The Alternative Truth About Teen Angst

When you hear the word depression, one often associates it with a terrible mental ailment that no cure seems to avail. According to the UK’s National Health Service (NHS), “depression is more than simply feeling unhappy or fed up for a few days”. Some people often think that depression is trivial and can be easily brushed off as it is mere “a sign of weakness”. Meanwhile, the World Health Organization (WHO) at the end of February declared depression as the single leading cause of disability worldwide. More than 300 million people suffered from depressive disorders in 2015, indicating an 18.4 percent increase in a decade, as stated in the report released by the United Nations agency.

The symptoms of depression range from mild to severe. They range from lasting feelings of unhappiness and hopelessness to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety. At its mildest, people may have feelings of utter sadness or low self-worth and at its worst, depression can lead to suicide. According to estimates by WHO, suicide is the second leading cause of death in 15-29-year-olds, which means that young adults are more susceptible to suicidal thoughts.


The devilish effect of social media

According to a study published in the journal Translational Psychiatry, more than one-third of teenage girls in the U.S. experience the first episode of depression. That number is three times higher than the rate for boys. There are a number of factors that make girls more prone to depression than their male counterpart. Rebecca Schwartz-Mette, an assistant professor in the department of psychology at the University of Maine, mentions pubertal changes, negative thinking styles such as rumination and low self-esteem as some of the common risk factors.

It’s undoubtedly hard to be a teenager. Puberty kicks in, hormonal changes followed by mood swings loom in, and not to mention the escalating peer pressures and academic expectations. The whole mix of changes can increase stress, anxiety and the risk of depression among all teens, research has long shown. And the increasing dependence on social media also exacerbates the problem. As psychiatrist and author Catherine Steiner-Adair explains, her young female patients often tell her they get their “entire identity” from their phone, constantly checking the number of “tags, likes, Instagram photos and Snapchat stories.”

In an age where information is so easily accessed, the internet community can be a hotbed of hate and jealousy. And with the advent of social media, where people can freely post their thoughts and share their stories, cyber-bullying and online harassment are bound to happen. Social media also allows social interaction between people who may never meet in real life but can be regarded as friends. But the dark side of the internet and social media has been unearthed. A survey by the Royal Society of Public Health in the UK shows that Instagram is ranked as the worst social media platform as it is often associated with high levels of anxiety, depression, bullying, and FOMO, or the “fear of missing out.” The survey, which was conducted among 1,500 14 to 24-year olds also found that Snapchat, Facebook, and Twitter all demonstrated negative effects overall on young people’s mental health.

But there is so much more to that. The more important question to ask is why is depression seemingly more prevalent in girls than boys? Or when a 14-year-old girl rants on her Facebook, does it show a symptom of depression or merely an attention-seeking behavior? Mental health is certainly an issue not to be overlooked. While there’s certainly a connection between social media use and signs of depression, parents need to stay vigilant in interpreting their children’s behaviors. When a child really seems to have changed, you can’t just write it off as adolescence.


Treatments for depression

If diagnosed early, depression can be treated effectively. Unfortunately, there are a number of cases where affected people refuse to seek help because of the social stigma that associates with mental disorders. Again, data from WHO shows that fewer than half of those affected in the world (in many countries, fewer than 10%) receive such treatments. Barriers to effective care include a lack of resources or lack of trained healthcare providers.

People with mild depression sometimes get better without any treatment, but in more severe cases they may need lots of help. Lifestyle changes are usually the first method of treatment to try. Getting more exercise, eating healthily and sleeping well can all have a powerful effect on our moods. However, people with more severe symptoms may also need professional help or receive a residential depression treatment.

Identifying depression does not solve the problem. If symptoms continue to appear, parents should be attentive and more importantly, offer help and listen. The challenge is to overcome the social stigma that often entails depression and other mental health disorders. This can be a long and hard journey for teenagers and their families, but the message to parents is to keep asking the right questions.

Are New Stock Exchange Listings Declining?

The capital markets landscape has changed considerably over the past two decades. The trend in the American stock market is the collapse in the number of listed companies. There were 7,322 in 1996; today there are 3,671. It has been almost a decade since AirBnB was founded. With it’s success, you would expect a company like AirBnB to have been listed. However, a decade on, it still remains unlisted. Amazon was three years old in 1997 when it floated. Airbnb has raised billions from private markets and has 26 external investors. There is a global phenomenon as new stock exchange listings are declining and listed companies are increasingly subject to takeover offers from trade buyers, private equity or other investment groups.

“For the past 20 years, public corporations in the United States have been disappearing. The number of U.S.-based companies listed on Nasdaq and the New York Stock Exchange has dropped by over half since 1996. The dot-com bust of 2000 and the financial crisis of 2008 account for some of this decline, yet the downward trend has continued with little let-up, even as the markets have reached record highs. The number of IPOs in the past five years is less than the number in 1996 alone. Something has gone wrong with the public corporation in the United States.” Gerald F. Davis, 2017.

