Academic Ceremonies December 2011

“Who cares? Studying various aspects of involving nurse specialists in primary care for urinary incontinence”

Involuntary urine loss is a common problem. The costs for incontinence requirements are high, annually 166 million Euros.  The number of patients increases as a result of the ageing population, and  consequently the costs increase. With adequate primary care, these costs could turn out considerably lower. This study shows that task support for GP’s from specialised urinary incontinence nurses would provide better quality of incontinence care at an acceptable price. Patients appeared very satisfied with the care by the nurses, who in turn were satisfied with their new tasks. The majority of GP’s found the role of the nurses useful. On the basis of these study results, the recommendation is to introduce this type of provision in primary health care, and to compare it with other, competing ways of incontinence care. This will provide more information in the future for the decision-making with regard to the concerned allowances for incontinence care.

Key words:

involuntary urine loss, treatment by FP, costs incontinence care

“European Contract Law between the Single Market and the Law Market”

“High-level visual object representations in inferior temporal cortex”

Visual object recognition is a computationally challenging task, but is accomplished by the human brain with relative ease. We used functional magnetic resonance imaging (fMRI) and a new method, representational similarity analysis, to investigate the brain mechanisms underlying the recognition of individual objects. We show that the representation of objects in high-level visual brain regions is inherently categorical and hierarchically organized, reflecting object categories of longstanding evolutionary relevance that match between human and monkey. Furthermore, perceived object similarity reflected the brain representation. Our work can be used to improve computational models of vision and offers a framework for quantitatively comparing brain and behaviour.

Key words:

object perception, brain, fMRI

“Genetic and nongenetic studies of schizophrenia”

“From vulnerability to resilience against depression. The value of daily-life positive emotions”

This thesis focuses on the role of emotions in resilience against depression. A series of daily-life studies suggests that especially positive emotions and enjoyment during pleasant daily-life situations are important in resilience against depression. The studies also showed that people can learn to experience more positive emotions in daily life. After a mindfulness training, people rated daily-life activities as more pleasant and experienced more positive emotions both overall and when engaging in pleasant activities. These increases in positivity went hand in hand with an improvement in depressive symptoms.

“Exploring the impact of diversity factors on problem-based collaborative learning”

“De doorwerking van natuurbeschermingsverdragen in de Europese en Nederlandse rechtsorde”

This dissertation investigates if the practice of the implementation of the nature protection treaties ratified by the Netherlands comes up to the doctrine on the implementation of treaties. The research shows that the implementation practice – particularly via the Judge – does not come up to this doctrine. On the other hand, the doctrine needs some more clarification, completion and actualization, and this dissertation provides and clearly describes these. The dissertation discusses eleven international treaties, among which the Bern Convention on the preservation of wild animals and plants and their natural environment in Europe; the Bonn Convention on the protection of migratory wild animal species; the Wetlands Convention and the Benelux Agreement of 1970 in the field of hunting and bird protection. As far as known, this is the first academic research that provides such an extensive analysis of all (living) area and species protection stipulations of each of the above mentioned treaties and compares these with the European en national nature protection legislation.

Key words:

nature protection treaties, doctrine, implementation 

“Predictive Toxicogenomics for the Identification of Chemical Carcinogens: Application to human hepatic cell lines”

For testing whether chemicals cause cancer to humans, numerous animals are used. Existing methods which do not use animals produce many false results. This thesis describes the development of a new method that successfully and more accurately identifies chemicals that cause cancer by damaging the genetic material of cells. This method does not use animals and therefore its application may reduce the use of experimental animals. For the development of this method toxicogenomics approaches – gene expression changes induced by chemicals – were applied to human liver cells, providing, therefore, more relevant results than animal testing. This thesis further shows that the application of such approaches to human liver cells helps us understand how chemicals affect normal cellular functions.

Key words:

chemicals, cancer, toxicogenomics, human cells 

“Focus on ad – Morphological alterations in mouse models of Alzheimer’s disease”

“Representation of the rewarding value of food in the human brain – Effects of dietary restraint, body weight, stress, and shifts in macronutrient intake”

“Snow white’s heritage: gender, social roles and alcohol use”

This thesis aimes to better understand and specify the conditions under which the relationship between social roles and alcohol use is most likely to be observed.According to the classic role theory: the higher the number of social roles the lower the drinking levels. The effect of roles is influenced by the extent to which social roles structure or fail to structure everyday life with meaningful activities. In general, family roles generally showed a higher protective impact on women’s alcohol use; among men a higher impact was found for socioeconomic factors. There is strong evidence for gender differences in how strongly social roles influence drinking. One of the central factors in explaining these gender differences is gender equity at the societal level: in societies with more gender equity, the additional role of maternal employment outside the home is more likely to decrease the mothers’ alcohol use.

