on well-being, needs to focus on activities which are attractive and affordable for the majority of both women and men.

  • 35.
    Sjögren, Katarina
    et al.
    Faculty of Medicine, Department of Clinical Sciences in Malmö, General Practice Lund University; School of Health Science, Blekinge Institute of Technology.
    Stjernberg, Louise
    School of Health Science, Blekinge Institute of Technology.
    A gender perspective on factors that influence outdoor recreational physical activity among the elderly2010In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 10, article id 34Article in journal (Refereed)
    Abstract [en]

    Background Physical activity (PA) is part of a healthy lifestyle and prevents many chronic health problems, in addition to promoting mental health. PA performed outdoors has been found particularly good for promoting one's well-being. The aim of this study was to investigate the extent to which outdoor recreational PA was carried out during 1 year, and the factors influencing such activities from a gender perspective among persons ≥ 60 years of age. Methods This study included 999 individuals 60-96 years of age living in the south eastern part of Sweden. Data collection was carried out during the years of 2001-2003. We measured the amount of regular light and/or intense outdoor recreational PA performed during the last year and determined the probability of performing PA as a function of 10 variables covering individual and socioeconomic factors. Results Our results suggest that being independent physically and healthy enough to manage one's personal hygiene and having access to areas for country walks were the most important factors associated with the probability of engaging in outdoor recreational PA for both men and women. Despite the level of performance being almost equal for the sexes as two-thirds of both had performed outdoor recreational PA during the preceding year more factors, i.e., living alone, being unable to cover an unexpected cost, fear of being violated, and fear of falling, were associated with the possibilities of engaging in outdoor recreational PA among women. Also increasing age seems to affect activities among women negatively to a higher extent than men. Conclusion Men and women seem to have different opportunities and needs with respect to performing PA. These considerations do not seem to be sufficiently taken into account today and improvements could be made concerning e.g., health-promoting activities suggested to the elderly by healthcare personnel and spatial planning within society. Promoting outdoor recreational PA that has restorative effects on well-being needs to focus on activities which are attractive and affordable for the majority of both men and women.

  • 36. Sjögren, Katarina
    et al.
    Stjernberg, Louise
    A gender perspective on factors that influence outdoor recreational physical activity among the elderly2010In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 10:34Article in journal (Refereed)
    Abstract [en]

    Background Physical activity (PA) is part of a healthy lifestyle and prevents many chronic health problems, in addition to promoting mental health. PA performed outdoors has been found particularly good for promoting one's well-being. The aim of this study was to investigate the extent to which outdoor recreational PA was carried out during 1 year, and the factors influencing such activities from a gender perspective among persons ≥ 60 years of age. Methods This study included 999 individuals 60-96 years of age living in the south eastern part of Sweden. Data collection was carried out during the years of 2001-2003. We measured the amount of regular light and/or intense outdoor recreational PA performed during the last year and determined the probability of performing PA as a function of 10 variables covering individual and socioeconomic factors. Results Our results suggest that being independent physically and healthy enough to manage one's personal hygiene and having access to areas for country walks were the most important factors associated with the probability of engaging in outdoor recreational PA for both men and women. Despite the level of performance being almost equal for the sexes as two-thirds of both had performed outdoor recreational PA during the preceding year more factors, i.e., living alone, being unable to cover an unexpected cost, fear of being violated, and fear of falling, were associated with the possibilities of engaging in outdoor recreational PA among women. Also increasing age seems to affect activities among women negatively to a higher extent than men. Conclusion Men and women seem to have different opportunities and needs with respect to performing PA. These considerations do not seem to be sufficiently taken into account today and improvements could be made concerning e.g., health-promoting activities suggested to the elderly by healthcare personnel and spatial planning within society. Promoting outdoor recreational PA that has restorative effects on well-being needs to focus on activities which are attractive and affordable for the majority of both men and women.