There are several reasons for this, including: increased regulation that has pushed up the cost of IPOs; selling to private equity is an alternative to listing; and there are a limited number of exchange traded funds (ETF’s), or passive funds, that invest in small companies.

Whilst new stock exchange listings are declining along with existing ones, we see a limited negative impact on the local economies of the exchanges, if any. Fundamentally the markets are operating the same as it did previously. However, with the rise of different investment options and fund-raising methods, we see a diversification in the way smaller companies are choosing to jump-start their growth, with other alternatives such as Lead Network to provide access to funding.

Craig Doidge. G. Andrew Karolyi, and René M. Stulz explored the ‘US listing gap’ that delves into the decrease in stock listings and increase in delistings.– ‘consistent with a decrease in the net benefit of a listing for U.S. firms. Since the listing peak in 1996, the propensity to be listed is lower for all firm size categories and industries, the new list rate is low, and the delist rate is high. The high delist rate accounts for 46% of the listing gap and the low new list rate for 54%. The high delist rate is explained by an unusually high rate of acquisitions of publicly listed firms.’

IPO’s have also been on the decline. However, those that do conduct IPO’s in the US ‘are raising more money than ever before, and more foreign companies executing cross-border listings choose to list in the US, compared with anywhere else in the world”, according to an EY publication. With retail investors shifting toward investing in exchange traded funds, we see smaller companies become more hesitant to list on the stock market due to the potential liability that this may bring on as more retail investors look toward exchange traded funds, who in turn have shifted away from smaller companies. Since ETFs track an index, they do not need to be actively managed, and the funds simply need to match their asset pool to whatever index they are tracking. In this sense, ETFs are passively managed as they do not proactively select the best investments for their customers This is further evidenced by the huge growth seen in the industry in the last two decades and in the future to come. PwC in their 2nd Annual Global ETF Survey has concluded that assets for ETFs will have tripled for the US and double globally in the next few years to come.

Regulation has also made listing difficult for smaller companies and even bigger ones. In the United States, regulation has proven to be negative for the market. LA times described the Securities Act of 1933 that ‘prohibits not only actual sales of securities but even the offering of securities to investors until the SEC’s Division of Corporation Finance signs off on hundreds of pages of disclosures and accounting information.’

Davis points out that there is now often less of a need to raise capital by selling stock for a large production facility in the globalised facility. Companies can now turn to private equity firms rather than needing to sell stock. The dominant capital markets are fundamentally healthy and remain the preferred choice for US and many foreign companies that seek to go public. The dynamics in the private capital market have changed significantly, at least temporarily, and allow companies to grow larger and stay private longer.


Is breaking into the Ivy leagues harder for rural students?

Many, in fact all, ivy league colleges boast that they look for an equal mix of students from urban and rural areas, but is this really true? Colleges like to advertise that they want diversified classes, and accept students from different cultures and socioeconomic backgrounds, but if this is so, why are the attendance numbers of students from low-income families or rural areas so much lower than those who have attended private high schools or come from families with history of ivy league attendance.

The Jack Kent Cooke Foundation, which believes and speaks out for “poverty preference” in college admissions, made a statement in 2016 which called out America’s name-brand colleges for making virtually no progress in admitting more low-income students into their campuses over the last decade.

Harold O. Levy, the foundation’s executive director, said that “college admissions for kids in poverty is profoundly unfair,” and believes that ivy league colleges should follow in the footsteps of public colleges and adopt a low-income preference in their application process. Whilst there is argument that offering preference to low-income students applying to college is just as unfair as offering it to high income students, Levy believes that it will only level the playing field, not imbalance it.

Or is it in fact a matter that the best low-income students aren’t applying to ivy league schools. Sean Logan, a former college admissions officer, states that students that either come from rural areas or low-income families, or a mixture of both, often don’t apply to the most selective colleges in fear that they aren’t good enough or can’t compete. He said meeting with students that have masses of potential but haven’t considered applying to ivy league colleges is “not an unusual experience for me, dealing with kids who just don’t understand how good they are and what their opportunities are.”

Perhaps it isn’t a matter of colleges discriminating against students from rural backgrounds, but instead the students discriminating against themselves. Professor at Harvard University’s Kennedy School of Government, Chris Avery, agreed with this observation and stated that he himself had also noticed this problem among scholars. Avery said that “many of the highest-achieving students from the poorest families really shut the doors themselves… as they don’t apply to any selective college anywhere.”

Research has confirmed that a large percentage of academically qualified students from low-income backgrounds aren’t applying to ivy league colleges, and studies have shown that students from high-income and/or high-achieving families are more than twice as likely to apply to ivy league or first-tier colleges than their low-income peers.

