International Migration, Integration and Social Cohesion online publications
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Prevention of infectious diseases:Vaccination and chemoprophylaxis strategies and the occurrence of breakthrough infections
No full textThis thesis provides insights into optimising infectious diseases preventive strategies for travellers and at-risk populations. We demonstrated that yellow fever and hepatitis A vaccines provide long-lasting protection in immunocompetent adults, while pneumococcal vaccination (PCV13/PPSV23) has poor long-term immunogenicity. In people living with HIV (PLWH) and patients on immunosuppressive therapy, long-term protection may be impaired for yellow fever, hepatitis A and pneumococcal vaccination, particularly for those on immunosuppressive combination therapy. However, PLWH and those on immunosuppressive monotherapy may maintain long-term hepatitis A protection through immunological memory. Vaccination before starting immunosuppressive therapy, as demonstrated for rabies vaccination, enhances immunogenicity. Tailoring vaccination guidelines to the needs of immunocompromised populations is essential to optimise long-term protection. Additionally, we showed substantial non-adherence to atovaquone-proguanil (AP) malaria chemoprophylaxis among travellers, especially post-travel, and propose a controlled human malaria infection (CHMI) model to study abbreviated AP regimens. Furthermore, we showed that malaria recrudescence after artemether-lumefantrine (AL) is rare in travellers but can be effectively retreated with AL, and we propose hair analysis as a future and novel tool to retrospectively assess drug exposure in malaria recrudescence. Future research should refine vaccination strategies, develop more appealing and cost-effective AP regimens, and further investigate the role of drug exposure in recrudescence
Solving European Problems with Regional Solutions? Conceptualizing ‘the Region’ in EU Higher Education and Climate Change Policies
No full textUnderstanding the EU as a Regional International Organization (RIO) raises several questions, including what the term ‘regional’ means in this designation and how the EU can be understood as a specific type of RIO. Drawing on a theoretical framework from regional geography and a legal analysis of the constitutional aspects of EU regional politics, we argue that the EU employs multiple conceptions of ‘region’ in its policymaking. In education policy, we explore how the European Higher Education Area has developed into a loose organization of higher education in Europe, drawing on multiple conceptions of ‘region’ which to an extent transcend nation-state boundaries. In climate policy, we explore how subnational regions play a role in the European Green Deal’s ‘just transition’. Both cases illustrate key dimensions of the EU as a RIO: first, that the ‘regions’ constructed in these policies ‘exceed’ their legal and political foundations (especially the assumption of a territorially-bounded, sovereign nation-state); and second, that the state is (re)constituted as a multi-scalar regional actor in EU politics. We conclude with reflections on the difference regional thinking makes to understanding the EU as a regional organization
Towards circular plastics:chemical recycling of high-density polyethylene-rich municipal waste using hydrothermal liquefaction
No full textPlastic waste presents significant environmental challenges, driving research into chemical recycling. High-density polyethylene (HDPE) is particularly difficult to recycle among common plastics due to its stability. Hydrothermal liquefaction (HTL) technology has emerged as a promising method to address these issues. This study applies HTL to convert post-consumer plastic waste, predominantly HDPE (93 wt%), into oil, gas, and char. The process achieved high oil yields (68–87 wt%), with limited gas (10–30 wt%) and minimal char (2–3 wt%). The oil properties were found to be adjustable based on reaction parameters: lower temperatures (430 °C) and shorter reaction times (1 min) produced heavier oils with a high saturated alkanes content, whereas higher temperatures (460 °C) and extended reaction times (60 min) yielded lighter oils with an increased aromatics content. Additionally, a higher water-to-plastic ratio favored alkenes production, resulting in a heavier oil with a limited aromatics fraction. This research illustrates the strong potential of HTL to transform real post-consumer plastic waste streams into new plastic monomers, thereby closing the loop in the chemical recycling of polyolefins and fostering an innovative approach for urban-industrial symbiosis and a circular economy.</p
Home in Refugee Camps
No full textThis chapter examines the concept of home in refugee camps and explores how homes are perceived in such sites. During the past decade, the number of displaced people living in state-run or makeshift camps across the globe has been steadily increasing. In the chapter, I consider the planning rationales, living conditions, power relations, and the processes of home making and belonging in refugee camps. I also analyse experiences of surveillance, control, and confinement and possibilities for agency, solidarity, and housing commoning practices among residents of refugee camps. I argue that the camp, and home in the camp, can be perceived as polysemic spaces balanced between authoritarian military humanitarianism and inventive social practices of contestation. Critical attention to home is an urgent priority in understanding lived experience of the growing global archipelago of refugee camps
The social context of psychiatric diagnostics and terrorism
No full textAchtergrond Terrorisme en psychiatrische diagnostiek zijn maatschappelijk verweven.Doel Inzicht bieden in de verschillende manieren waarop psychiatrische diagnostiek en het begrip terrorisme zich tot elkaar verhouden en wat dit betekent voor de psychiatrische praktijk.Methode Een beschouwing over dit thema vanuit het perspectief van het veiligheidsdomein en dat van de psychiatrie.Resultaten Taalgebruik, toepassingen van het stoornisbegrip en wetenschappelijk onderzoek hebben impact op maatschappelijke beeldvorming van terrorisme. Daarbij worden de rol van de psychiater in het debat en de bijdrage van psychische problematiek aan het ontwikkelingspad naar terrorisme vertroebeld als er alleen in elkaar uitsluitende uitersten wordt gesproken, bijvoorbeeld ‘mad ór bad’, ‘terrorist óf psychiatrisch patiënt’.Conclusie Professionals in de psychiatrie worden in het maatschappelijk debat uitgedaagd hun rol voortdurend te heroverwegen om zowel de veiligheid in de samenleving als het belang van de patiënt als (potentiële) terrorist te waarborgen
HIPEC and immunotherapy for ovarian cancer
