Posttraumatic stress and symptom improvement in Norwegian tourists exposed to the 2004 tsunami – a longitudinal study

Background Mental health consequences of disasters are frequently studied. However, few studies have investigated symptom improvement in victims after natural disasters. This study aimed to identify predictors of 6 months post-disaster stress symptoms and to study 6 months and 24 months course of symptoms among Norwegian tourists who experienced the 2004 tsunami. Methods Norwegian tourists (≥18 years) who experienced the 2004 tsunami (n = 2468) were invited to return a postal questionnaire at two points of time. The first data set was collected at 6 months (T1, n = 899) and the second data set at 24 months post-disaster (T2, n = 1180). The population studied consisted of those who responded at both assessments (n = 674). Impact of Event Scale Revised (IES-R) was used to measure posttraumatic stress symptoms. IES–R score ≥33 (caseness) was used to identify various symptom trajectories from T1 to T2. Multiple linear regression was used to determine predictors of posttraumatic stress at T1 and to identify variables associated with symptom improvement from T1 to T2. Results The majority was identified as non-case at both assessments (57.7%), while 20.8% of the respondents were identified as case at both assessments. Symptoms at T1 were positively related to female gender, older age, unemployment, being chased or caught by the waves, witnessing death or suffering, loss of loved ones, experiencing intense fear during the disaster, low conscientiousness, neuroticism and low levels of social support. The IES-R sum score declined from 24.6 (SD = 18.5) at T1 to 22.9 (SD = 18.3) at T2, p < 0.001. Emotional stability and high IES-R scores at T1 were positively related to symptom improvement, while received social support was not. Being referred to a mental health specialist was negatively related to symptom improvement. Conclusions A significant minority (20-30%) among Norwegian tourists developed enduring posttraumatic stress symptoms in the aftermath of the 2004 tsunami. Tsunami exposure, peritraumatic fear, neuroticism and low levels of social support were the strongest predictors of posttraumatic stress at 6 months post-disaster. Decrease in posttraumatic stress was related to emotional stability and higher symptom levels at T1. Being referred to a mental health specialist did not facilitate symptom improvement

Posttraumatic stress disorder in people with visual impairment compared with the general population

Background: People with a visual impairment appear to have an increased risk of experiencing potentially traumatizing life events and possibly also subsequently developing post-traumatic stress disorder (PTSD). This study investigated the point prevalence of PTSD in people with a visual impairment compared with the general population of Norway and examined factors associated with PTSD among people with a visual impairment. Methods: A telephone-based survey was administered to a probability sample of 1216 adults with a visual impairment. Of these, 736 (61% response rate) participated. A probability sample from the general population served as a reference (n = 1792, 36% response rate). PTSD was measured with the PTSD Checklist for the DSM-5 (PCL-5), based on the currently most bothersome event reported from the Life Events Checklist for DSM-5 (LEC-5). We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Results: The prevalence of PTSD was higher among people with a visual impairment than in the general population, both for men (9.0% vs. 3.8%) and women (13.9% vs. 8.5%). The prevalence rates of PTSD from the illness or injury that had caused the vision loss (men 3.9%, women 2.2%) accounted for a considerable part of the difference between the populations. For women, PTSD related to sexual assaults also contributed significantly to a higher PTSD prevalence in the visually impaired versus the general population (5.2% vs. 2.2%), while for men there were no other event categories which resulted in significant differences. Among people with a visual impairment, the higher risk of PTSD was associated with lower age, female gender, having acquired the vision loss, and having other impairments in addition to the vision loss. Conclusion: The higher prevalence of PTSD in people with a visual impairment suggests that vulnerability to mental health problems is associated with serious life events. The higher incidence than in the general population is partly due to the illness or injury that had led to the vision loss and partly due to people with vision loss appearing to be more vulnerable through exposure to other types of potentially traumatizing events, such as sexual abuse.publishedVersio

Quality of life in people with visual impairment compared with the general population