Key words:

alcohol use, gender, culture, social roles

“Serving well by selling well”

“Prader-Willi Syndrome: genotype and phenotype at adult age”​

“Failure mechanisms of the lumbar disc prosthesis”

Lower back pains are a large social problem in today’s society. If conservative treatment (for example exercise therapy, pain medication) doesn’t help, a back operation can be considered. A relatively new technique is placing lumbar disc prosthesis to replace the intervertebral disc. It is not clear how these disc prostheses will turn out in the long term. In the MUMC+, 100 patients were seen with back and/or leg pain complaints after placement of a disc prosthesis. In a number of these patients, a repair operation was performed. Two repair operations have been compared. Both repair operations resulted in an improvement of the pain and the function. Moreover, large numbers of wear particles and inflammation cells turned out to be present in the tissue, comparable to reactions that occur in worn hip and knee prostheses.

Key words:

lower back pains, treatment, operation, disc prosthesis

“Rescuing A Patient in Deteriorating Situations (RAPIDS); A programmatic approach in developing and evaluating a simulation-based educational program”

“Molecular imaging of acute and healing myocardial infarction”

“Targeting PPARs in metabolic risk management: a pharmacological and nutritional approach”

“Exploiting geometric properties in combinatorial optimization”

A part of the thesis is devoted to a trajectory optimisation helicopter problem which originally came from Afghanistan and US army. Sometimes there is a need to evacuate soldiers from a battlefield to a hospital. A helicopter is normally used in this case. It has to avoid the mountains on the way; but because the air density is lower on high altitudes the helicopter loses its speed if it goes up. Therefore, it is not clear which trajectory is the fastest as it definitely does not match the shortest trajectory. We model this problem in several ways and obtain the theoretical fastest trajectories without obstacles. These results are also used to design an effective algorithm for one of the obstacle cases. Further research may lead, for example, to a quick helicopter route planner which minimizes the time of a trip.

Key words:

trajectory optimization, helicopter, algorithm, routepanner

“Blood-contacting biomaterials for critical clinical applications”

“Non-invasive measurements in wheezing preschool children”

About 30% of preschool children suffer from asthmatic complaints, such as wheezing. Only 30% of these children develop asthma, the rest loses the complaints as they grow older.  Wheeze is a complex complaint and it is not known whether, as in asthma, it is accompanied by bronchial infection. This dissertation shows that wheezing children exhale more inflammatory substances than children without complaints. This indicates an increased bronchial infection. Inflammatory substances in the exhaled air were determined by means of a patented instrument. Measuring inflammatory substances in the exhaled air is an innovative and non-invasive way of early detecting bronchial infection. This enables a quicker en more effective treatment of this very common bronchial complaint.

Key words:

wheeze, asthma, bronchial infection, breath, children

“Microvascular actions of insulin: studies on the interaction with angiotensin II and on the postprandial state”

“Mijnbouw en Arbeidsmarkt in Nederlands-Limburg”

This dissertation studies the policy of the mining management for recruitment, selection and binding of the personnel to the company, as well as the consequences of this policy for the composition of the miner’s population. Miners’ sons from the own region, other Limburg inhabitants, other Dutchmen, and only then foreigners, that was in general the order that was followed in recruiting personnel.  In the case of compulsory redundancies, the order was the other way around. That is how the Limburg mining managers ultimately succeeded in their objective to build a workforce from mainly ‘own people’. That result was achieved through very conscious recruitment and binding strategies, but also thanks to favourable circumstances.

Key words:

Limburg mining industry, personnel policy

“Decision making in surgical treatment of chronic low back pain”

Chronic low back pain is the most common cause of absenteeism in our society. When painkillers and exercise therapy don’t give results, a painful vertebra can be surgically fastened. This so-called spondylodesis operation indeed adequately lowers the pain for certain patients, but the results vary strongly. Spine specialists use prognostic tests to predict the result. For this dissertation Dutch spine experts were interviewed about their selection criteria for spondylodesis in daily practice. This showed a considerable difference between physicians in the use of prognostic tests and the treatment of chronic low back pain. After analysis of a large patient cohort and a subsequent systematic literature study, it turned out that none of the tests has sufficient predictive quality for use in the daily medical practice. The results of spondylodesis in chronic low back pain remain unpredictable, with consequences for patients, health care Insurance companies and policymakers.

