Academic Ceremonies October 2009

“Zuurvlees”. (“Stewed meat”)

“Psychopathology and ageing; towards a better understanding of psychosis and depression in later life”

Research into psychosis and depression is often conducted among young people, but this dissertation concerns elderly people. Psychotic symptoms namely often originate in the second half of life. Moreover, the prognosis is particularly unfavourable when people over 65 have their first psychosis. Depression in elderly is often accompanied by disorders in thinking (such as memory loss). Köhler’s research clearly shows that, in contrast with earlier assumptions, the cognitive disorders are permanent. In healthy elderly, depression appears to be a risk factor for accelerated cognitive decline. Small lesions in the white substance of the brains appear to be the underlying causes.

Key words:

depression, psychosis, elderly people, cognitive disorder

“The interplay between genetics and epigenetics in colorectal cancer”

Colorectal cancer has a high mortality, also because the disease is often detected at a too late stage. Colorectal cancer is the end result of a complex interplay of genetic and epigenetic (processes that influence the gene expression with changing the DNA base order) deviations. Studying genetic and epigenetic deviations shows that epigenetic deviations occur early in the development of colorectal cancer and are therefore very useful in the early detection of the disease. On the basis of genetic and epigenetic deviations colorectal cancers can be divided into subgroups that differ in behaviour and survival. Future research will show whether these subgroups need a different treatment strategy.  

Key words:

colorectal cancer, genetics, epigenetics

“Dietary acrylamide intake and human cancer risk”

Acrylamide is a substance that is found in food, such as French fries, chips, cookies and coffee. This PhD research contains epidemiological research into the relation between acrylamide intake via food and the cancer risk. The risk of cervical and ovarian cancer turns out to be increased with rising acrylamide intake. There is also a positive relation between acrylamide and the risk of kidney cancer in men and women and oral cavity cancer in women. On the other hand, the study also provides indications for a risk reducing connection between acrylamide and lung cancer and bladder cancer in women, and prostate carcinoma and pharynx cancer in men. These connections must also be investigated in other studies to gain more certainty about their causes. 

Key words:

acrylamide, cancer, food

“Beyond Weber and Straight Cucumbers: Bureaucratic Politics in the EU”

“Constitutionalising Polycontexturality: the Legal Foundations of Tansnational ‘private’ Regimes”

“Theory- and evidence-based interventions to enhance adherence among HIV-infected patients using highly active antiretroviral therapy”

“Rechtsbescherming en overheidsovereenkomsten”

“Hypnotics and Anxiolytics”

A large number of experimental behaviour studies with healthy young volunteers show that hypnotics and anxiolytics can negatively influence the driving ability. It was generally expected that these negative effects would be less strongly manifested in patients as a result of the additional favourable effects on the sleep or anxiety disorder and the habituation that occurs after long-term use. Comparative studies with patients and more vulnerable groups such as elderly people are rare. This dissertation investigates to which extent factors such as age, gender, (sleep) disorder and the emission speed of the drug influence the effects of hypnotics and anxiolytics on the driving ability. It turns out that there is hardly any difference between the young volunteers and vulnerable groups such as patients and elderly people. The results do not support the general expectation.

Key words:

hypnotics and anxiolytics, driving ability, sleeplessness

“Bias for the unattractive self: on the role of attention in eating disorders and body dissatisfaction”

There is still a lot of uncertainty about the exact cause of eating disorders. At the same time, women are increasingly more often dissatisfied with their body. This dissertation studies the role of attention in the causes and maintenance of eating disorders, and in particular body dissatisfaction. It turns out that eating disorder patients, in comparison to healthy women, more quickly notice information that concerns the body and more slowly take divert their attention from information that concerns food. Furthermore, it appears that the way women look at their own body plays an important role in the way they feel about their own body. Looking at ugly body parts causes body dissatisfaction, while looking at beautiful body parts can lead to more body satisfaction.  

Key words:

eating disorders, attention, body dissatisfaction

“Theodoor Weustenraad (1805-1849) en de ‘Percessie van Scherpenheuvel’”

The lawyer, journalist and poet Theodoor Weustenraad (1805-1849) was captured by the ideals of freedom and equality and he dreamed of a new earth. After his law studies in Liège, Weustenraad became editor of the newspaper L’Éclaireur, in which he disputed the government politics of Willem I. In 1830, he fled to Belgium. He believed in a better future thanks to the industry and he praised the miracles of technique. With essays and poems he contributed to the formation of a nation in the young Belgian state. His elegy Maestrichtfrom 1834 marks the beginning of the myth that presents Commander-in Chief General Dibbets as the rapist of the Maastricht will of the people. The biography is followed by the issue of the manuscript of the ‘Percessie van Scherpenheuvel’. This mock epic of 2000 verses in Maastricht dialect still appears very much alive, even 160 years after Weustenraad’s death.

