Modeling of the Temporal Patterns of Fluoxetine Prescriptions and Suicide Rates in the United States

BACKGROUND: To study the potential association of antidepressant use and suicide at a population level, we analyzed the associations between suicide rates and dispensing of the prototypic SSRI antidepressant fluoxetine in the United States during the period 1960–2002. METHODS AND FINDINGS: Sources of data included Centers of Disease Control and US Census Bureau age-adjusted suicide rates since 1960 and numbers of fluoxetine sales in the US, since its introduction in 1988. We conducted statistical analysis of age-adjusted population data and prescription numbers. Suicide rates fluctuated between 12.2 and 13.7 per 100,000 for the entire population from the early 1960s until 1988. Since then, suicide rates have gradually declined, with the lowest value of 10.4 per 100,000 in 2000. This steady decline is significantly associated with increased numbers of fluoxetine prescriptions dispensed from 2,469,000 in 1988 to 33,320,000 in 2002 (r(s) = −0.92; p < 0.001). Mathematical modeling of what suicide rates would have been during the 1988–2002 period based on pre-1988 data indicates that since the introduction of fluoxetine in 1988 through 2002 there has been a cumulative decrease in expected suicide mortality of 33,600 individuals (posterior median, 95% Bayesian credible interval 22,400–45,000). CONCLUSIONS: The introduction of SSRIs in 1988 has been temporally associated with a substantial reduction in the number of suicides. This effect may have been more apparent in the female population, whom we postulate might have particularly benefited from SSRI treatment. While these types of data cannot lead to conclusions on causality, we suggest here that in the context of untreated depression being the major cause of suicide, antidepressant treatment could have had a contributory role in the reduction of suicide rates in the period 1988–2002

Disarmament and Development: An Idea Whose Time Should Have Come

SUMMARY In 1982 the General Assembly advised governments ‘to start to plan and prepare for a conversion process which could be implemented in a disarmament situation’. But to make the required decisions and actions, drastic changes were needed in the behaviour of political leaders, particularly those of the dominant military powers. So far, efforts to create a political constituency for disarmament and development have not been successful. Only the Swedish government has undertaken a study, resulting in the report, In Pursuit of Disarmament . Although this study does not necessarily establish a model that can be replicated in other countries, it does show that the UN's recommendations can in principle be put into effect. SOMMAIRE Désarmement et développement: II n'est jamais trop tard pour y penser En 1982 l'Assemblée Générale conseillait aux gouvernements 'de commencer à planifier et à préparer un procédé de conversion qui pourrait être rendu effectif dans une situation de désarmement. ‘Mais afin de prendre les décisions correctes et d'agir en conséquence, il faudrait des changements radicaux dans l'attitude des chefs politiques, particulièrement ceux des puissances militaires dominantes’. Jusqu'à présent les efforts dirigés à la création d'une circonscription électorale politique en faveur du désarmement et du développement n'ont pas abouti. Seul le gouvernement Suédois a entrepris une étude, figurant dans mon rapport, In Pursuit of Disarmament . Quoique cette étude n'établit pas nécessairement un modèle qui pourrait être adapté dans d'autres pays, il montre que les recommendations des Nations Unies peuvent en principe être mise en pratique. RESUMEN Desarme y desarrollo: una idea cuyo turno debiera haber llegado En 1982, la Asamblea General le recomendó a los gobiernos ‘que empezaran a planificar y a prepararse para un proceso de conversión a implementarse en una situación de desarme’. El comportamiento de los dirigentes políticos, especialmente de aquellos dé las potencias militares dominantes tiene que cambiar drásticamente si se quiere adoptar las decisiones y llevar a cabo acciones necesarias. Hasta ahora, los esfuerzos desplegados para crear un entorno político favorable al desarme y el desarrollo no han tenido éxito. Sólo el gobierno sueco ha realizado un estudio que culminó en mi informe En Búsqueda del Desarme . A pesar de que este estudio no establece necesariamente un modelo que se pueda copiar en otros países, demuestra que las recomendaciones de las Naciones Unidas pueden, en principio, ponerse en práctica

