ObjectivesThis study investigated whether the early outreach programme following the Utøya massacre reached out to the parents of the young survivors. Additionally, we explored whether specialised mental healthcare services were provided to parents presenting elevated levels of PTSD and depression reactions.DesignCross-sectional survey, face-to-face interviews and questionnaires.SettingNorway, aftermath of the Utøya massacre, 4–7 months postdisaster.BackgroundFollowing the Utøya massacre, proactive early outreach programmes were launched in all municipalities that were affected, facilitating access to appropriate healthcare services.ParticipantsA total of 453 parents of the Utøya survivors aged 13–33 years took part. Overall, 59.8% of the survivors were represented by one or more parent in our study.Main outcome measuresEngagement with the proactive early outreach programme (psychosocial crisis teams and contact persons in the municipalities), utilisation of healthcare services (general practitioner and specialised mental healthcare services) and mental distress (UCLA PTSD-RI and HSCL-8).ResultsA majority of the participants reported contact with the proactive early outreach programme (crisis team, 73.9%; and contact person, 73.0%). Failure of outreach to parents was significantly associated with non-intact family structure (crisis team: OR 1.69, 95% CI 1.05 to 2.72, p=0.032) and non-Norwegian origin (crisis team: OR 2.39, 95% CI 1.14 to 4.98, p=0.021). Gender of the parent was not significantly associated with failure of the outreach programme (p≥0.075). Provision of specialised mental healthcare services was significantly associated with higher levels of PTSD (OR 2.08, 95% CI 1.55 to 2.79, p<0.001) and depression (OR 2.42, 95% CI 1.71 to 3.43, p<0.001) and not with the sociodemography (p≥0.122).ConclusionsProactive early outreach strategies may be helpful in identifying healthcare needs and facilitating access to the required services in a population struck by disaster. Our findings prompt increased attention to the complexity of family structures in reaching out universally to modern families following a disaster.
ObjectivesTo assess changes in parents’ short-term and long-term primary and specialised healthcare consumption following a terrorist attack threatening the lives of their children.DesignRegistry-based study comparing parental healthcare service consumption in the 3 years before and the 3 years after a terrorist attack.SettingThe aftermath of the Utøya terrorist attack. The regular, publicly funded, universal healthcare system in Norway. Parents learning of a terrorist attack on their adolescent and young adult child ren.ParticipantsMothers (n=226) and fathers (n=141) of a total of 263 survivors of the Utøya terrorist attack (54.6% of all survivors 13–33 years, n=482).Main outcome measuresWe report primary and specialised somatic and mental healthcare service consumption in the early (0–6 months) and delayed (>6–36 months) aftermath of the attack, both in terms of frequency of services consumed (assessed by age-adjusted negative binomial hurdle regression) and proportions of mothers and fathers provided for (mean semiannual values). The predisaster and postdisaster rates were compared by rate ratios (RRs), and 95% CI were generated through bootstrap replications.ResultsFrequency of primary healthcare service consumption increased significantly in both mothers and fathers in the early aftermath of the attack (mothers: RR=1.97, 95% CI 1.76 to 2.23; fathers: RR=1.73, 95% CI 1.36 to 2.29) and remained significantly elevated throughout the delayed aftermath. In the specialised mental healthcare services, a significant increase in the frequency of service consumption was observed in mothers only (early: RR=7.00, 95% CI 3.86 to 19.02; delayed: RR=3.20, 95% CI 1.49 to 9.49). In specialised somatic healthcare, no significant change was found.ConclusionFollowing terrorist attacks, healthcare providers must prepare for increased healthcare needs in survivors and their close family members, such as parents. Needs may present shortly after the attack and require long-term follow-up.
Background: Life threat to children may induce severe posttraumatic stress reactions (PTSR) in parents. Troubled mothers and fathers may turn to their general practitioner (GP) for help. Objective: This study investigated frequency of GP visits in mothers and fathers of adolescent and young adult terrorism survivors related to their own PTSR and PTSR in their surviving children. Method: Self-reported early PTSR (4–5 months post-disaster) in 196 mothers, 113 fathers and 240 survivors of the 2011 Utøya terrorist attack were linked to parents’ three years pre- and post-disaster primary healthcare data from a national reimbursement claims database. Frequency of parents’ GP visits was regressed on parent and child PTSR, first separately, then in combination, and finally by including an interaction. Negative binominal regressions, adjusted for parents’ pre-disaster GP visits and socio-demography, were performed separately for mothers and fathers and for the early (<6 months) and delayed (6–36 months) aftermath of the terrorist attack. Results: Parents’ early PTSR were significantly associated with higher early frequency of GP visits in mothers (rate ratio, RR = 1.31, 95%CI 1.09–1.56) and fathers (RR = 1.40, 95%CI 1.03–1.91). In the delayed aftermath, early PTSR were significantly associated with higher frequency of GP visits in mothers only (RR = 1.21, 95%CI 1.04–1.41). Early PTSR in children were not significantly associated with an overall increase in GP visits. On the contrary, in mothers, child PTSR predicted significant decrease in GP visits the delayed aftermath (RR = 0.83, 95%CI 0.71–0.97). Conclusions: Our study suggests that GPs may play an important role in identifying and providing for parents’ post-disaster healthcare needs. GPs need to be aware that distressed individuals are likely to approach them following disasters and must prepare for both short- and long-term healthcare needs.