Key words: 

biography, journalism, literature, dialect

“Chemische eiwitsynthese in beeld” (“Chemical protein synthesis portrayed”)

“With the body in mind; the role of exercise and acid-base balance in panic”

We studied the antipanic effects of acute exercise while, at the same time, mechanisms of experimental panic provocation. We demonstrated that acute exercise is a useful technique to alleviate these panic attacks provoked by CO2 inhalations.

We also used pharmacological and genetic techniques to explore key neurotransmitter systems related to experimental panic. In this process, we learned that blocking the endorphin system with naltrexone does not change the panic response to CO2 but does, by itself, elicit symptoms that resemble panic.

We also learned that the panic reaction to CO2 is associated with a gene variant involved in the activity of serotonin.

Key words:

antipanic effects, exercise, CO2 inhalations

“On the pathway from stress to psychosis”

Genetic and environmental influences play a role in the development of a psychosis. A way of studying possible genetic influences is by looking at risk factors that also occur in family members of patients. It was found that patients who had a psychosis and are more sensitive to stress in daily life, have brothers and sisters who are also more sensitive to this small daily stress. It was also found that stress sensitivity is mainly related to psychotic symptoms such as delusions and hallucinations, the so-called ‘positive symptoms’. It is therefore perhaps useful to focus directly on this underlying risk factor.  

Key words:

genetic factors, psychosis, stress sensitivity

“Substrate metabolism in type 2 diabetes”​​

“From Primary Commodity Dependence to Diversification and Growth”

This thesis shows that the reliance on primary commodity export and the incapability of attracting sufficient technological knowledge for a diversified production hinder development in of many Sub-Saharan African countries. Our results show that a certain threshold level of export diversification is indispensable for long-term economic growth. Policy efforts should therefore be geared towards building export diversification for a long-term economic development.

Key words:

developing countries, export, sustainability, diversification

“The role of Public Capital on Economic Development”

This thesis explores the possible role of public capital in economic development in relation to inequality, growth, and poverty trap. Inequality is bad to growth when imperfection in credit markets prevents the poor from undertaking the efficient amount of investment. The thesis shows analytically that certain public investment may relax some of their resource constraints through factor substitution and thus improve the distribution of income and hence economic growth. The thesis also studies the role of public capital in poverty trap. The empirical side of the study addresses more policy-oriented problems: How much does public capital matter to economic growth, in developing countries? How big should it be?

Key words:

income inequality, public capital, economic growth and poverty traps

“Satellite cells and skeletal muscle characteristics in sarcopernia”

Ageing involves loss of muscle mass and muscular strength, also called sarcopernia. This leads to functional limitations and it reduces the quality of life. Satellite cells (the so-called ‘muscle stem cells”) are essential for the maintenance of muscular tissue. This dissertation shows that sarcopernia involves a decrease of the number of satellite cells in the skeletal muscles. Power training can make the number of satellite cells increase again and it is an effective method to restore muscle mass and muscular strength. The research in this dissertation shows that satellite cells play a primary role in sarcopernia and in the increase of muscle mass after power training in elderly people.

Key words:

muscle mass, muscular strength, sarcopernia, satellite cells, power training

“Connecting health care professionals: Studies on a generic HER system framework”

Electronic Patient File (EPD) systems contain information about the health and health problems of patients. These systems have evolved from administrative systems into sources of knowledge that support the care process. The current tendency towards multidisciplinary, integrated care requires a virtual EPD that integrates the health information of a patient from various sources, exchanges information with other systems and processes new medical concepts. The National EPD is a rudimentary example of such a virtual EPD. This dissertation presents a generic EPD system framework and investigates if this framework fulfils the requirements. The framework was tested by the development and implementation of an EPD system (PropeRWeb). This implementation was subsequently evaluated. This showed that the security aspects have to be intensified and standardized, especially if medical data are exchanged between organizations.