Whilst Sean Logan found this to be because low-income students failed to believe in themselves, Avery’s research has shown that it’s because students from rural areas, or families that don’t have a history of college attendance, simply aren’t aware of their options and don’t know about these high-potential colleges. Of course most students are aware of the iconic ivy league colleges, such as Brown, Harvard and Columbia, but there are second-tier ivy league schools that are much less renowned and have a higher percentage of students that come from working-class families.

Of course there is also the reason of financial restraint. Most students from low-income earning backgrounds simply cannot afford the expensive tuition fees that come attached to ivy league college degrees. But whilst these colleges charge the most for their educations, they also give out the most scholarships. And while public universities continue to suffer from federal and state budget cuts, causing them to increase their prices and reduce their financial aid, the ivy leagues and best-endowed private colleges are allocating more resources to student financing. Perhaps if this information was better broadcasted to the public, more low-income students would realise that they have a better opportunity of graduating from an ivy league college with no debt than the do a public university.

Only 29 percent of of 18- to 24-year-olds in rural areas are enrolled in college, which when compared to the 47 percent of their urban peers, representants a significant undermatch. And whilst we know that usually students from rural areas are from lower-income families and represent the frightening minority when it comes to ivy league admissions, perhaps a reason for this percentage undermatch is because they simply don’t see the reason for it.

Higher education is an undiscussed subject in rural communities, and rural America has been much slower in seeing the net value of higher education. College doesn’t seem that important to people who have grown up on a family owned and operated farm, but with the recent increase of regional economic suffering, perhaps this mindset needs to change. For example, over the part four years Kentucky has lost lost 10,000 coal jobs paying $60,000 to $70,000 a year, which has sent residents into a panic as they struggle to find replacement work when they have no real skills.

It’s no secret that the largest socio-economic class in America is the middle-working class. With that in mind, it means that low-income students represent not only the largest percent of graduating high school students, but also the future of America’s workforce and intellectual power. So perhaps it’s time we start doing more to encourage low-income and rural students to apply to college, and the ivy leagues to make more of an effort to find them and support them.

Has our obsession with Hollywood stars led to a materialistic society?

Celebrities have always played a large role in shaping society and establishing acceptable cultural norms. For years we have idolised the rich and famous, our devotion and enthrall rivalling what humanity once gave to royal families or the Greek and Roman gods. However, what is new is the obsession society has developed with materialistic products as a result of observing the behaviours of our celebrity idols.

The American dream which was once based on individualism and being able to build success from working hard, has now transformed into something much more materialistic. In today’s modern society, the Kardashians are our heroes and the American dream is to achieve their luxury and exuberant lifestyle. America, and most of the western world, is obsessed with shopping and buying unnecessary commodities, and whilst this is great for the retail industry, what is it doing to our society?

Self-worth is no longer associated with academia or career driven achievements, but with how well-known you are in the area in which you live. Hard work today is determined by how much ‘stuff’ you have and whether you have the new iPhone or the latest car. People are no longer envious about good grades or solid career paths, but instead of those who manage to cheat the system and rise to fame for doing as little as possible. Our view on normal has skewed, and what was once considered normal; ‘to go to school, get good grades, go to college or get a good job, provide for your family, be careful with money because it doesn’t grow on trees, and when you return from work, spend quality time with the family’ is basically an old-school way to live, forgotten are the great values and qualities it instilled in people. Our view on ‘normal life’ has changed, and although we now live comfortably and have technology that can further our society, whether the change is for the better is still debatable.

Ellen Goodman made a great statement about society’s new and widely accepted way of living, she said  “normal is getting dressed in clothes that you buy for work and driving through traffic in a car that you are still paying for, in order to get to the job you need to pay for the clothes and the car, and the house you leave vacant all day so you can afford to live in it.” And who do we have to thank for this new ‘normal’ way of living? The celebrities.

Our idolised celebrities live these rich and extravagant lifestyles that we all wish we could live, and although this living status isn’t normal or realistic for the rest of us, it doesn’t stop us for striving to obtain it . However, for those that haven’t been lucky enough to get paid to live these lifestyles, trying to obtain celebrity status living often means that we have to work so hard that we never actually get to enjoy the fruits of our labour; that expensive car that sits in the garage all day whilst we’re at work, the amazing holiday house by the beach that we never get to visit, the amazing jacuzzi at home that we never use because we get home from work too late. So why do we do it? We’re all guilty of it, and it’s because our favourite celebrities have told us to. They might not have said it in so many words, by this is the effects of constantly seeing their extravagant lifestyles and (often paid for) advertisements plastered all over our social platforms and every other form of online or offline media.

