Dealing with death and disaster

Asian Studie

The teaching strategies of Kakuban Shonin: A new reading of Choganbo Shoo's Uchigikishu

Kakuban's lectures were noted down bij his pupils, customary, and Choo's notes are extant. It is remarkable how many joke-like anecdotes come up. This may well have ben part of the attraction of Kakuban's teaching which attracted great crowds, it is said.Cultuur- en godsdienstgeschiedenis van Korea en Japa

Cholestase bij pasgeborenen als gevolg van parenterale voeding

Toediening van totale parenterale voeding (TPN) aan pasgeborenen is geassocieerd met het ontstaan van cholestase. Ondanks intensief onderzoek zijn de pathofysiologische mechanismen slechts gedeeltelijk opgehelderd. In dit artikel wordt ingegaan op de huidige inzichten in de risicofactoren die geassocieerd zijn met TPN-cholestase bij pasgeborenen, de specifieke bestanddelen en deficiënties van TPN die cholestase kunnen veroorzaken, de mogelijke relatie met de ‘fysiologische cholestase van de pasgeborene’, die de pasgeborene kwetsbaarder maakt voor potentieel hepatotoxische stoffen, en de transportsystemen in de levercelmembraan die betrokken zijn bij galvorming. De hypothese dat ‘cholestatische galzuren’ een rol spelen in de etiologie van TPN-cholestase en de therapeutische mogelijkheden worden besproken.Administration of total parenteral nutrition (TPN) to neonates is associated with the occurrence of cholestasis. Despite intensive research, the pathophysiological mechanisms have not been elucidated. In this review we describe the present insights into the risk factors for the development of TPN-associated cholestasis, the specific components or lack of components (deficiencies) in TPN that can cause cholestasis, the possible correlation with 'physiologic cholestasis of the neonate', which makes the infant more susceptible for potentially hepatotoxic compounds, and the transport systems in the liver cell membrane which are involved in bile formation. The hypothesis that 'cholestatic bile salts' play a role in the etiology of TPN-related cholestasis and the therapeutic options will be discussed.</p

Stop or go? Preventive cognitive therapy with guided tapering of antidepressants during pregnancy: Study protocol of a pragmatic multicentre non-inferiority randomized controlled trial

Background: Approximately 6.2% of women in the USA and 3.7% of women in the UK, use Selective Serotonin Reuptake Inhibitors (SSRIs) during their pregnancies because of depression and/or anxiety. In the Netherlands, this prevalence is around 2%. Nonetheless, SSRI use during pregnancy is still controversial. On the one hand SSRIs may be toxic to the intrauterine developing child, while on the other hand relapse or recurrence of depression during pregnancy poses risks for both mother and child. Among patients and professionals there is an urgent need for evidence from randomized studies to make rational decisions regarding continuation or tapering of SSRIs during pregnancy. At present, no such studies exist. Methods/Design: 'Stop or Go' is a pragmatic multicentre randomized non-inferiority trial among 200 pregnant women with a gestational age of less than 16weeks who use SSRIs without clinically relevant depressive symptoms. Women allocated to the intervention group will receive preventive cognitive therapy with gradual, guided discontinuation of SSRIs under medical management (STOP). Women in the control group will continue the use of SSRIs (GO). Primary outcome will be the (cumulative) incidence of relapse or recurrence of maternal depressive disorder (as assessed by the Structured Clinical Inter

Stop or go? Preventive cognitive therapy with guided tapering of antidepressants during pregnancy:study protocol of a pragmatic multicentre non-inferiority randomized controlled trial

