Trond Nordfjærn

A cross‐cultural comparison of road traffic risk perceptions, attitudes towards traffic safety and driver behaviour

The present study investigated cross‐cultural differences in road traffic risk perception, risk sensitivity and risk willingness in Norway, Russia, India, Ghana, Tanzania and Uganda. Differences in driver attitudes and driver behaviour were also examined. An additional aim was to test whether the risk constructs and driver attitudes explained the variation in risky driver behaviour in these countries. To obtain these aims, a questionnaire survey was conducted among a randomly obtained representative sample of the Norwegian public (n = 247). Stratified samples were established in Russia (n = 245), India (n = 196), Ghana (n = 299), Tanzania (n = 559) and Uganda (n = 415). The respondents completed a questionnaire which consisted of validated self‐reported measures of the risk constructs, and driver attitudes and behaviour. Norwegians reported safer attitudes regarding drinking and driving, and speeding in road traffic. These respondents also reported more seat belt use and lower frequencies of drinking and driving than the remaining subsamples. Respondents from Sub‐Saharan Africa reported higher road traffic risk perceptions and risk sensitivity than respondents from Norway, Russia and India. Respondents from Tanzania reported the highest willingness to take risks both in traffic and in general. Participants from Sub‐Saharan Africa and India reported safer attitudes in regard to speaking out to an unsafe driver, rule violations and sanctions, attitudes towards pedestrians, and traffic rules and knowledge. Respondents from Sub‐Saharan Africa also reported more precautious behaviour and less speeding. The predictive model of driver behaviour explained a satisfactory amount of variance in Norway, Russia and India, but was poorly fitted in the African countries. The results are discussed in line with the general risk environments and the road traffic systems in high‐ and low‐income countries. Challenges related to measuring road traffic attitudes and behaviour in low‐income countries are also discussed.

Culture related to road traffic safety: A comparison of eight countries using two conceptualizations of culture

The majority of previous cross-country studies of human factors relevant to traffic safety have not operationalized and measured culture. Also studies in this vein have mostly been carried out in Europe and the United States. The aim of the study was to examine country cluster differences, based on the Cultures Consequences framework, in road traffic risk perception, attitudes towards traffic safety and driver behaviour in samples from Norway, Russia, India, Ghana, Tanzania, Uganda, Turkey and Iran. An additional aim was to examine cluster differences in road traffic culture as symbol use and to investigate whether this theoretical cultural framework predicts risk perception, attitudes towards traffic safety and driver behaviour in the country clusters. The sample consisted of a total of 2418 individuals who were obtained by convenience sampling in the different countries. The countries segmented into four Cultures Consequences clusters; Norway, Russia and India, Sub-Saharan Africa, and Near East countries. The findings showed that Norwegians reported overall safer attitudes towards traffic safety and driver behaviour than the remaining country clusters. Individuals in Africa reported the highest risk perception. The countries also differed substantially in road traffic culture as symbol use. Contrary to established cultural theory, prediction models revealed that cultural factors were stronger predictors of driver behaviour than of risk perception. Also, the social cognitive risk constructs (i.e. risk perception and attitudes) solely explained variance in driver behaviour in the Norwegian and Russia/India clusters. Previous empirical efforts, which aimed to demonstrate that culture is important for the risk perception criterion, may have focused on a criterion variable that is not strongly related to driver behaviour. Furthermore, countermeasures aimed to influence social cognition may have stronger applicability in countries with a more individualistic western cultural orientation.

Treatment and recovery as perceived by patients with substance addiction.

Social relations to therapists and other patients in treatment are important for positive and negative experiences among patients with substance addiction. * Improvements in mental health and substance use were considered as the more important areas of recovery among these patients. * One of the core reasons for premature dropout could be a failure to establish positive social relations and temptations to relapse to substance use. Abstract Research concerning patients with substance addiction and how they perceive their treatment remains scant. The objective of this study was therefore to examine positive and negative perceptions of treatment and recovery from the perspectives of these patients. Data were collected with semi-structured interviews among seven patients who completed treatment and six patients who prematurely dropped out from their programme (n= 13). Patients were strategically sampled from five inpatient facilities and one outpatient opioid maintenance treatment clinic located in two Norwegian counties. All interviews were transcribed and thereafter analysed with contextual content analysis aided by the qsr nvivo 8.0 software. This was carried out to obtain information about the manifest positive and negative content in the interviews. The results showed that the therapeutic alliance and mutual influences among patients were important for perceptions of treatment. Frequent staff turnover also related to these perceptions. The more important domains of recovery were psychosocial functioning and substance use. The implications of the results were discussed in relation to clinical practice and further research.