Aim The aim of the present study was to examine quality of life and its associated factors among adults with visual impairment in Norway. Subject and methods Of the 1216 adults contacted, 736 (61% response rate) participated in a cross-sectional survey. A general population probability sample served as reference (n=1792, 36% response rate). Differences between the populations were examined with independent t-tests for continuous variables and with Chi-square tests for categorical variables. Quality of life covariates were investigated with linear regression analysis. Results People with visual impairment had lower quality of life than the general Norwegian population, across all age groups (mean QOL: 6.8 versus 7.6, p<0.001) and within all age groups (all p<0.01). Compared with the general population, people with visual impairment were less likely to report the highest levels and more likely to report intermediate levels of quality of life. Higher quality of life was associated with lower onset-age of impaired vision (B=-0.11, p<0.001), having employment (B=0.36, p=0.02), lower levels of loneliness (B=-0.28, p<0.001) and higher levels of social support (B=0.40, p<0.001) and general self-efficacy (B=0.07, p<0.001). Conclusion Quality of life was lower among people with visual impairment and may be increased by promoting work participation, social inclusion, connectedness, and coping.publishedVersio

Biofilm forming abilities of Salmonella are correlated with persistence in fish meal- and feed factories

<p>Abstract</p> <p>Background</p> <p>Feed contaminated with <it>Salmonella </it>spp. constitutes a risk of <it>Salmonella </it>infections in animals, and subsequently in the consumers of animal products. <it>Salmonella </it>are occasionally isolated from the feed factory environment and some clones of <it>Salmonella </it>persist in the factory environment for several years. One hypothesis is that biofilm formation facilitates persistence by protecting bacteria against environmental stress, e.g. disinfection. The aim of this study was to investigate the biofilm forming potential of <it>Salmonella </it>strains from feed- and fishmeal factories. The study included 111 <it>Salmonella </it>strains isolated from Norwegian feed and fish meal factories in the period 1991–2006 of serovar Agona, serovar Montevideo, serovar Senftenberg and serovar Typhimurium.</p> <p>Results</p> <p>Significant differences were found between serovars regarding the abilities to form biofilm on polystyrene (microtiter plate assay) and in the air-liquid interface of nutrient broth (pellicle assay). Strains of serovar Agona and serovar Montevideo were good biofilm producers. In Norwegian factories, clones of these serovars have been observed to persist for several years. Most serovar Senftenberg clones appear to persist for a shorter period, and strains of this serovar were medium biofilm producers in our test systems. Strains of the serovar Typhimurium were relatively poor biofilm producers. <it>Salmonella </it>ser. Typhimurium clones have not been observed to persist even though this serovar is resident in Norwegian wild life. When classifying strains according to persistence or presumed non-persistence, persistent strains produced more biofilm than presumed non-persisting strains.</p> <p>Conclusion</p> <p>The results indicate a correlation between persistence and biofilm formation which suggests that biofilm forming ability may be an important factor for persistence of <it>Salmonella </it>in the factory environment.</p

Pervasive Listeria monocytogenes is common in the Norwegian food system and is associated with increased prevalence of stress survival and resistance determinants

To investigate the diversity, distribution, persistence, and prevalence of stress survival and resistance genes of Listeria monocytogenes clones dominating in food processing environments in Norway, genome sequences from 769 L. monocytogenes isolates from food industry environments, foods, and raw materials (512 of which were sequenced in the present study) were subjected to whole-genome multilocus sequence typing (wgMLST), single-nucleotide polymorphism (SNP), and comparative genomic analyses. The data set comprised isolates from nine meat and six salmon processing facilities in Norway collected over a period of three decades. The most prevalent clonal complex (CC) was CC121, found in 10 factories, followed by CC7, CC8, and CC9, found in 7 factories each. Overall, 72% of the isolates were classified as persistent, showing 20 or fewer wgMLST allelic differences toward an isolate found in the same factory in a different calendar year. Moreover, over half of the isolates (56%) showed this level of genetic similarity toward an isolate collected from a different food processing facility. These were designated as pervasive strains, defined as clusters with the same level of genetic similarity as persistent strains but isolated from different factories. The prevalence of genetic determinants associated with increased survival in food processing environments, including heavy metal and biocide resistance determinants, stress response genes, and inlA truncation mutations, showed a highly significant increase among pervasive isolates but not among persistent isolates. Furthermore, these genes were significantly more prevalent among the isolates from food processing environments compared to in isolates from natural and rural environments (n = 218) and clinical isolates (n = 111) from NorwaypublishedVersio