  • 37. Sjögren, Katarina
    et al.
    Stjernberg, Louise
    Factors influencing outdoor recreation physical activity among elderly in the south eastern part of Sweden2009Conference paper (Refereed)
    Abstract [en]

    Background The elderly population in the world are increasing. Health promoting activities aiming at a long healthy life among the elderly is a central public health issue. Regular outdoor recreation physical activity is associated with physical and mental health benefits, also if starting late in life. We studied outdoor recreation physical activities and factors influencing such activities, among persons aged >60 years. Methods The study was performed within the longitudinal Swedish National Study on Aging and Care. Baseline data were collected between 2001 and 2003. Respondents completed a questionnaire about sex, age, outdoor physical activities during the last year, access to recreational areas, socioeconomic status, social network, anxiety of falling or being assaulted outdoors and capability to have a shower by themselves. A binary logistic regression was used to determine differences in variables constituting on factors enhancing the probability on performing outdoor recreation physical activities. Results In total, 999/1402 (71 %) respondents aged 60-96 years answered all the questions in the questionnaire. Of those, 659/999 (66 %) had performed outdoor recreation physical activities several times/week during the last year. The probability on performing activities was significantly higher among women when compared to men. The activities decreased significantly when becoming >80 years, especially among women. Also, being a woman with poor economy decreased the probability significantly compared to men in the same situation. Other factors which significantly increased the performance were; access to a recreational area, if respondents were not anxious of falling and if respondents were capable to have a shower by themselves. Conclusions To facilitate outdoor physical activities among elderly, extra support seems important for men <80 years and for both sexes when becoming >80 years. Also, those anxious of falling and women with a poor economy need support. Access to recreational areas is of importance.

  • 38. Stjernberg, Louise
    A newly detected TBE focus in the south-eastern part of Sweden: a follow-up study of TBEV seroprevalence, 1991 and 2002.2007Conference paper (Refereed)
    Abstract [en]

    Background. In 2002, 2 cases of tick-borne encephalitis were diagnosed among inhabitants living in a tick endemic area on the island of Aspö in south-eastern Sweden. During the previous 25 years, only 2 additional cases had been diagnosed in that region of Sweden. To study presence and evolution of seroprevalence of antibodies to the tick-borne encephalitis virus we carried out a follow-up study, comparing inhabitants´ immunoglobulin G antibody levels against the virus in blood samples drawn in 1991 and 2002. Method. The island of Aspö is located in the south-eastern archipelago by the Baltic Sea in the county of Blekinge, Sweden. Due to the confirmed cases of tick-borne encephalitis, permanent and part-time residents were offered tick-borne encephalitis vaccination in the autumn of 2002. Blood samples were collected and analyzed by the two-step enzyme-linked immunosorbent assay to detect immunoglobulin G antibodies against tick-borne encephalitis virus. Also, questionnaires including questions about sex, age, earlier history of and previous vaccination against tick-borne encephalitis, residency on Aspö, history of observed tick-bites and earlier history of Lyme borreliosis and human granulocytic erhlichiosis, was filled in. All those individuals who had participated in a study on LB performed in 1991, and where available blood samples made it possible to compare tick-borne encephalitis immunoglobulin G seroprevalence, were included in the follow-up. Results. A significant increase in immunoglobulin G levels was seen during the follow-up with 24 (12.0%) of 200 blood samples being seropositive in 2002 versus 7 (3,5%) of 200 blood samples in 1991. However, only five participants converted from seronegative level during the 11 y follow-up and one of these participants had been vaccinated against tick-borne encephalitis during the observation period. In only four of all positive sera from 2002 and in no sera from 1991, were neutralizing antibodies against tick-borne encephalitis virus demonstrated. Compared with women, significantly more men were seropositive. In comparison with other age groups the greatest increase was seen in the age group 20 to 29 years. However, most seropostive levels were seen among those >50 years. Conclusion. Although we found seropositive blood samples in this area already in 1991, the existence of tick-borne encephalitis virus at that time is doubtful since no neutralizing antibodies against tick-borne encephalitis virus were demonstrated. During the 11 years follow-up an obvious increase of tick-borne encephalitis immunoglobulin G seropositive levels in humans was seen. Recommending preventing measures, including vaccination against tick-borne encephalitis is of importance for people regularly staying in this endemic area.