Traffic risk perception, road safety attitudes, and behaviors among road users: a comparison of Turkey and Norway

The present study aims to investigate differences in road safety attitudes, driver behavior, and traffic risk perception between Turkey and Norway. A questionnaire survey was conducted among a sample of Norwegian (n = 247) and Turkish (n = 213) road users. The results show that Turkish respondents perceived traffic risk to be higher than Norwegian respondents. Turkish respondents reported safer attitudes towards drinking and driving than Norwegian respondents, while Norwegians reported safer attitudes towards speeding. Turkish respondents reported a lower frequency of speeding behaviors than Norwegian respondents, whereas Norwegian respondents reported a lower frequency of drinking and driving. Traffic risk perception was related to road safety attitudes and behaviors among Norwegian respondents but not among Turkish respondents. The results were discussed with respect to differences in traffic safety, traffic culture, and the development levels in Turkey and Norway.

The role of alprazolam for the treatment of panic disorder in Australia

Objective: To investigate the potential impact of increasing prescription rates of alprazolam for the treatment of panic disorder (PD) in Australia through a review of efficacy, tolerability and adverse outcome literature. Methods: Data were sourced by a literature search using MEDLINE, Embase, PsycINFO and a manual search of scientific journals to identify relevant articles. Clinical practice guidelines from the American Psychiatric Association, National Institute of Clinical Excellence, Royal Australian and New Zealand College of Psychiatrists and World Federation of Societies of Biological Psychiatry were sourced. Prescription data were sourced from Australian governmental sources. Results: Alprazolam has shown efficacy for control of PD symptoms, particularly in short-term controlled clinical trials, but is no longer recommended as a first-line pharmacological treatment due to concerns about the risks of developing tolerance, dependence and abuse potential. Almost no evidence is available comparing alprazolam to current first-line pharmacological treatment. Despite this, prescription rates are increasing. A number of potential issues including use in overdose and impact on car accidents are noted. Conclusion: Although effective for PD symptoms in clinical trials, a number of potential issues may exist with use. Consideration of its future place in PD treatment in Australia may be warranted.

Interrelations Between Patients’ Personal Life Events, Psychosocial Distress, and Substance Use

This study investigated interrelations between life events, psychosocial distress, self-efficacy, and substance use among patients manifesting substance use disorders. Gender differences in these interrelations were also explored. Patients (N = 352) were recruited during 2008 and 2009 from 16 Norwegian facilities. These patients completed a questionnaire with validated measurement instruments. Interrelations were investigated by SEM analysis. The results suggested that negative life events facilitated substance use and psychological distress. Positive life events were associated with self-efficacy, but weakly related to substance use. The results supported the notion that males are more prone to use substances when faced upon negative life events.

Co-occurrence between mental distress and poly-drug use: A ten year prospective study of patients from substance abuse treatment

INTRODUCTION Longitudinal research investigating psychiatric trajectories among patients with poly-drug use patterns remains relatively scant, even though this specific population is at elevated risk for multiple negative outcomes. The present study examined temporal associations between poly-drug use (i.e. heroin, cannabis, tranquilizers, and amphetamines) and mental distress over a 10-year period. METHODS A clinical cohort of 481 patients was recruited from substance use treatment facilities in Norway, and prospectively interviewed 1, 2, 7 and 10years after the initial data collection at treatment admission. At each assessment participants completed a questionnaire addressing their substance use and mental distress. Longitudinal growth models were used to examine whether, and if so, how, levels of drug use were associated with the level and rate of change in mental distress over time. RESULTS Results from the longitudinal growth models showed a co-occurrence between active poly-drug use and mental distress, such that there was a dose-response effect where mental distress increased both in magnitude and over time with the number of drugs used. Reduction in mental distress during the 10-year study period was evident only in the no-drug use condition. Use of multiple drugs and mental distress appear strongly co-related over time. CONCLUSIONS Pre-treatment assessment should carefully identify individuals manifesting poly-drug use and mental disorders. Treatment and follow-up services should be tailored to their specific needs.

