Academic Ceremonies May 2010

“The challenges and needs of older people as HIV and aids caregivers in South Africa”

In the past decades, older people have become important caregivers for adult children who are sick due to HIV or AIDS, and for grandchildren that stayed alone after the death or disease of one or both parents. This dissertation gives insight in the burden of care that the older people experience and in the psychosocial and socio-economic factors that influence this. The dissertation also describes the development and evaluation of an intervention programme focused on the support of older people with their tasks as caregivers. The results show that after the workshops older people regard themselves more capable of providing care than they did before. Furthermore, cooperation with relevant stake holders in society is necessary for the improvement of structural needs of older caregivers, such as financial assistance and access to social security.

Key words:

HIV, AIDS, older people, South Africa, care giving

“Improving health literacy, self efficacy and personal skills: towards culturally tailored behavioural interventions for African women”

Black women in South Africa bear the highest burden of HIV and the condom use among this population of women is low. The aims of the research were to examine determinants of condom use among HIV positive and HIV negative isiXhosa speaking women separately. We found that dry sex (e.g. sex  after vaginal treatment with substances that often dry and tighten the vaginal wall) among HIV-negative Xhosa women is primarily determined by the preference for dry sex of a dominant male partner. Women’s motivation for negotiating condom use is primarily influenced by their desire to please their partners For South African HIV-positive and HIV-negative black women the fear of stigma because of HIV/AIDS is the biggest barrier to participate in HIV/AIDS efficacy trials. Interventions to enhance condom use by HIV-positive black South African women need to focus on the reinforcement of self-confidence. HIV behavioural interventions  have to be associated with poverty alleviation initiatives and have to be accompanied by behavioural interventions specific to men.

Key words

HIV, condom use, Xhosa women,  

“Neuromodulation for functional bowel disorders”

“Het opslaan van een oog. Tijdelijkheid en ongelijktijdigheid in hedendaagse kunst”

“Linking Cognitive and Cerebral Aging; evidence from structural and functional MRI”

“Discovery of ligands for Frizzled and their promises for the diagnosis and treatment of cardiovascular disease”

“Involving patients in cardiovascular risk management in general practice – evaluation of a nurse-led intervention”

The IMPALA-project teaches nurse practitioners in the general practice to identify people who run a strongly increased risk of cardiovascular diseases and to work together with these people on a ‘tailor-made’ plan for a healthier lifestyle. Individual freedom of choice is central in this approach. The project distinguishes itself from many other preventative projects because of the emphasis on joint decision-making: the patient’s preference is taken into account in the action plan. This research shows that patients can better assess their risk of developing a cardiovascular disease as a result of IMPALA. Also the lifestyle of patients improves and the risk decreases, although not more than in patients that visited a nurse practitioner who did not use IMPALA. The latter control group was identified in the same way.

“When the brain speaks for itself; exploiting hemodynamic brain signals for motor-independent communication”

Human communication entirely depends on the functional integrity of the neuro-muscular system. In the so-called ‘locked-in’ syndrome, completely paralyzed patients become incapable of interacting with their surroundings – while being fully conscious and awake. Providing such patients with motor-independent means of communication therefore is of high importance. For the last 20 years, related research has focused on developing ‘brain-computer interfaces’ implementing neuroelectric signals for communication. In the studies presented in this thesis, an alternative approach was followed, namely the possibility to exploit hemodynamic brain signals as measured with functional magnetic resonance imaging. The newly developed communication procedures proved to be highly robust and effective. As they are also easy-to-apply they might help affected patients already in the near future.

“La Côte d’Ivoire et la gestion durable des resources naturelles marines”

“Antioxidant activity: from model to man”

Oxygen is toxic. Our cells are continuously attacked by reactive forms of oxygen (oxidants). For our protection we have anti-oxidants, which we extract from food or which the cells produce themselves. Anti-oxidants work in various ways. This dissertation describes a method that allows a good determination of the anti-oxidant activity. To be able to offer protection, the anti-oxidant has to be absorbed by the body. This was tested in test persons who took apples, fruit salad and a fruit drink. It turned out that the fruit salad and the fruit drink protect against the toxicity of oxygen. Apples are less effective.  