It’s not just America, children are growing up all over the world with unrealistic expectations that have been bred by constantly seeing the wealth and materialism of celebrity-obsessed societies. And with shopping being easier than ever, it begs a question for the future, if we’re worried about our ‘empty’ and ‘destructive’ celebrity driven societies today, what does it mean for generations to come. With the rapidly transforming information age, online shopping has never been easier. Almost every store, no matter how small or how large, has an online platform, facilitated by online coupons and promo codes, and paid for advertisements on our favourite celebrity social media accounts. It’s simply too easy to fall into the materialistic trap and consumerist way of life, we can hardly blame society for making this change when it’s all they see and hear.

A 2015 study by Jennifer Lewallen, Brandon Miller and Elizabeth Behm-Morawitz, titled ‘Lifestyles of the Rich and Famous: Celebrity Media Diet and the Cultivation of Emerging Adults’ Materialism’, explores the relationships between celebrity media diet and materialism, using 224 young adults as study subjects. The study determined that the main cause of materialism was a cause of both celebrity magazine consumption and celebrity TV news. Findings from the study suggested that in a society where celebrity media news is high, young adults are inevitably pushed towards consumerism.

Social studies like this are far from uncommon, but what are we doing with this knowledge? Our society continues to be an environment of celebrity-saturated media and materialistic values. It begs the question of what does this mean for future generations? It’s scary to think that our consumerist lifestyles could progress any further, but unless there’s a revolt against idolising the rich and famous, especially those that have achieved this status through no meaningful way i.e. today’s reality stars, it’s likely that our materialistic obsessions will develop further, and society will truly say goodbye to the once solid values our elders tried so hard to uphold.

Child Drowning Incidents Highlight the Need for a Policy Response to Unsafe Home Pools

Drowning, defined by the World Health Organisation, as respiratory impairment from submersion/immersion in liquid, has shown an alarming increase in the last few years. In fact, according to Arrive Alive, it is the 3rd leading cause of unintentional injury death worldwide. More alarming is the fact that its occurrence is mostly in the innocuous swimming pools, and very often, at the child’s own home.

Research in US, puts children aged, 1 to 4, as the most susceptible age group involved in the incidents of drowning. Statistics compiled by the KK Women’s and Children’s Hospital (KKH), Singapore also showed an upward trend of drowning or submersion incidents that involved children of pre-school age. Though the younger children around the world seem to be more vulnerable to water-related accidents, research shows that the older ones, including those who know swimming, are no less at-risk. This is because, when it comes to water- related incidents, risk-taking and overconfidence in an older child plays a significant role in water deaths, especially in boys. This puts the boys in ‘at-risk’ bracket consistently in all the major drowning incidents around the world.

Not surprisingly, most reported drowning incidents are fatal. In addition, most of these that make it to the newspaper headlines involve death. However, non-fatal drowning involving the hidden victims are equally concerning and have recently being included in the drowning statistics. Clinically identified as “non-fatal drowning” victims, these mostly consist of the curious toddlers who are attracted to the swimming pool at their homes or neighbourhood, and who walk in to the pool to play with the water. These worrying statistics makes it imperative to monitor young children at all times, regardless of the size of the pool. It also insists that the safety measures are put in place.

One of these measures, include the use of safety barriers and recently, the National Safety Council released regulations on 4-sided residential pool fencing. According to the report, four-sided fencing around the swimming pool is the best protection possible. “When our children somehow find their way to the pool in our absence, we need to make it difficult for them to get in,” says Michael Corkery, President of Pool Guard USA.  “Well-built four-sided pool fences that are, at least, 1.2 m high, with vertical bars no more than 100mm apart and horizontal bars at least 900mm will do just that. These fences are even more effective than human presence because they will always be there,” says Michael. To make it more comprehensive, the US Consumer Product Safety commission has come with a Safety Barrier Guidelines for Swimming Pool.

Apart from erecting the appropriate fences, it is also essential that the parents and supervisors of young children are equipped with the emergency protocol in case of drowning related incidents. Having appropriate reaching or throwing equipment, knowing emergency numbers to call in distress, life jackets and a first aid kit available with emergency instructions inside are a must in each household where small children have access to a swimming pool.

The U.S. Consumer Product Safety Commission (CPSC) further suggests safety tips for swimmers and, these are specifically directed towards parents of children swimming in the pool. They advise parents not to leave their child unattended and recommend that parents should teach children not only how to swim, but should also equip them with basic water safety tips. Red Cross further spells out the dos and the don’ts of water safety and have come up with a free swim app to prepare for water emergencies.

