This thing called life
Peter Aldhous warns us about the new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as if it will be something of a nuclear bomb (12 December 2009, p 38). I disagree.
The DSM is not the only classification of mental and behavioural disorders. It is used mostly in the US. The rest of the world uses Section F of the World Health Organization’s . Some doctors don’t even consult a manual to reach their diagnoses.
Aldhous reports on an , where Allen Frances wrote that broadening categories within the DSM would result in the medicalisation of normality and “a deluge of unneeded medication”. I would argue that the effects will be hardly noticeable 鈥� because this is already happening.
I have worked as a psychiatrist for 10 years, enough time to see an increasing number of people consulting psychiatrists for all sorts of life-related problems, and using diagnostic terms to tell us that they are depressed, bipolar or suicidal.
At first, I thought that it was all the fault of us doctors, that we medicalise these poor, unhappy, non-coping people. But the longer I work, the more clearly I see that people want “a diagnosis” because a diagnosis means there must be a treatment, and a treatment amounts to an easy way of getting their life or themselves fixed.
Then they ask for medication. They want tablets to stop them crying, although their mother died only two weeks ago, or something to calm them down when they become aggressive after they have a drink. They ask us to sort out their unruly children who have never known any boundaries. They want it sorted and they want it now. This problem is partly a result of the modern pressure to be happy and advert-perfect all the time; if you aren’t, there must be something wrong with you. Another part of it is the lack of life skills and poor social support networks courtesy of the decline of traditional family structures and close friendships.
I am astounded by the number of people who come to ask me for a diagnosis, and who are then unhappy when I try to explain that this is called “life”. If the DSM is a bomb that is going to explode, it will probably generate more smoke than fire.
Buyer power
Monterey Bay Aquarium and its Seafood Watch programme agree with the call in New 杏吧原创‘s editorial for “sound science” to be the basis for determining what is and what isn’t a sustainable fishery (9 January, p 5). Seafood Watch has established itself among consumers and major seafood buyers as a reliable source for identifying sustainable wild-caught and farmed seafood. Since 1999, we have based all our seafood recommendations on the best available science, and vetted them with independent experts.
We are having a real impact on the major seafood buyers and must strongly disagree with researcher Jennifer Jacquet, who seems to dismiss the role of consumer-awareness programmes (9 January, p 11).
It is true that focusing only on consumers won’t drive change in the way fish are caught and farmed. But grass-roots consumer demand underlies the success we and others in the sustainable seafood movement are having with major buyers, whose seafood purchasing decisions are changing the way fish are caught and farmed worldwide.
Seafood Watch is best known for its consumer pocket-guides and iPhone application, but we also work with major buyers. We have partnerships with both Compass Group and ARMARK, North America’s two largest food service companies, which are now buying millions of kilograms of sustainable seafood in collaboration with Seafood Watch. Others in the broader sustainable seafood movement are forming similar alliances with major retailers. In large measure, consumer demand inspired by programmes like Seafood Watch is what is driving this change.
Consumer seafood-awareness programmes aren’t the be-all and end-all, but they are a critical part of a campaign that must succeed if we want a future with healthy oceans.
Your article also incorrectly stated that the Monterey Bay Aquarium’s Seafood Watch programme rates Atlantic halibut as a sustainable species. In fact, our clearly identify Atlantic halibut as a Red List species to avoid.
Future-proofing pics
Like Bryn Glover, I am concerned about how to preserve digital family photos for 50 years or so (9 January, p 26). Not only do you have to worry about the storage medium, but you also have to worry about the software and hardware needed to view them. While jpeg seems to be a widely accepted format, who is to say that in 50 years’ time the jpeg image captured today will still be viewable? Printed photos avoid these potential problems.
In lieu of prints, my solution is to ask my son to look after the transferring of the files to new storage media as and when the technology changes.
From Matthew Stevens
Bryn Glover is worried about preserving his digital photos for posterity. For family photographs, I use CDs with a pure-gold layer, which are guaranteed for 100 years and are in fact mandated by some hospitals for long-term data storage. Being effectively inert, the gold does not corrode like the aluminium in cheaper CDs.
Thornleigh, New South Wales, Australia
The editor writes:
鈥� You can read further discussion of modern data storage options on page 36 of this issue.
Salt targets
As New 杏吧原创 reports, New York City has recently launched its “National Salt Reduction Initiative” in a bid to reduce the salt intake and improve the health of its residents (16 January, p 4). The report failed to mention the acknowledgement that New York City gave to the UK’s salt-reduction programme in the creation of its own.
Since 2004, the UK Food Standards Agency has been working closely with industry to encourage reductions in salt levels across a wide range of foods by setting voluntary salt targets. This work has run alongside several high-impact consumer-awareness campaigns and has been very successful in reducing salt intake from 9.5 grams per person per day to 8.6 grams. As referenced by , our work in the UK served as a model for the city’s salt-reduction initiative.
Find your level
Mark Buchanan discusses the oft-experienced phenomenon of managerial incompetence, but fails to suggest a solution (19 December 2009, p 68).
I have one 鈥� it is based on the idea that promotion should be seen as an opportunity to demonstrate competence in a different position. If someone is promoted to a position in which they subsequently demonstrate incompetence, then that person is demoted to their previous position without loss of their promotion-level salary. The promotion, even if revoked later, would nevertheless raise the salary of the employee, recognising his or her full competence in their original role.
It would soon become clear that if a person had not been promoted and later demoted, they had not yet reached their optimal position. If, on the other hand, one had not been promoted at all within a reasonable time then the inference would be that the person may not even be competent in their present position. The scheme would provide more scope for promotion in the first place, as upper management need not fear long-term company damage should the promotee prove incompetent in the new position.
Bear versus croc
I find it odd that the polar bear is often claimed to be the world’s largest land predator, as it was in your article on large marine reptiles (31 October 2009, p 32).
Though not normally classed as land animals, saltwater crocodiles spend much of their time in fresh or brackish water, or lazing on river banks 鈥� behaviour similar to that of the polar bear. At around 1000 kilograms, the largest saltwater crocodiles weigh more than most polar bears.
Rock 'n' a hard sweet
You report findings that diabetics who stringently control their blood-sugar levels are more likely to crash their cars than people with poorly controlled diabetes (12 December 2009, p 7).
In 30 years of driving with type 1 diabetes, I have trodden the fine line between the low-sugar recommendations of doctors and the requirement of the UK’s Driver and Vehicle Licensing Agency (DVLA) and the insurers for no “low-sugar events”. I have only had one uncontrolled low-sugar event while driving, but this set off alarm bells at the DVLA and insurers for a few years.
Unfortunately, to maintain zero chances of a low-sugar event occurring, diabetics either have to be perfect patients or edge our glucose levels higher to be on the safe side for the duration of each stint behind the wheel. The latter is far easier to do but carries with it the long-term probability of organ damage, particularly to the eyes: a kind of catch-22 situation, as eyesight problems often cause diabetics to lose their driving licences in later years.
Most diabetics receive numerous medicals and eye tests each year, unlike the average motorist. Combine that with the fear that an incident might scupper future driving, and we may well be more careful and safer drivers overall.
For the record
鈥� Graham Colditz works as an epidemiologist at Washington University in St Louis, not the University of Washington as we said in our report on the health impacts of living in poor neighbourhoods (16 January, p 6).
鈥� We lamented that some skiers fail to pull a “chord” to inflate their avalanche airbag systems, a circumstance that could be explained by their being tone-deaf, we suppose (16 January, p 15).