Academic Ceremonies November 2009

“WWW and its Enduring Effects on Export Marketing: Do Web Capabilities Matter?”

“Common carotid artery morphology and dynamics estimated with automatic ultrasound segmentation”

In this thesis, new computational methods are introduced for better analysis of ultrasound images of the common carotid artery (CCA). Estimation of the anatomical features and mechanical properties of the CCA with ultrasound is important for prevention and treatment of cardiovascular diseases, and assessment of cardiovascular risk. Using the new methods presented, CCA morphology and dynamics are estimated automatically, providing sonographers with an improved feedback. The automatic algorithms effectively reduce the variability of the estimates, while compensating for typical nuisances of ultrasound imaging.

“New approaches to improve the evaluation of mammograms”

Breast cancer is the most common type of cancer in women in the Netherlands. In hospitals, there is a growing demand for mammograms (X-ray of the breast) in combination with an increasing shortage of radiologists.  This dissertation shows that making use of trained radiodiagnostic laboratory assistants in the independent preselection of mammograms can be an effective and efficient innovation in daily clinical practice that is legally possible. To increase cancer detection, laboratory assistants can be employed as second assessor. The use of computer software in the assessment of mammograms in daily clinical practice does not appear effective.

Key words:

breast cancer, mammogram, radiodiagnostic laboratory assistants

“Stimulation of Different Foot Structures and Functions. Effects on physical performance in older adults”

Fall risk factors, such as impairment in mobility, strength, flexibility and some foot problems in older adults, can be minimized by improving physical performance. It was, however, unclear whether stimulation of different foot structures and functions by wearing insoles with raised projections, or by foot gymnastic exercises, combined with conventional training, has an additional effect on? physical performance. The primary findings were that the conventional training program in itself resulted in significant improvements in gait performance and muscle power compared to the control group. Neither wearing insoles during everyday life, nor foot gymnastic exercises had additional effects on physical performance

“Making Lifestyle work Long-term effects in the prevention of type 2 diabetes”

Type 2 diabetes mellitus increasingly occurs worldwide. The main factors that increase the risk of type 2 diabetes are overweight and too little exercise. The SLIM life style intervention shows that better food and more exercise, based on existing guidelines, lower the risk of developing diabetes with 47%. This effect was achieved in a period of 3-6 years in persons with an increased risk of developing this disease. Therefore, the SLIM lifestyle intervention can postpone and perhaps even prevent type 2 diabetes, which lowers the costs of diabetes-related healthcare and improves the quality of life. 

Key words:

diabetes, nutrition, exercise. 

“Enhanced Recovery After Surgery Fact or Fiction ?”

The traditional hospitalization after intestinal surgery lasts 10 – 12 days. At the end of the nineties it was shown that this hospitalization period could be reduced to 2 days with an enhanced recovery programme. This dissertation evaluates the attainability of short hospitalization after major intestinal surgery in daily practice. It is shown that the implementation of an enhanced recovery programme leads to a quicker recovery and a shorter stay at the hospital, but that discharge from the hospital after 2 days is currently still fiction. However, there is no doubt that in the future recovery after surgery can be enhanced in such a way that even intestinal surgery can be performed in day treatment.

Key words:

enhanced recovery programme, intestinal surgery

“Two-photon microscopic imaging of neo-vasculature in atherosclerotic plaques and tumors”

Formation of new small blood vessels (‘angiogenesis’) characterizes the development of atherosclerosis and cancer, the most common causes of death in Western society. This dissertation uses magnetic resonance imaging (MRI) and two-photon laser scanning microscopy (TPLSM) to image and quantify the density and angiogenesis of these blood vessels. In the future, these techniques could find a clinical application in the early diagnosis of the potential complications of atherosclerosis and cancer, respectively cardiovascular problems and metastasis. This makes treatment at an early stage possible, which could prevent clinical complications as a result of these diseases.

Trefwoorden:

angiogenesis, atherosclerosis, cancer, MRI, TPLSM

“Multisensory Cortical Interactions Between Speech and Script in Fluent and Dyslexic Readers”

In the Netherlands, one out of twenty children has dyslexia. This means that approximately 90.000 children in our country experience serious problems with learning to read and write. One of the most important steps for successfully learning to read is learning the associations between some letters and sounds (the alphabetic principle). Knowledge about the neurobiological mechanisms that underlie this skill is therefore crucial for the understanding of disturbed reading development. This dissertation used functional brain scans (fMRI) to study how the brains of normal readers and of adults and children with dyslexia process letter-sound associations. People with dyslexia show a deviant linking of letters and sounds in the brains. This might possibly be the cause why people with dyslexia read badly. A second cause of reading problems was found in the domain of speech processing. Adults and children with dyslexia showed lesser brain activity in the processing of sounds than normal readers. Both explanations are possibly relevant for a complete understanding of learning to read and reading problems.

