Academic Ceremonies July 2011

“Time in teams: methodological issues in the study of temporal dynamics”

“The role of neuroimaging phenotypes in ecogenetic studies of psychotic disorder”

Schizophrenia occurs in 1 of 100 persons and is a serious psychological disorder that involves severely disturbed contact with reality. Genetic and environmental influences play a role in the development of schizophrenia. The studies in this thesis delivered proof of associations between changes in the brain in individuals with an increased risk of schizophrenia and environmental factors such as cannabis use, childhood trauma and daily stress. In spite of the fact that the exact underlying mechanisms are not known yet, it is possible to speculate that differences in sensitivity to the environment are manifested in structural changes in the brain, which results in the development of psychotic symptoms.

Key words:

schizophrenia, brain changes, gene-environment interaction, stress, cannabis, childhood trauma, genetic risk

“The antioxidant flavonoid 7-mono-O (B-hydroxyethyl)- Rutoside: from clinic to concept”

Flavonoids are antioxidants that make an important contribution to the good effects of vegetables and fruit on health. Research was conducted into the flavonoid monoHER, a promising substance that can be applied to prevent heart damage as a result of chemotherapy.  MonoHER turns out to be an extremely good antioxidant, which explains its positive effects. It also turns out that substances our body makes from monoHER, so-called metabolites, are important for the health effect of monoHER; they can contribute to keeping heart and vessels in good condition and to inhibiting disturbed inflammation processes that play a damaging role in many diseases, ranging from diabetes and lung and liver diseases to ageing. These metabolites are possibly even more powerful than monoHER itself. This research has showed how monoHER works and allows us to apply monoHER more effectively. 

Key words:

monoHER, flavonoid, antioxidant, metabolites, health

“Managing work-based postgraduate medical education in clinical departments”

“Vascular Calcifications and Matrix Gla Protein in Hypertensive Subjects”

People with calcified vessels have an increased risk of developing cardiovascular diseases compared to people without calcifications. This dissertation describes research into vascular calcification in people with hypertension. Matrix Gla protein inhibits, if activated by vitamin K, the development of vascular calcifications. With more calcification we found lower vitamin K levels and a relation between Matrix Gla protein and stiffness of blood vessels. And finally, patients who take vitamin K inhibiting medicines long-term also have more vessel calcifications. Administering vitamin K turned out to inhibit calcification in test animals. Whether this also applies to humans and if the risk of cardiovascular diseases decreases then needs further investigation. 

Key words:

vascular calcification, vitamin K, cardiovascular risk matrix Gla protein

“Parietal Matters in Early Alzheimer's Disease: evidence from structural and functional MRI”

Presently, imaging techniques, such as MRI, enable early diagnosis of brain diseases. Up to now, early diagnostics of Alzheimer mainly focused on areas in the temporal lobe, but this lacks precision. This dissertation investigated if studying an area connected to the temporal lobe, the parietal lobe, can improve the reliability of the diagnosis. The results show that changes in the structure and function of parietal areas can support early detection of Alzheimer. The research offers new insights about possible underlying causes of this disorder, such as a reduced connectivity between the temporal lobe and the parietal lobe. 

Key words:

brains, Alzheimer, early diagnostics, MRI

“Vestibular Exploration on advanced diagnostics and Therapy”

Studies of the vestibular system with advanced diagnostic instruments show that the perception of tilts mainly depends on emotional information and less on vestibular (inner ear) information. This creates the possibility to help patients with a serious vestibular disability improve their postural balance by replacing the vestibular information by sensory information. For that purpose an advanced vibratory belt was developed that transfers information about body tilts via the tactile sense around the waist. In these disabled patients, this vibratory belt shows a significant improvement in balance, self-confidence and independence.

Key words:

vestibular system, emotional information, vestibular information

“Frail elderly; identification and disability prevention in primary care”

Frail elderly run an increased risk of developing disabilities in activities. How can we identify frail elderly who live in their own homes, and which interventions support them in doing (and continuing to do) the activities that are meaningful to them? This dissertation concludes that existing screening instruments for frailty have potential, but still insufficiently select the right target group. Frail elderly show satisfaction with an innovative interdisciplinary intervention programme (‘Care out of Precaution’), focused on self-management of meaningful activities. Primary care professionals are also positive and find the programme manageable; it stimulates interdisciplinary and preventive work. A few adjustments are still needed for successful implementation in primary care.

Key words:

frail elderly, prevention, screening, intervention

“The Welfare Effects of Integrating AIDS Treatment with Food Transfers: evidence from Zambia”

Many HIV/AIDS treatment programmes now combine free provision of medication with food assistance for patients threatened by hunger and malnutrition. This study evaluates the health and economic effects from this combined aid. The study is based on data collected from 400 families in Zambia after 6 months of food aid distribution. The main findings of the study are that it improves adherence to AIDS medication (i.e. the patient takes it regular) but has no effect on the patient’s weight gain. Food aid appears to encourage male non-patient adults to increase their work or in cases where they were unemployed, to return to work, while for female non-patient adults they only return to work when the patient has taken medicine for a long time. However, food aid appears to be discouraging AIDS patients from working or returning to work. The main conclusion of the thesis is that food transfers in the form of food aid generally have a beneficial impact on the recipients, but food aid providers need to facilitate a gentle transition from food aid to self sustenance, through linking up patients with job training or access to micro-credit.

Key words:

AIDS treatment, food aid

“Childhood overweight: parents in control? On the Influence of parents in maintaining children’s weight problems”

This dissertation studies the role of parents in children’s overweight. The first part focuses on the influence of restriction on eating behaviour. The assumption is that using too much control can lead to undesired eating behaviour and overweight.  Two studies confirm this hypothesis: prohibiting both attractive and less attractive food leads to a greater desire and a larger intake of this forbidden food. The second part focuses on the role of parents in treating overweight. Results show that an intervention which is only aimed at parents is effective in reducing overweight. 

Key words:

childhood overweight, parents, influence eating behaviour

“Evaluating Clinical Teaching through Cognitive Apprenticeship”

Supervision of medical students is the key to successful learning during apprenticeships. However, this supervision is often carried out by doctors who are experts in their professional field, but who have often received too little additional training to fulfil their role of supervisor. To help doctors improve their supervising skills this dissertation presents an instrument (the Maastricht Clinical Teaching Questionnaire) that was developed to allow students to give feedback to their supervisors, as well as a model that can structure supervision during the apprenticeships. Research has shown the usability and practical relevance of the instrument and the model, which allows optimizing supervision during apprenticeships.  

Key words:

research medical education, apprenticeship, supervision

“Exploratory Pathway Analysis”

“Nieuwe wijnen in oude vaten”