International Migration, Integration and Social Cohesion online publications
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The malleability of emotional memory:Modification and measurement
Get PDFEmotional memory plays a crucial role in guiding our behaviour, helping us to adapt and thrive in our ever-changing world. However, when emotional memory becomes maladaptive, it can lead to anxiety and related disorders. Fundamental research into fear learning and memory has opened new avenues for understanding and targeting maladaptive emotional memories via, for instance, reconsolidation interference. This is a process thought to directly weaken emotional memory, which may prevent relapse. To improve psychological interventions, it is not only important to explore the malleability of emotional memory by investigating novel treatment mechanisms, but also to capture changes in emotional memory expression over time, which requires good measurement tools. The overarching aim of this dissertation was to explore and capture the dynamic and complex nature of emotional memory. In the first part, we tested the effectiveness and translational value of a reconsolidation intervention, a treatment designed to modify maladaptive fear memories. This involved examining changes in self-reported fear and avoidance behaviour to better understand the temporal dissociation of emotional memory facets following treatment (Chapter II). The second part of this dissertation focused on improving the assessment of emotional memory and exploring how the act of measurement may affect emotional memory expression (Chapters III-V). Together, the research presented in this dissertation illustrates when emotional memory expression does – or does not – change and thereby contributes to our understanding of the plasticity of emotional memory, offering insights relevant to improving psychological treatments
From dialogue to decision:Using technology to facilitate shared decision-making in a fall prevention context
Get PDFFalls are a leading cause of traumatic injury among older patients, and medication intake is a big risk factor for falls. General practitioners and older patients should evaluate the patient’s medication usage together regularly while engaging in a shared decision-making conversation. However, this is currently often not done (sufficiently). This dissertation aims to describe the systematic development and evaluation of a technological intervention that can provide personalized decision support to general practitioners and older patients to facilitate shared decision-making regarding the medication-related fall risk. The intervention consists of a clinical decision support system with a prediction model that calculates individualized fall risks, and a patient portal that helps the patient prepare for the consultation with their general practitioner. The dissertation describes the systematic development of these systems, applying a user-centered design approach in which end users are involved in all phases of the development process. Prototypes were developed based on a systematic literature review, focus groups, and interviews. These prototypes were further improved by conducting usability testing with a think-aloud method. The dissertation also describes the evaluation of the intervention with a randomized controlled trial. The results are promising. The intervention enhanced shared decision-making, increased patients’ satisfaction with the communication during the consultation, and diminished the level of decisional conflict experienced by patients. The effects on the medication changes made during the consultations seem promising, but for now remain inconclusive and need further exploration. This dissertation has showcased the great potential of innovative technology-driven interventions to empower patients and guide healthcare providers to engage in effective shared decision-making
Monumentalising identities:Presenting dress, gender and identity in funerary portraits in the Roman north-west
Get PDFThis dissertation examines the impact of the integration of the far north-western provinces into the Roman Empire on the (self-)representation of people through clothing, hairstyles, jewellery, and accessories. It focuses on the adoption, adaptation, rejection, or invention of new dress elements in dress, employing the concept of anchored innovations - the ways in which people relate and then embed ‘new’ things into their pre-existing traditions, beliefs and ambitions - to understand the dynamics of cultural change. Funerary portraiture serves as the primary evidence, as a medium of public representation designed by and for local communities, which offer an insight into local views on status, cultural, ethnic, and gender identities.The study reveals differing views on gender norms between Italy and the far north-west, and illustrates the flexibility of the gendered meaning and use of objects. Regional diversity in response to Roman influence becomes apparent from the remarkable rarity of the toga in the far north-west, as opposed to the Rhineland and other parts of the Roman empire. Yet while the toga is rare in the far north-west, the synthesis (the Roman dining costume) indicates a familiarity and acceptance of Roman cultural practices of both men and women, particularly in Roman Britain.By far the most dominant form of dress in the far north-west is the local innovation known as Gallic dress. The local origin and distribution of this dress style, however, does not represent a rejection of Italian-Roman culture. A tension between local and empire-wide trends, and the creative ways in which people combined references to the local and Roman within their appearance, is apparent in the Gallic tunic. The widespread adoption of Gallic dress coincided with the decline of fibulae, rendering the once common objects obsolete. This abandonment signalled a significant change in appearance, though it does not necessarily imply the demise of ethnic identities.In hairstyles, veiling, and bonnets, we observe varying levels of “Roman-ness” as a distinguishable aspect in dress, with bonnets most clearly illustrating a differentiation between Roman and local dress in the provinces. This indicates that innovations occurred across a spectrum of Roman-ness and were met with different levels of acceptance
