Medical training of seafarers: International Maritime Health Foundation (IMHF) Expert Panel Consensus Statement

Background: Medical emergencies and on-going medical conditions on board may seriously impair seafarers’ health and safety, and also negatively impact on future work prospects for seafarers. When a seafarer gets ill or injured on a ship, medical treatment often relies on the competences on his colleagues on board. The aim of this project was to establish a consensus-based minimum standard for medical education for seafarers, in order to ensure competency for adequate management of ill-health on board. Materials and methods: International Maritime Health Foundation (IMHF) conducted a workshop on medical training of seafarers. A research-based approach to gain consensus on core learning outcomes/competences developed by the Tuning Project, has been used. This method was used by Tuning (Medicine) to gain consensus on core learning outcomes for primary medical degrees (Master of Medicine) across Europe. Results: The result of the project is a set of learning outcomes/competences in medical training for merchant seafarers. Conclusions: The project resulted in a set of learning outcomes/competences on medical training of the seafarers that will be submitted to the relevant bodies of International Maritime Organization (IMO) in the process of the development of model courses 1.13, 1.14 and 1.15

Post-disaster healthcare for parents. A longitudinal study of the mothers and fathers of the Utøya survivors

Mothers and fathers may suffer severe traumatisation from learning of or witnessing events that threaten the lives of their children. Adolescents and young adults are often among victims of terrorist attacks. Yet, little is known about parents’ post-disaster healthcare needs. This thesis investigates post-disaster healthcare services provided to parents of the survivors of the 2011 Utøya terrorist attack, by combining registry-based data on parental healthcare consumption in the three-year periods before and after the terrorist attack with self-reported data from the mothers and fathers, and their children. A broad range of healthcare services were addressed, including regular primary and specialised healthcare and the extraordinary crisis response programme set up by municipalities throughout the country in the wake of the attack. The extraordinary crisis response programme succeeded in reaching out to a majority of the parents. Yet, parents of non-Norwegian origin and of non-intact families ran an increased risk of being left out of the proactive follow-up. Nearly all mothers and fathers turned to their general practitioner (GP) for help, a majority for psychological health complaints. More frequent GP visits was related to higher levels of distress. A minority of the more distressed parents were also provided for by specialised mental healthcare providers. In conclusion, Parents witnessing or learning of a terrorist attack that threatens the life of their children may be in need of a wide range of post-disaster healthcare services. GPs may play a key role in providing for general complaints in the many, whereas specialised mental healthcare providers may play an important role in providing for the needs of the most severely traumatised. Psychosocial crisis response programmes may proactively facilitate access to healthcare, but need to find ways to overcome sociodemographic barriers to outreach in parents

Early postdisaster health outreach to modern families: a cross-sectional study

ABSTRACT Objectives: This 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. Design: Cross-sectional survey, face-to-face interviews and questionnaires. Setting: Norway, aftermath of the Utøya massacre, 4–7 months postdisaster. Background: Following the Utøya massacre, proactive early outreach programmes were launched in all municipalities that were affected, facilitating access to appropriate healthcare services. Participants: A 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 measures: Engagement 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). Results: A 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). Conclusions: Proactive 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