Academic Ceremonies February 2009

“Emotional support for chronically ill elderly persons; feasibility, effectiveness and cost-effectiveness of a minimal psychological intervention”

Many chronically ill people struggle with mood problems such as depression, fear and insecurity. This dissertation studies a short psychological treatment aimed at reducing depression in chronically ill elderly. Primary health care nurses visit elderly people at home and teach them how the can become active self-managers. It turns out that the treatment is positively received by both elderly people and nurses. In the long run, the treatment also reduces depressive symptoms and fear and it improves the daily functioning compared to chronically ill elderly, who received the regular care from their GP. This approach does not raise the costs. The treatment will soon be further introduced in a large number of GP practices in South-Limburg.

Key words:

depression, chronically ill people, elderly

“The Periaqueductal Gray and Defensive Behavior: new clues from an old concept”

The aim of the studies presented in this thesis was to investigate the possibilities to modulate the activity of the dlPAG (dorsolateral periaqueductal gray, the primitive structure of the brain) in order to induce or attenuate fear responses in the rat. The fear and panic animal model was specifically chosen to gain more knowledge about the functional anatomy and behavioural phenotype of defensive behaviour. At present, we are still in the early stages of understanding fearful emotion and cognitive behaviour and the exact role of the PAG in these behaviours. Nevertheless, recent developments in neuroscience will gradually reveal the nature and complexities of emotionality of defensive behaviour in our phylogenetically old brain structure – the PAG. 

“The logic of Coincidence: Agenda-setting in the European Union on Development Co-operation. After the Fall of the Berlin Wall”

The thesis looks at the evolution of EU development cooperation - the major tool of the Union’s external policy - after the EU had emerged as a global player in the aftermath of the fall of the Berlin Wall and provides clear evidence that the end of the cold war has triggered a redefinition of EU development policy, especially regarding the inclusion of Eastern European neighbors and the prioritization of poverty. The study is based on the concept of a policy window, as a situation created by an event which provides opportunities for policy change within a limited timeframe and discusses the underlying question in how far one major event can decisively impact on agenda-setting and decision-making.

Key words:

Europe, development policy, ACP

“The role of human papillomavirus in the Development of tonsillar squamous cell carcinomas”

Malignant tumours departing from the tonsils occur more and more frequently over the years. Besides the well-known risk factors such as smoking and excessive alcohol consumption, it has become clear that also human papillomaviruses (HPV) play a role in the development of these tumours. Patients with tumours that were caused by HPV are less often smokers and/or drinkers, have more metastases and a better survival  compared to patients with tumours in which the virus was not present. Also in the molecular area HPV-positive tumours differ from HPV-negative tumours. This offers perspectives for the development of both new therapies and tests for the determination of individual therapy choice.

“Exporteerbaarheid van het Nederlandse pensioenstelsel naar de Europese Unie”

“The Role of Demand in Technical Change”

This thesis is rooted on the new knowledge economy and product innovation. It reflects on the idea that innovations, if they are successful, change the habits and customs of a society. For these inventions to have a positive effect on the growth (and wealth) of a society, they have to become new needs for the consumers. When compared with classical economic theory, this research models a consumer which is closer to human nature: preferences change to allow the purchase of new goods while retaining some old habits. In this framework a radical innovation is the one that is needed by the majority of the population.

“The Impact of Social Capital on Economic and Social Outcomes”

Researchers have used the concept of social capital to explain various associations with socio-economic outcomes. However two important aspects have largely been ignored: (i) what forms social capital, and (ii) how social capital affects outcomes. This study provides advancements on these relatively shallow aspects. First, by reducing transaction costs such as monitoring costs, creating new forms of information exchange and influencing (and regulating selfish) behaviour through norms, higher social capital induces innovation. Second, we provide a relatively original approach to the measurement of social capital and use these new indicators to explain differences in crime rates across geographical space in the Netherlands. Third, institutions are important in shaping social capital. Good “social capital” forms in geographical areas where the power of the chief executive is constrained, where the level of education is high, where universities existed as repositories of culture and where the population was less heterogeneous.

