Academic Ceremonies November 2011

“Semi-Nonparametric Indirect Inference”

“Informal payments for Health Care Services in Albania”

“The role of rumination in the development of depressive symptoms in youth”

Can adolescents become depressed from negative thinking? This dissertation addressed the question to which extent continuous worrying about depressive feelings and stressful events (ruminating) is connected to depressive complaints in adolescents. Studies show that ruminating is strongly connected to depressive complaints, already from the age of ten. However, the effect of ruminating on later depressive complaints is modest. This summons the question to which extent ruminating is a risk factor for the development of depression or a side-effect. Future research will have to focus on the causality between ruminating and depression in adolescents.

“Mechanisms of surface perception uncovered by visual illusions”

“Endometrial maturation: the role of oestradiol and progesterone”
 

“Incentives in the diagnosis treatment combination payment system for specialist medical care”

This dissertation studies several new financial incentives for doctors and hospitals since in 2005 the Diagnosis Treatment Combination (DBC) system was introduced. It turns out, among others, that the production in that part of the hospital care where payment takes place per operation (the so-called B-segment) has increased and that a more expensive DBC is chosen than medically necessary (upcoding). Empirical proof was found for all these effects. Exactly how big this total effect is cannot be quantified, because it is not possible to extrapolate for all analyses to the entire sector of specialist medical care. 
Parts of the current DBC problems will be solved with the introduction of DOT in 2012, but the risk of upcoding will continue to exist. Monitoring and benchmarking institutions both with regard to case mix as volume by health care Insurance companies will be the main challenge for 2012.

Key words:

DBC system, medical specialists, hospital

“Droit International de l’environnement et mise en oeuvre du droit a l’eau potable en Afrique centrale: le cas du Cameroun”

For years, numerous studies and conferences were focused on the right to water, but, none of them have solved the problem of guaranteeing it. Several texts recognized the existence of this right, without giving it the character of binding law. This thesis seeks to: give to the right to drinking water a better definition, find against whom this right must be guaranteed, transpose the best situations in Central Africa and in Cameroon in particular, find sketches solutions to difficulties encountered in implementing this right in Cameroun.

Key words:

international environmental Law, right to drinking water, Central Africa, Cameroun

“Bee-inspired Distributed Optimization”

Despite the fact that the honey bee has a limited intelligence, she is capable of amazing achievements. By cooperating and distributing tasks so-called swarm intelligence is created. That way, they can solve amazingly complex problems, such as effectively searching food in an unknown world. Many of these problems are similar to problems we people try to solve, the so-called combinatory optimization problems. An example is navigation software: find the shortest/fastest/cheapest route. For this PhD research the behaviour of the honey bee and the resulting swarm intelligence is a source of inspiration for making optimization algorithms with artificial swarm intelligence. The results of this research show that bee-inspired swarm intelligence is promising/performs well in solving combinatory optimization problems.

Key words:

Swarm intelligence, combinatory optimization problems, honey bee

“De menselijke motor”

“Surgical Treatment of Secondary Hepatic Malignancies’

“Fatty acid metabolism in the metabolic syndrome”

The metabolic syndrome is a combination of risk factors for diabetes 2 and cardiovascular diseases. Both an increased fat level in the blood as disorders in the muscle fat metabolism can lead to undesired fat accumulation in the muscle tissue, which can disturb the working of the hormone insulin. This dissertation shows that replacing saturated fats in food by complex carbohydrates and a fish oil supplement lowers the risk of metabolic syndrome, particularly through effects on the fat level in the blood. The replacement of saturated fats with unsaturated fats or complex carbohydrates has little influence on the muscle fat metabolism and the working of insulin in persons with metabolic syndrome.

Key words:

metabolic syndrome, fat metabolism, food

“Physical functioning in low back pain”

“Gezondheidsbevordering en voortgezet onderwijs, verstandshuwelijk of echte liefde?”