  • 39. Stjernberg, Louise
    Epidemiological aspects of tick borne diseases with focus on risk and prevention2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The incidence and variety of diseases associated with ticks have increased world-wide and ticks are currently considered to be second only to mosquitoes as vectors of human infectious diseases in the world. In the northern hemisphere, Ixodes ricinus, the most common tick, transmits diseases caused by several infectious pathogens, including different types of bacteria, virus and protozoa. In Sweden, Lyme borreliosis, tick-borne encephalitis and erlichiosis are established, and more than 10.000 people are infected each year. This thesis focuses on aspects of risks associated with tick bites, the risk of contracting tick borne diseases including long-term outcome, and preventive measures and behaviour among people living in tick endemic areas. The first study describes the long-term outcome in patients treated with antibiotics due to neuroborreliosis. At the follow up, 75% of the patients had recovered completely and 25% (95% confidence interval; 17% - 33%) suffered from residual neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy. In order to avoid sequelae, early diagnosis and treatment are of great importance. The second study investigated the exposure and contraction of tick-bites with the risk of developing Lyme borreliosis from these tick-bites. Results showed that among people well aware of tick-borne diseases and who inspect their skin daily for ticks, the monthly rate of being tick bitten was 0.04 (95% confidence interval; 0.02-0.06) per 10 hours spent out of doors. Within six months, 3% had contracted Lyme borreliosis, i.e. the risk of developing this disease was 0.5% (95% confidence interval; 0.44-0.56) per tick-bite. The third (experimental) study was aimed at determining whether light-coloured or dark-coloured clothing had the least attractive effect on Ixodes ricinus. The overall found ticks between the both colours differed significantly, with 62% (95% confidence interval; 59% - 65%) of the ticks found on light-coloured clothing. Dark-coloured clothing seems to attract fewer ticks. The fourth study describes tick preventive measures, and their predictors, taken among highly exposed people. In total, 69% of the participants regularly took preventive measures, personally and/or in the environment. When analysing gender and preventive measure solely, women took more preventive measures compared to men. When analysing all risk variables together, spending less time in tick endemic area and being tick bitten the same tick season significantly increased the probability of taking any preventive measures. After being tick bitten, men increased their performance of preventive measures more than women.

  • 40.
    Stjernberg, Louise
    Lund University.
    Epidemiological aspects of tick borne diseases with focus on risk and prevention2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The incidence and variety of diseases associated with ticks have increased world-wide and ticks are currently considered to be second only to mosquitoes as vectors of human infectious diseases in the world. In the northern hemisphere, Ixodes ricinus, the most common tick, transmits diseases caused by several infectious pathogens, including different types of bacteria, virus and protozoa. In Sweden, Lyme borreliosis, tick-borne encephalitis and erlichiosis are established, and more than 10.000 people are infected each year. This thesis focuses on aspects of risks associated with tick bites, the risk of contracting tick borne diseases including long-term outcome, and preventive measures and behaviour among people living in tick endemic areas. The first study describes the long-term outcome in patients treated with antibiotics due to neuroborreliosis. At the follow up, 75% of the patients had recovered completely and 25% (95% confidence interval; 17% - 33%) suffered from residual neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy. In order to avoid sequelae, early diagnosis and treatment are of great importance. The second study investigated the exposure and contraction of tick-bites with the risk of developing Lyme borreliosis from these tick-bites. Results showed that among people well aware of tick-borne diseases and who inspect their skin daily for ticks, the monthly rate of being tick bitten was 0.04 (95% confidence interval; 0.02-0.06) per 10 hours spent out of doors. Within six months, 3% had contracted Lyme borreliosis, i.e. the risk of developing this disease was 0.5% (95% confidence interval; 0.44-0.56) per tick-bite. The third (experimental) study was aimed at determining whether light-coloured or dark-coloured clothing had the least attractive effect on Ixodes ricinus. The overall found ticks between the both colours differed significantly, with 62% (95% confidence interval; 59% - 65%) of the ticks found on light-coloured clothing. Dark-coloured clothing seems to attract fewer ticks. The fourth study describes tick preventive measures, and their predictors, taken among highly exposed people. In total, 69% of the participants regularly took preventive measures, personally and/or in the environment. When analysing gender and preventive measure solely, women took more preventive measures compared to men. When analysing all risk variables together, spending less time in tick endemic area and being tick bitten the same tick season significantly increased the probability of taking any preventive measures. After being tick bitten, men increased their performance of preventive measures more than women.