Key words:

Antioxidant, radical damage, fruit, oxidants

“Money and Mobility: Migration and Remittances”

In recent years, migration has increased rapidly and become a more prominent feature of the world economy and the public policy debate.  According to the United Nations, there are estimated to be more than 200 million international migrants in 2010. Remittances, the money that the migrants send back to their home countries, reached an estimated $328 billion in 2008.  This dissertation primarily focuses on processes and consequences of economic migration and more specifically of remittance sending/receiving. This dissertation focuses on the determinants of migration that prompt economic migrants to leave their countries of origin, on   how remittances are currently empirically measured and on how migrants send remittances once they have decided to do so. Research was also done on the effect immigrant integration had on the remittance channel decision and on health care spending in the sending country. 

Key words:

migration, immigration, remittances, migrant  

“Misdaad en straf; een herbezinning op het strafrecht vanuit mystiek perspectief”

This book critically discusses both the ruling penal theories and the current criminal procedure and reveals their main limitations and shortcomings. This research particularly critically studies the overestimation of the crime control effect and the supposed moral character of criminal law. Besides fundamental criticism of the criminal law, this book also offers an alternative for today’s cynical crime control. Based on the mysticism and related man and world views, a beginning is made for a mystical criminal law that does not revolve around punishment but around restoration of damage and relations. Important concepts in this context are solidarity, remorse, forgiveness and reconciliation. This book goes against the spirit of the age.  

Key words:

criminal procedure, penal theory, crime control

“Global rebalancing: Cultures of Crisis”

“On the role of superoxide radicals (O2*) in fibrosis”

“Understanding social interaction in computer- supported collaborative learning”

In this dissertation, we focus on understanding social interaction of learners in authentic and relevant settings, who worked and learned together in virtual teams for an extended period of time. The findings indicate that differences in academic motivation influences the type of contributions to discourse as well as the position a learner takes within the social network in our setting. Extrinsically motivated learners had a preference to connect to highly intrinsically motivated learners. Our findings might explain why in distance learning large differences in participation are found and why certain learners are more inclined to drop-out in class.

Key words:

distance learning, social interaction

“Public Health implications of the Mediterranean diet; its interaction with active and passive smoking”

“The effects of metformin on metabolism and cardiovascular disease in type 2 diabetes”

Patients with diabetes type 2 benefit from continuing the metformin treatment when the moment has come that insulin administering becomes necessary. This is shown by this research that studied the long-term (4.3 years) effects of metformin on among others cardiovascular diseases. The metformin induced improvement in cardiovascular diseases was partly explained by weight loss and improvement in endothelial function in the metformin group, but not by lower insulin levels. Finally, long-term metformin treatment turned out to considerably decrease the risk of developing a vitamin B12 deficiency. The present guidelines, however, don’t make recommendations for the prevention and detection of vitamin B12 deficiencies during the metformin treatment. This research presents strong arguments for the routine determination of vitamin B12 during the metformin treatment.

Key words:

metformin, cardiovascular diseases, endothelial dysfunction, inflammation, vitamin B12

“Towards better diagnosis and monitoring of asthma and cystic fibrosis in children; the value of non-invasive inflammometry”

Asthma and cystic fibrosis (CF) are very common chronic (children’s) lung diseases. Although chronic inflammation of the bronchial tubes is at the centre of the pathophysiology of asthma and CF, this inflammation does not hold a place in the diagnostics, treatment and monitoring of these disorders. The reason for this is that the current methods of measuring inflammation, such as broncoalveolar lavage or biopsy, are too invasive to be used as a routine. New non-invasive methods concern the analysis of exhaled air by measuring nitrogen monoxide or volatile organic components (VOCs) in exhaled air and analysis of biomarkers in exhaled air condensate.  The research shows that exhaled air analysis is a good addition to conventional parameters such as symptoms, physical examination and lung function. This can improve the diagnostics and treatment of children with asthma and CF.

Key words:

asthma, cystic fibrosis, non-invasive methods

“Hemodialysis Access-Induced Distal Ischemia (HAIDI); diagnosis and surgical management”

“Bioactive compounds in whole grain wheat”

Bread can be healthier! Consuming whole-grain foods can prevent cardiovascular diseases, type-2 diabetes and metabolic syndrome. This is due to bioactive compounds in whole grain, such as antioxidants and anti-inflammatory compounds. We found that the different fractions of a wheat grain vary much in their content. The external fractions of the grain, the bran and specially the aleurone, are the richest. We observed that processing the bran in whole-grain breads increased three times the levels of bioactive compounds in blood and urine in humans. This thesis shows that a daily consumed food like bread can be improved to deliver beneficial compounds.

Key words:

whole-grain bread, bran, bioactive compound, antioxidant, inflammation

“Chirurg: van dokter tot jongleur”