In addition to the safety preparedness by the parents, there are renewed calls for legislative regulations on the matter of pool safety as well. In Australia, for example, Leader Community News launched the ‘Make our Pools Safe’ campaign to highlight concerns around Victoria’s confusing system of pool fencing laws. Their request was to set up a pool register and to require home- owners to obtain a pool barrier compliance certificate when their property was sold or leased. There are also countries like New Zealand, which already have established regulations for home swimming pools in place. However, though states like Florida, and Arizona have created their own individual pool fence laws, there is no federal pool fence law currently in place in the US.

With each drowning incident involving a young child, it becomes a race against time to save a young life in his or her own home swimming pool. As statistics rise consistently, there is a need to not only have safety preparedness by the parents and the supervisors, but there is also a need to make legislative changes that make safety a must for all swimming pools at homes.

What Does “Skinny” Mean? An East vs. West Comparison

According to the National Association of Eating Disorders, eating disorders are historically associated with white women. However when recent research showed a rise in eating disorders in Asia, it is thought to be correlated with Western influence. As over the past century, Americans have become obsessed with the idea of being “thin”, associating it with upper class status. This is not the case, as being “thin” is considered the “typical” body type in Asian cultures and there are increasing individual and collectivist pressures to maintain it.

Individual pressure can include reading magazines and watching television shows where women are portrayed with thin figures. The pressure to remain thin is constructed through social norms, often cultural. Collectivist pressure can include the influence of family and friends. In South Korea, if you are above the average weight, you are constantly reminded by everyone how “big” you are. South Koreans are also well-known for their diet fads, as perpetrated by their entertainment figures. The craze with plastic surgery also does not help the cause, with women constantly relying on procedures to improve how they look.  Because being thin is considered the “normal” type of body, you are often shunned by your friends and peers if you do not fit the stereotype.

Extreme weight-loss methods can include surgery, diet drugs, skipping meals, crazy diet plans. Bartiartic surgery is a surgical procedure that reduces the stomach volume by as much as 80% and maintains high metabolism. This method is typically performed on obese patients who have struggled to get their weight down through diets and exercise. This has proven to help patients regain their health and self-esteem, ultimately increasing their confidence. Diet pills are the growing factor that serves the economic interest of the multibillion-dollar weight loss industry and large pharmaceutical companies. Skipping meals is a method often used by teenagers, assumming that not eating is the number one tip to weight loss. Crazy diet plans can range from the Sweet Potato diet (only consuming sweet potatoes for three meals a day, everyday), Paper cup diet (three paper cups to determine portion sizing for rice, vegetables/meat and fruit) and the Lemon detox diet (cleansing your inner organs with a mixture of lemon, pure maple syrup, cayenne pepper and water; six to 12 glasses a day). Our society is unfortunately very familiarized with diet trends, and some of us have even tried these drastic measures.

Society often thinks that skinny means healthy, but that is actually not true. People who have more body fat, regardless of their size, may have a higher risk of dying early than people whose bodies have less fat. There is such thing as “skinny fat” and people don’t realize that – it is possible to be thin and out of shape and this is not healthy. BMI (body mass index) is often used to measure obesity, by seeing the relation of weight to height. Recent research has shown that this is not a good method to showcase body composition or health because someone with a lot of muscle mass may have a high BMI and fall into the overweight category, even though they are far from that.

What people don’t know is that eating disorders are considered a type of mental illness. It is difficult for one to talk about what they are going through, when they are trapped in a culture of shame, weakness and labelling among the South Asian community. Mental illness is taboo in Asia because people take it as if there is something wrong with you. It can be a risk to a family’s reputation and status, two things which are still important in most Asian nations. Professor Dinesh Bhugra, an expert in mental health at King’s College London says it is part of the nation’s language, “There is no word for depression in South Asian languages. The identified causes are usually ‘life’s ups and downs’.” With mental illness a growing topic in the world with people open and ready to discuss it, Asia has not jumped on the bandwagon. “This is not a place where you are going to admit to any weakness… it’s also a disease that is not connected to Japanese culture, and is seen as an import, something that has come from somewhere else.” Dr Nancy Snow, an international relations expert says. The cultural landscape in Asia has to change and it has to start from changing the mindsets of older generations. A Professor of medicine and radiology at the University of Manitoba in Canada says, “In our society, there’s this mantra that thin is “in” and being heavy is “bad”. Health is about more than the number on your scale.” Health is important in all three aspects: emotional, physical and mental. When all three factors are united, then you are finally healthy.

To age gracefully or forever inject? The public health implications of cosmetic injectables


The Botox obsession has increased dramatically since it received FDA approval for cosmetic use in 2002. Women and men across the globe have become long-term devotees. Younger people are being encouraged to commence Botox earlier rather than later to prevent the visible signs of aging.

According to the American Society for Aesthetic Plastic Surgery, over 4.5 million Botox injections were performed in the United States in 2016, a 10% increase from 2015. The American Society of Plastic Surgeons has found that 20,676 sites were injected among patients aged 13-19 and an additional 7,000 filler procedures were performed. The International Society of Aesthetic Plastic Surgery (ISAPS) reports that in 2016 over 8.5 million dermal injections were administered globally.

