International Migration, Integration and Social Cohesion online publications
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Ouder worden als ervaring:Een dialogisch onderzoek naar waarheid en betekenis van ouder worden in de 21e eeuw
Full text linkNooit eerder werden zoveel mensen zo oud als nu, in het begin van de eenentwintigste eeuw: wij worden massaal ouder. Tijdens een decennialange volwassenheid zijn ziekte en dood voor veel mensen bijna afwezig: onze jeugd lijkt eindeloos. In deze snel veranderende samenleving zijn levenservaring en verworven kennis niet altijd inzetbaar: die lijken al snel ouderwets. Dit alles maakt ouder worden tot een andere ervaring dan in alle vorige eeuwen. Een andere ervaring ook dan gangbare culturele narratieven ons doen geloven. Ouder worden is niet ‘jong’ blijven. Evenmin is het alleen maar verlies. Wat is de waarheid van ouder worden dan wel? En hoe kun je daaraan betekenis geven?Filosoof Suzanne Biewinga onderzoekt de mogelijkheid van een nieuwe verwoording van waarheid en betekenis van ouder worden, aansluitend bij de ervaringen, inzichten, zorgen en verlangens van ouderen zelf. In haar filosofiewerkplaats gaat zij met groepen ouderen in dialoog over waarden en heikele punten van ouder worden. In wisselwerking met deze groepsgesprekken bestudeert zij het werk van hedendaagse denkers en wetenschappers over de menselijke ervaring als verlangend, belichaamd, sociaal en eindig wezen. Onderzoek naar de filosofieën van stoïcijnen en epicuristen uit de Grieks-Romeinse tijd biedt een referentiepunt om in de huidige tijd vernieuwend te denken en spreken.Zo ontstaat een nieuwe semantische ruimte: geen alternatief standaardnarratief maar een talige, denk- en ontmoetingsruimte waarin klassieke waarden en deugden een eigentijdse in- en aanvulling krijgen. Een pleidooi voor een maatschappelijke bewegingsruimte, waarin ouder worden verschijnt als een leven dat ouderen daadwerkelijk kunnen en willen leiden
Pan-Africanism:A legacy of slavery
Full text linkPan-Africanism has been studied as an ideology, an epistemology, a theory; and also, as a social movement. However, it has insufficiently been studied as an institutionalized phenomenon and as a producer of knowledge. Most work has been conducted on the emergence of Pan-Africanism in the African diaspora in the mid-to-late 19th century. Yet, far less has been written about Pan-Africanism as an epistemology, that is as a set of ideas and ideologies.In this dissertation, it is argued that Pan Africanism is part of an Africana intellectual tradition. Both Pan-Africanism, as a series of epistemologies – and the Africana intellectual tradition - emerged directly from history and experience. It is therefore argued that epistemic Pan-African knowledge production uses history and experience as its reference. That is, it does not construct its intellectualisms from reading the enlightenment writers, such as is commonly practiced within the European intellectual tradition.Throughout its history, Pan-Africanism saw numerous unreasonable responses from predominantly (former) colonizing powers to reasonable arguments voiced in Pan-African congress petitions and speeches. This happened against the background of a changing world order. Whereas Pan-Africanism started in a situation dominated by the necessity to engage, it moved to a situation in which it increasingly was able to confront (former) colonial and imperial powers. As the circumstances of world politics changed, so did the epicenter of Pan Africanism, and in this dissertation, the author highlights how Pan-Africanism moved its epicenter from the Diaspora to Africa, where it was transformed and institutionalized
Gut microbiota and pneumonia:From health to severe infection
Full text linkThis thesis investigates the composition and impact of human microbiota throughout the continuum of health to severe pneumonia, in order to decipher the role and targetability of the microbiome in infection susceptibility, severe illness and its recovery. Despite the recent surge in research on the role of gut microbiota in enteric infections, current understanding on the role of microbiota during pneumonia in humans is limited, and no microbiota-targeted therapies have been implemented in everyday management. We hypothesised that the gut microbiota - particularly obligate anaerobic butyrate-producing bacteria - play a protective role against systemic infections in healthy individuals, are distorted during pneumonia and its recovery, safeguard against adverse clinical outcomes in hospitalised patients, and represent a treatable trait. We used general population cohorts, cohorts of hospitalised patients (including during their recovery), and murine models of pneumonia to examine the role of microbiota before, during and following pneumonia. Our findings show that gut and lung microbiota are altered during hospital admission for pneumonia, and correlate with clinical outcomes. Gut microbiota alterations precede hospitalisation and are associated with infection susceptibility, but also remain altered following recovery. Finally, we describe strategies to target gut microbiota to improve outcomes during pneumonia. Overall, this work advances our understanding of the role of gut microbiota in pneumonia, and its potential as preventive and therapeutic target