  • 41. Stjernberg, Louise
    Future challenges and current innovations in applied health technology and public health2010Other (Other (popular science, discussion, etc.))
    Abstract [en]

    One of the challenges in research and education is to be innovative in helping society to develop sustainable applied technology, i.e. applied health technology that keeps pace with the need in society, both nationally and internationally for technology development in health promotion and prevention as well as in healthcare and social services. The School of Health Science at Blekinge Institute of Technology (BTH) has the stated aim of moving in that direction as new areas of research and education are formulated. The School has defined Health and Technology and Sustainable Active Ageing as the two main focal areas for research and education. To emphasise the importance of bringing research and education into line with each another, a “Bachelor programme in Public Health Science aligned to Community Planning”, was established and started in 2009.

  • 42. Stjernberg, Louise
    The risk of acquiring tick-bites in south-eastern Sweden2002Conference paper (Refereed)
    Abstract [en]

    The aim of the survey was to study the risk of tick-bites when exposed during daily activities in a tick endemic region in the south-eastern part of Sweden, between May 2000-March 2001. All the participants were well aware of ticks and tick-borne diseases and every day from May until September inspected their skin and filled in a diary sheet, registering e.g. visited geographical places, time out-of-doors and observed tick-bites. In addition, questionnaires were filled in when entering and at the end of the study. They included questions, e.g. about earlier history of tick-bites or previous undergone tick-borne diseases and out-of-door activities during the studied period. Of the participants, 197/235 (84%) were bitten during the observation period of whom 47/235 (20%) were bitten at = 10 occasions. The incidence was 0.04 (95% CI 0.02-0.06) tick-bitten participants per 10 hours spent out-of-doors. Totally, the participants registered 1767 tick-bites, i.e. an incidence of 0.14 (95% CI 0.10-0.18) tick-bites per 10 hours spent out-of-doors. There were no significant differences of the distribution of tick-bitten participants between children and adults (p=0.19), nor when taking in consider gender (p=0.09). Within six months after the registration period, 8/235 (3%) had been treated for a physician diagnosed Lyme borreliosis (LB). To conclude, we found a risk of 4% to be tick-bitten per 10 hours spent out-of-doors in this region. Although the participants consciousness we found a population at high risk to be tick-bitten. The risk to acquire LB was 1/221 tick-bites. If the participants not have performed such a meticulously daily tick inspection the risk of developing LB would probably increased. However, our study further strengthens the opinion to not recommend routinely prophylactic treatment for observed tick-bites.

  • 43.
    Stjernberg, Louise
    et al.
    School of Health Science, Blekinge Institute of Technology; Department of Community Medicine, Lund University.
    Berglund, Johan
    School of Health Science, Blekinge Institute of Technology; Department of Community Medicine, Lund University.
    Detecting ticks on light versus dark clothing2005In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 37, no 5, p. 361-364Article in journal (Refereed)
    Abstract [en]

    It is common belief that ticks are more visible and easier to detect on light clothing in comparison with dark clothing. We studied which of the clothing, light or dark, had the least attractive effect on Ixodes ricinus, thus minimizing exposure and thereby in theory help to prevent tick borne diseases in humans. Ten participants, exposed by walking in tick endemic areas, wore alternately light and dark clothing before every new exposure. Nymphal and adult ticks on the clothing were collected and counted. Totally, 886 nymphal ticks were collected. The overall mean in found ticks between the both groups differed significantly, with 20.8 more ticks per person on light clothing. All participants had more ticks on light clothing in all periods of exposure. Dark clothing seems to attract fewer ticks.

