International Migration, Integration and Social Cohesion online publications
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Evidence-informed decision making in occupational health and safety
Full text linkDecisions to (de-)implement occupational safety and health (OSH) interventions are not always supported by the best available scientific evidence. The aim of this thesis is to investigate how researchers can support OSH decision makers in using the best available evidence when (de-)implementing OSH interventions. In the first part of the thesis, we looked at the quality of evidence from research studies that can inform policy makers’ and other stakeholders’ decisions. In the second part of the thesis, we analysed how OSH decision makers can make evidence-informed decisions from both a population and individual perspective. The thesis consists of five studies: two Cochrane systematic reviews, an analysis of the reporting quality of randomized controlled trials (RCTs) in OSH, the implementation of the evidence-to-decision framework for policy decisions regarding (de-)implementing return to work coordination interventions, and the development and feasibility study of a decision aid for healthcare workers on the use of double gloves to prevent needle-stick injuries.We found moderate to very low-quality evidence from OSH intervention studies. Most trials do not fulfil the Consolidated Standards of Reporting Trials (CONSORT) which negatively impacts the risk of bias assessments, and thus the quality of the evidence in OSH. The evidence-to-decision framework for policy makers and a decision-aid for workers enabled a systematic and transparent approach to decision making that is informed by the best available evidence for all relevant decision-making criteria, such as effectiveness, costs, and personal values
Beyond indeterminacy:On reputation and interpretation in international law
Full text linkThis dissertation explores the role of reputation in the practice of interpretation in international law. First, it argues that reputation has been fundamentally misconceptualised in legal scholarship, and proposes a more sociologically-inspired understanding of the concept. It then argues that in the frequent absence of centralized interpretation and enforcement in international law, reputation has an important role in processes of stabilization and change in the practice of interpretation: participants in that practice care about what others think of them, and therefore meaningfully orient their interpretive expressions towards each other. Interpretations of international law stabilize and change as a result. It is by way of such processes that indeterminacy makes way for relative determinacy, and international law is ‘made’ and ‘remade’. The project explores interpretation under the spell of reputation in two case studies: the interpretation of the principle of self-determination as codified in the UN Charter, and the interpretation of the ‘political prohibition clause’ in the World Bank’s Articles of Agreement
Cracking tolerance:Examining tissue microenvironments in early arthritis
No full textThe study of human biopsies provides great insights into the specialized tissue environments that maintain immune homeostasis in the body. Direct comparisons between healthy and diseased tissues enhance our understanding of the mechanisms underlying disease onset and progression. Rheumatoid Arthritis (RA) is a chronic autoimmune disease of unknown origin which is characterized by synovial joint inflammation which if left untreated leads to pannus formation causing pain, swelling and bone damage. In this thesis we first explored immune perturbations in the lymph node and synovium in both preclinical and established RA. The findings in this thesis revealed an enrichment of neutrophils within the lymph node of established arthritis patients. Lymph node analysis of RA patients and individuals at risk of developing disease (RA-risk) and uncovered a type I interferon signature in RA-risk individuals and a T follicular helper cell profile in RA patients. Synovial tissue analysis of RA-risk individuals and RA patients revealed increased DNA damage and a reduced capacity for DNA repair in synovial fibroblasts. The final chapters focused on the crosstalk between lymph node fibroblasts and T cells and its impact on immunological tolerance. Lymph node fibroblasts were shown to uniquely maintain regulatory T cells in a HLA-DR dependent manner. This mechanism was not perturbed in RA patients and RA-risk individuals despite a reduced expression of HLA-DR on ex-vivo LN fibroblasts. Collectively, the chapters of this thesis present compelling evidence for alterations in the immunological landscape of the lymph node and synovium during the earliest phases of autoimmunity
Precarious motherhood:Maternal health/care and the state in Los Angeles, USA