Accelerated 4D MRI for the assessment of aortic motion
Full text linkMarfan 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
The persuasiveness of political targeting
No full textIn an era where digital technologies shape our daily lives, political campaigning has undergone a revolutionary transformation, using sophisticated voter data to reach individuals with personalized messages. Through a literature review and three empirical studies, this dissertation enhances our understanding of political targeting's nuances and effectiveness. The literature review identifies gaps in existing research, such as the lack of comparative analysis of targeting strategies, dynamic examination of repeated ad exposure, exploration of mechanisms between ad exposure and voting behavior, and individual and contextual moderating effects. To address these gaps, the dissertation presents empirical evidence using three innovative methodologies: a hybrid approach of browser tracking and panel surveys, a combination of mobile experience sampling, panel surveys, and content analysis, and a longitudinal experimental design. These methods capture online political ad exposure in realistic election settings. The dissertation overall finds small persuasive effects of political advertising. Repeated exposure to online political ads increases the likelihood of voting for the advertised party, especially among voters with lower political knowledge and online privacy literacy. Issue-based targeting, where ads address topics important to the voter, is perceived more positively and enhances voting behavior, transcending partisan biases. Ads aligning with both party and issue preferences are most positively received, with no significant difference in effectiveness between party-based and issue-based targeting. This dissertation emphasizes the need for educational initiatives to improve online privacy literacy, and calls for regulatory measures to protect vulnerable groups from manipulative content. It contributes to fostering a healthier information consumption environment during elections
New insights in eosinophilic gastrointestinal diseases
No full textEosinophilic esophagitis (EoE) is a chronic condition driven by type 2 immunity and commonly triggered by dietary antigens. Conventional diagnostic tools (skin prick, serum IgE) lack accuracy. It was demonstrated that ex vivo culturing of esophageal biopsies with food antigens elicited more relevant inflammatory responses than systemic tests. Identified cytokines (IL-5, IL-8, MCP-1, TNF) served as stronger predictors of food triggers.A recently described phenomenon FIRE (Food-induced Immediate Response of the Esophagus) presents with rapid postprandial symptoms. High-resolution manometry showed that allergen exposure caused increased contractile vigor but no major motility abnormalities. This suggests that mechanisms beyond motility changes are responsible. Treatment adherence was suboptimal in approximately 42% of patients with EoE, paralleling other chronic diseases. Younger age (<40) and low necessity beliefs were significant predictors of non-adherence. This underscores the need for enhanced shared decision-making and structured adherence monitoring.A cohort of patients with non-EoE eosinophilic gastrointestinal disorders (EGIDs) was examined. Patients exhibited nonspecific symptoms and frequently normal endoscopy despite mucosal eosinophilia. No evidence of disease extension across sites or layers was observed. Symptom improvement was common, though standardized treatment strategies are lacking.Finally, the role of eosinophils in ulcerative colitis (UC) was investigated. Elevated eosinophil counts correlated with severe disease but were not prognostic in new UC, suggesting a secondary inflammatory role rather than causality
"So you're just a normal person. Just like me?":Difference evasion in managing an advantaged identity and legitimising inequality
No full textWestern liberal societies claim to value equality and diversity, yet they remain increasingly unequal and resistant to difference. In these societies, members of advantaged groups often convey an egalitarian standpoint toward disadvantaged group members by emphasising their individuality and fundamental sameness (e.g., “I don’t see colour/sexual orientation/gender identity, I see people”). In downplaying people’s disadvantaged group memberships and thereby evading difference, advantaged group members may implicitly obscure markers of intergroup inequality, blur their own advantaged status, and legitimise structural inequality in turn. This dissertation explores how such crossroads between people’s equalising outlooks and rising inequality unfolds, investigating thus when and how evading difference prevents advantaged group members from developing a structural understanding of inequality and, in turn, enables them to blur their dominance. Using qualitative interviews, quantitative surveys, and experiments, I addressed this question in two intergroup settings where equalising outlooks have taken deep root in the Netherlands: (1) the ethno-racial intergroup context and (2) the sexual orientation and gender identity intergroup context. The findings seek to deepen understanding of how people who evade difference in managing cultural diversity can instead develop structural views of inequality and inform policies that foster such structural views across society