A comparison between healthcare workers and non-healthcare workers’ anxiety, depression and PTSD during the initial COVID -19 lockdown

Objective Several studies have found that Healthcare workers are vulnerable to mental health problems during the COVID-19 pandemic. However, few studies have made comparisons of healthcare workers (HCWs) and non-HCWs. The current study aimed to compare mental health problems among HCWs with non-HCWs during the initial lockdown of COVID 19. Study design A population-based cross-sectional survey. Methods The survey was conducted by means of an open web link between April and May 2020. Data were collected by self-report. The PTSD Checklist for DSM-5 (PCL-5) was used to assess posttraumatic stress. Results A total of 4527 citizens answered the questionnaire and 32.1% were HCWs. The majority were female, under 60 years of age, and lived in urban areas. Among the HCWs, the majority were registered nurses working in hospitals. The prevalence were 12.8% vs 19.1% for anxiety, 8.5% vs 14.5% for depression and 13.6% vs 20.9% for PTSD among HCWs and non-HCWs respectively. The highest prevalence's for anxiety and PTSD among HCWs were found for those under 40 years of age and having low education level (<12 years). Conclusion Mental health problems was significantly lower among HCWs compared to non-HCWs. However, the COVID-19 poses a challenge for HCWs, especially young HCWs and those with low level of education. Providing support, appropriate education, training, and authoritative information to the different members of the HCWs could be effective ways to minimize the psychological effect.publishedVersio

Micro ecosystems from feed industry surfaces: a survival and biofilm study of Salmonella versus host resident flora strains

<p>Abstract</p> <p>Background</p> <p>The presence of <it>Salmonella </it>enterica serovars in feed ingredients, products and processing facilities is a well recognized problem worldwide. In Norwegian feed factories, strict control measures are implemented to avoid establishment and spreading of <it>Salmonella </it>throughout the processing chain. There is limited knowledge on the presence and survival of the resident microflora in feed production plants. Information on interactions between <it>Salmonella </it>and other bacteria in feed production plants and how they affect survival and biofilm formation of <it>Salmonella </it>is also limited. The aim of this study was to identify resident microbiota found in feed production environments, and to compare the survival of resident flora strains and <it>Salmonella </it>to stress factors typically found in feed processing environments. Moreover, the role of dominant resident flora strains in the biofilm development of <it>Salmonella </it>was determined.</p> <p>Results</p> <p>Surface microflora characterization from two feed productions plants, by means of 16 S rDNA sequencing, revealed a wide diversity of bacteria. Survival, disinfection and biofilm formation experiments were conducted on selected dominant resident flora strains and <it>Salmonella</it>. Results showed higher survival properties by resident flora isolates for desiccation, and disinfection compared to <it>Salmonella </it>isolates. Dual-species biofilms favored <it>Salmonella </it>growth compared to <it>Salmonella </it>in mono-species biofilms, with biovolume increases of 2.8-fold and 3.2-fold in the presence of <it>Staphylococcus </it>and <it>Pseudomonas</it>, respectively.</p> <p>Conclusions</p> <p>These results offer an overview of the microflora composition found in feed industry processing environments, their survival under relevant stresses and their potential effect on biofilm formation in the presence of <it>Salmonella</it>. Eliminating the establishment of resident flora isolates in feed industry surfaces is therefore of interest for impeding conditions for <it>Salmonella </it>colonization and growth on feed industry surfaces. In-depth investigations are still needed to determine whether resident flora has a definite role in the persistence of <it>Salmonella </it>in feed processing environments.</p

Use of alcohol and addictive drugs during the COVID-19 outbreak in Norway: associations with mental health and pandemic-related problems

