International Migration, Integration and Social Cohesion online publications
Not a member yet
484620 research outputs found
Sort by
An investigation of the role of striatal dopamine in learning, motivation, habits and movement
Get PDFDecades of research show dopamine's importance in motivated behavior and reward learning, yet ongoing debate persists over its precise role, reflecting a shift towards recognizing diverse, region-specific functions of dopamine across the striatum. This thesis utilizes fast-scan cyclic voltammetry (FSCV) to study dopamine function in different striatal subregions of behaving animals, uncovering heterogeneous dopamine release across regions and a distinct reward prediction error (RPE) signal exclusively in the limbic portion. While dopamine in the nucleus accumbens core (NAC) encodes reward and aversion in opposite directions, it does not fully encode an aversive prediction error (APE). Furthermore, the thesis identifies general organizational principles of dopamine signaling, highlighting regional differences in expression, and discovers a neural determinant of habit formation, emphasizing the critical role of dorsomedial striatum (DMS) dopamine. Additionally, it demonstrates dopamine release in both ventromedial striatum (VMS) and dorsolateral striatum (DLS) during self-motivated movement initiation, independent of external motivational stimuli, and shows that acceleration during locomotion is not linearly related to changes in dopamine concentration
Word learning:When associative learning meets social-pragmatic expectations
Get PDFHow we learn words has been a long-standing debate in psycholinguistics. Social-pragmatic approaches argue that word learning is underpinned by learners’ social-cognitive abilities, which allow them to determine the communicative intentions of their interlocutors. Associative learning approaches, on the other hand, suggest that word learning is possible thanks to the human ability to track the frequency of co-occurrences between a word and its referent. An intermediate approach is the communicative/intentional framework, which posits that the relationship between a word and its referent is mediated by the speaker's intention to refer to a particular (set of) object(s). The studies presented in this dissertation take this assumption as their theoretical backdrop and pose two general research questions: 1) to what extent do social-pragmatic cues affect cross-situational word learning?; and 2) when in time do social-pragmatic effects emerge when learning words across situations? We designed five experiments that tested the effects of speaker reliability and speaker informativeness on cross-situational word learning. The results neither support nor contradict the hypothesis that exposure to an unreliable speaker results in learning fewer words and/or relying on associative learning mechanisms. Furthermore, the evidence that participants were sensitive to speaker reliability was inconsistent. However, when the effect of speaker informativeness on word learning was measured over time (by means of an eye-tracker), the results showed that speaker informativeness influenced the initial selection of objects as potential referents. This finding highlights the importance of fine-grained measures when studying how we learn words
Early Barrett’s neoplasia:Gaining insight into patients’ well-being
Get PDFEndoscopic treatment has proven to be a minimally invasive, safe and effective method to treat patients with early Barrett’s neoplasia. However, the excellent results are not in proportion to patients’ reported health related quality of life (HRQOL), well-being, and fear of cancer recurrence.We evaluated HRQOL and illness perceptions alongside a randomized controlled trial, in which patients with Barrett’s esophagus were treated with radio frequency ablation (RFA) or were kept under endoscopic surveillance. We found that HRQOL in RFA patients was comparable to that of patients under surveillance. However, RFA patients reported fewer concerns and their overall perception of the condition was less-threatening compared to patients undergoing surveillance We also explored HRQOL, general fear and fear for cancer recurrence in patients treated endoscopically for early Barrett’s neoplasia and compared that with patients with more advanced disease treated surgically. We found that patients treated endoscopically reported better HRQOL and less cancer symptoms than surgically treated patients. However, endoscopically treated patients worried as much about cancer recurrence as patients treated surgically. Furthermore, general fear and fear of cancer (recurrence) of endoscopically treated patients declined over time, but not as much as in surgically treated patients. Finally, we aimed to gain insight into the reasons why endoscopically treated patients fear or do not fear cancer recurrence using interviews. Reasons that induced fear of cancer recurrence were related to physical symptoms, if cancer was diagnosed as an accidental finding, and experiences with cancer in close relations. Endoscopic surveillance was mentioned as a reason for not experiencing fear of cancer recurrence
The human element in judicial decision-making:The role of personal attitudes
