Academic Ceremonies October 2013

“Management of late preterm prelabour rupture of membranes”

When a pregnant woman’s membranes rupture between three and six weeks before her due date, it is preferable to take no action rather than to artificially induce. The risk of infection does not increase when no action is taken and a premature birth may result in additional complications. That is the main conclusion of this PhD dissertation, which followed more than 1000 women with broken membranes through a collaboration with 60 Dutch hospitals. However, for women who had Group B streptococcus (bacteria) in their vaginas, artificial induction seemed to make sense. Further research into this is needed.

Trefwoorden:

zwangerschap, voortijdig vliezen breken, kunstmatig inleiden

“Adiposity in COPD”

“Adding eyebrows to CSCL; understanding the combined use of synchronous and asynchronous communication and the role of motivation in computer-supported collaborative learning”

In addition to email and discussion forums, students can now also communicate and collaborate via videoconference environments. This PhD dissertation investigated how students use the possibilities of synchronous communication during weekly videoconferences and asynchronous communication with text messages outside the videoconferences, and how that relates to their satisfaction, motivation and learning outcomes. Despite the fact that synchronous communication is more ‘social’, students’ satisfaction did not increase and their performance was lower in the years when the videoconference system was used compared to the years when only asynchronous communication was used. However, indications were found that the use of the videoconference system decreased the differences between intrinsically and extrinsically motivated students with regard to the quantity and quality of asynchronous communication.

Key words:

online collaborative learning, videoconferencing, motivation

“Why Jamaica wants to protect Champagne: Intellectual Property protection in EU bilateral trade agreements”

“Stock Market Dynamics of Marketing Decision-Making”

Recent anecdotal evidence has stimulated much debate about whether the stock market enhances or impedes long-run firm investments in product innovation. Academic research, arguably, does not yet understand the stock market dynamics of public firm innovation behavior. This dissertation explores how firms manipulate their innovation and investments efforts in a response to stock market incentives. It is also investigated how public firms convey their innovation potential to the investor community, and how firms seek to improve communication channels with the investor community. Overall, the research outlines substantial and so far neglected costs of a stock market listing. These results offer implications for firms managing innovation activities and for economic institutions developing policies that guide firm behavior.

Key words:

firm investments, product innovation, stock market

“Voordat het wal het schip keert” 

“Is that your final answer ? How doctors should check decisions”

“Sexuality and Intellectual Disability; implications for sex education”

Despite the many problems that people with intellectual disabilities experience in the field of sexuality, such as difficulties forming relationships and experiences with sexual abuse, sexuality remains a neglected topic. This doctoral research shows that effective sex education programmes for people with intellectual disabilities are still not available in the Netherlands. Further, people with intellectual disabilities themselves can provide some new insights into what is important for sex education. Their carers also should be supportive in providing sex education. Finally, more research needs to be done into which methods are most effective for providing sex education to people with intellectual disabilities.

Key words:

intellectual disability, sex education, sexuality, Intervention Mapping

“Sexuality and Intellectual Disability; implications for sex education”

This dissertation investigates the link between the level and distribution of education and institutional change in societies where elites have a privileged access to political and economic organizations. Political elites should have sufficient skills to benefit from a modern economy and to respect property rights. However, more education of the general population might not necessarily contribute to stable property rights if income is not growing at the same time. Ethnocentric organizations are one of the reasons why a certain group of elites continues to dominate society in many developing countries. A case study on Kenya shows that the role of ethnicity in society depends on initial within-group inequality as well as the history of state formation.

Key words:

education, elite, ethnocentrism, Kenya

“Where borders and health care meet: Five studies in movements between health care systems”

National health systems have been conceived to fund, organise and deliver health care services within the borders of the domestic territory.  Why then do Dutch health insurers make contracts with Belgian hospitals?  Why do Californians go to Mexico for medical care, and Indian doctors migrate to the UK?  On our doorstep, more than 90% of German students at Maastricht University go back home when they need to see a doctor, while the Academisch Ziekenhuis Maastricht and Universitätsklinikum Aachen share surgeons, patients and equipment across the border. Whether globally or locally, these movements signal that health care is no longer a national affair. This thesis explores why and how health care actors make use of new options outside national health systems, and looks into the developments, such as increased mobility, European integration and the introduction of market mechanisms to health care, which are driving this change.

Trefwoorden:

health care, cross-border

“Combating the Dark Side: Managing Performance Reinvigoration of Long-Term Relationships”

“Complementarity in Innovation and Development; A Cross-country Comparison”

“Plantar pressures in diabetic polyneuropathy; the influence of gait pattern and exercise therapy”

“Moleculair spoorzoeken in ontspoorde cellen”

“Empirical Investigations of Costs and Benefits of Vocational Education and Training”

“Primary prevention of asthma among children”

An estimated 115,000 Dutch children suffer from asthma. There is no known cure but arresting the disease at the earliest stages is a goal.  It seems that prevention with several components (multifaceted) is more clinically effective than prevention with just one component (unifaceted); but it is not known if it is also cost-effective.  This dissertation looked at risk factors for asthma among six-year old children and examined the cost-effectiveness of various prevention programmes.  The conclusion is that asthma among first-degree family members significantly increases a child’s asthma risk, which is almost trebled when parents also smoke in the first post-natal year.  More importantly, multifaceted primary prevention can be cost-effective and preferred over usual care and unifaceted prevention.