No full textOvarian cancer poses a significant global health burden, with mortality rates exceeding those of other gynecologic cancers. Despite initial sensitivity to chemotherapy and treatment with cytoreductive surgery, most patients experience recurrent disease and require multiple lines of therapy. Over time, relapses become increasingly resistant to treatment, ultimately leading to death. Although the disease is characterized by substantial heterogeneity, across histologic subtypes, molecular profiles, and tumor microenvironments, most patients still receive largely uniform treatment. This one-size-fits-all approach reflects a gap between our growing biological understanding and the availability of treatment options capable of targeting these differences. Therapeutic strategies such as hyperthermic intraperitoneal chemotherapy (HIPEC) and immune checkpoint inhibitors have emerged as promising approaches, yet many critical questions remain. Specifically, what is the long-term efficacy of HIPEC when added to interval cytoreductive surgery? How effective is HIPEC in routine clinical practice outside the trial setting? How can perioperative care be optimized? Which tumor micro-environmental or molecular features explain sensitivity or resistance to these treatments? Are there specific populations, such as those with BRCA mutations or other homologous recombination defects that are more or less likely to respond? Why does only a small minority of ovarian cancer patients benefit from immunotherapy and who are they? This thesis addresses these questions through a combination of clinical and translational research, aiming to better define the role of HIPEC and immunotherapy in ovarian cancer and to identify potential predictive biomarkers. Part I focuses on HIPEC, and Part II on immune checkpoint inhibition, both in the setting of advanced-stage ovarian cancer
Doing diversity? Analyzing support for diversity policies with a conjoint experiment
No full textThis study examines hiring managers' (i.e., employees with hiring responsibilities) support for hiring policies aimed at increasing diversity. Research has shown that some policies are more helpful in combating discrimination and increasing diversity than others, but we do not know whether those who apply the policies support them. This is surprising, because hiring managers' support for diversity policies is important for the successful implementation of policies. We discuss three motives underlying policy support: the desire for diversity, the goal of meritocratic hiring, and the maintenance of agency. Using data from an original conjoint experiment collected in the Netherlands (N = 512 individuals), we examine the extent to which hiring managers support diversity policies, whether they prefer other hiring policies, or if they favor the absence of regulations altogether. We find that, rather than policies that increase organizational diversity, hiring managers support policies that preserve their autonomy while maintaining established organizational policies. Marginal means analyses and multilevel regression models show that policy support aligns most strongly with the agency motive alongside concerns about fairness and merit-based selection. Hiring managers prefer an unstructured screening process and are reluctant to support hiring quota and the use of standardized or anonymous application forms. These preferences are particularly pronounced in smaller organizations and where little to no formalized hiring policies are in place. Our findings highlight the need for organizations to address hiring managers' complex motivational concerns, including desires for autonomy, fairness, and status quo maintenance, to ensure effective policy implementation
Political socialization across places:differential effects on multiculturalist attitudes in urban and rural areas?
Get PDFExtensive literature shows that inhabitants from urbanized areas tend to have more multicultural attitudes than those from rural areas, and these differences seem especially pronounced among younger generations. To explore why, we study ‘the formative years of adolescence’ and focus on an often-overlooked mechanism in the literature: political socialization through discussing politics with various actors such as parents, peers, and teachers. We argue that political socialization differently affects multicultural attitudes in urban and rural areas, and test our hypotheses by using the Dutch Adolescent Panel on Democratic Values (DAPDV) dataset, a representative panel study among adolescents in the Netherlands between ages 11 and 16. This allows us to not only analyze whether the associations between political discussion and multicultural attitudes differ between urban and rural areas, but to also disentangle influence from selection effects. We find that political socialization through parents and peers is related to multicultural attitudes differently in urban and rural contexts. It is associated with more multiculturalism in urban areas but not in rural areas. These associations are fully the result of selection mechanisms, and no support for the direct influence of political socialization on multicultural attitudes is found. Overall, our findings stress the importance of further studying the role of political socialization in adolescence to help us understand increasing geographic political polarization across many democratic societies
Breaking through the blockage:Advances in care for children with functional constipation
Get PDFThis dissertation aims to “break through the blockages” in our understanding and care of children with functional constipation by providing new insights into both evaluation and management. Part I focuses on the evaluation of children with functional constipation. Chapter 1 describes the interrater reliability of high-resolution anorectal manometry studies. In chapter 2, outcomes of colonic manometry catheter placement during colonoscopy and using fluoroscopy are compared. Chapter 3 evaluates the effect of glycerin on colonic motility and compares the response induced by both bisacodyl and glycerin in children undergoing colonic manometry. In chapter 4, anorectal and colonic motility in children with tethered cord syndrome are described and compared to the findings in children with functional constipation. Part II addresses the therapeutic management of children with intractable constipation. Chapter 5 explores the diagnostic and treatment practices among pediatric gastroenterologists worldwide for children with intractable constipation. Chapter 6 systematically reviews the literature to investigate the outcomes following antegrade continence enema treatment in children with functional constipation, specifically focusing on treatment success. Chapter 7 describes the colonic motility and anatomy utilizing both colonic manometry and contrast enema studies in children treated with antegrade continence enemas. In chapter 8 the feasibility, efficacy, and safety of percutaneous posterior tibial nerve stimulation compared to sham stimulation in children with functional constipation due to pelvic floor dyssynergia is evaluated.</p