Crowdworker Economics in the Gig Economy

The nature of work is changing. As labor increasingly trends to casual work in the emerging gig economy, understanding the broader economic context is crucial to effective engage- ment with a contingent workforce. Crowdsourcing represents an early manifestation of this fluid, laisser-faire, on-demand workforce. This work analyzes the results of four large-scale surveys of US-based Amazon Mechanical Turk workers recorded over a six-year period, providing compa- rable measures to national statistics. Our results show that despite unemployment far higher than national levels, crowd- workers are seeing positive shifts in employment status and household income. Our most recent surveys indicate a trend away from full-time-equivalent crowdwork, coupled with a reduction in estimated poverty levels to below national figures. These trends are indicative of an increasingly flexible workforce, able to maximize their opportunities in a rapidly changing national labor market, which may have material impacts on existing models of crowdworker behavior.This work was supported by an EPSRC studentship and EPSRC grants EP/N010558/1 and EP/R004471/1

Carbon stored in human settlements: the conterminous United States

Urban areas are home to more than half of the world's people, responsible for >70% of anthropogenic release of carbon dioxide and 76% of wood used for industrial purposes. By 2050 the proportion of the urban population is expected to increase to 70% worldwide. Despite fast rates of change and potential value for mitigation of carbon dioxide emissions, the organic carbon storage in human settlements has not been well quantified. Here, we show that human settlements can store as much carbon per unit area (23–42 kg C m −2 urban areas and 7–16 kg C m −2 exurban areas) as tropical forests, which have the highest carbon density of natural ecosystems (4–25 kg C m −2 ). By the year 2000 carbon storage attributed to human settlements of the conterminous United States was 18 Pg of carbon or 10% of its total land carbon storage. Sixty-four percent of this carbon was attributed to soil, 20% to vegetation, 11% to landfills, and 5% to buildings. To offset rising urban emissions of carbon, regional and national governments should consider how to protect or even to increase carbon storage of human-dominated landscapes. Rigorous studies addressing carbon budgets of human settlements and vulnerability of their carbon storage are needed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75157/1/j.1365-2486.2009.02002.x.pd

Single parenting: Interventions in the transitional stage

Following divorce or separation, many mother-headed families need to mourn losses, including reduced economic resources. They need to reestablish family rituals, confront such issues as time management and structural changes that can result in scapegoating or over-reliance on a parental child. Normalizing difficulties associated with parenting is important because single parents tend to internalize societal attribution of family difficulties to inadequate family structure rather than developmental stages, limited economic resources, and negative expectations about the capacity of women to head families.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44289/1/10591_2004_Article_BF00891869.pd

Prototyping Self in Silicon Valley, Deep Diversity as a Framework for Anthropological Inquiry

High-technology work fuels a dynamic global exchange from technopoles throughout the world, but especially between East and South Asia and the northern Californian region of Silicon Valley. This migration drives an expanded number of ancestral identities. Professional and activity-based identities flourish as Silicon Valley’s strong narrative of meritocracy loosens the grip of birth ascription on the creation of identities. These achieved identities proliferate as people experiment on their own sense of self. Traditional conceptual tools related to immigration, and even such contemporary approaches as Appadurai’s ethnoscapes, do not adequately illuminate the ethnographic data on Silicon Valley workers, families, and especially youth. The concept of deep diversity, first posed by philosopher Charles Taylor and reified by anthropologist Clifford Geertz, reinterprets the interactions of traditional ethnic identity categories, providing a powerful framework with which to think

Is the test of senior friendly ⁄child resistant packaging ethical?

Research has documented the drastic reduction of unintentional poisonings of children since the introduction of child resistant (CR) packaging. However, studies also indicate that consumers report difficulty using CR packages, in part because tests which determine the ‘senior friendliness’ of CR designs that are used throughout the world disallow people with ‘overt or obvious’ disabilities from being test subjects. Our review of drug package usability suggests that the current tests of CR packaging can and should be revised to correct this problem. We use US legislation, regulation and data to exemplify these points, but the conclusions are applicable to all protocols that include the exclusionary provision

Diasporas and democratization in the post-communist world

If diaspora communities are socialized with democratic values in Western societies, they could be expected to be sympathetic to the democratization of their home countries. However, there is a high degree of variation in their behavior. Contrary to the predominant understanding in the literature that diasporas act in exclusively nationalist ways, this article argues that they do engage with the democratization of their home countries. Various challenges to the sovereignty of their homelands explain whether diasporas involve with procedural or liberal aspects of democratization. Drawing evidence from the activities of the Ukrainian, Serbian, Albanian and Armenian diasporas after the end of communism, I argue that unless diasporas are linked to home countries that enjoy both international legal and domestic sovereignty, they will involve only with procedural aspects of democratization. Diasporas filter international pressure to democratize post-communist societies by utilizing democratic procedures to advance unresolved nationalist goals