The demand for Botox has given rise to increased supply, not all of which is above board. A growing number of procedures are being performed in homes by novice, unqualified practitioners or patients themselves to save time and money. Cosmetic injectables including Botox, Juvederm, Dermaveen can be purchased easily online in unregulated markets. Online purchases come with little assurance of the product’s authenticity and no reprise if anything goes wrong.

Botox parties are an increasingly popular way of accessing treatments at a lower cost with friends, advertised by some providers as “more gratifying than a Tupperware party, more fun than Pampered Chef and more twenty-first century than Avon”. In these settings, it is crucial that a patient’s medical history is screened beforehand to reduce the likelihood of adverse reactions as it should not be used in patients with autoimmune conditions. Patients with infections such as sinusitis, periodontal disease, ear, nose, or throat infections, or dental abscesses should not be treated until the condition has resolved. Practitioners must have a comprehensive understanding of facial anatomy to prevent injection into the blood stream, excessive bruising, swelling, loss of vision, droopy-eye or permanent paralysis. Although the risk of Botox spreading to other parts of the body is low, it is important to have access to a licensed health practitioner who is responsible for providing post-treatment care.

Although Botox parties are predominantly held with a qualified doctor, reports of unqualified nurses injecting patients have emerged in recent years. Some practitioners have been found guilty of re-using syringes with a new needle tip, believing a false misconception that the Centres for Disease Control and Prevention is working to eradicate. Syringes should only ever be used once, as they can transmit blood-borne diseases including Hepatitis B, C and HIV.

The risk of infection that comes with injecting in a non-sterile home environment is high and health professionals recommend that procedures be undertaken in a doctor’s office that has infection control procedures in place. According to a consensus paper developed by an international group of esthetic physicians, it is important for practitioners to choose their patients carefully to avoid complications and not allow profit motives to drive clinical decisions.

The all-too-common habit of a few units each month may seem like a harmless investment in the in youthful looks but it may not be so. The long-term health consequences of Botox are rarely discussed. Many websites advertising procedures do not adequately inform patients of the risks. The Mayo Clinic highlights that injections can induce crooked smile, drooling, dry eyes or excessive tearing. More harmful side effects indicative of botulism include trouble speaking or swallowing, trouble breathing and loss of bladder control and require immediate medical attention. Muscle wastage, weakness and bone density loss have also been demonstrated in animal and human studies. Researchers at the University of Washington demonstrate their findings in mice, with the ratio of bone volume to tissue volume decreasing in the femur and tibia of injected limbs by 43.2% and 54.3%, respectively. The first study in humans confirms this finding, with oral health radiologists observing decreased density in exposed patients. Patients are therefore at risk of facial fractures – both painful and costly to treat in terms of medical bills and lost wages.

Men and women of all ages should think carefully before deciding to put themselves at risk of infection, muscle wastage and bone density loss for the sake of esthetics. The average cost of a mandible fracture in the United States is approximately $36,000 or more if there are additional complications. Ageing is a natural part of life – why not do it gracefully?

A Global Outlook on the Pest Control Industry

The pest control industry is booming given recent global outbreaks of mosquito-borne diseases like Zika.
The pest control industry is booming given recent global outbreaks of mosquito-borne diseases like Zika.

Over time, an increased need for hygienic and pest-free environments has increased the need and demand for pest control services. Expected to grow at a healthy rate, the international pest control services market is intended to exceed US $22 Billion by 2026. Pest control is a process for managing or exterminating various living organisms which are harmful to human beings. Pests can include bedbugs, cockroaches, termites, reptiles and other unwanted organisms. These animals are considered “pests” because they interfere in residential, commercial, agriculture and industrial processes.

Residentially and commercially, living in a cockroach-infested house makes you more vulnerable to allergies, germs, and ultimately diseases. Cockroaches eat many types of material besides food scraps (paper products, clothing items, cardboard) and can adapt to an environment quickly and adopt high endurance levels that makes it even more difficult to get rid of them. Roach killer techniques can range from chemical control to mechanical control and pest control. Chemical control can be in the shape of a killer spray that contains toxic chemicals, poison gel baits that kill entire colonies or sticky glue traps where you can find out which areas are more infested than others depending on how many dead roaches you find on the trap. Because of recent concerns of health and environmental impact from customers however, companies have been using more organic chemicals.

Agriculturally, when rodents aren’t controlled, they can come overnight and completely destroy crops, causing widespread economic repercussions on the agricultural industry. They can inflict a large number of economic damage because of their population size, diversity and feeding habits. Agricultural pests are one of the number one key factors affecting small farm production. Industrially, pests can cause serious damage to existing structure and foundations (rotting wood or other soft materials). Sometimes the damage is serious enough that a whole structure can become useless, for example termites eating on a leg of a wooden table.