From dialogue to decision:Using technology to facilitate shared decision-making in a fall prevention context
Get PDFFalls are a leading cause of traumatic injury among older patients, and medication intake is a big risk factor for falls. General practitioners and older patients should evaluate the patient’s medication usage together regularly while engaging in a shared decision-making conversation. However, this is currently often not done (sufficiently). This dissertation aims to describe the systematic development and evaluation of a technological intervention that can provide personalized decision support to general practitioners and older patients to facilitate shared decision-making regarding the medication-related fall risk. The intervention consists of a clinical decision support system with a prediction model that calculates individualized fall risks, and a patient portal that helps the patient prepare for the consultation with their general practitioner. The dissertation describes the systematic development of these systems, applying a user-centered design approach in which end users are involved in all phases of the development process. Prototypes were developed based on a systematic literature review, focus groups, and interviews. These prototypes were further improved by conducting usability testing with a think-aloud method. The dissertation also describes the evaluation of the intervention with a randomized controlled trial. The results are promising. The intervention enhanced shared decision-making, increased patients’ satisfaction with the communication during the consultation, and diminished the level of decisional conflict experienced by patients. The effects on the medication changes made during the consultations seem promising, but for now remain inconclusive and need further exploration. This dissertation has showcased the great potential of innovative technology-driven interventions to empower patients and guide healthcare providers to engage in effective shared decision-making
Congenital microphthalmia and anophthalmia:Biometrics and treatment using three-dimensional techniques
Get PDFCongenital microphthalmia and anophthalmia (MICA) are rare developmental anomalies characterized by the presence of a small or absent eye, respectively. In the Netherlands, approximately 4 to 17 children are born with this condition annually. In many cases, the visual prognosis is poor. Treatment then focuses on minimizing facial asymmetry as much as possible and ensuring the ability to wear a well-fitting and aesthetically pleasing ocular prosthesis.This dissertation focuses on practical questions regarding the management of MICA: when is this treatment indicated? How urgently should it be initiated? What does the treatment process entail? What constitutes the most appropriate outcome measure for evaluating success? Additionally, the potential applications of 3D-printed ocular prostheses are explored.To address these questions, the MICA cohort at Amsterdam UMC was studied from 2013 to 2022. This research proposes a classification system based on axial length measurements obtained via ultrasonography. Axial length is expressed as a percentage relative to the unaffected (or least affected) eye: 0–45% indicates severe microphthalmia, 45–75% moderate microphthalmia, and 75–100% mild microphthalmia. Children with eyes smaller than 10.5 mm ideally require treatment within the first few months of life, as such cases are more frequently associated with orbital growth retardation and an increased risk of facial asymmetry.Our findings, combining objective measurements with subjective assessments, suggest that the primary treatment goal should focus on achieving horizontal palpebral fissure (HPF) symmetry exceeding 80% relative to the unaffected (or least affected) side. Personalized, 3D-printed conformer therapy often achieves orbital dimensions exceeding 80% of the unaffected side, promotes the formation of adequate conjunctival fornices, and facilitates the use of aesthetically pleasing ocular prostheses
Inflammation and lipids in atherosclerosis:From disease mechanisms to therapeutic targeting
