International Migration, Integration and Social Cohesion online publications
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Perspective matters in recovery:From fragmented to collaborative care in complex psychosis
Get PDFPeople with a hard to manage psychosis and complex co-occurring challenges (“complex psychosis”) and their families often go through long and difficult care trajectories in mental healthcare, including admission to long-term inpatient mental health rehabilitation services. Arguably, they face a complicated (personal) recovery process. People with a complex psychosis, families and professionals often hold diverging views on the problem, and what should happen, which complicates their collaboration for recovery. Unfortunately, research on complex psychosis is scarce, due to the very complexity of problems and potential unwillingness and/or inability to consent to research. This thesis explored perspectives that potentially help to improve care for people with a complex psychosis and their families. Part I discusses prerequisites to do research in this hard-to-access group. Part II focuses on preventing cumbersome trajectories, including the role of familial cognitive vulnerability, long-term outcome prediction and hypotheses on ways to care delivery to people with complex psychosis. Part III focuses on the needs people with a complex psychosis, their family and mental health professionals have to effectively collaborate for recovery, based on their personal perspectives. In conclusion, participatory research, early identification of vulnerabilities of those with complex psychosis, and collaborative care that tolerates diverging perspectives, with continuity of those involved, should go together, to prevent fragmentation and foster growth in people with a complex psychosis, their family and professionals
From tissue to clinical practice and back again:A translational approach to adrenoleukodystrophy
No full textX-linked adrenoleukodystrophy (ALD) is the most common genetic white matter disease of the central nervous system. It is characterized by a quickly progressive leukodystrophy in the brains of a large proportion of affected boys and men, and as a more slowly progressive myeloneuropathy in the spinal cords of all adult men and most women. While the clinical and biochemical features of ALD have been well documented, its underlying pathophysiology and the reasons for variability between patients remain poorly understood. This thesis investigates the pathology of ALD and, through a translational approach, seeks to link disease mechanisms to clinical manifestations. Part I examines the pathology of ALD: chapter 2 presents a literature review and proposes a working model for its disease mechanisms, while chapter 3 applies quantitative MRI techniques to non-invasively assess tissue-level changes. Part II focuses on the clinical spectrum of ALD, relating it to lipidomics (chapter 4), movement analysis (chapter 5), and established conventional outcome measures in trials (chapter 6). Part III places the clinical impact of ALD in a broader societal context by exploring the perspectives of affected individuals on its inclusion in the Dutch newborn screening program
Exploring the long-term course of psychosis:Understanding longitudinal changes and interrelationships between recovery domains in different phases of psychotic disorders
No full textPsychotic disorders are disruptive on multiple aspects of life. In this doctoral thesis I evaluated longitudinal changes in patients with psychotic disorders on the following recovery domains: social functioning, symptoms, personal recovery or quality of life and cognition. In part 1 I investigated longitudinal changes in the four recovery domains separately through meta-analyses that included studies evaluating longitudinal changes in patients with psychotic disorders over a follow-up period of at least 1 year. The influence of the patients’ duration of illness and other personal, clinical and social patient characteristics on these longitudinal changes were also evaluated. In part 2 I investigated to what extent changes in one recovery domain was associated with changes in another recovery domain through both a meta-analysis and through a longitudinal cohort study. Overall, results indicated that people with psychotic disorders improve substantially over time in symptoms and social functioning, especially for patients with early psychosis, but cognition and personal recovery showed modest or no improvement over time. Improvement in social functioning, symptoms and cognition were associated with one another, indicating that longitudinal changes in these recovery domains might reinforce each other. Changes in personal recovery were hardly associated with changes in other recovery domains. This suggests that improvements in social functioning and symptoms did not translate into a more positive subjective experience of overcoming mental illness. This thesis taught us that improvement in time in patients with psychotic disorders is possible, but special attention is needed for long-term improvement in cognition and personal recovery
The art of restitution:Pursuing justice through restitution committees for Nazi-looted art