  • 44. Stjernberg, Louise
    et al.
    Berglund, Johan
    Detecting ticks on light versus dark clothing2005In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 37, no 5, p. 361-364Article in journal (Refereed)
    Abstract [en]

    It is common belief that ticks are more visible and easier to detect on light clothing in comparison with dark clothing. We studied which of the clothing, light or dark, had the least attractive effect on Ixodes ricinus, thus minimizing exposure and thereby in theory help to prevent tick borne diseases in humans. Ten participants, exposed by walking in tick endemic areas, wore alternately light and dark clothing before every new exposure. Nymphal and adult ticks on the clothing were collected and counted. Totally, 886 nymphal ticks were collected. The overall mean in found ticks between the both groups differed significantly, with 20.8 more ticks per person on light clothing. All participants had more ticks on light clothing in all periods of exposure. Dark clothing seems to attract fewer ticks.

  • 45.
    Stjernberg, Louise
    et al.
    Lund, University.
    Berglund, Johan
    Garlic as a tick repellent2001In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 285, no 1, p. 41-42Article in journal (Refereed)
    Abstract [en]

    Comments and reply on; Stjernberg L, Berglund J. Garlic as an insect repellent

  • 46. Stjernberg, Louise
    et al.
    Berglund, Johan
    Garlic as a tick repellent2001In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 285, no 1, p. 41-42Article in journal (Refereed)
    Abstract [en]

    Comments and reply on; Stjernberg L, Berglund J. Garlic as an insect repellent

  • 47.
    Stjernberg, Louise
    et al.
    Lund University.
    Berglund, Johan
    Garlic as an insect repellent2000In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 284, no 7, p. 831-831Article in journal (Refereed)
    Abstract [en]

    Objectives: To study if Swedish marine conscripts are a population of high risk to tick-bites and tick-borne diseases and if tick-bites could be prevented by consumption of garlic. Design: Prospective, randomised double blind intervention trial. Subjects: 100 individuals from south-eastern Sweden in military service during 1998. Interventions: The survey participants consumed 1200 mg Allium sativum/placebo for eight weeks, had a wash-out period then changed to placebo/Allium sativum consumption for another ten weeks. All participants had uniform clothes, the same diet, participated in similar activities, stayed equal time in tick-endemic nature etceteras. Main outcome measures: Tick-bites were registered in a diary-sheet after daily inspection of the skin. Results: Totally 286 tick-bites were registered by the participants. On average the participants registered 0.2 tick-bites per week during military service compared to 0.03 tick-bites during leave. Results shows significant reduction in tick-bites when consuming garlic compared to placebo (p<0.05). Furthermore, during placebo consumption, a greater number of the participants were bitten by ticks (incidence per 10 weeks = garlic, intention to treat 0.5, per protocol 0.6, placebo, intention to treat 0.5, per protocol 0.7). Swedish marine conscripts are at high risk of tick bites during military service. Preventive measures, including vaccinations against tick-transmitted diseases, should be considered. However, our results suggest that garlic may be considered as a tick repellent for individuals and populations at high risk for tick bite, rather than other agents that might have more adverse effects.

  • 48. Stjernberg, Louise
    et al.
    Berglund, Johan
    Garlic as an insect repellent2000In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 284, no 7, p. 831-Article in journal (Refereed)
    Abstract [en]