Background: Approximately 6.2 % of women in the USA and 3.7 % of women in the UK, use Selective Serotonin Reuptake Inhibitors (SSRIs) during their pregnancies because of depression and/or anxiety. In the Netherlands, this prevalence is around 2 %. Nonetheless, SSRI use during pregnancy is still controversial. On the one hand SSRIs may be toxic to the intrauterine developing child, while on the other hand relapse or recurrence of depression during pregnancy poses risks for both mother and child. Among patients and professionals there is an urgent need for evidence from randomized studies to make rational decisions regarding continuation or tapering of SSRIs during pregnancy. At present, no such studies exist.Methods/Design: 'Stop or Go' is a pragmatic multicentre randomized non-inferiority trial among 200 pregnant women with a gestational age of less than 16 weeks who use SSRIs without clinically relevant depressive symptoms. Women allocated to the intervention group will receive preventive cognitive therapy with gradual, guided discontinuation of SSRIs under medical management (STOP). Women in the control group will continue the use of SSRIs (GO). Primary outcome will be the (cumulative) incidence of relapse or recurrence of maternal depressive disorder (as assessed by the Structured Clinical Interview for DSM disorders) during pregnancy and up to three months postpartum. Secondary outcomes will be child outcome (neonatal outcomes and psychomotor and behavioural outcomes up to 24 months postpartum), and health-care costs. Total study duration for participants will be therefore be 30 months. We specified a non-inferiority margin of 15 % difference in relapse risk.Discussion: This study is the first to investigate the effect of guided tapering of SSRIs with preventive cognitive therapy from early pregnancy onwards as compared to continuation of SSRIs during pregnancy. We will study the effects on both mother and child with a pragmatic approach. Additionally, the study examines cost effectiveness. If non-inferiority of preventive cognitive therapy with guided tapering of SSRIs compared to intended continuation of SSRIs is demonstrated for the primary outcome, this may be the preferential strategy during pregnancy.</p

The Importance of Kōden in the Establishment of Identity: The Title of the Dainichikyō in the Opening Sequence of the Hizōki

The various lineages of Esoteric Buddhism in Japan all have their identity based on tradition, history, and selected preferences in doctrine and ritual. This article describes how identity-definition may take place in the instrcution courses of the priests called koden. As example, the mention of the title of the Dainichikyo as the first line of the influential Hizoki is presented with a number of possible explanations. The range of the subjects that are touched upon warrants further research into the actual training of the priests and into the way they shape their ritual work which is supportive of set notions in Japanese society.</p

The teaching strategies of Kakuban Shonin: A new reading of Choganbo Shoo's Uchigikishu

Kakuban's lectures were noted down bij his pupils, customary, and Choo's notes are extant. It is remarkable how many joke-like anecdotes come up. This may well have ben part of the attraction of Kakuban's teaching which attracted great crowds, it is said.</p

The Importance of Kōden in the Establishment of Identity: The Title of the Dainichikyō in the Opening Sequence of the Hizōki

The various lineages of Esoteric Buddhism in Japan all have their identity based on tradition, history, and selected preferences in doctrine and ritual. This article describes how identity-definition may take place in the instrcution courses of the priests called koden. As example, the mention of the title of the Dainichikyo as the first line of the influential Hizoki is presented with a number of possible explanations. The range of the subjects that are touched upon warrants further research into the actual training of the priests and into the way they shape their ritual work which is supportive of set notions in Japanese society.Article / Letter to edito

The Importance of Kōden in the Establishment of Identity: The Title of the Dainichikyō in the Opening Sequence of the Hizōki

The various lineages of Esoteric Buddhism in Japan all have their identity based on tradition, history, and selected preferences in doctrine and ritual. This article describes how identity-definition may take place in the instrcution courses of the priests called koden. As example, the mention of the title of the Dainichikyo as the first line of the influential Hizoki is presented with a number of possible explanations. The range of the subjects that are touched upon warrants further research into the actual training of the priests and into the way they shape their ritual work which is supportive of set notions in Japanese society.Asian Studie

Boeddha's en Kami : De ontwikkeling van de Japanse religie

De Japanse maatschappij is een geseculariseerde samenleving waarin allerlei oude religieuze tradities en ideeën zijn blijven bestaan, soms duidelijk herkenbaar, soms onderhuids. In de tegenwoordige cultuur vinden we derhalve vele gebruiken die met de Japanse religie te maken hebben. Deze religie is een bonte verzameling van allerlei culten en geloofssystemen van zowel inheemse als buitenlandse oorsprong. Zo treffen we in Japan vormen van onder andere sjamanisme, taoïsme, confucianisme, boeddhisme aan. Het boekje 'Boeddha's en Kami, de ontwikkeling van de Japanse religie' is bedoeld om de niet-expert in grote lijnen te laten zien hoe in de loop der tijden al deze gedachtestromingen zich ontwikkeld en soms vermengd hebben en hoe de complexe hedendaagse Japanse religie tot stand is gekomen