Background: The outbreak of COVID-19 has had a major impact on people's daily life. This study aimed to examine use of alcohol and addictive drugs during the COVID-19 outbreak in Norway and examine their association with mental health problems and problems related to the pandemic. Methods: A sample of 4,527 persons responded to the survey. Use of alcohol and addictive drugs were cross-tabulated with sociodemographic variables, mental health problems, and problems related to COVID-19. Logistic regression analyses were used to examine the strength of the associations. Results: Daily use of alcohol was associated with depression and expecting financial loss in relation to the COVID-19 outbreak. Use of cannabis was associated with expecting financial loss in relation to COVID-19. Use of sedatives was associated with anxiety, depression, and insomnia. Use of painkillers was associated with insomnia and self-reported risk of complications if contracting the coronavirus. Conclusion: The occurrence of mental health problems is more important for an understanding of the use of alcohol and addictive drugs during the COVID-19 outbreak in Norway, compared to specific pandemic-related worries.publishedVersio

Whole-Genome Sequencing Analysis of Listeria monocytogenes from Rural, Urban, and Farm Environments in Norway: Genetic Diversity, Persistence, and Relation to Clinical and Food Isolates

Listeria monocytogenes is a ubiquitous environmental bacterium associated with a wide variety of natural and human-made environments, such as soil, vegetation, livestock, food processing environments, and urban areas. It is also among the deadliest foodborne pathogens, and knowledge about its presence and diversity in potential sources is crucial to effectively track and control it in the food chain. Isolation of L. monocytogenes from various rural and urban environments showed higher prevalence in agricultural and urban developments than in forest or mountain areas, and that detection was positively associated with rainfall. Whole-genome sequencing (WGS) was performed for the collected isolates and for L. monocytogenes from Norwegian dairy farms and slugs (218 isolates in total). The data were compared to available data sets from clinical and food-associated sources in Norway collected within the last decade. Multiple examples of clusters of isolates with 0 to 8 whole-genome multilocus sequence typing (wgMLST) allelic differences were collected over time in the same location, demonstrating persistence of L. monocytogenes in natural, urban, and farm environments. Furthermore, several clusters with 6 to 20 wgMLST allelic differences containing isolates collected across different locations, times, and habitats were identified, including nine clusters harboring clinical isolates. The most ubiquitous clones found in soil and other natural and animal ecosystems (CC91, CC11, and CC37) were distinct from clones predominating among both clinical (CC7, CC121, and CC1) and food (CC9, CC121, CC7, and CC8) isolates. The analyses indicated that ST91 was more prevalent in Norway than other countries and revealed a high proportion of the hypovirulent ST121 among Norwegian clinical cases.publishedVersio

Serious life events and post-traumatic stress disorder in the Norwegian population

Background: It has been suggested that countries with more resources and better healthcare have populations with a higher risk of posttraumatic stress disorder (PTSD). Norway is a high-income country with good public healthcare. Aims: To examine lifetime trauma exposure and the point prevalence of PTSD in the general Norwegian population. Method: A survey was administered to a national probability sample of 5500 adults (aged ≥18 years). Of 4961 eligible individuals, 1792 responded (36%). Responders and non-responders did not differ significantly in age, gender or urban versus rural residence. Trauma exposure was measured using the Life Events Checklist for the DSM-5. PTSD was measured with the PTSD Checklist for the DSM-5. We used the DSM-5 diagnostic guidelines to categorise participants as fulfilling the PTSD symptom criteria or not. Results: At least one serious lifetime event was reported by 85% of men and 86% of women. The most common event categories were transportation accident and life-threatening illness or injury. The point prevalence of PTSD was 3.8% for men and 8.5% for women. The most common events causing PTSD were sexual and physical assaults, life-threatening illness or injury, and sudden violent deaths. Risk of PTSD increased proportionally with the number of event categories experienced. Conclusions: High estimates of serious life events and correspondingly high rates of PTSD in the Norwegian population support the paradox that countries with more resources and better healthcare have higher risk of PTSD. Possible explanations are high expectations for a risk-free life and high attention to potential harmful mental health effects of serious life events.publishedVersio