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Irritable bowel syndrome in developing countries--a disorder of civilization or colonization?

While irritable bowel syndrome (IBS) is common in the West, early studies suggest that the prevalence is low in developing countries. However, recent studies point to increasing prevalence in newly developed Asian economies. The presentation appears to differ from the West, with a lack of female predominance, a greater frequency of upper abdominal pain and defecatory symptoms perceived as being less bothersome. This difference, together with the preoccupation with organic disease, could explain why we may be missing IBS in Asia and also why excess surgery has been observed in some Asian countries. While a recent study from China, consistent with western studies, support an important role for infection and inflammation, early studies from India reporting no association between amoebic infection and IBS appear to dispute this observation. To reconcile these seemingly contradictory observations, an hygiene hypothesis model is proposed. Exposure to a variety of microorganisms early in life could result in the colonization of the intestine with microflora that can respond more efficiently to an episode of gastroenteritis. Together with the changes with evolution of Asian economies such as westernization of the diet and increased psychosocial stress, it is proposed that loss of this internal protective effect, could give rise to a more uniform worldwide prevalence of IBS.

Culture↗

The classification of trauma. Lessons leaned in classifying injuries of 1,797 patients from civil disturbances in Northern Ireland, 1969-1971.

The difficulties of applying the rules of the International Classification of Diseases to trauma cases are discussed on the basis of coding the injuries of 1,797 injured patients from civil disorders in Northern Ireland, 1969-1971. Certain inadequacies of the code are indicated and suggestions made about ways to modify it and make its applications more informative.

Civil Disorders↗

Crush injury and crush syndrome: a consensus statement.

Crush syndrome remains rare in European practice but is common in areas of civil disorder and where society has given way to civil war or natural disaster. Clinicians in the west are becoming increasingly involved in such situations and there is no reason to believe that the few instances due to conventional causes, such as an elderly person collapsing or road traffic accidents, will cease. Therefore, it is important that clinicians who deal rarely with crush syndrome have access to appropriate guidelines. This consensus report seeks to provide such advice.

Adult↗

Consensus statement on crush injury and crush syndrome.

Crush syndrome remains rare in European practice. It is, however, common in areas of civil disorder and where the normal structures of society have given way to civil war or natural disaster. Western doctors are becoming increasingly involved in such situations and there is no reason to believe that instances due to more conventional causes, such as collapse in the elderly or road traffic accidents will cease. For all these reasons it is important that clinicians who deal infrequently with crush syndrome have access to appropriate guidelines. This consensus report seeks to provide such advice.

Adult↗

Consensus statement on the early management of crush injury and prevention of crush syndrome.

Crush Syndrome remains rare in European practice. It is however common in areas of civil disorder and where the normal structures of society have given way to civil war or natural disaster. Western Doctors are becoming increasingly involved in such situations and there is no reason to believe that instances due to more conventional causes, such as collapse in the elderly or road traffic accidents will cease. For all these reasons it is important that clinicians who deal infrequently with crush syndrome have access to appropriate guidelines. This consensus report seeks to provide such advice.

Crush Syndrome↗

[Unsaturated fatty acids omega-3. I. Structure, sources, determination, metabolism in the organism].

Fats covered approximately 22% of energy requirements in diets of ancient human being, and simultaneously the value of ratio of polyunsaturated fatty acids (PUFA) to saturated (SFA) was estimated as 1.4 and the proportion of PUFA omega 6 to PUFA omega 3 was 1:1. During the last twenty thousands years the composition of human diets was changing dramatically due to economical, culture and social changes. However, there are indicators that the ratio of PUFA omega 6 to PUFA omega 3 in human diet was unchanging until beginning of XIX century. Dramatic technological breakthrough in food technology during last 100 years caused radical changes in the structure and quality of food consumption. It is estimated that at present fats cover about 40% of energy requirements in diets of people in developed countries, and the value of ratio of dietary PUFA omega 6 to PUFA omega 3 is 25:1 and even 50:1. Epidemiological nutritional studies indicate that in populations which consume inadequate amount of PUFA omega 3 most often occur the disorders on atherosclerotic and immunological background as compared to populations which consume diets with appropriate covering the requirements of dietary PUFA omega 3. Therefore, it could be supposed that increased occurrence so-called civilization disorders is the result of increased consumption of highly manufactured food with changed composition (and also to increased fats consumption and decreased consumption of PUFA omega 3). This hypothesis is confirmed by the observations that the supplementation of diets with PUFA omega 3 gives the desirable results in the treatment of many disorders. The main objective of this two parts paper is to characterize the polyunsaturated fatty acids, their metabolic path ways as well as the possibilities of the use of the diet supplementation with PUFA omega 3 in the treatment and prophylaxis of some metabolic disorders. The structure, sources, determination and pathways in organism are discussed in part I, and the role of eicosanoids originating from respective PUFA omega 3 and advantages of the supplementation the diet with PUFA are discussed in part II.