At the crossroads of epilepsy and Alzheimer's disease:Investigating the role of LRP1 in the cerebral vasculature
Full text linkThere is increasing evidence that people with epilepsy have an increased risk of developing Alzheimer’s disease (AD). Epilepsy is also relatively more common in people with AD. Epileptiform activity may even accelerate the progression of AD. Therefore, managing epileptiform activity is crucial. However, a significant proportion of patients do not achieve seizure freedom following anti-seizure medications. Understanding underlying neurobiological mechanisms is essential for developing of new therapies. Accumulation of amyloid beta (Aβ) in the brain, a neuropathological hallmark of AD, has been observed in (a subset of) patients with epilepsy. In this thesis, we investigated the role of low-density lipoprotein receptor-related protein 1 (LRP1), a multifunctional transmembrane receptor involved in many physiological processes, including the clearance of brain Aβ via the blood-brain barrier (BBB). LRP1 expression in brain capillaries diminishes during aging and in AD. In this thesis, we show that LRP1 is downregulated at the BBB in both experimental epilepsy and patients with epilepsy. Furthermore, inducible knockout of brain endothelial LRP1 in transgenic mice leads to epileptiform activity and cognitive dysfunction associated with gliosis rather than brain Aβ accumulation or the increase of its soluble form. Future research should focus on therapeutic strategies aimed at preventing or restoring the loss of brain endothelial LRP1, potentially reducing epilepsy and cognitive decline
Rare treatment, real barriers:A critical appraisal of cholic acid treatment
Full text linkThe thesis Rare Treatment, Real Barriers: A Critical Appraisal of Cholic Acid Treatment, explores the pharmaceutical, regulatory, and clinical dimensions of cholic acid (CA) therapy for patients with rare bile acid synthesis disorders (BASDs). While CA is an authorized orphan drug in the EU and US, its evidence base is limited and access in the Netherlands has been unavailable. To address this gap, the Amsterdam UMC developed a pharmacy-compounded CA formulation to enable both patient care and clinical research.The work demonstrates how pharmacists can bridge the gap between unavailable commercial medicines and patient needs by developing safe, high-quality compounded formulations under Good Manufacturing Practice (GMP) conditions. The thesis evaluates the analytical quality of CA as an active pharmaceutical ingredient, validates the compounded formulation, and confirms its stability and safety. A prospective clinical study further assesses long-term biochemical and clinical effects in patients with AMACR and 3β-HSD deficiency, showing biochemical improvement and good tolerability.Beyond its clinical findings, the thesis highlights the broader role of pharmacy compounding as an instrument of pharmaceutical innovation, access, and personalized medicine. It underscores the societal and ethical responsibility of pharmacists to ensure continuity of care when industrial supply fails or becomes unaffordable.By integrating pharmaceutical science, clinical research, and policy analysis, this work illustrates how the pharmacist’s expertise remains essential in safeguarding access to effective treatment for patients with rare diseases.<br/
Novel assessment techniques to diagnose syndesmotic instability
No full textIf not treated or missed, syndesmotic instability may lead to osteoarthritic changes over time and impact patient quality of life and function. Syndesmotic instability should be treated surgically with either a static or dynamic treatment strategy. This thesis aims to improve existing diagnostic assessment techniques of the syndesmosis and to develop new ones in three parts, including I. arthroscopic assessment for diagnosing syndesmotic instability, II. new methods for diagnosing syndesmotic instability using portable ultrasound and weightbearing computed tomography (CT), III. methods to assess radiographic and patient functional outcomes after treatment. The key takeaways from this thesis are:1. The 2.0 mm threshold value of arthroscopic distal tibiofibular diastasis may lead to overtreatment of coronal syndesmotic instability. 2. Dynamic ultrasound allows one to evaluate sagittal translation of the distal tibiofibular joint effectively and reliably. 3. In biomechanical research portable ultrasound performed like arthroscopy when diagnosing syndesmotic instability in the sagittal plane. 4. In biomechanical research portable ultrasound could reliably detect tibiofibular clear space opening after external rotation stress. 5. (portable) Ultrasound is readily available, non-invasive, low-cost, affording contralateral comparison, and therefore a technique worth investigating further.6. Weightbearing CT scan is a very promising technique for diagnosing syndesmotic instability.7. Syndesmotic area seems the best and most reliable 2D parameter to detect instability or (mal)reduction of the syndesmosis.8. Screw and tightrope reduction techniques do not restore syndesmotic area as compared to the intact contralateral ankle. 9. We found no difference in clinical outcomes between screw and tightrope reduction techniques