Key words:

dyslexia, reading, brain activity

“Development electrophysiological studies of letter –speech sound processing in normal reading and dyslexia”

An important step in the development of reading is learning to link letters to speech sounds. Studies in adults showed that letters and speech sounds are quickly and automatically linked. It was also shown that the development into fast and automatic linking, as in adults, takes years. Remarkable is that dyslectic children with four years ‘reading experience do not quickly and automatically process letter – speech sound couples, but still process as normally reading children with one year of reading experience. These enormous arrears prevent learning to read quickly and faultlessly. Therefore, reading therapies should definitely focus on the automation of letter speech sound linking.

Key words:

dyslexia, letter – speech sound linking, reading development

“The Future of Tourism in Antarctica: Challenges for Sustainability”

Tourism in Antarctica is growing rapidly in volume and diversifying into an ever wider range of activities, transport modes and destinations. Tourism is a complex phenomenon; tourism development in Antarctica is no exception. Further, Antarctica is a global common, which limits the formal regulatory options for controlling tourism development. This configuration has raised concerns among academics, NGOs and policy makers, The central aim of this thesis is to explore strategic challenges of future Antarctic tourism in the context of sustainable development. A transdisciplinary and integrated research approach is taken to meet this objective. Based on a combination of stakeholder perspectives derived from a series of scenario workshops and in-depth interviews, academic literature, policy documentation, and visitor data, different future pathways are explored and analysed for implications.

“Romanian adolescents: health-risk behaviours and smoking prevention”

“Regulation of Polycomb Group proteins. The complex, the kinase and the interactor”

Identity and function of cells are determined by genes, and it is evenly important which genes are and are not active. DNA in the cell core is wrapped in chromatin. Before genes can find expression, they have to be unwrapped. This dissertation studies how signals outside the cell influence the wrapping and unwrapping of DNA. Wrapping the genes is among others determined by Polycomb Group (PcG) proteins. On the basis of changes in PcG function and chromatin binding we show a new mechanism with which gene activity can be adjusted and cells can react to changing circumstances. A better understanding of gene environment interactions contributes to more effective treatment and prevention of diseases such as obesity, diabetes and cancer. 

Key words:

Epigenetics, Polycomb Group proteins, gene environment interaction

“Children’s memory: Treasure of Treachery of the Mind? Precursors of children’s false memories”

The memory of children can fairly easily be influenced. Research namely shows that suggestive interviewing techniques can lead to children ‘remembering’ fictitious events.  These memory errors are also called pseudo-memories. This dissertation studies factors that are connected with the development of pseudo-memories in children. It turns out that children very easily develop pseudo-memories of unlikely events (namely a UFO kidnapping). Furthermore, negative occurrences give more cause for pseudo-memories than neutral events.  Finally, it turns out that having a lot of knowledge about events increases the possibility of pseudo-memories. These results are important in trials where children are subject to suggestive interviewing. 

“Hospital system design. Creating supply flexibility to match demand variability”

Hospitals can reduce waiting times for patients if they can make their care supply more flexible. Moreover, a more flexible organization structure will realize a quicker flow of patients through the hospital. That is the conclusion of Hanneke Molema, based on her research in various hospitals in the Netherlands and India. The need for a better match of care and patients increases now the demand for complex care rises. To meet this requirement, Molema finds that hospitals should dare to let go of their current rigid structure base don specializations. The dissertation contains examples of what hospitals can do differently with a view to better respond to the volume and nature of patient demands.

Key words:

hospital, care demand, organization structure

“Decisional processes in obsessive-compulsive spectrum disorders. From neuropsychology to clinical implications”

The spectrum of Obsessive–compulsive related disorders (OCSD) is comprised of disorders as OCD, body dysmorphic disorder, eating disorders, pathological gambling and autism. The hypothesis of this thesis was that obsessive-compulsive spectrum disorders may be conceptualized as a disorder of decision-making and that this could lead to a better understanding of its physiopathology, to a new approach in its investigation and to novel strategies for both physical and behavioural treatment. This redefinition of OCD may have very important implications in the field of OCD research, making it possible to define different subtypes of OCD patients beyond the psychopathology of the disorder, characterised by common genetic substrates and common neurofunctional profiles. This approach is not simply a strategy to resolve classificatory issues, but it is a way of defining reliable outcome predictors and to implement specific treatment strategies.