Key words:

asthma, children, prevention, risk factors

“Social Threat Hurts! The influence of social threat on pain”

“Rescuing Modernity; global heritage Assemblages & Modern Architecture in Africa”

UNESCO aims to tackle Africa’s underrepresentation on its World Heritage List by inscribing instances of 19th and 20th century modern architecture and urban planning there. But, what is one to make of the utopias of progress and development for which these buildings and sites stand? After all, concern for ‘modern heritage’ invariably – and paradoxically it seems – has to reckon with those utopias as problematic futures of the past, a circumstance complicating intentions to preserve a recent ‘culture’ of modernization on the African continent. The present dissertation introduces the concept of global heritage assemblages to analyze this problem. Based on multi-sited anthropological fieldwork, it describes how various governmental, intergovernmental and non-governmental actors engage with colonial and post-colonial built heritage found in Eritrea, Tanzania, Niger and the Republic of the Congo.

Key words:

UNESCO World Heritage, Africa, global heritage assemblages

“Peri-operative Atrial Fibrillation in Cardiac Surgery; Impact on outcome”

“Effects of developmental fluoxetine exposure on neurobehavioral outcomes”

Depression during pregnancy and in the post-natal period occurs in 20% of women. A large number of women take antidepressants, mainly Prozac, during this period. The effect that the stress during pregnancy in combination with Prozac has on the offspring has hardly been investigated. In this study, pregnant rats were subjected to stress, after which they were administered Prozac with the active ingredient fluoxetine in the post-natal period. The effects on the offspring were examined with relation to depressed and anxious behaviour, the stress system, the hippocampus and sexual behaviour. Among other things, fluoxetine normalises the effects of prenatal stress on depressive behaviour. Without exposure to stress, fluoxetine inhibits sexual behaviour in male offspring and stimulates sexual behaviour in female offspring.

Key words:

post-natal depression, antidepressant

“Active Ownership”

This dissertation presents the latest empirical evidence on shareholder engagement strategies which can be used by shareholders to control managerial behaviour and to promote sustainable business practices. It postulates that the shareholders should become active owners and raise their voice if they are discontent with corporate performance or corporate environmental and social standards. Specifically, this dissertation discusses shareholder resolutions and direct private engagement tactics which shareholders can use to improve corporate governance, social and environmental behaviour. The main conclusion is that shareholders should realize that they can promote better environmental, social, and governance standards at corporations they invest in.

Key words:

shareholder engagement strategies, sustainability, managerial behaviour

“Assessment of clinical competence: Reliability, Validity, Feasibility and Educational Impact of the mini-CEX”

“Towards a learner-centred approach to postgraduate Communication skills teaching”

Teaching communication skills (CS) to junior doctors during postgraduate training remains problematic. Direct observation of junior doctors followed by feedback is a powerful way to teach CS in clinical practice. However, little is known about the effects of training supervisors on how to give feedback to junior doctors about their patient CS. In this study, a training program for supervisors on how to teach CS was designed and tested with clinical supervisors. It proves to be feasible, appreciated and effective in that it changes perceptions and behaviours and helps shift a paradigm change from a teacher centred to a more learner centred approach. To enhance transfer, training must be closely linked to formal and informal opportunities to practice teaching CS and supervisors should be able to join a community of teachers where exchanges of experiences can take place.

Key words:

teaching communication skills, doctors, postgraduate

“Learning to be the patient advocate. The development of a communication skills course to enhance nurses’ contribution to the informed consent process”

“Explaining Suicide in South African Adolescents: Psychosocial and environmental precursors” 

“Plus Ultra”

“Mechanisms of cardiovascular disease in the Metabolic syndrome and type 2 diabetes mellitus: Focus on adverse intermediate phenotypes”

“Perfect Equilibrium in Infinite Games”

“Optimizing Chlamydia trachomatis and Treponema pallidum diagnostics” 

The expression ‘assumptions are the mother of all mistakes’ certainly applies to sexually transmitted infections (STIs). Therefore this PhD dissertation examines a number of assumptions about the diagnostics of STIs. It was shown thatChlamydia trachomatis DNA is extremely stable in various preservation conditions; this knowledge is very important because, for example, a lot of research is being carried out with (old) frozen materials from patients. In addition, the quick tests for detecting Chlamydia trachomatis were evaluated. These proved to be very insensitive and thus unreliable, even while some of them were freely available on the internet! Optimising diagnostics can contribute to reversing the prevalence of STIs.

Trefwoorden:

SOA, Chlamydia trachomatis, diagnostiek

“Psychogenic non-epileptic seizures; a separate disorder or part of a continuum?”