Although North America and Western Europe are currently the largest markets for pest control services, Asia-Pacific has a high-growth potential. Demand for pest control services could be attributed to the fact that there is a rise in international tourism and that various pests thrive in warmer climates. Some pests are displaying unusual migration habits due to both manmade and natural factors, such as global warming. Climate change not only affects farming practices, but also affects the distributions and life cycles of pests, disease-causing organisms and crop-pollinating insects and animals. Some insects and flying creatures are also multiplying at faster rates.

China and India have enough cultivable land to grow crops, factoring in the urbanization and technological growth in agriculture. People are looking into pest control services for crop protection to prevent and avoid losses. Emerging economies within the nation also mean higher standards of living and an increase in disposable income amongst the community, resulting in the continuous demand of hygiene and cleanliness.

One of the ongoing challenges the pest control industry is facing is how expensive the services are. Some people have resorted to studying reports by themselves and learning how to DIY the methods. It is important to note that however, research have shown that there is indeed a direct correlation between cleanliness and health. Patients admitted to rooms previously occupied by infected individuals are at a higher risk of acquiring these organisms from contaminated surfaces. This means improved hand hygiene can prevent multidrug-resistant organisms which has been recognized as one of the defining factors to outbreaks. Cleaning your home can help prevent pest outbreaks and also include benefits for good mental and physical health. Firstly, not only does it help to clear your airways, it also cleans all the places rodents can potentially habituate. The Environmental Protection Agency says that indoor air can be up to five times more polluted than the outdoors. Indoor air means we are breathing in dust mites, pet fur residue, pollen, mold, bug skeletons, toxins from cleaning products and chemicals from our own clothing and bedding. Secondly, the act of cleaning your house actually gives you sufficient exercise, leading to a healthier and more active life.

People who were surveyed reported that they get a better night’s rest when their sheets are freshly cleaned – a prevention and elimination of potential bedbugs. People who described their living spaces as “cluttered” are proven to be more tired and stressed out compared to those who have clean and organized rooms. Cockroaches find shelter in holes or cracks around window and door frames, water pipes and baseboards. If there is a hole in the water pipe, this leakage needs to be fixed immediately because water on the ground can lure the cockroach out. Brad Fischer, the District Service Manager at Batzner Pest Control says, “The real problem tends to come from the unseen areas, like a spill underneath an oven, or crumbs not being vacuumed along the walls in a dining area.”

How Far Is Too Far? The Booming Cosmetic Surgery Industry and the Never-Ending Strive for Perfection


In today’s hyper-perfectionist world, almost any cosmetic procedure can be performed to nip, tuck, lift or fill anything the patient deems to be “in need of fixing”. Labiaplasties can be performed improve the appearance of female genitals, belly button surgery can change “outies” to “innies” and eyelash transplants can solve the problem of thinning lashes. Eyelid procedures are common among women of Asian descent to form European eyelid creases. New mothers can return to their pre-pregnancy physique with a post-partum “mummy makeover” to lift and augment the breasts, tuck the tummy and remove unwanted fat.

Esthetics are not just for women. Men are increasingly large consumers in the cosmetic surgery industry, seeking perfect proportions, shapes and sizes in all parts. Gynaecomastia procedures, otherwise known as a male breast reduction, are being performed to improve the size of male breast tissue and correct for areola deformity. Washboard abs can be created with high-definition Vaser liposuction, touted as “a less invasive treatment alternative, with less pain and no skin damage”.

More alarmingly, adolescents are becoming increasingly fixated on perfection. Developmental changes during puberty can leave many young people feeling self-conscious. Given the ease with which surgery can be performed today, what was once a normal, albeit inconvenient stage of growing up, is now entirely avoidable. Breast implants are a growing trend in graduation gifts with parents giving implants to their graduating daughters before college. In the United States, the number of 18-year-olds who underwent breast-implant surgery nearly tripled from 2002 to 2003, to 11,326.

According to the American Society of Plastic Surgeons, 15.9 million surgical and minimally invasive cosmetic procedures were performed in the United States in 2015. Since the year 2000, the overall number of procedures in the United States alone has risen by 115 percent.

Last year, Americans spent $16 billion on procedures.

The cost of surgery has dramatically decreased with the rise of medical tourism, making procedures more accessible to the everyday consumer. A rhinoplasty no longer requires a lifetime of saving and can come with post-operative down-time in an exotic resort. Epidemiological data on medical tourism is difficult to obtain, though ongoing case reports and infection outbreaks serve as a reminder that it is not without risks.