Safety attitudes, behaviour, anxiety and perceived control among professional and non-professional drivers

The current study aimed to investigate differences in psychological safety factors such as attitudes and behaviour among professional and non-professional drivers. Differences in accident involvement and the number of speeding tickets were also investigated. An additional aim was to study factors associated with risky driver behaviour and speeding tickets in these groups. A questionnaire survey was distributed by mail to a randomly selected sample from the Norwegian population registry (N = 6203). The response rate was 30% and the final sample consisted of 1864 individuals. Adjusted for demographic characteristics and road traffic exposure the results showed that professional drivers (n = 113) reported significantly less seat belt use and watchful driving than non-professional drivers (n = 1594). Professional drivers reported significantly less fun riding and safer attitudes regarding addressing the unsafe driving of others. The professional drivers also reported significantly safer behaviour related to drink driving, but lower priorities of road traffic safety. Professional drivers perceived significantly more control and had been involved in more accidents than the non-professional drivers. The results suggest that professional drivers may constitute a risk group in road traffic. Further research could focus on barriers of seat belt use and mechanisms, which could promote safety priorities in this driver group. The knowledge gained by such studies could be utilised by company managers in order to promote safer behaviour among professional drivers.

Comparison of drugs used by nightclub patrons and criminal offenders in Oslo, Norway

The aim of this study was to investigate psychoactive drug use among nightclub patrons by analysing samples of oral fluid and compare with findings in blood samples from criminal suspects. We hypothesized that the profile of illicit drug use among nightclub patrons is different from what we observe in those forensic cases. Research stations were established outside nine popular nightclubs with different profiles and patron-characteristics in downtown Oslo. Data and sample collection was conducted on Fridays and Saturdays in March and May 2014. Individuals and groups who entered defined recruitment zones from 23:00 to 03:30 were invited to participate in this voluntary and anonymous study. Oral fluid was collected using the Intercept Oral Fluid Sampling Device. Methanol was added to increase the recovery of cannabinoids from the device. Sample preparation was performed using liquid-liquid extraction with ethyl acetate/heptane (4:1) after adding internal standards, ammonium carbonate buffer pH 9.3 and Triton X100. The first 80 samples were analysed for 122 substances, which included psychoactive medicinal drugs, classical illicit drugs and new psychoactive substances (NPS). Based on the findings and discussions with police and customs authorities, the remaining oral fluid samples were analysed for 46 substances. Among the 500 samples collected during the study period, we found illicit drugs in 25.4% and medicinal drugs in 4.2% of the samples. The most prevalent substances were: cocaine 14.6%, THC 12.4%, amphetamine/methamphetamine 2.8%, diazepam 1.2% and clonazepam 1.0%. Various NPS were found in 1.4% of the samples. The prevalence of drugs in blood samples from criminal suspects were for cocaine 3.4%, THC 34.7%, amphetamine/methamphetamine 37.0%, diazepam 12.0%, and clonazepam 29.3%. Multi-drug use was more common among criminal suspects (41.3%) than among club patrons (6.8%). The results showed that the drug use pattern among nightclub patrons was substantially different from the drug use pattern manifested by individuals apprehended by the police suspected for criminal conduct.

A population-based cohort study of anxiety, depression, sleep and alcohol outcomes among benzodiazepine and z-hypnotic users

OBJECTIVE The present study aimed to examine anxiety, depression, sleep and alcohol outcomes among individuals who were prescribed benzodiazepines or z-hypnotics in a Norwegian population-based sample (n = 58,967). METHODS This 13 year historical cohort study obtained baseline measures of self-report anxiety, depression, sleep difficulties and alcohol use from the Nord-Trøndelag Health Study (HUNT 2, 1995-1997). Information about outcomes was collected from the third wave (HUNT 3, 2006-2008) of the same epidemiological study. Prescription records of benzodiazepines and z-hypnotics were obtained from the Norwegian prescription database (NorPD, 2004-2008) and were linked to the HUNT 2 and HUNT 3 questionnaire data. RESULTS Among the 58,967 respondents who were eligible for the study, 13,774 (23%) received at least one prescription of benzodiazepines or z-hypnotics in the period 2004-2008. Benzodiazepine use was associated with a higher risk of severe anxiety, depression and sleep outcomes. The assumption that benzodiazepine use is prospectively associated with a higher risk of problematic alcohol use was not supported. CONCLUSIONS Consideration and discussion of the future place of benzodiazepines in treatment of anxiety and sleep difficulties in Norway could be warranted. Benzodiazepines may be efficient in reducing symptoms in the short term, but evidence from this long temporal follow-up study indicates limited positive influences in the long term.