Animals↗

[Paleopathology of ancient Egyptian mummies and skeletons. Investigations on the occurrence and frequency of specific diseases during various time periods in the necropolis of Thebes-West].

The scientific investigation of mummies and skeletons provides considerable data for the reconstruction of the living conditions and diseases of past populations. We describe the data on four completely analyzed tomb complexes from the huge necropolis of Thebes-West in Upper Egypt dating to different time periods. A total of 211 individuals from the so-called "Middle Kingdom" (MK, c. 2050-1750 BC) were compared to 273 individuals from the "New Kingdom" (NK) to "Late Period" (LP, in total 1550-500 BC). The age at death and the sex ratio were comparable between both groups. There was a high rate of early death with a maximum between the 2nd and 3rd decade of life but infant/adolescent burials were comparably rare. This early death is assumed to be due to an elevated prevalence of various infectious diseases. Likewise, a high rate of tuberculosis infections was seen in those individuals regardless of which time period they came from. Metabolic disorders with osseous manifestations, such as scurvy, osteomalacia and chronic anemia (cribra orbitalia, porotic hyperostosis) were found with a high frequency in the MK populations but significantly less in the NK-LP populations. On the other hand signs of trauma were comparably high, and lesions due to degenerative joint and vertebral diseases were significantly higher in LP than in MK or NK individuals suggesting a higher mechanical load in the later populations. Cases of malignant (secondary) bone tumors and various soft tissue/organ diseases indicate that "civilization" disorders were present when the living conditions assured survival into advanced age. In summary, we provide circumstantial evidence that the systematic and concise analysis of mummy and skeletal remains can allow a reconstruction of major aspects of life and disease in historic populations, although a complete reconstruction is not possible.

Bone Diseases↗

Hidden consequences of state violence: spinal cord injuries in Soweto, South Africa.

Many spinal cord injured people in Soweto are victims of direct, repressive state violence, such as police shootings. All of them are victims of the indirect structural violence that is institutionalized against both blacks and disabled people in South Africa. SCI people in Soweto are therefore subject to two sources of disadvantage and exclusion. This paper describes a survey of 88 SCI Sowetans. Their lives are marked by poverty and social isolation. Their experiences bring into sharp focus some of the concrete and hidden results of apartheid as a violent and disabling system.

Adult↗

Policing, collective action and social movement theory: the case of the Northern Ireland civil rights campaign.

In this paper we examine the relationship between social movements and the police through an analysis of the Civil Rights Movement (CRM) which emerged in the late 1960s in Northern Ireland. Following della Porta (1995) and Melucci (1996) we argue that the way in which episodes of collective action are policed can affect profoundly both levels of mobilization and the orientation of social movements. We also submit that the symbolic and representational dimensions of policing can be a significant trigger in the stimulation of identification processes and collective action. The paper concludes by questioning some of the assumptions contained within social movement theory, and their applicability to divided societies such as Northern Ireland.

Catholicism↗

Acoustic anti-personnel weapons: an inhumane future?

High intensity sound is foremost among newer technologies being considered by the military for use in war weaponry and in control of civil disorder, particularly in the United States where some weapons may be nearing deployment. The various forms of acoustic energy and the weapons in which they could be applied are considered, and the adverse effects on humans described; these can be serious and persistent, and are potentially lethal. Military applications for which high energy sound has been contemplated in the past or are being considered for the future are examined, and some existing research projects reviewed. Such uses of acoustic energy in war are criticized in the light of the obligation imposed by existing international humanitarian law for weapons not to cause 'unnecessary suffering' or 'superfluous injury'. The humanitarian community must advocate greater humanitarian protection in warfare.

Acoustics↗

Sociopolitical antecedents to Stonewall: analysis of the origins of the gay rights movement in the United States.

The 1969 Stonewall riot in New York City is widely celebrated as the beginning of the modern gay rights movement. However, the social changes that followed were possible only because of a decades-long indigenous organization. This article examines three traditional organizational theories on social action movements and applies Aldon Morris's analytical framework for understanding collective social action to the emergence of the modern U.S. gay civil rights movement. The author concludes that social workers need to understand how to gain access to and support indigenous social structures to assist oppressed groups to bring about social change.

Civil Disorders↗