Academic Ceremonies November 2008

“Malaria and  Anaemie. The impact on maternal and perinatal outcomes.”

“Due diligence . Een beschouwing over het due diligence onderzoek volgens het Nederlands recht”

The book contains a comprehensive study of the phenomenon of due diligence ("suitable caution" or "due attentiveness"). A due diligence investigation is conducted when business transactions are concluded, such as mergers and take-overs and capital market transactions. "From the outside" it is not possible to see if liabilities are taken aboard (hidden financial obligations). A due diligence investigation is carried out to avoid disappointments afterwards. This dissertation describes everything that is involved with due diligence. One of the main conclusions is that in case of a transaction both parties have an investigation as well as a notification obligation. 

“Articular cartilage lesions; Advances in conservative and surgical  interventions”

A cartilage lesion in the joint does not recover spontaneously, and ultimately it will lead to complaints and wear. The initial treatment is conservative and can consist of administering hyaluronic acid in the joint. This dissertation shows that hyaluronic acid has a preventive effect on the surrounding cartilage. When conservative treatment fails, surgical intervention is an option. One of the new cartilage repair techniques is the so-called scaffold tissue-engineering; the implantation of a porous carrier material, without or with cells, in the cartilage lesion. The recovery after implantation of various carrier materials was compared and the risk of inflammation was determined. 
Collection box foundation that sponsored part of the printing costs: the Anna Foundation SenterNovem financed the experiments. 

Key words:

cartilage, tissue-engineering

“Natural Ah receptor agonists in the human diet : beneficial food components or unperceived risk factors?”

Dioxins activate the Ah receptor signal protein and this causes the toxicity of these environmental polluters. Some natural substances in vegetables and fruit also activate this Ah receptor. Studied was for this dissertation if these natural Ah receptor agonists (NAhRA"s) can have effects that are comparable to the dioxins" effect. In cultivated intestinal cells the influence is similar on an important step in the production of proteins (gene expression). Besides that, NAhRA"s can have positive as well as negative effects on DNA damage. After eating products with many NAhRA"s, Ah receptor activation effects appear not clearly demonstrable. A probable reason may be that NAhRA"s are quickly broken down and dioxins are not. However, frequent consumption of high doses of NahRA"s via food supplement is possibly not without risk. 

Key words:

natural Ah receptor agonists (NAhRA"s); DNA damage; food supplements

“Psychophysiology and the detection of deception: Promises and perils”

The use of the traditional lie detector is controversial. It has no solid academic foundation and the margin of error is considerable. Yet, registering physical reactions can be useful in police tracing. Not as a lie, but as a memory detector. That can be done by means of measuring the brain activity, but also on the basis of reactions of the autonomous nerve system, such as the transpiration in the hand palms. That way, for example the presence of offender knowledge can be shown. This method is academically anchored and can be a useful addition to the arsenal of police tracing tools.

Key words:

lie detector, memory detector, knowledge about the offender, police tracing

“De anatomie van de eed” (“The anatomy of the oath”)

“De novo apoA-I production: regulation and nutritional effects”

The risk of cardiovascular diseases can be lowered by increasing the "good cholesterol" (HDL) in our blood. HDL is directly formed by the protein apoA-I. The conclusion of this dissertation is that the saturated fatty acid laurine acid (a.o. present in coconut oil and dairy products) is possible a food component to increase the production of the apoA-I. Furthermore, the protein C/EBP¦Â can be an important factor in the regulation of apoA-I in liver and small intestine cells. Finally, the dissertation concludes that policosanols, substances in a.o. cane sugar, have no favourable effect on the metabolism of cholesterol.
The dissertation was printed with financial support from the "Nederlandse Hartstichting" and the "Fonds voor het hart".

Key words:

cardiovascular diseases, HDL, apoA-I; C/EBPβ; policosanols

“Venous Graft Remodeling. Novel Mechanisms and Pharmaco-modulation Strategies”

“Children with cryptogenic localization related epilepsy: Clinical outcome.”

Children with cryptogenic localization related epilepsy (CLRE) have epileptic attacks for which no cause can be found; about one third of the children with epilepsy have this type of epilepsy. Epilepsy influences the development of the neuropsychological functions: the school developments and the behaviour. The neurological and neuropsychological development of a group of children with CLRE was studied. 
The group is very mixed, but then CLRE cannot be compared with other types of epilepsy. Therefore CLRE deserves more attention from researchers. Because of the possible effects on the further development each child and its parents should be supported in a multidisciplinary way. 