This research shows that health holds no structural position in the policy and practice of schools for secondary education. Schools recognize the need of attention for the students and their physical and social environment, but due to many obligations imposed by the authorities they are forced to make choices. Still, this dissertation offers leads for improvement: 

• Better connection to educational goals.
• Support based on the wishes and needs of schools. 
• Bearing in mind the possibilities in a school and the results the school has to show.
• Offering intensive guidance in the change process of schools with the introduction of a new policy.   

Key words:

school health policy, secondary education, options for improvement 

“Social Integration of people with intellectual disabilities in neighbourhoods: Sitting on the fence”

In the Netherlands, people with intellectual disabilities (ID) are increasingly living in small scale care facilities in regular neighbourhoods. This thesis discusses the concerns about social integration of people with ID. From the opposition often expressed by (potential) neighbours about accepting people with ID in their neighbourhood, to the lack of interest in social contact with neighbours with ID after they have moved in. The underlying mechanisms responsible for the different social responses to anticipated contact with neighbours with ID, and the daily reality of interactions between neighbours with and without ID are illustrated. This knowledge can help improve neighbourhood social integration of people with ID.

Key words:

intellectual disability, social integration, community care, attitudes, intergroup contact

“Uitgebalanceerd”

“Supporting healthcare professionals to encourage patients to decrease cardiovascular risk attributable to physical inactivity”

People with one or more cardiovascular risk factors and an inactive lifestyle have an increased risk of cardiovascular diseases and diabetes type 2. This dissertation studies the effectiveness of the ways in which health care professionals incite these people to exercise. The fact is that by improving the cardiovascular condition, the risk can be reduced. Intensive physical activity turns out to have the biggest risk reducing effect. People who become ‘physically fit’ as a result of intensive exercise, reach the best results. Shortly, it is not so much ‘that’ you exercise, but ‘how intensively’ you exercise.

Key words:

cardiovascular risk factors, physical fitness, exercise

“Multifocal Intraocular Lenses in Cataract Surgery”

“The dissemination of the healthy diet program; Krachtvoer for Dutch prevocational schools”

For quite some time already, the task of schools is no longer limited to knowledge transfer.  Krachtvoer is a healthy diet programme on breakfast, fruit and snacks for the first and second grades of prevocational schools. The aim is to get students to think about their own eating habits and, if necessary, to try and improve them.  The programme often uses practical methods, such as test lessons or a recipe competition. Schools are supported by the municipal health services (GGD) for the implementation of Krachtvoer.  This dissertation presents a scientific evaluation of Krachtvoer and the support by the GGD with the programme. The classes are well appreciated by students and teachers and they lead to an improvement of the fruit and snack habits of students.

Key words:

Krachtvoer, eating habits, prevocational students

“Learning to diagnose using patient video cases in paediatrics: perceptive and cognitive processes”​

“De idylle voorbij; verbeelding van moederschap in Nederlandse literatuur 1980 tot 2010”

Motherhood is nowadays imperatively idealized in Dutch society. Consequently, many mothers don’t experience it as natural to speak about the unpleasant sides and experiences of motherhood.  Contemporary Dutch literature, however, particularly describes mothers who don’t (can’t) fulfil this ideal. They lose control and get off the right track. The dissertation focuses on the relation between this type of novels and the social motherhood ideal, bringing together literature sociological research and novel interpretations in an innovative way. The analysis of four novels by Vonne van der Meer, Saskia Noort, Renate Dorrestein and Maya Rasker is at the centre of the dissertation. One of the conclusions is that literature can retort the conventional rosy motherhood ideal. 

Key words:

motherhood, unpleasant sides, literature  

“Microarray-based expression signatures: potential application for individualized cancer treatment”

Identifying new biomarkers and setting therapeutic targets to improve treatment is one of the spearhead aims of cancer research. It is clear that more precise methods for the prediction of treatment result and determination of optimal treatment per individual are necessary. The use of new techniques such as gene expression micro arrays (or gene chip) offers the possibility to identify new markers, but the analysis of this type of data is not uncomplicated. By means of this technique a biomarker was developed that can be used for several cancer types. Moreover, methods were developed to improve the quality of gene expression based markers, which will lead to quicker use in the clinic. 

Key words:

biomarker, cancer, gene expression micro arrays

“BTW-verleden met perspectief”