Key words:

Chronic low back pain, spondylodesis, prognostic tests, patient selection

“Bargaining power in strategic games and economic decision-making”

“Op weg naar zichtbaarheid”

“Le Droit Maritime International et le transport des Hydrocarbures”

Preventive and curative fight against oil spills are an undeniable fact nowadays. The law system of prevention of oil spills regulates the construction of ships and emissions of hydrocarbons. It estab-lishes, inter alia, double hull and on shore reception facilities requirements. Curative measures con-sist in operational measures and compensation rules for victims of oil spills. However, fight against oil spills in Africa is thwarted by the lack of integrated emergency response plans. Compensation rules are sufficiently underdeterrent in comparison with classic rules of evidence of oil pollution damages and the causal link between these damages and the polluter ship activity. 

“Spinal cord stimulation in neuropathic pain, technical aspects and effectiveness”

“On the alignment of the European Patent Convention and the Patent Cooperation Treaty with requirements of the Patent Law Treaty”

In 2000, a new international patent treaty (Patent Law Treaty) was established, which ‘streamlines and harmonizes’ the formal requirements that patent granting bodies can impose with the submission of patent applications.  The intention is that existing patent laws are adjusted to this. However, because very many conditions are not compulsory, the new treaty leaves to much freedom in their implementation in the existing patent laws. Consequently, not much streamlining or harmonizing was realized. To keep the new patent treaty as simple as possible, one often refers to another international patent treaty (Patent Cooperation Treaty); because of that, these two treaties are legally linked. It is therefore very peculiar that particularly this patent treaty has not been aligned with the new treaty. 

“Dual allegiance in organizational teams”

The function of a management team is to coordinate the organizational tasks from different perspectives with managers from various disciplines.  In doing so, each manager comes across sub-interests that depend on the position (for example region or division manager), or the function he/she represents (for example HR, sales, finance). For successful functioning of a management team the mutual relations are important. For the improvement of team functioning, usually the influence of personality traits is studied. This dissertation, on the contrary, analyses how the representation of sub-interests influences the team functioning. This research shows that when these sub-interests are not taken into account with the decision-making, managers can experience an internal conflict between the various sub-interests. This obstructs a good mutual relation and consequently the team functioning.

Key words:

management team, functioning

“Nucleo-cytoskeletal interactions in the mechanical functioning of the cell”

The central question in this dissertation is what happens when the mechanical network that supports the cell nucleus is disturbed.  The role of lamin proteins is crucial here. They form the lamina that gives the cell nucleus the necessary firmness and connects it to the cell skeleton. When lamin A/C is disturbed, the cell nucleus weakens: cracks develop in the nucleus membrane and the nucleus itself becomes weaker and less resistant to mechanical forces. Also in the surrounding cell skeleton all kinds of deviations develop, which affect the normal functioning of the cell. This leads to a range of diseases that are together called ‘laminopathies’.

Key words:

celkern, lamine-eiwitten

“Molecular progression markers in cervical premalignancies. Development of a diagnostic MLPA-assay”

All over the world, cervical cancer is a very common type of tumour. Infection with the Human Papilloma Virus (HPV) is the main risk factor, but the virus can only cause cancer in combination with other factors. This research investigated if it is possible to identify malignant cervical deviations by searching for other risk factors than the infection with the carcinogenic HPV alone. For this purpose a test was developed that can detect a series of these risk factors, such as the number of virus particles and incorporation of the virus in the human DNA. Also deviations in certain human genes could be shown in these tumours. With this newly developed HPV MLPA test, we are capable of identifying malignant cervical deviations with 85% accuracy.

Key words:

cervical cancer, HPV, MLPA

“A disrupted balance? Prevention of terrorism and compliance with fundamental legal rights and principles of law – the Dutch anti-terrorism legislation”

Since 9/11, combating terrorism has gained top priority in Dutch politics. The counter terrorism policy  primarily focuses on prevention and has led to extensive anti-terrorism legislation. This thesis discusses the scope of the Dutch anti-terrorism legislation within and beyond criminal law and its impact on principles of (criminal) law and fundamental legal rights. To what extent are the statutory criteria for the application of pre-trial anti-terrorism powers and measures, and their practical implementation, in compliance with the relevant fundamental legal rights and principles of law as enshrined in European treaties? Firstly, it is ascertained what constitutes an act of terrorism according to the Dutch criminal law system, and how the criminalisation of terrorism affects criminal liability. Secondly, the thesis discusses what level of suspicion is required to apply which powers and/or measures to counter terrorism. Thirdly, the way the application of these state powers affects which fundamental legal rights and principles of law is scrutinised.