Get PDFThe dissertation aims to gain insight into the role personal attitudes play in the professional judicial decision-making process. It builds on (i) insights from legal theory on the human element of judicial decision-making and on judicial impartiality, and (ii) what is known from psychological research about the role personal attitudes play in daily decision-making. Based on these theoretical perspectives it can be argued that empirical research on what role judges’ personal attitudes have in their decision-making is lacking. 77 semi-structured interviews were held with Dutch first instance court judges from three different district courts and from all areas of law. The results of these interviews provided insight into whether judges think personal attitudes play a role in their decision-making, and if so, how, and into whether judges experience a conflict between their personal attitudes and their impartiality. Additionally, an experimental vignette study was conducted to explore if, in an experimental setting, attitudes would be present when judges rule in a fictitious case and whether this has a direct effect on the decisional outcome. This dissertation underlines the importance of personal attitudes in the judicial decision-making while at the same time presenting a more intricate picture of their role. It opens a critical conversation about acknowledging and addressing the human element within judicial reasoning, aiming to foster a judicial process that is as fair and unbiased as humanly possible
Painting the road in sickle cell disease:Addressing the burden of pain
Get PDFSickle cell disease (SCD) is an inherited hemoglobinopathy that affects millions of people worldwide with increasing prevalence. SCD results in a substantial burden with progressive organ damage and recurrent painful crises (vaso-occlusive crises; VOCs). While hematopoietic stem cell transplantation and gene therapy are emerging options, they are not accessible to most patients with SCD. Therefore, insight in the most prevalent complications and organ damage as well as effective pain management strategies are urgently needed. This thesis provides an overview of the morbidity and mortality in an unselected cohort of newly diagnosed patients with SCD and addresses pain in SCD from different perspectives, including epidemiology, impact on quality of life, methods for identifying, monitoring and predicting pain, and management strategies.Chapter 2 provided an overview of morbidity and mortality in a national cohort of neonatally diagnosed children with SCD in the Netherlands. Chapter 3 examined the impact of hospitalization for VOCs on health-related quality of life. In Chapter 4, we leveraged the Apple Watch to predict pain scores in adults with SCD who were admitted to the day hospital for VOC using machine learning techniques. Chapter 5 extended this study to cover both hospital admission and the 30-day period following discharge. In Chapter 6, we explored the use of breath analysis as a diagnostic tool to differentiate between VOC and steady state in patients with SCD. Finally, Chapter 7 summarized evidence for non-pharmacological interventions as complementary options for managing pain in children with SCD
Biologics in pediatric rheumatology:Towards personalized medicine
Get PDFSince the introduction of biologics, treatment options for children with rheumatic diseases have increased, and their outcome has improved enormously. However, finding the best treatment strategy can sometimes be a quest, partly because it is unknown which drug works best for the individual patient or which side effects will occur. This thesis, aims to gain more knowledge about personalizing treatment with biologics for children with rheumatic diseases. The first part of this thesis focusses on the treatment of children with Juvenile Idiopathic Arthritis (JIA). We provided an overview of children with JIA treated with anti-TNF drugs at the Amsterdam UMC, where drug concentrations and anti-drug antibodies (ADAs) in the blood were measured and concluded that therapeutic drug monitoring in anti-TNF treatment may be valuable in making personalized treatment decisions in JIA. We analyzed pharmacokinetic data in this patient population and described the development of a pharmacokinetic model specific for children with JIA for infliximab and for adalimumab. In the second part, the focus was on children with systemic autoimmune diseases treated with rituximab. An overview of pharmacokinetics and pharmacodynamics of rituximab in children with various systemic autoimmune diseases was presented, focusing on rituximab levels in blood, presence of rituximab ADAs, B cell depletion and time to repopulation and anaphylactic reactions. We reported the frequency and severity of infections after rituximab and studied the association with immunoglobulin levels. Distribution of B cell subsets in the peripheral blood of these children was described before rituximab treatment and after B cell repopulation
Patient and family involvement in care after oncology surgery
