Wednesday, February 20, 2008

Midlife Suicide--On the radar of Public Health professionals

A NYT article by Patricia Cohen highlights recent findings about "an unusually large increase in suicides among middle-aged Americans in recent years."

A new five-year analysis of the nation’s death rates recently released by the federal Centers for Disease Control and Prevention found that the suicide rate among 45-to-54-year-olds increased nearly 20 percent from 1999 to 2004, the latest year studied, far outpacing changes in nearly every other age group. (All figures are adjusted for population.)
...The question is why...
Experts say that the poignancy of a young death and higher suicide rates among the very old in the past have drawn the vast majority of news attention and prevention resources. For example, $82 million was devoted to youth suicide prevention programs in 2004... Suicide in middle age, by comparison, is often seen as coming at the end of a long downhill slide, a problem of alcoholics and addicts, society’s losers.
“There’s a social-bias issue here,” said Dr. Eric C. Caine, co-director at the Center for the Study of Prevention of Suicide at the University of Rochester Medical Center, explaining why suicide in the middle years of life had not been extensively studied before.
There is a “national support system for those under 19, and those 65 and older,” Dr. Caine added, but not for people in between, even though “the bulk of the burden from suicide is in the middle years of life.”
Of the more than 32,000 people who committed suicide in 2004, 14,607 were 40 to 64 years old (6,906 of those were 45 to 54); 5,198 were over 65; 2,434 were under 21 years old.

Read the article in its entirety here. [Link.] The reader comments are worth a read.

Tuesday, February 12, 2008

Can we fight bird flu by thinking globally and acting locally?

Ashfak Bokhari has written an articulate, to-the-point piece on the corporate roots of the dreaded bird flu in Dawn, Pakistan's English newspaper.
...[It] is the industrialisation of today’s poultry sector which is creating conditions for bird flu to emerge again and again and spread rapidly. The example of Bangladesh is quite illustrative. The country is seen as a success story of the “livestock revolution”, having converted about half of its national poultry production from backyards to intensive and semi-intensive industrial farms. The micro-credit NGO, the Bangladesh Rural Advancement Committee (BRAC) was instrumental in this transition by financing groups of poor women to set up thousands of mini-factory farms.

In the process the BRAC became a major, vertically integrated poultry corporation, with its own large-scale hatcheries, poultry farms, and feed mills that supply the smaller units...In 2005, the government contracted [BRAC] to monitor “hotspots ” in the country where migratory birds flock, and to convert the country ’s open-house hatcheries into bio-secure closed facilities. But these actions failed to stop the bird flu outbreak of March 2007 which happened at a completely closed poultry farm – one of the country’s largest broiler operations and hatcheries. From there, it spread quickly through the smaller model farms and some other large-scale operations.

But what happened in Laos is a different story. The major reason why the country has not suffered widespread bird flu outbreaks like its neighbours (Hong Kong, Thailand, Vietnam and China are the most affected) is that there is almost no contact between its small-scale poultry farms, which produce nearly all of the domestic poultry supply, and its commercial operations, which are integrated with foreign poultry companies.

Laos effectively stamped out the disease by closing the border to poultry from Thailand and culling chickens at the commercial operations...[U]nlike in Thailand and Vietnam, small-scale farmers in Laos are not supplied by big companies with day-old chicks or feed and, outside of its capital, poultry is produced and consumed locally. Poultry production is also more spread out in Laos. It is less dense, less integrated and less homogeneous – all of which keeps bird flu from spreading and evolving into more pathogenic forms.

The Laos experience suggests that the key to protecting backyard poultry and people from bird flu is to protect them from industrial poultry and poultry products. ...Traditional farmer knowledge and biodiversity combined with simple bio -security measures appropriate to small farms may be all that is required to manage the disease effectively in most rural communities. [Link]
The article, which you can read in its entirety here, is thought-provoking. However, intensive farming and industrialization of farm production mechanisms were embraced in the last century not only for corporate profits, but also to efficiently produce enough to meet the basic needs of a growing population worldwide. (Whether these needs were met is a different can of worms.)

As a student interning in mega-dairies and doing rounds in vertically integrated poultry farms, I thought of the trend as 'quantity first and foremost.' All practices and developments were data driven. You couldn't argue with production numbers even as you simultaneously learnt about endangered breeds and lack of biodiversity in livestock. I am not even touching upon the issues of public health and hygiene that are to be considered while packaging and transporting milk and meat to consumers concentrated in mega-cities.

Perhaps national objectives, for the most part, were deliberately and necessarily narrow. Perhaps people did not ask all the right questions, and systems did not put a value on differing viewpoints.

Wednesday, February 6, 2008

The Imposter Syndrome

Dr. Richard Sigurdson, Dean of the Faculty of Arts and Professor of Political Studies at the University of Manitoba, has an enlightening introduction to the phenomenon known as the Imposter Syndrome.
... the term "Impostor Phenomenon" (IP) was coined by psychologist Pauline Rose Clance. Working with psychotherapist Suzanne Imes in 1978, she discovered a condition of self-doubt and failure to internalize success in a sample of more than 150 high-achieving women. [Link]
Now I know. After 16 years of post-secondary education and 3 further years of post-doctoral training, I learn that there is possibly a term to describe what I experienced all those years. Ironically, I learn about it at a time when I finally feel self-assured and confident enough to look forward to a potentially meaningful and successful academic career ahead of me. All it took for me to experience this transformation was to work on my own for the past 2 years--identify a new research area, write my own papers for peer review from start to finish, and call my successes (and my failures) my own--without the comfort of support and timely criticism that are usually taken for granted within established research groups. It also helps that I am no longer living on a post-doctoral salary. Much as I hate to put it in writing in a public place, the fact remains that being paid comparatively better also makes me want to prove to myself and to my seniors that I am worth the price.

How else can I explain the change in my attitudes and beliefs toward myself and my professional scope? Except for age (and marriage and motherhood), all other background variables I came with when I stepped into a postgraduate program in North America remain the same after all these years. I am left to conclude that age (or rather, accompanying maturity and personal life experiences), relative independence at work, and some tangible rewards have finally made me lose my fear of failure and gain a realistic perspective of my role in an ever-expanding world of research possibilities limited only by the imagination. (The finiteness of research funding and publishing space in journals are blissfully and temporarily forgotten on purpose).