“Children with cryptogenic localization related epilepsy: Neuropsychological outcome.”

Children with cryptogenic localization related epilepsy (CLRE) have epilepsy of which the cause is unclear. Their attacks start at one point in the brains. 
Until now, very little was known about the course of CLRE. This research shows that there is a considerable chance that children with CLRE reach a reasonable attack control (attack reduction or disappearance). However, this can take a while. In that period, the cognitive functioning, the behaviour and the school results can be negatively influenced, which can subsequently have a considerable (negative) influence on the further development of the child. To prevent this, it is very important that the child is examined, supported and followed in a multidisciplinary way as soon as possible after the start of the epilepsy. 

Key words:

epilepsy, CLRE, neuropsychological course, children

“Protein supplementation as a dietary strategy to improve glycemic control in type 2 diabetes”

This dissertation shows that many patients with type 2 diabetes ( "adult-onset diabetes") who receive medical treatment can still unnoticed suffer from dangerously high concentrations of blood glucose concentrations. The combined intake of carbohydrates with a protein mixture (protein hydrolysate/amino acid) not only leads to an increased insulin production, but also to an increase in the muscular tissue production in people with type diabetes. 
People who have had type 2 diabetes for a longer time already, produce more insulin by the consumption of extra protein as a result of which the blood glucose concentrations after a meal are decreased. This can have positive effects in the fight against diabetes-related complications. 

Key words:

protein consumption; type 2 diabetes; hyperglycaemia; muscular tissue production

“The Politics of European Union Health Policy-making”

EU health policy is paradoxical. Harmonization of legislation in this field is impossible, because financing and organization of health care systems are national competencies where "Brussels" has no role. This research shows that the rules of free trade are sometimes (mis-?)used as a legal basis for European bills in the field of health policy. There is a risk that public health or health care take second place and economic considerations first. This is also determined by the question which Directorate-General (Enterprise or Health) of the European Commission is responsible, the role of lobbyists and the strategic use of the subsidiarity principle (what can be done by a lower administrative body, may not be carried out by a higher institution). 

Key words:

EU decision-making; health policy

“Top Management Team Impact on Organizations: Determinants from inside and outside the boardroom”

Top Management Teams (TMTs, in the Netherlands often designated as 'Raad van Bestuur') are expected to make a difference for their organizations. This dissertation, at the crossroads of the fields of management and psychology, deals with the question how TMTs can have such an impact.The results indicate that the determinants of TMT impact lie both inside the boardroom, in the team's internal processes and states, and outside the boardroom, in the interface of TMT and middle managers. The findings have implications for practicing top managers, trainers, consultants and team coaches that want to enhance the impact of a TMT on its organization's performance.

Key word:

impact TMT’s

“Suum cuique?-enkele opmerkingen over de rechtsmachtverdeling tussen bestuursrechter en burgerlijke rechter”

“Essays on Law and Economics of State Aid”

The competition policy of the European Community has undergone extensive reform during the past decade. Competition rules have been modernised and simplified and enforcement has been decentralised. The most significant aspect of modernisation has been the introduction of a more rigorous economic analysis, both in the areas of anti-trust and state aid. The Community system for the control of state aid has been effective in restraining the propensity of Member States to subsidise their firms for strategic or political reasons. It has prevented significant distortions to cross-border competition. But it is not a perfect system. Too much aid has been allowed and the granting of illegal aid is not penalised vigorously enough.

Key words:

state aid; anti-trust; competition; European Community

“Psychopathic traits in Dutch adolescent offender and community samples: relationships with gender, age, institutional misbehavior, substance use and interpersonal style”

Psychopathy is a personality disorder that is marked by interpersonal (egocentricity, manipulation), affective (superficial emotions, lack of empathy) and behaviour characteristics (impulsivity, irresponsible behaviour) that are a risk factor for criminal and violent behaviour. Psychopathic traits often already manifest themselves in youth and early intervention is only possible with the earliest possible identification. This dissertation focuses on the Psychopathic Checklist: Youth Version (PCL:JV), a tool for diagnosing psychopathic traits in adolescents. The research shows that this tool can be reliably used by trained professionals. The PCL:JV is strong predictor of unacceptable behaviour in a judicial institution, in particular of physical violence. The research also found interesting differences in the manifestation of psychopathic traits in girls and boys. 