“Financial Advice Online. Experiments Investigating Trust in an Online Human Advisor”

Increasingly, customers interact with company representatives such as financial advisors online instead of face-to-face. This dissertation investigates how feelings of (physical) presence and trust can be created during voice- or video calls. The results of two experimental studies clearly demonstrated that factors such as an existing relationship, the interaction style applied by the advisor, or certain situations in which a customer is accompanied by a second person (purchase pal) help to increase trust and sales.
Thus, companies who aim at maximizing sales via technology-mediated consultations with customers need to know how to use the technology. This dissertation provides several suggestions that where successfully tested.

Key words:

sales, trust, online consultation, technology

“The hypercoagulable state in patients with Essential Trombocythemia and Polycythemia Vera”

“Gender Sensitivity in Health Care Practices: From Awareness to Action”

It has been extensively shown that differences as a result of gender influence sickness and health in scientific literature. And yet, valuable insights and procedures about gender differences have been scarcely implemented in health care practices. So far, there are no systematic descriptions of gender sensitive ‘best practices’. This dissertation wishes to contribute to this by making an analysis of the current practice and knowledge about the implementation of gender sensitivity. For a ‘good practice’ it is necessary that professional follow training programmes, that there is active involvement of key figures in the organisation and that there is structural (Financial and political) support from the political environment. Training of professionals is an important catalyst for gender sensitivity, but not enough for sustainable differences in practice.  

Key words:

gender, diversity, implementation, health care

“Financial Liberalization, Exchange Rates, and Economic Development”

This dissertation studies the effects of financial liberalization on exchange rates and economic development. The presence of capital controls is found to have no effect on uncovered interest rate parity, while it increases downward exchange rate risk. Nevertheless, empirical evidence shows that capital controls on inflows may enhance economic growth in emerging countries. This thesis also proposes project finance as a form of capital that is particularly suitable for countries with low levels of financial development.

Key words:

financial liberalization, exchange rates, economic development

“Influence or Selection. Dynamics of friendship networks and smoking behavior in adolescence”

Do adolescents influence each other into smoking? Do smoking adolescents for example choose other smokers as friends? To find out how to prevent that adolescents start smoking the development of smoking behaviour and friendship networks were analysed in six European countries. At various moments in time, adolescents were asked to report on their friendships and smoking behaviour. Our results confirm that friends often show the same smoking behaviour. Adolescents indicated that they chose friends with the same smoking behaviour and that they let themselves be less influenced by friends with a different smoking behaviour. The findings suggest that friendship networks play an important role in the development of smoking behaviour and could be used in interventions for the prevention of smoking.

Key words:

smoking behaviour, adolescents, prevention, social networks

“Contested Cultural Property. The Return of Nazi Spoliated Art and Human Remains from Public Collections”

This PhD dissertation analyses and reflects upon the current state of the law and (legal) practice in the Netherlands, the United Kingdom and France with regard to the return of cultural objects from public (museum) collections. The research focuses on those two cases that have led to a recalibration of the restitution debate: the return of Nazi spoliated art and the repatriation of human remains. The debate on the return of Nazi spoliated art (re-) emerged in the Netherlands at the end of the 1990s with the Goudstikker case. Claims for the return of human remains were sparked by the passing of the ‘Native American Graves Protection and Repatriation Act’ in the United States in 1990. Since then, museums all over the world have received claims for the return of human remains. The recent return of the head of Badu Bonsu from the Netherlands emphasizes the relevancy of the research.

“Intellectual Property and Developing Countries: Balancing Rights and Obligations”

“Legal Migration to the European union: 10 years after tampere”

In 1999 the Tampere European Council adopted a policy programme in the area of Justice and Home Affairs aiming at establishing a common European immigration policy based on the ‘fair treatment’ of third-country nationals. Ten years later, at the end of 2009, a new policy programme will be adopted during the Swedish presidency. This book provides an analysis of EU and national immigration law ten years after Tampere and immediately prior to the adoption of the ‘Stockholm programme’. Five Directives on legal migration, implementing measures and national legislation in five Member States are critically assessed in terms of compliance with EU principles of law, international human rights instruments and the Tampere objective of ‘fair treatment’.

“Advancement of the Brown Norway rat as a model for food allergy. Route of exposure – Immunomodulation – Allergogenomics”

“The dean as an academic manager: the phantom of the opera?”