Academic Ceremonies February 2010

“Genetics in the news; studying the effects of Mass media genetic health messages on health cognitions and behaviour”

The social value of technological applications of genetics, such as genetic screening, can be enormously improved by informing the public about them.  Mass communication, however, is too general and can at best indicate possible individual differences in DNA structure. Mass media genetic health messages often lead to denial of susceptibility and do not motivate to change of unhealthy behaviour. Because of the lack of personal relevance the mass media therefore do not appear to be the ideal communication channel for the improvement of preventive behaviour on the basis of genetic information. Recommended is specifically aimed communication explaining the meaning of the message for the recipient, and additional advice about changes in lifestyle.

Key words:

genetics, mass communication, prevention

“Politics of Provision; the co-production of Genetic technologies and health care arrangements in Germany, the Netherlands, and the United Kingdom”

Genetic research for the determination of a genetic predisposition for a disease is not covered by the health care insurance in everyone’s case. This dissertation studies the procedure of selection for participation and coverage in Germany, the Netherlands and the United Kingdom. It turns out that differences in the organisation of health care and the stand towards genetics lead to the use of different criteria in these countries. In the Netherlands, for example, the criteria are focused on the coverage of various patients and risk groups, whereas the United Kingdom wants to reach the largest possible percentage of the total population. Exclusion from research then has mainly to do with the way health care systems deal with new technologies (such as genetics). This is a reason for a broad political discussion about the coverage of new health care technologies.

Key words:

genetic research, health care system

“Herordening van het sacrale. Religie, ethiek en zorginnovatie”

“Noninvasive imaging of hypoxia, hypoxia response and drug delivery”

Imaging (PET/CT scan) in cancer patients is an increasingly important element in both diagnosis and treatment. Hypoxia (lack of oxygen) is an important characteristic of tumours that causes resistance against cancer treatments. For efficient treatment of hypoxia it is important to know to which extent and where hypoxia is present in a tumour. This dissertation shows the possibility of determining hypoxia and the reaction of the cell to that low oxygen tension in a non-invasive way.  We also proved that imaging is useful to follow the absorption of medication against cancer. Imaging will ultimately lead to an increased chance of survival by quicker and better selection of patients for specific treatments. 

Key words:

cancer, imaging, hypoxia

“Interactive Epistemology and Reasoning: On the foundations of Game Theory”

This PhD thesis is about epistemic game theory, which is a field that studies how people reason about their opponents before making a decision. So we are interested in what is going on in a person’s mind before he comes to choose. The analysis consists of two steps: First we try to describe the person’s way of reasoning by means of a formal mathematical model. Then, we ask which patterns of reasoning seem reasonable, and try to find out the choices that can be made under such natural ways of reasoning. The field of epistemic game theory is thus on the interface between psychology, philosophy, mathematics, economics, and decision theory.

Key words:

game theory, epistemic approach

“Thrombin generation and fibrin formation in dilutional coagulopathy; towards improved peri-operative transfusion protocols”

“Impression Management in Consultancy: Behavior tendencies, processes, and effectiveness”

People are able to select the information they display to others in order to make a desired impression and thereby change others’ thinking and subsequent behavior. This so-called impression management (IM) is expected to make a difference for consultants’ performance. This dissertation deals with the question whether and how IM can have such an influence. The results indicate that certain IM behaviors positively influence consultants’ performance. However, IM can as well lead to the experience of stress and deteriorate consultants’ performance levels. It was found that personal characteristics, as e.g. age and cultural background were found to have an effect on IM choice. Moreover, it was learned that the IM effect vanishes over time. The results lead to the conclusion that IM should be seen as an integral part of a consultant work performance. Selection processes and training sessions are seen as possible ways to find and train not only good consultants but also good impression managers.

Key words:

impression management, behavior, consultant

“Prevalence and Factors Associated with Depressive Morbidity in Women Visiting Perinatal Primary Health Care Settings of Dar es Salaam, Tanzania”

“Heart failure self-management: balancing between medical and psychosocial needs; evaluation of a cognitive-behavioural self-management group programme”

Self-management plays an important role in dealing with chronic heart failure in day-to-day life. In the American ‘Chronic Disease Self-Management Programme’ (CDSMP) people learn to handle the medical, social and emotional consequences of their chronic disease. Effectiveness and applicability of this group programme was investigated in a randomized study on heart failure patients. The meetings (2.5 hours) every six weeks were presided by a trained pair, consisting of a specialized nurse and a heart failure patient. The programme turns out to be usable and effective in the short term. However, earlier shown long-term effects fail to appear. This can possibly be explained by differences in health care, where the CDSMP in its present form possibly adds too little to the existing health care offer for heart failure patients in the Netherlands. 
(This research was financially supported by the ‘Nederlandse Hartstichting’ and the ‘Profileringsfonds’ University Hospital Maastricht.)

Key words:

zelfmanagement, hartfalen, evaluatieonderzoek

“Immune modulation by dietary glucans from oat and mushrooms; results from in vitro, animal and human studies”

There is more and more evidence that the immune reaction, and along with that the risk of certain diseases, is influenced by nutrients. Examples of such a nutrient are glucans that are found in oats and mushrooms. Therefore, in this dissertation we studied the effects of alfa- and bèta-glucans on immune reactions in the intestine and to a lesser degree in the entire body (systemic immune reactions). Our studies showed that the consumption of bèta-glucan from oats advance the immune reaction in the intestine in vitro (“in the test-tube”) in people and in vivo (“in the body”) in mice, while it does not stimulate the systemic immune reaction. Consumption of both alfa- and bèta-glucans from mushrooms stimulate the systemic immune cells of mice in vitro but the alfa-glucans had no clear effect on the systemic immune response in people.

Key words:

immune system, nutrition, glucans

“Gut feelings in General Practice”

Reason and feeling closely cooperate in general practitioners’ diagnostic thinking. GPs sometimes experience gut feelings in the patient contact. Researchers from the universities of Maastricht and Antwerp showed that most GPs take those feelings seriously and that these feelings can direct their diagnostic actions. Also medical disciplinary committees take the gut feelings seriously, witness the fact that in the Netherlands they reproached GPs en specialists regularly in the past ten years for not listening to their gut feelings. The researchers have established an international research agenda to further study and improve the diagnostic meaning of the gut feelings.

Key words:

general practitioner, diagnostics, gut-feeling