Get PDFIn the forthcoming years, health care systems are anticipated to undergo drastic transformations, wherein the responsibility for providing care will also be partially delegated to the patient and their families. Evidence suggests that family involvement enhances patient outcomes, yet practical methods for engaging them remain limited. This thesis explores innovative strategies to involve patients and their families in fundamental care following oncological gastrointestinal surgery, with several interventions developed, tested, and evaluated in the surgical departments of the Amsterdam UMC.In Chapter 2, a prospective cohort pilot study assessed the impact of a surgical ward breakfast buffet as a low-cost, simple intervention to involve patients in their post-surgery care. This approach not only engaged patients but also helped address postoperative undernourishment. Chapter 3 examines the challenges of involving family members, particularly during the COVID-19 pandemic when hospital visitations were restricted. A retrospective cohort study investigated the effects of these restrictions on complications such as delirium, falls, pneumonia, pressure ulcers, and readmissions among surgical patients. Chapters 4, 5, 6, and 7 focus on the Family Involvement Program (FIP), where family members actively participated in fundamental care post-surgery. These chapters include both qualitative evaluations using interpretative phenomenological analysis and a patient-preference cohort study examining surgical and caregiver outcomes. Lastly, Chapter 8 explores digital alternatives for patient and family involvement. A scoping review was conducted to assess the effectiveness of video calls in hospital wards as a method for maintaining family engagement in patient care
Responding to dementia:A critical phenomenology of everyday life among community-dwelling people with dementia in the Netherlands
Get PDFHow do people go about their everyday lives when stories told about them prefigure their ultimate disownment? As images of an overpowering increase in the prevalence of dementia warn general publics about the syndrome’s incapacitating effects, little is known about what we could learn from the ways in which people living with a dementia diagnose give shape to their lives in a positive sense. This dissertation offers both a lifeworld perspective on the challenges facing people living with a dementia diagnose, and ideas about how others could join people with dementia in making life with it a more habitable place. In this ethnography Laura Vermeulen takes her readers along in every day moments drawn from her five-year spanning study with community dwelling people with dementia who lived alone in a big city in the Netherlands. Vermeulen highlights how underlying the practical challenges and social forms of exclusion people with dementia face, many of them grapple with the existential quest to keep life going as a fundamental responsive process. She advances her critical phenomenological approach as allowing researchers and the general public a new framework for understanding and working with dementia. This relational approach helps us to rework care and support practices into ones facilitating larger circles of family, friends, and acquaintances in grappling with the social and existential quests coming up in lives with dementia. Vermeulen argues that by joining people with a diagnosis in considering what ‘dementia’ resonates with in our lives, we may queer dominant notions of selfhood and understand attempts at living with dementia as pointing us the way in our fostering of fundamentally human abilities
Profonde décadence: fictieve impressa in Frans-Nederlands drukwerk in de achttiende eeuw
No full textMaterialising China:Material culture and perceptions of China in the late seventeenth-century Dutch Republic
Get PDFThis dissertation examines the relationship between material culture and images and ideas of China in the Dutch Republic during the second half of the seventeenth century. Through qualitative case-studies, this study analyses the availability of Chinese objects (how and where one could encounter and acquire them), written responses to specific Chinese artefacts, and material responses to a variety of Chinese(-looking) artefacts and imagery. These case-studies demonstrate how the unprecedented increase of the availability of Chinese artefacts encouraged those who encountered them in the seventeenth-century Dutch Republic to adjust or develop their views of China and of themselves, how in turn such views could be expressed in the domestic production of Dutch material culture. Written responses from Constantijn Huygens, Nicolaas Witsen, and their correspondents to a kuancai lacquer screen and a Han-dynasty bronze mirror, reveal how such Chinese objects were used both to test existing knowledge and to acquire new knowledge of China in a vast network of informants. The artefacts challenged and contributed to transforming world views in the early modern period and helped materialise an imagined China. Tracing the origins and adaptations of the Chinese-looking motifs applied on Dutch material culture showed how something as integrally Chinese as character script could become disconnected from its cultural connotation and absorbed into the design repertoire of Delftware artisans, and how the applications of Chinese-looking iconography onto a medium interlinked with Dutch domesticity (tin-glazed tiles) impacted its effect. The latter materialised a new kind of Dutchness. <br/