Key words:

electronic patient file, standards, archetypes, EPD, care ICT

“Framing health communication messages”

“Effect of housing in an enriched environment on the recovery from experimental inflammatory pain”

“Competency in shaping one’s life; autonomy of older adults with type 2 diabetes mellitus who are treated in a nurse-led clinic”

“On the digital road to recovery? Assessment, theory, and treatment of depression via the Internet”

Self-help treatment of depression via the Internet without professional support is not more effective than the regular care by the general practitioner. Both first-line treatments are insufficiently capable of reducing depressive complaints. Directly after the treatment as well as one year later, the complaints are still considerable. Especially for people with serious complaints these treatments appear insufficiently effective. This is the conclusion of Esther de Graaf in her dissertation. Although self-help via the Internet seems promising, more research has to be conducted in who benefits from it and who doesn’t.  A stringent policy concerning the implementation of online self-help in the current care system is necessary, as well as its reimbursement by health care insurance companies.  

Key words:

depression, online self-help, general practitioner

“Stress reactivity in borderline personality disorder”

This dissertation studies emotional and psychotic reactions of borderline patients in daily life, and it studies the effects of trauma in childhood on emotional stress reactivity in an adult group of frequent visitors of the general practitioner. It turns out that borderline patients react significantly more emotionally and psychotically to everyday stress than people with psychotic disorders, people with anxiety related personality disorders and healthy control persons. The GP visitors who experienced trauma in childhood reacted emotionally significantly stronger to everyday stress than the group without trauma. This effect was the most explicit for trauma under the age of ten.   

It is for the first time that this phenomenon is scientifically demonstrated in daily life. The results underline the impact of everyday stress on borderline patients and adults who experienced trauma in childhood. This shows the wide importance of stress reduction.

Key words:

stress, emoties, psychose, borderline persoonlijkheidsstoornis​

“Van kwaad tot erger; de sociale constructie van satanisch ritueel misbruik in de Verenigde Staten en Nederland”. (“From bad to worse; the social construction of satanic ritual abuse in the United States and the Netherlands”)

The dissertation “Van kwaad tot erger” studies the debate about satanic ritual abuse in the United States and the Netherlands. The course of the debate is discussed on the basis of developments within the social fields where the debate is held, namely psychotherapy, media and the criminal law practice. A few notorious (criminal) law cases that had a great influence on the course of the debate are used as examples, e.g. the sexual abuse scandal in Oude Pekela, the Eper incest case and the Dutroux case. Similarities and differences in the social, political and religious structures of the USA and the Netherlands are studied. An explanation is also provided for the fact that the debate about satanic ritual abuse in the USA has turned into a moral panic (the most extensive form of collective behaviour that is out of proportion, stronger than mass hysteria), while this did not happen in the Netherlands.

Key words:

satanic ritual abuse, criminal law, psychotherapy, media

“Dietary protein in the regulation of the somatotropic axis”

Too little growth hormone can be a cause of growth retardation in children, and of too much belly fat in adults. For these people extra growth hormone can have positive results regarding respectively the growth in height and the body composition. This dissertation shows that food is an effective means to increase the amount of growth hormone in the blood. Soy protein and milk protein, whether or not in combination with fats or carbohydrates, turned out to be effective strategies for stimulating growth hormone release. This can offer perspectives for a dietary therapy to restore reduced growth hormone levels, or for a suitable diagnostic instrument to determine a deficit of growth hormone.

Key words:

growth hormone, food, diagnostics

“Dietary proteins and energy balance”

It is known that diets with a relatively high protein level are an effective means for weight loss and weight maintenance after weight loss. This dissertation describes effects of (specific) proteins in the food on appetite and food intake during a following meal and on energy use. Some proteins (alpha-lactalbumin, gelatine and gelatine with added tryptophan) suppress the appetite 40% stronger than other proteins (casein, soy and whey) and reduce the food intake during a following meal with 20%. The appetite suppressing effect of proteins is reinforced by the absence of carbohydrates in the diet. With regard to the effect of proteins on the energy use it turns out that a high-protein diet increases the energy use, regardless of the other macronutrients in the diet.

Key words:

diets, protein level, energy balance

“In vivo dosimetry using MOSFET detectors in radiotherapy”

The radiation dose of radiotherapy treatment of tumours if mainly determined on the basis of calculation models. More concrete evidence of the quantity of effectively delivered c.q. received radiation is given by a measurement during the radiation; more certainty cannot be given.  

A new type of miniature radiometer was tested and subsequently used for measurements during external radiation (while the meter was placed on the patient during treatment) and during internal radiation of the prostate (brachytherapy, where the meter was brought into the urethra).   

Via this method sufficient data can be collected, to learn from, to prevent errors, to reduce complications and to improve treatment methods if necessary.

Key words:

radiometers, radiotherapy, tumours