Sjøfolk kommer hverandre til unnsetning. Norge kan ikke lenger lukke øynene for nøden i Middelhavet.-Én drukningsulykke er én for mye, sa Erna Solberg, da hun i sommer fikk presentert Redningsselskapets tall over drukningsulykker i Norge (1). Solberg ba «båtfolket» ta ansvar. Det er le å vaere enig i en nullvisjon. Ingen fortjener å drukne.Sommeren 2015 arbeidet jeg som skipslege i Middelhavet, som del av Norges bidrag for å avhjelpe den humanitaere situasjonen i havområdene nord for Libya (2). Inntrykkene derfra var sterke. Jeg så skrekkslagne mennesker overla til seg selv i åpent hav, tomme for mat og drivstoff og prisgi vaer og vind. Jeg så forkomne mennesker stuvet sammen, te i te i gummibåter. Jeg så mennesker nedlåst under dekk, tomme for luft. Jeg så brudd, åpne sår og etseskader. Jeg så skader e er mishandling og vold. Jeg så kropper som fløt i sjøen og mennesker som kjempet for livet i vannmassene. Jeg så voksne og barn. Jeg så gravide og gamle. Jeg så smerte, angst og fortvilelse. Jeg så død.
One result of a warmer global climate is increased maritime activity in the Arctic. Areas that used to be covered by ice and snow are now accessible for the scientific community and commercial users. The Norwegian government has chosen tourism as a pillar of the economy of Svalbard and facilitates the development of the tourism industry. Aase and Jabour have shown that tourist vessels sail as far north as 82° N, beyond the range of geostationary satellites. The Polar Code states that appropriate communication equipment to enable telemedical assistance in polar areas shall be provided. This paper describes a series of functional telemedicine tests carried out on board the Norwegian Coast Guard vessel NoCGV Svalbard during her transit between Svalbard and the Norwegian mainland in September 2019. Communication was established between the vessel and Haukeland University Hospital in Bergen, Norway, using the new Iridium NEXT constellation of communication satellites. Our tests show that medical services that require low bandwidths work.
Tilleggsbehandling med liraglutid ved type 2-diabetes synes å redusere risikoen for nyresykdom. Illustrasjonsfoto: Science Photo LibraryType 2-diabetes er en vanlig årsak til nyresvikt. Det er vist at liraglutid, en glukagonlignende peptid-1-analog, har en gunstig effekt på blodsukkerkontroll og overlevelse ved diabetes. Kan midlet også gi redusert risiko for utvikling av nyresykdom? I en nylig publisert studie ble om lag 10 000 pasienter med type 2-diabetes randomisert til å motta vanlig diabetesbehandling med tillegg av liraglutid eller placebo og fulgt opp i 3,5-5 år (1). Som mål på nyresviktutvikling hadde forfatterne laget et skåringsverktøy som omfattet makroalbuminuri, serum-kreatininnivå, dialysebehov og nyrerelatert død. Liraglutidbehandling førte til en signifikant reduksjon i nyresviktutvikling (hasardratio 0,78; 95 % KI 0,67-0,92), og reduksjonen var saerlig knyttet til lavere forekomst av makroalbuminuri.-Denne studien er en fortsettelse av den internasjonale liraglutidstudien, der man tidligere har undersøkt effekten av liraglutid på kardiovaskulaer sykdom, sier Tore Julsrud Berg, som er overlege og førsteamanuensis ved Avdeling for endokrinologi, sykelig overvekt og forebyggende medisin, Oslo universitetssykehus.-Effekten av tilleggsbehandling med liraglutid er tydelig, men ikke veldig stor -man må behandle 45 pasienter for å hindre at én pasient utvikler makroalbuminuri eller alvorligere nyresykdom, påpeker Berg.
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