Get PDFThis thesis explored novel strategies to improve cardiovascular risk management by investigating lipids, inflammation, and plasma proteomics in individuals at risk for atherosclerotic cardiovascular disease (ASCVD). Part I examined the role of triglyceride-rich lipoproteins and systemic inflammation in ASCVD and acute pancreatitis. One study showed that the association between remnant cholesterol and ASCVD events was largely independent of systemic inflammation, suggesting independent pathways. A randomized placebo-controlled trial with olezarsen showed that treatment reduced both fasting and postprandial triglyceride levels and altered monocyte phenotype and function. These findings indicate a potential for olezarsen to reduce the risk of both acute pancreatitis and ASCVD. Part II focused on inflammation as a driver of plaque vulnerability and cardiovascular events. LDL cholesterol, hsCRP, and Lp(a) were associated with increased long-term ASCVD risk in primary prevention patients within a large European cohort. Inflammatory markers IL-6 and hsCRP were associated with high-risk plaque features and progression. Moreover, 68Ga-DOTATATE PET/CT imaging showed promise in detecting vascular inflammation beyond systemic biomarkers. Part III investigated the utility of plasma proteomics in improving ASCVD risk prediction and informing treatment decisions. Proteomic analyses improved prediction of plaque progression and identified key inflammatory and apoptotic pathways. A study on PCSK9 inhibition and colchicine revealed differing proteomic effects, while another study on PCSK9 inhibition showed consistency between pharmacologic and genetically predicted effects. Together, these findings suggest that integrating biomarkers, imaging, and targeted therapies may support a more personalized approach to ASCVD prevention
<i>Bacillus subtilis </i>as a cell factory for bio-based production processes
No full textThe objective of this thesis was to better explore the metabolic potential of Bacillus subtilis, by analyzing and comparing production of primary and secondary metabolites in various food-grade, spore-deficient strains and industrially used strains. In chapter 2 it was demonstrated that by selecting different strains of B. subtilis, the application range of this bacterial species can be significantly expanded. Subsequently, the food ingredient pulcherrimin (chapter 3) that can be used as antimicrobial agent and the (biobased) chemical pyridine-2,6-dicarboxylic acid (chapter 4), which can serve as the precursor for biopolymers, were selected as case studies to explore the feasibility of developing B. subtilis as a cell factory for biotechnologically valuable compounds. Additionally, a method that can facilitate high-throughput detection of pyridine-2,6-dicarboxylic acid in fermentation broths was developed (chapter 5). The latter provides an efficient tool enabling unbiased screening of the compound’s production. The work led to novel insights for the construction of B. subtilis based cell factories designed for pyridine-2,6-dicarboxylic acid production. In summary, this study demonstrates the potential use of B. subtilis beyond enzyme production and further highlights its contribution to the bio-based economy.</p
Being in control:Policing bodies, emotions and violence
Get PDFWe expect the police to ‘be in control’. At the same time, control is essential to officers’ daily routines, for executing their job of maintaining public order, and ensuring safety for others and themselves. But what does it mean to ‘have’ or to ‘be’ in control? How do officers maintain it? In what ways do they attempt to gain control, and how do they make sure not to lose it; over situations, civilians or suspects, and over themselves? While control is at the heart of many policing studies and analysed from fields of criminology, sociology, law, political science, social- and public policy and other behavioural sciences, control itself is rarely questioned.In this book, I examine what control means in the context of police work. Based on a long-term ethnography of the Dutch police, I answer how control works from three analytical lenses: 1) violence and antagonism, 2) bodies and emotions, and 3) trajectories and anticipations. I develop a phenomenological-interactionist approach to analyse officers’ micro-level behaviours in antagonistic interactions, their embodied and emotional experiences, and meaning-making of control and violence.I show that control is not a matter of ‘to have or to have not’. Rather, police officers enact control; they put it into being. I propose a non-essentialist understanding of control to elucidate in what ways it is enacted. More specifically, I illustrate that police officers enact realities of control on bodily, emotional, discursive and visual levels by constructing particular futures, using certain discourses and applying forms of emotion/body regulation. The feeling of ‘being in control’ is thus also enacted. In short, this book specifies the ways in which police officers ‘do control’. <br/
A Computational Framework for Modelling Biomechanical Tumour Dynamics and Tissue Interactions: A Proof-of-Concept in Pleural Mesothelioma
No full textIn Malignant Pleural Mesothelioma (MPM), solid stress and tissue deformation significantly impact tumour growth and invasion. This study presents a computational framework that integrates biomechanical tumour dynamics, tissue deformation, and force interactions within a realistic anatomical setting. Using the Finite Element Method, the framework is applied to a lung mesh reconstructed from CT scans, incorporating a synthetic mesothelioma tumour with defined material properties. Numerical results from the simulations closely match the analytical solution, with deviations within 5%, confirming the model’s reliability and accuracy. Simulations of point compression and surface expansion effectively capture the localised tumour deformation and lung volume changes, replicating expected breathing mechanics under different conditions. The findings emphasize the role of mechanical interactions in tumour progression, demonstrating how increased tissue stiffness affects deformation patterns and respiratory dynamics. This study establishes a foundation for integrating computational biomechanics with predictive tumour modelling, offering potential applications in personalised medicine for MPM