    Objectives: To study if Swedish marine conscripts are a population of high risk to tick-bites and tick-borne diseases and if tick-bites could be prevented by consumption of garlic. Design: Prospective, randomised double blind intervention trial. Subjects: 100 individuals from south-eastern Sweden in military service during 1998. Interventions: The survey participants consumed 1200 mg Allium sativum/placebo for eight weeks, had a wash-out period then changed to placebo/Allium sativum consumption for another ten weeks. All participants had uniform clothes, the same diet, participated in similar activities, stayed equal time in tick-endemic nature etceteras. Main outcome measures: Tick-bites were registered in a diary-sheet after daily inspection of the skin. Results: Totally 286 tick-bites were registered by the participants. On average the participants registered 0.2 tick-bites per week during military service compared to 0.03 tick-bites during leave. Results shows significant reduction in tick-bites when consuming garlic compared to placebo (p<0.05). Furthermore, during placebo consumption, a greater number of the participants were bitten by ticks (incidence per 10 weeks = garlic, intention to treat 0.5, per protocol 0.6, placebo, intention to treat 0.5, per protocol 0.7). Swedish marine conscripts are at high risk of tick bites during military service. Preventive measures, including vaccinations against tick-transmitted diseases, should be considered. However, our results suggest that garlic may be considered as a tick repellent for individuals and populations at high risk for tick bite, rather than other agents that might have more adverse effects.

  • 49. Stjernberg, Louise
    et al.
    Berglund, Johan
    Risk of acquiring tick bites in south-eastern Sweden2002In: Scandinavian journal of infectious diseases , ISSN 0035-5548, Vol. 34, no 11, p. 840-844Article in journal (Refereed)
    Abstract [en]

    The incidence and the temporal pattern of tick bites were studied in a population frequently out-of-doors in a tick endemic area in south-eastern Sweden between May 2000-March 2001. The participants, who were well aware of tick-borne diseases, inspected their skin daily from May until September and completed a diary sheet, registering visited geographical places, time out-of-doors, observed tick-bites, etc. The participants were also given questionnaires in both the initial and final stages of the study, asking questions about their earlier history of tick-bites, previous tick-borne diseases and out-of-door activities. The incidence was 0.04 (95% confidence interval 0.02-0.06) tick-bitten participants/10 h spent out-of-doors. In total, the participants registered 1767 tick bites, i.e. an incidence of 0.14 (95% CI 0.10-0.18) tick-bites/10 h spent out-of-doors. Within 6 months after the registration period, 8/235 (3%) had been treated for physician-diagnosed Lyme borreliosis. In conclusion, this study found a 4% risk to be tick-bitten per 10 h spent out-of-doors. The risk of contracting Lyme borreliosis was 1/221 tick bites (0.5%, 95% CI 0.44-0.56). Thus, our results indicate a low risk of acquiring Lyme borreliosis when using daily tick checks and we underline the opinion of not recommending routine prophylactic treatment for observed tick-bites.

  • 50.
    Stjernberg, Louise
    et al.
    Department of Community Medicine, Lund University.
    Berglund, Johan
    Risk of acquiring tick bites in south-eastern Sweden2002In: Scandinavian journal of infectious diseases, ISSN 0036-5548, Vol. 34, no 11, p. 840-844Article in journal (Refereed)
    Abstract [en]

    The incidence and the temporal pattern of tick bites were studied in a population frequently out-of-doors in a tick endemic area in south-eastern Sweden between May 2000-March 2001. The participants, who were well aware of tick-borne diseases, inspected their skin daily from May until September and completed a diary sheet, registering visited geographical places, time out-of-doors, observed tick-bites, etc. The participants were also given questionnaires in both the initial and final stages of the study, asking questions about their earlier history of tick-bites, previous tick-borne diseases and out-of-door activities. The incidence was 0.04 (95% confidence interval 0.02-0.06) tick-bitten participants/10 h spent out-of-doors. In total, the participants registered 1767 tick bites, i.e. an incidence of 0.14 (95% CI 0.10-0.18) tick-bites/10 h spent out-of-doors. Within 6 months after the registration period, 8/235 (3%) had been treated for physician-diagnosed Lyme borreliosis. In conclusion, this study found a 4% risk to be tick-bitten per 10 h spent out-of-doors. The risk of contracting Lyme borreliosis was 1/221 tick bites (0.5%, 95% CI 0.44-0.56). Thus, our results indicate a low risk of acquiring Lyme borreliosis when using daily tick checks and we underline the opinion of not recommending routine prophylactic treatment for observed tick-bites.

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