No full textThis doctoral thesis explores the impact of State-induced precarity on the maternal health and mother work of Central American asylum-seeking women living in Los Angeles, U.S. Using ethnographic data collected from 2019-2021, I trace how multiple forms of precarity increase in the lives of Central American asylum-seeking women as they navigate healthcare and social service access while caring for their children. Likewise, I explore service providers’ understanding of and responses to women’s precarity– specifically Home Visitation staff and Community-Based Doulas. Through this research, I demonstrate how precarity is induced in the lives of racialized, marginalized asylum-seekers in the U.S. through various methods of structural violence such as legal violence, infrastructural violence and reproductive governance. Additionally, I discuss how structural racism further perpetuates precarity for racialized, marginalized women through the white medical gaze and State surveillance of their parenting practices. Together, I argue that these forms of precaritization are mechanisms of reproductive violence that must be attended to in order to ensure the advancement of reproductive justice in the United States
Elijah in a Roman coat:Der Nister’s <i>The Family Mashber</i>: a mystical and subversive text
Full text linkThis book is about the novel The Family Mashber written in the Soviet Union in the time of the Stalinist repression by Der Nister, the pseudonym of Pinkhas (Pini) Kahanovitz. With this socialist-realist historical novel Der Nister, who used to be a symbolist writer, adapted and developed his literary style. Nevertheless, the novel’s ambiguity, mystical motifs and symbolism have puzzled many readers. The leading question of this study is whether Der Nister’s The Family Mashber hides a mystical layer under its realistic surface, intended to be understood by a limited number of readers, and if so, how it is realised, what it implies for our understanding of the text and whether or not it also reflects on the historical reality of Der Nister’s time. The conclusion is that The Family Mashber is a multi-layered text and that Der Nister continued his kabbalistic style under the cover of a socialist-realist novel. The esoteric level of the text undermines the socialist-realist narrative and is therefore subversive. Intertextuality and knowledge of the Jewish (mystical) tradition are the key to unlock this esoteric level. Der Nister also used certain narrative techniques to mislead or manipulate the reader in assuming he changed course as a writer and adapted himself to socialist-realism. In The Family Mashber Der Nister also reflects on his own writership. In this way the novel also reflects on the social and political circumstances of the 1930s in the Soviet Union. Der Nister uses the image of Elijah in a Roman coat as an illustration of his subversive writership in disguise. He compares The Family Mashber to the Zohar, presenting it as innovation of Torah, meant to strengthen Jewish tradition even in times of persecution
Plants for health:Investigating the broader impacts of the Plants for Joints lifestyle intervention
Full text linkThis thesis builds upon the Plants for Joints (PFJ) randomized controlled trials (RCTs), which demonstrated significant improvements in disease activity in rheumatoid arthritis (RA), as well as pain, stiffness, and physical function in osteoarthritis (OA). It extends these findings by investigating secondary effects, underlying mechanisms, perceived usefulness, cost-effectiveness, and long-term outcomes of the PFJ lifestyle intervention.A systematic review showed that high-fiber, plant-based diets are consistently more effective at improving clinical and microbiome outcomes in chronic inflammatory diseases, compared to other dietary patterns. Secondary analyses of the PFJ RCTs showed significant reductions in body fat and liver fat content, improvements in gut barrier integrity, favorable shifts in microbiome composition and metabolites, and positive effects on stress-related parameters in RA. Further research indicated no evidence of mucosal anti-modified protein antibody production in the gut.A process evaluation highlighted high participant satisfaction, empowerment, and the importance of self-monitoring, social support, and guidance. Economic analyses demonstrated that the PFJ intervention was on average less costly and more effective compared to only usual care. Long-term follow-up over two years showed sustained improvements in disease activity, pain, stiffness, physical function, several metabolic risk factors, and reduced medication use, with continued adherence to intervention recommendations.Together, these findings show PFJ is a feasible, acceptable, and sustainable lifestyle intervention with broad health benefits. Beyond symptom relief, PFJ positively influences body composition, metabolic health, the gut microbiome, stress regulation, and quality of life, underscoring its potential as an adjunct treatment for RA, OA, and possibly other chronic diseases
Minoritized citizens' perspectives on political representation