No full textLooted art has long been associated with war, but the Nazi regime elevated cultural plunder to an unprecedented scale, making it a central instrument in the persecution of Jews and other targeted groups. Early post-war restitution proved limited, and since the late 1990s new mechanisms were established in response to international calls for long-overdue justice.This thesis examines the evolving approaches to Nazi-looted art restitution in Austria, the United Kingdom, and the Netherlands, focusing on the committees created to adjudicate such claims. It argues that a paradigm shift has occurred: from a strictly legal to a morally driven, victim-centred framework. These committees prioritize recognition of suffering and procedural justice, yet face the challenge of balancing legal certainty with morally just outcomes.From an institutional perspective, the study shows that all three committees deliberately departed from traditional legal frameworks, favouring flexible procedures and accessibility. While initially praised, this informality exposed weaknesses such as lack of transparency, juridification, and dependence on the executive. Substantively, their approaches diverge: Austria remains rooted in legal doctrine, the UK embraces moral reasoning, and the Netherlands has developed a discretionary framework that increasingly acknowledges historical injustices and victim agency.Engaging with scholarly debates, this thesis advocates a hybrid model that embeds moral reasoning within a legal framework. Sustainable legitimacy requires legal safeguards to ensure transparency, independence, and procedural clarity, while leaving space for moral considerations. Only such a hybrid paradigm can reconcile legal structure with recognition of historical injustice, strengthening victims’ agency and ensuring context-sensitive restitution
Escaping on Iberian ships arriving in Caribbean camps:Second World War refugees in global transit
Get PDFDuring the Second World War, Jewish refugees fled the Low Countries and found their way to Iberian harbors and ships, and eventually reached the Caribbean. Much to their surprise, they were interned in camps in Curaçao, Jamaica, and Suriname. Their confinement lasted from days to years, after which they pursued varied paths—some relocating within the Caribbean, others moving to the United States, or even returning to Europe to fight the Axis Powers. This dissertation investigates not only their routes and camp experiences but also these histories’ lasting effects and why they remain largely absent from public memory.The dissertation is structured along two approaches. The first two chapters adopt a “locality” lens: The Ship analyzes the refugees’ liminal transatlantic journeys, drawing on scarce shipboard sources and analyzing colonial authorities’ attitudes toward and expectations of Jewish and non-Jewish inhabitants. The Camp compares internment sites, showing how architecture, restrictions, and racialized contexts shaped the lives and experiences of refugees. The third chapter examines the exit routes from internment—through military service, employment, or personal connections—and traces the subsequent wartime lives of refugees across the Caribbean. The fourth chapter extends to postwar trajectories and memory, exploring how flight experiences were woven into family histories and remembered (or forgotten) across continents.Finally, the dissertation demonstrates the value of juxtaposing sites of arrival and stresses the importance of source-finding. Drawing from archives, private collections, synagogue archives, and (recorded) interviews, it reconstructs overlooked histories of global wartime transit and displacement
Atmosphere/Amsterdam:Architectural media and the urban (re)imagination of nature
No full textIn the summer of 2020, the city of Amsterdam published the Amsterdam Green Infrastructure Vision 2050: A Liveable City for People, Plants, and Animals as part of the larger (re)positioning of Amsterdam as a ‘sustainable’ city. This article-based dissertation focuses on seven different sites to explore how architecture contributes to the imagination and realization of sustainability: The interactive cartographic database Maps Amsterdam, the three residential building projects ReGen Villages, The Urban Tree Village and VERTICAL, and the three neighborhood (re)developments Sloterdijk, Zuidas and Bajeskwartier. From drawings and sketches of initial designs via virtual renderings and animations to photographs and videos of the construction, architecture can be understood as an inherently mediated process – and yet, these media are rarely approached as a site of negotiation. Conceptualizing the term architectural media, this thesis positions mediations of architecture as a key site of place-making and meaning-making – particularly in processes of urban transformation. In the context of the ‘sustainable’ city, architectural media are (re)imagining urban nature(s), (re)constructing urban future(s) and (re)producing urban atmosphere(s). Weaving together the different case studies, the individual chapters move through the architectural process, from the initial urban policies and plans delineating the city’s development to virtual renderings of proposed constructions, architectural models as haptic visualizations of neighborhood development plans, architectural photographs of different moments in the construction process to the construction site itself. Taken together, the chapters underline how becoming ‘sustainable’ and making a ‘sustainable’ city are entangled processes of imagination and realization.</p
In defence of the informed mind:The applicability of international human rights law for the conduct of extraterritorial influence operations by States