“Confronting smokers with previously undetected airflow limitation for smoking cessation”

COPD (or chronic bronchitis and pulmonary emphysema) is a common serious lung disease that is mainly caused by smoking. Especially for smokers with COPD it is of vital importance that they quit smoking. The purpose of this study was to investigate if more people quit if they are early traced and confronted with COPD. Over 300 smokers participated in the experiment. In the long term, the confronting approach turned out not to be better than a standard treatment; after 12 months only 11% was still non-smoker. The high relapse indicates how difficult it is for smokers to lose their addiction.

Key words:

smoking cessation, COPD (chronic obstructive pulmonary disease)

"Preferenties ¡­ referenties" ("Preferences¡­ references")

“Psychological Predictors and Treatment Outcome in Chronic Pain”

This dissertation makes a first step to the identification of specific psychological factors that can have an influence on the treatment outcome in chronic pain patients. Literature study shows that depression, catastrophizing (exaggerated negative thoughts about pain) and the fact that the pain is beyond control, have a negative influence on the treatment. The results of this study partly endorse these findings. Depression is an important predictor of the effectiveness of a medical treatment (without multidisciplinary approach or psychological treatment) in chronic pain patients; depressive patients have fewer results from the treatment in the field of pain reduction and improvement of quality of life. These results are an important step in the process of optimizing the treatment of chronic pain patients. 

Key words:

chronic pain, psychological predictors

“Effects of Experimental Febrile Seizures on the Developing Brain”

Febrile seizures are a kind of epileptic attacks that are provoked by high fever in young children. The febrile seizures themselves are mostly innocent, but the risk of the development of epilepsy increases in a number of children that had febrile seizures. The results as described in the dissertation show that febrile seizures in an animal model disturb the brain development. The growth of new neurons is disordered and long after the febrile seizures there are still changes in the brain structure that can be measured by means of a brain scan (MRI). Also subtle behaviour changes occur. These results suggest that the disturbed brain development as a result of febrile seizures plays a role in the development of epilepsy. 

Key words:

febrile seizures; epilepsy

“Genetics of mood disorders: from pharmacogenetics to disease genetics”

Mood disorders are the most common severe adult psychiatric disorders. These disorders are influenced by both genetic and environmental factors. 
This dissertation deals with pharmacogenetics (the study of gene variants influencing drug response) to investigate the relation between gene variants and antidepressant response. Besides an analysis of newly reported gene variants on antidepressant response, the dissertation includes the first meta analysis ever of the most important gene for antidepressant response (HTTLPR).
The knowledge of genetic influence on mood disorders and drug response can be used to construct profiles of individuals characterized by specific risks. This knowledge will allow to possibly modulate the environment in order to minimize the negative impact of the individual genetic profile. This could also lead to a personalized medicine but also to a deeper knowledge of genetic influences on humans.

Key words:

mood disorders, pharmacogenetics

“High blood pressure and target-organ damage of the brain”

“Medicines for diseases of the Developing World: Innovation And Economic Policy”

This dissertation studies the difficult relation between the public and the private sector in the fight against poverty in third world countries. Firms expect to obtain a return on their investments, while poorer countries cannot purchase these new products. This dissertation presents an analytical framework for new financing methods for R&D. It studies the positive and negative effects of ¡®push-pull" mechanisms. It provides new insights in the relation between on the one hand company investments and technical, market-related and financial risks, and on the other hand economic incentives including patents that governments can use to support the development of new medicines against neglected diseases, and thereby improve the international welfare of the most deprived populations in the world. 

Key words:

armoedebestrijding, financieringsmethodes

“Corneal desiccation in rigid gas permeable contact lens wear”

Little research is conducted into dry eyes of wearers of form-stable contact lenses (previously called hard lenses). The results of this dissertation show that the blinking behaviour of wearers of form-stable lenses is less optimal than in non-lens-wearers (less complete blinks), and the least optimal in people with dry eyes. The dissertation also found that the tear volume on the eye was less in wearers of form-stable lenses than in non-lens-wearers. The conclusion is that it is best to strive for limiting the effect of the contact lens on both the tear film as the eye lenses. For this purpose, detailed information about the shape of the cornea is necessary. A relatively new technique, corneatopography, can help describe this shape and can contribute to the production of better lenses.

“Corporate Governance and Sustainability in Global Property Markets”​

“Efficiency of Dutch hospitals”