“Knowledge Flows and Social Capital”

This research studies the role of social capital in distributed learning and innovation for sustainable agriculture. Social capital is mapped using informal social networks of an innovative rural Indian community. These networks transfer relevant knowledge, goods, credit and socio-political support. Theoretical results on core-periphery structures, used to identify dominant cores in each network, highlight the unequal distribution of social capital in knowledge, business and socio-political domains. A lack of social capital for knowledge among farmers is used to explain the near absence of innovation capacity building in the community. Socio-economic hierarchies such as those driven by business relations between farmers and their credit providers or crop buyers, and caste-based dominance, are important determinants of community action for innovation.

“Verdediging in Transitie; de positie van de advocaat in strafzaken in postcommunistisch Polen”

After the collapse of the communist regime, there have been attempts in Poland to strengthen the position of the defence and bring it into conformity with the demands of the European Convention of Human Rights (ECHR) by means of adaptations of the criminal procedure. This research clarifies how that was done and how the new situation relates to the conditions for an effective defence that can be derived from the ECHR. Based on that information, conclusions are formulated about the factors that have determined the effect of the realized reforms and lessons are derived about the (possible) effects of government-initiated optimization of defence rights.

Key words:

Law of criminal procedure, defence, honest trial, constitutional state 

“The exercise-induced oxidative stress paradox In COPD”

Loss of muscular function often occurs in patients with COPD and leads to a decreased effort capacity and increased mortality and morbidity. Oxidative stress (reduced oxygen intake by cells caused by the formation of free radicals) and inflammatory reactions seem to play an important role here. A training programme improves the effort capacity of COPD patients, but in healthy persons on the contrary an intensive effort causes an oxidative stress and inflammatory response. This dissertation shows that COPD patients compared to healthy persons have an increased oxidative stress response, both in a situation of rest as during efforts. In patients did was not accompanied by an inflammatory response. It also turned out that after completion of a lung rehabilitation programme with regular exercise, COPD patients experienced less oxidative stress during efforts and an improved effort capacity. This favourable effect is probably the result of a more efficient energy metabolism.

Key words:

COPD, oxidative stress, inflammation, effort, rehabilitation

“Met recht naar Klimaat-bescherming”; over de rol van het recht en de markt voor het klimaatbeleid” (‘Rightfully towards climate protection; about the role of law and market’)

“Characterization of anticoagulant functions of protein S”

“Hard to get, hard to keep; Dissemination of and Exposure to internet-delivered health behaviour change interventions aimed at adolescents”

Because of the wide range of internet lifestyle advice and interventions have great potential via this medium, but as yet these websites are only used sparsely by adolescents. On the basis of a literature study and research among experts and adolescents themselves, strategies were developed for the improvement of exposure to internet interventions. These strategies were subsequently tested on existing internet interventions (for example focused on alcohol use). A link to school activities turns out a good way of bringing this type of websites to the attention of adolescents. Online recommendations by word of mouth via an email from a friend are also a strategy that has proven effective. To raise the number of visits to such websites, they must not be  an accumulation of technical possibilities, but they have to reflect what adolescents really want and effectively use. 

Key words:

internet, adolescents, health

“Reconstruction the Self Problems of Choice, Fate and Justification in the Eugenics-debate”

In the last decennia, bio-ethics has withdrawn itself in the issue of which biomedical ethics work best, instead of concentrating on what is the best procedure for a concrete moral problem. The discussion is about the way that other people’s choices can be facilitated best, not about what these choices should be. This dissertation discusses the consequences of that for the discussion about new, liberal eugenics: selective reproduction that is not focused on the prevention of serious diseases, but on the preferences of the parents (for example more intelligent, more resistant). Such applications cannot be excluded anymore with the current biomedical ethics. On the basis of Jürgen Habermas’ concept of ‘the self’, Landeweerd develops an alternative for the currently used concept in which autonomy is only connected to free choice. By connecting autonomy with identity, many forms of eugenics appear to be problematic because that which is choice for prospective parents, will be fate for the eugenically created.

Key words:

bio-ethics, eugenics

“Endotoxin and microparticles as markers for inflammation and coagulation”