No full textThe thesis aims to explore how international human rights law applies to the conduct of disinformation, propaganda and other cognitive manipulations by foreign States. In light of the revolutionary developments in information technology and the parallel dependency on mediated information exchange in modern societies, the study examines novel legal problems raised by foreign cognitive influence operations from the perspective of the individual directly targeted or indirectly affected. The thesis raises the issue of extraterritorial applicability of human rights in cognitive operations lacking a direct physical impact and examines the compatibility of such State activities with selected substantive human rights and freedoms that aim to protect the receipt, processing and exchange of information against impermissible interference by a State. The research aims to contribute to an ongoing academic debate concerning the role of human rights law in the information era, with a plea to international human rights law in defence of the informed mind
Democracy, control, legitimacy:Separation of powers and EU trade and investment policy
No full textThis thesis examines the institutional framework and practices of negotiation of trade and investment agreements by the European Union (EU) through the lens of separation of powers. Trade policy and trade agreements have the potential to affect the rights and obligations of individuals and generate significant distributive consequences. In addition, the scope of EU trade policy has gradually broadened, and it increasingly deals with non-economic topics, such as industrial and climate policies. In turn, the normative framework of separation of powers developed in this thesis evaluates how EU governance in the field of trade fares against two fundamental objectives: democratic will formation and control. The normative examination carried out in this thesis combines the legal-doctrinal method with case studies dedicated to specific trade or investment agreements that draw on content analysis of various policy documents and expert interviews. This thesis demonstrates that the law and practices of EU trade policy evoke not an ideal of separation, but rather that of confusion of powers. The legal framework and practices in question are consensus-oriented (not agonistic) because of its complexity, the abundance of inputs, and the great number of veto players. At the same time, this framework is arguably well-suited to prevent abuse of power, often precisely for the reasons that make it insufficiently democratic. The thesis also underscores the underexplored role of the Trade Policy Committee of the Council and the European Commission’s framing and agenda-setting powers which translate into a long-term intellectual leadership over trade policy strategy
Living the postcolony:Egyptian (be)longings in Paris
No full textThis dissertation examines how Egyptian migrants make a life in postcolonial Paris. It is based on fourteen months of fieldwork between January 2017 and February 2018 in Paris and its suburbs. Convening the many ways in which Paris is lived as a postcolony, it examines the poetics and politics of differentiated belonging, postcolonial relationalities, bureaucratic resilience, parenting dilemmas and migrant futures. It centers on the repertoires, ways of life, everyday references and frames of Egyptians in Paris. While these lives unfold within institutionally channeled and politically coded regimes, it deliberately foregrounds the perspectival locations through which migrants understand and make their presence in this postcolonial space and the ways in which they seek to make familial and familiar lives there. By doing so, this research provides a crucial relational phenomenological understanding of postcolonial belonging in Europe
Accelerated 4D MRI for the assessment of aortic motion
No full textMarfan syndrome (MFS) is a genetic connective tissue disorder that increases the risk of life-threatening aortic complications such as aneurysm, dissection, and rupture. Clinical decisions are typically based on aortic diameter, yet dissections can occur before reaching surgical thresholds. This highlights the need for novel biomarkers to identify high-risk individuals earlier. Aortic motion and deformation, influenced by arterial stiffness and vessel wall biomechanics, may serve as such biomarkers. While cardiovascular magnetic resonance imaging (MRI) has improved assessment of aortic morphology, its four-dimensional (4D) potential for capturing dynamic behavior throughout the cardiac cycle remains underutilized.This thesis focused on advancing 4D MRI methods for improved analysis of aortic motion. Specifically, it aimed to: 1) optimize the acquisition and reconstruction of a 3D time-resolved bright blood MRI sequence, and 2) develop postprocessing tools to quantify aortic dynamics, with the ultimate goal of finding novel biomarkers for aortic remodeling through (future) studies in cohorts of MFS patients and healthy volunteers.Chapter 2 details the development of a 4D MRI pipeline using a free-running balanced steady-state free precession (bSSFP) sequence, demonstrating reproducible aortic diameter and displacement measurements in healthy volunteers. Chapter 3 presents a convolutional neural network for automated aortic segmentation, enabling assessment of dynamic motion. Chapter 4 introduces technical optimizations to improve image quality at 3 Tesla. Chapter 5 applies the pipeline in MFS patients and healthy volunteers, revealing biomechanical differences and correlations with known markers of arterial stiffness. Chapter 6 explores localized pulse wave velocity as a biomarker, though variability highlights the need for refinement.</p