These risks are of concern to public health professionals. Infection control policies in developing countries are often lax in comparison to developed countries. Mycobacterial infections have been recurrent in the Dominican Republic over the last five years, causing pulmonary and skin infections that can last up to 12 months. As drug-resistant superbugs continue to emerge in the United States, is it worth the risk of going under the knife in a less-developed country? Patients may also be at risk of infectious diseases more prevalent in other countries that can increase the cost of treatment and jeopardise the health of their family and friends.

An increasing body of evidence has found that Botox rapidly degrades bone density, putting patients at risk of fractures. Researchers at the University of Washington demonstrate their findings in mice, with the ratio of bone volume to tissue volume decreasing in the femur and tibia of injected limbs by 43.2% and 54.3%, respectively. The first study in humans confirms this finding, with maxillofacial radiologists observing decreased density in exposed patients.

Complications of cosmetic surgery are rare, but include infection, bleeding, fluid and salt imbalance, and allergic and potentially fatal anesthetic reactions. When PIP breast implants ruptured in a number of women throughout the world, the French manufacturer refused to pay compensation to those affected. Women who received the breast implants were faced with the cost of removal, leaving many unable to afford to remove or replace them. The impact on some patients was described as irreversible, imposing years of pain and anguish. The immune systems of some women were so low that they cannot undergo future surgeries, leaving them with a damaged version of the body they so desperately tried to change.

Surgical site infections (SSIs) are uncommon among patients in high-quality healthcare settings, however if pre-operative and post-operative procedures and antibiotics are not administered rigorously, infection can take hold. In Korea, despite having the largest per capita concentration of plastic surgeons in the world, a number of legal cases have been recorded for site infection resulting in health complications and the need for additional surgery.

In Sweden, a man in his thirties recently died during penis enlargement surgery. The process enlargement process routinely injects fat into the penis, though in this case caused an embolism resulting in cardiac arrest. Although treating doctors noted it was the first death among a healthy young man, others have spoken out against the procedure. A urologist from the Mayo clinic describes the procedure as “completely useless” that can lead to significant consequences including disfigurement and permanent erectile dysfunction.

Is perfection worth it? From a public health perspective, no.

Book Review: DragonKeeper by Carole Wilkinson

My mom bought me Dragonkeeper by Australian author Carole Wilkinson when it was first published in 2003 by Black Dog Books. Soon after, it was spun into a trilogy. A story about an ancient dragon and a slave-girl-turned-dragon-keeper’s perilous journey to get to their end destination while battling evil necromancers and greedy individuals, in the meantime creating valuable relationships and meaningful friendships; it provided a passageway to China. As I look at the publisher’s page, I see my mother’s handwritten note of the date and place where the book was purchased. Although I was eight years old when I first read it, it is a book that I return to.

Midway through the book, Ping, the book’s heroine, finds herself escaping a near-death experience as Chang’an villagers try to sacrifice her in hopes that the gods would gift them rain for their crops. Just when it seemed as if the gods were not going to answer, Danzi the dragon intervenes by flapping his wings, beating the clouds, creating rain, and allowing Ping to escape. Such moments endure not only for the rich plot but also for how the book portrays ancient Chinese life.  Wilkinson even provides a glossary of terms in the back of the book to guide readers, helping those who do not know what jujubes or chinaberry leaves are or when the Han Dynasty took place. She evocatively showcases different Chinese traditions, superstitions, as well as eating and living habits. For example, she offers a hilarious scene in which Danzi tells Ping that she smells, which Ping finds ridiculous since she had taken a bath three months earlier and did not see a need for another one so soon.

Most important, Wilkinson’s book reminds of a time when gender equality was lacking. In showcasing a young girl who was undermined from birth who eventually started to discover her strengths, learn to harness her weaknesses, and ultimately finds out who she was as a young woman, Wilkinson offers young readers hope and a positive role model with the need to persevere. A lot of people were hesitant to take Ping seriously as she was female. As the herbalist-ex-dragon keeper Wang Cao explains, “It has never been a female before.” Baby boys were seen as investments who could grow up to be strong and earn good money. Baby girls, in contrast, were seen as liabilities, quickly married off to other families. Although it is not, for the most part, prevalent in society now, existing older generations in Asia (in Korea, Indonesia, China, for example) can still maintain such views.

For me, Dragonkeeper is one of the must-read books of all time. Although coined as a children’s book, I remember grimacing at the gruesome, violent parts throughout the pages. Definitely not a Disney story, The Dragonkeeper deals with gritty issues like poverty, greed, and death. Wonderfully written, Wilkinson takes dark themes and spins them into a touching ending. With an extensive library at home, there are a few books that I return to again and again, but Carole Wilkinson’s Dragonkeeper is one of them.

Mentioned in this article: Dragonkeeper, Caroline Wilson, Best Advisor