BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The ...BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.展开更多
Rudyard Kipling is the first British writer to win the Nobel Prize for literature in 1907.Due to the influence of the First World War and the huge blow of his own beloved son John's death on the battlefield,Kiplin...Rudyard Kipling is the first British writer to win the Nobel Prize for literature in 1907.Due to the influence of the First World War and the huge blow of his own beloved son John's death on the battlefield,Kipling's later writing pays more attention to the pain and trauma which the war brings,and the noble qualities of love,belief,and tenacity in human nature after the baptisms of pain and trauma.This paper selects two poems—"My Boy Jack"and"A Nativity"in Kipling's later poetry creation career.Freud's "trauma" and treatment theories are employed to study the two mothers' "self- trauma- healing mechanism"in face of pain and trauma,and to interpret the two mother images that experience the war-torn pain and trauma,and achieve their spiritual salvation at last.Through the transformation of the two mothers,Kipling wants to mourn his beloved son's death and expresses his determination and hope of faith and commitment in order to heal his inner pain and trauma,which unwittingly realizes Freud's trauma-healing theory.Key words:展开更多
基金Supported by the UNC UNAN FGID Epidemiology Study Project,No.54-1808958.
文摘BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.
文摘Rudyard Kipling is the first British writer to win the Nobel Prize for literature in 1907.Due to the influence of the First World War and the huge blow of his own beloved son John's death on the battlefield,Kipling's later writing pays more attention to the pain and trauma which the war brings,and the noble qualities of love,belief,and tenacity in human nature after the baptisms of pain and trauma.This paper selects two poems—"My Boy Jack"and"A Nativity"in Kipling's later poetry creation career.Freud's "trauma" and treatment theories are employed to study the two mothers' "self- trauma- healing mechanism"in face of pain and trauma,and to interpret the two mother images that experience the war-torn pain and trauma,and achieve their spiritual salvation at last.Through the transformation of the two mothers,Kipling wants to mourn his beloved son's death and expresses his determination and hope of faith and commitment in order to heal his inner pain and trauma,which unwittingly realizes Freud's trauma-healing theory.Key words:
