Culture and Christianity negotiated in Hindu society: a case study of a church in Central and Western Nepal

This thesis examines in what ways and to what extent Nepali Christians retain or change their way of living after they become Christians. This is achieved through a case study approach focusing on four selected congregations. These cases examine the life of the Christians from conversion through socio-religious negotiations of boundaries to cross-religious relationships and friendships. These cases are also a lens for identifying whether or not Nepali Christians connect in a logical way with the local culture through an inculturation process. The research methodology draws on primary source data from fieldwork and recorded interviews. The qualitative data are analysed using Grounded Theory Analysis which at the same time serves as a constant comparison data validation in examining internal and interrelated consistency of interviews. Secondary source data encompass literature ranging from the disciplines of anthropology and theology to Nepalese history. The conclusions reveal that, when practising their belief among traditional religious people, Christians demonstrate spiritual insight about traditional religious life. These insights provide opportunities for Christians to play key roles in local Nepalese life. Negotiation of both social and religious boundaries has proved to be challenging to most Christians particularly within their own exclusive domains. Christians have however made attempts to address any potential conflicts across the religious divide. The most significant contributions of this research are: i) to demonstrate how Christians proactively negotiate socio-religious boundaries; ii) in doing so to provide information about Christians’ attitude to traditional Nepalis and to other Christians, and iii) to provide evidence for and about Christian individual sovereignty during decision-making processes. These are new insights about Nepalese Christianity and the process of inculturation

Impaired hepatic drug and steroid metabolism in congenital adrenal hyperplasia due to P450 oxidoreductase deficiency

Objective: Patients with congenital adrenal hyperplasia due to P450 oxidoreductase (POR) deficiency(ORD) present with disordered sex development and glucocorticoid deficiency. This is due to disruption of electron transfer from mutant POR to microsomal cytochrome P450 (CYP) enzymes that play a key role in glucocorticoid and sex steroid synthesis. POR also transfers electrons to all major drugmetabolizing CYP enzymes, including CYP3A4 that inactivates glucocorticoid and oestrogens. However, whether ORD results in impairment of in vivo drug metabolism has never been studied. Design:We studied an adult patient with ORD due to homozygous POR A287P, the most frequent POR mutation in Caucasians, and her clinically unaffected, heterozygous mother. The patient had received standard dose oestrogen replacement from 17 until 37 years of age when it was stopped after she developed breast cancer. Methods: Both subjects underwent in vivo cocktail phenotyping comprising the oral administration of caffeine, tolbutamide, omeprazole, dextromethorphan hydrobromide and midazolam to assess the five major drug-metabolizing CYP enzymes. We also performed genotyping for variant CYP alleles known to affect drug metabolism. Results: Though CYP enzyme genotyping predicted normal or high enzymatic activities in both subjects, in vivo assessment showed subnormal activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in the patient and of CYP1A2 and CYP2C9 in her mother. Conclusions: Our results provide in vivo evidence for an important role of POR in regulating drug metabolism and detoxification. In patients with ORD, in vivo assessment of drug-metabolizing activities with subsequent tailoring of drug therapy and steroid replacement should be considered

Er der betænkeligheder ved udviklingen i den moderne kriminalitetsbekæmpelse?

Intet resum´

Revitalization in Judea: an anthropological study of the Damascus Document

This thesis seeks to gain a fresh perspective on the movement reflected in the Damascus Document by asking if it could be seen as a Revitalization Movement, a theoretical construct developed by the American anthropologist Anthony Wallace. Signs of a cultural identity crisis and the changes in society causing it are evident throughout the Damascus Document. By comparing the findings to Wallace's model, we understand that the movement could have developed as a reaction to a context of profound cultural changes. This study challenges the prominent view that the major crisis causing the rise of the movement was the Babylonian exile, as another paradigm related to Isa 7 .17, featuring Ephraim's departure from Judah, is alluded to in several ways. The princes of Judah are compared to Ephraim and depicted as those who depart, because they have adopted a foreign way of life, the way of the kings of Greece. While both paradigms were seen to represent collective memories used as warnings of judgment, the theme of division of the northern and the southern kingdoms in the past is portrayed as comparable to the current conflict in society

Arzneimittelinteraktionen mit antiretroviralen Medikamenten

Zusammenfassung: Arzneimittelwechselwirkungen sind bei der Behandlung von HIV-Infizierten häufig, da die hochaktive antiretrovirale Therapie immer mehrere Wirkstoffe beinhaltet. Dazu kommen oft Medikamente gegen opportunistische Infektionen und Begleiterkrankungen. Alle Proteaseinhibitoren führen zu einer Inhibition von CYP3A, das im Metabolismus von rund 50% aller Arzneistoffe wichtig ist, beispielsweise Simvastatin, Atorvastatin, Sildenafil und Clarithromycin. Ritonavir ist von allen Proteaseinhibitoren der stärkste Hemmstoff der CYP3A-Aktivität. Dies wird auch genutzt, um die Bioverfügbarkeit anderer Proteaseinhibitoren zu erhöhen. Durch die nichtnukleosidischen Reverse-Transkriptase-Inhibitoren Efavirenz und Nevirapin wird die CYP3A-Aktivität in der Dauertherapie gesteigert. Um Interaktionen vorzubeugen, müssen zu Beginn und bei Therapieende die Dosierungen von CYP3A-Substraten angepasst werden. Interaktionen können auch durch die Beeinflussung von glukuronidierenden Enzymen oder Transportproteinen entstehen. So wird P-Glykoprotein durch Ritonavir gehemmt, was zu einer Erhöhung der Exposition gegenüber vielen Chemotherapeutika führ

Drug monitoring in child and adolescent psychiatry for improved efficacy and safety of psychopharmacotherapy

Most psychotropic drugs used in the treatment of children and adolescents are applied "off label" with a direct risk of under- or overdosing and a delayed risk of long-term side effects. The selection of doses in paediatric psychiatric patients requires a consideration of pharmacokinetic parameters and the development of central nervous system, and warrants specific studies in children and adolescents. Because these are lacking for most of the psychotropic drugs applied in the Child and Adolescent and Psychiatry, therapeutic drug monitoring (TDM) is a valid tool to optimise pharmacotherapy and to enable to adjust the dosage of drugs according to the characteristics of the individual patient. Multi-centre TDM studies enable the identification of age- and development-dependent therapeutic ranges of blood concentrations and facilitate a highly qualified standardized documentation in the child and adolescent health care system. In addition, they will provide data for future research on psychopharmacological treatment in children and adolescents, as a baseline for example for clinically relevant interactions with various co-medications. Therefore, a German-Austrian-Swiss "Competence Network on Therapeutic Drug Monitoring in Child and Adolescent Psychiatry" was founded [1] introducing a comprehensive internet data base for the collection of demographic, safety and efficacy data as well as blood concentrations of psychotropic drugs in children and adolescents