Objectif Express 1 96.epub
Ainoha Sistek
Estimates of individuals at high risk for eating disorders ranged from 2 to 54.8%. The eating disorder-related variables identified were desire to be thin, body dissatisfaction, disturbed-, and dieting- eating behavior. Identified correlates were increased affluence, media use, western influences, and obesity. An additional finding was that in some cases eating disorders were expressed somatically rather than psychiatrically.
In the Arab world a curvy body was perceived as fertile, so eating disorders were assumed to be rare. In recent years, however, due to rapid sociocultural changes, Western influences, media use, and increased affluence, Arabs have started to admire a thinner body. Consequently, research has now begun to address the existence of eating disorders in the Arab world. The increased popularity of the desire to be thin has been associated with soft symptoms such as disturbed eating behavior, body dissatisfaction and dieting behavior. In addition to Arabs at risk for eating disorders, eating disorder symptoms identified include binge eating, self- induced vomiting, and laxative use. Sometimes, eating disorders manifest themselves in a different way in the Arab world: some Arabs have expressed eating disorders somatically, as nausea, stomach ache, and so on, rather than psychiatrically. There is a need for assessment tools to be adjusted to the Arab culture. Improved knowledge will facilitate recognition of eating disorders, encourage people to seek treatment and decrease the stigma of psychotherapy.
Although EDs have been reported in the Arab world [28, 29, 36, 53,54,55], there is limited valid data [56], and the substantial differences in the expression of EDs among different cultures [7, 52, 57, 58] are yet to be taken into account. For example, somatic expression of EDs is more likely in the Arab world than in the West [52, 58]. Some Arabs attribute a restrictive food pattern to somatic complaints [59], while there are also reports of body dissatisfaction and fear of fatness [52, 58]. Examples of somatic complaints are stomach ache, feeling bloated or an absence of appetite [59]. In addition, perceptions of body image also differ between cultures [52].
Interestingly, predominant identification with a Middle Eastern culture was associated with a risk for AN [29, 64], while predominant identification with a Western culture was associated with a risk for BN [64], for instance among European expatriates resident in Oman, among Omani Arabs [29] and among Iranians [64]. Omani Arabs tended to express their ED symptoms somatically (e.g. bloated stomach, nausea, reduced, fluttering feeling in the stomach, throat discomfort, etc.), while Western populations were more likely to express them psychiatrically [52, 58].
Figure 3 Mechanism of action of the dmLT adjuvant. (I) At the vaccination site, the dmLT adjuvant stimulates the innate immune response and activated epithelial cells secrete IL-8 and G-CSF. (II) Dendritic cells (DCs) are activated and recruited at the injection site where they process and present the antigen. It also upregulates the costimulatory molecules, i.e., CD80 and CD86, and stimulates the expression of IL-1, IL-6, IL-23, and G-CSF. (III) The activated DCs migrate to secondary lymphoid organs where they stimulate the differentiation of antibody-secreting plasma B cells and the generation of antigen-specific Th cells. Overall, a strong Th17 immune response is imparted. Th17 cells are identified as essential in immunity and in stimulating germinal center formation in secondary lymphoid organs as well as in enhancing IgA secretion.
L' autre Allemagne , une Allemagne contre Hitler [152], a certes existé, mais ces expressions mêmes soulignent après coup son caractère désespérément minoritaire et isolé. Toute opposition a été vite réduite par l'exil, la prison ou l'internement en camp. Démocrates, socialistes et communistes ont payé par milliers le plus lourd tribut, ainsi que tous ceux qui refusaient la guerre, le salut nazi ou tout signe d'allégeance à l'idolâtrie entourant le Führer. La délation de masse a sévi et plongé le pays dans une atmosphère de crainte, où nul ne peut plus s'ouvrir sans risques à son voisin, des enfants endoctrinés allant jusqu'à dénoncer leurs parents.
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