No full textThis dissertation examines how minoritized citizens with migration backgrounds in Western Europe experience political representation. While the number of minoritized politicians is gradually increasing, parliaments still fail to reflect society’s diversity. At the same time, debates on immigration, integration, and Islam shape the political landscape. These dynamics raise key questions: how do citizens with migration backgrounds perceive political representation, how do processes of minoritization influence these perceptions, and what opportunities do citizens see to influence political representation? This dissertation argues that examining citizen perspectives allows scholars to critically assess, integrate, and extend existing theoretical models. It highlights the persistent barriers minorities face in achieving equal political influence and shows that a growing number of minoritized politicians does not automatically result in feelings of adequate representation. The study underscores the importance of intersectional analysis in political representation research, providing insights into within- and between-group differences in how citizens want to be represented, in what ways, and by whom
Preterm birth:Risk recognition and intervention effectiveness
No full textPreterm birth is not a disease; it is a classification used to define the timing of birth relative to gestational age. It reflects when a birth occurs, not why it occurs, and is the outcome of various causes that can disrupt physiological gestation. The heterogeneity in preterm birth causes implies that a one-size-fits-all approach to its screening tools and interventions is not realistic. The dynamic interaction of individual risk factors complicates the prediction which risk factor(s) will exert the greatest impact, while others remain undetected, making a cause-targeted approach more challenging. Not all cases of preterm birth are attributable to cervical dysfunction, nor do they necessarily manifest with cervical shortening. By embracing preterm birth as an outcome with multiple causes, instead of a singular disease entity, universal cervical length measurement should become an essential part in preterm birth prevention as it is a valuable tool to detect cervical dysfunction. This thesis advocates for a comprehensive package of prevention strategies that addresses the full spectrum of biological causes of preterm birth, while acknowledging that many risk factors extend into the environmental and socio-economic domain and require a broader, systemic approach. We need to move away from the pursuit of a single one-tool-predicts all, or one-intervention-prevents all, as this could overlook the true potential of targeted strategies to address specific causes of preterm birth
Track & trace transcription factor localization and dynamics
Full text linkTranscription factors (TFs) are key regulators of gene expression. These proteins need to find and bind specific sequences in the DNA to regulate expression of their target genes. How TFs are organized within cells and how they localize their targets is unclear. In this thesis, we use advanced live-cell imaging techniques to study the regulation of transcription factor localization & dynamics in budding yeast. Chapter 2 is a review on how studying dynamics of transcriptional proteins provides insights in the molecular mechanisms underlying gene transcription. Chapter 3 is a protocol on how to perform live-cell single-molecule fluorescence imaging in budding yeast. In Chapter 4, we studied a yeast TF which localizes in clusters inside cells, to identify the regulatory mechanisms of TF clustering and its role in gene regulation in an endogenous context. Finally, in Chapter 5, we present the use of a novel single-molecule imaging technique and apply this to measure both the search time and binding time of this yeast TF at a specific target locus in living cells, combined with genomic perturbations, to study the regulation of TF binding dynamics at their genomic targets
Interventions for pancreatic diseases:Improving treatment while considering costs
Full text linkThis thesis explores the clinical and economic aspects of pancreatic diseases, focusing on pancreatic resections, interventional strategies for acute pancreatitis, and advancements in minimally invasive surgical techniques for chronic pancreatitis. Through systematic reviews, cost analyses, and randomized controlled trial protocols, key challenges and opportunities in optimizing pancreatic disease management are identified. The findings highlight the significant financial burden of pancreatic resections, underscoring the need for standardized reporting of complications and costs. Additionally, the potential benefits of robot-assisted surgery are evaluated, which may improve patient outcomes and reduce hospital stays, while considering its cost. In acute pancreatitis, a step-up, delayed approach for infected necrotizing pancreatitis, in line with current guidelines is recommended. The ongoing PICUS-2 and PANACOTTA trials will further expand on treatment strategies for idiopathic acute pancreatitis and chronic pancreatitis, respectively. Future research should focus on refining surgical techniques, enhancing perioperative care, and evaluating long-term (patient-reported) outcomes. Integrating cost-effective, patient-centered strategies will be crucial for advancing pancreatic surgery and improving both clinical and economic outcomes. This thesis provides insights that could shape future clinical practices and healthcare policies in pancreatic disease management