Key words:

criminal law, anti-terrorism legislation, fundamental  rights

“Reconciling Privatization with Human Rights”

Under the influence of globalisation many countries have been compelled to privatise the provision of a number of State and public services. This trend towards privatisation has been met with skepticism from the human rights world. In this study, the privatisation phenomenon is analysed with the aim of establishing whether it can be reconciled with the human rights obligations of States. 
The study addresses the issue of accountability for the conduct of entities exercising governmental functions and discusses the need for a new model where privatized entities are directly accountable for human rights abuses. It also focuses on two case studies involving privatisation in two different sectors: the alleged abuses of contractors from two private military and security companies in Abu Ghraib, Iraq, and the privatisation of water in the city of Buenos Aires, Argentina.

Key words:

globalization, privatization, human rights, regulation

“Caring about Care; investigating the effects of different Communication styles in medical and educational credence Services”

Within this PhD research the focus was on services that customers might not be able to judge due to lack of knowledge. The studies investigate how the communication style of service providers – here physician and teacher –  might influence attitudes (e.g. satisfaction) and behaviors (e.g. compliance or helping behavior) of customers – here patient and student. We differentiated between two types of communication styles: care communication (also known as socio-emotional) and cure communication (task-oriented). We found out that different communication styles trigger different feelings which ultimately influence desired outcomes. Furthermore, we could demonstrate that certain communication style is especially beneficial for certain personality traits in order to perform a desired behavior (e.g. care communication could help shy students to exhibit helping behavior within the classroom).

Key words:

communication styles, emotions, credence services, satisfaction, compliance, helping behavior

“Legitimacy of Humanitarian Military Intervention”

Moral and legal justification of the ‘humanitarian military intervention’ (HMI) concept and its applications are highly problematic undertakings. This study proposes a radical departure from the difficult normative debates by empirically assessing the degree of ‘humanitarianism’ behind 1114 cases of military interventions in the period of 1946-2005. The novelty of this approach is based on a systematic evaluation of the ‘humanitarianism’ behind the ‘motives and means’ of individual military interventions on the one hand, and of the ‘humanitarianism’ behind their ‘outcomes’ on the other hand. The findings of the study map the general trends and associations among the factors, indicating that it is really possible to achieve ‘humanitarian ends’ using ‘military means’, but only under limited circumstances.

Key words:

humanitarian military intervention, justification

“Patient enablement: a living dialogue. Exploring perspectives on patient enablement and consultation quality”

“Nutritional and genetic determinants of cognitive ageing; A neuroepidemiological approach”

“Cross cultural studies on adolescent cannabis use and psychosis”

This dissertation presents epidemiological studies into the effects of cannabis use during adolescence. The results show that the use of cannabis increases the risk of psychotic symptoms. It turns out that the earlier the adolescents start using cannabis, the bigger the risk of becoming psychotic later. This effect appeared to have disappeared when they used cannabis after their 14th year of age. This the first time this connection is also shown in non-Western societies. Furthermore, two Dutch and Greek studies are described, showing that adolescents, who experienced traumatic events in their childhood, are more sensitive to the psychotic effects of cannabis.

“Staff Development in Higher Education Working to improve practices of experts in educational development of teachers and transfer of learning to the workplace”

“Dynamic Microsimulation for Public Policy Analysis”

This dissertation studies an increasingly important policy modelling tool: dynamic microsimulation. Dynamic microsimulation can be used to forecast lifetime social economic profiles of every individual in a society and analyse how these interact with public policies. The research shows that, with the help of a microsimulation model, it is possible to reconstruct an individual career path using limited available data. In addition, this dissertation improves the accuracies in simulating individual employment options and the timing of retirement. The study also analyses how microsimulation results are affected when combined with certain macro projections. These methodological improvements in microsimulation may help researchers and policymakers to explore intended and unintended effects of public policies with greater details and accuracies, even before these policies are implemented.

Key words:

microsimulation, individual profiles, public policy, individual career path

“Effects of Air Pollution on Haemostasis and Atherosclerosis”

Air pollution is a part of urban life and consists of small particles (particulate matter; PM) in different sizes and gases. The associations of PM with cardiovascular health including thrombosis and atherosclerosis have been suggested but the underlying mechanism is not fully understood. A thrombus is formed upon an imbalance in the blood coagulation system. In this dissertation, the procoagulant effects of PM and gases are reported based on extensive experimental studies. The focus of the research was on the two main pathways of blood coagulation; the tissue factor dependent and especially the factor XII dependent pathway. From the cardiovascular perspective, the effects of biodiesel exhaust as an alternative fuel to conventional diesel in the progression of atherosclerosis, are compared.  The name biodiesel is misleading, given its harmful vascular effects as compared to regular petroleum diesel.

Key words:

air pollution, particulate matter (PM), biodiesel, cardiovascular diseases, blood coagulation