In this dissertation we present the results of our research on Helicobacter pylori infections in childhood, focusing on the prevalence, diagnosis and treatment of the infection. Our studies were... Show moreIn this dissertation we present the results of our research on Helicobacter pylori infections in childhood, focusing on the prevalence, diagnosis and treatment of the infection. Our studies were conducted in the Netherlands, Europe and Indonesia. We discuss diagnostic tests, therapeutic regimens, resistance and preventive measurements. We highlight clinical and pathophysiological aspects of the infection and describe which particular strains are prevalent and how transmission occurs. Presently, there are no established correlations between a Helicobacter pylori infection and recurrent abdominal pain, gastroesophageal reflux disease or growth retardation. We present data on the prevalence of Helicobacter pylori in young infants in the Netherlands and observe that children with at least one non-Dutch parent form a risk group. We assess risk factors in a Europe-wide study on gastroduodenal erosions and ulcers in childhood. In our study, Helicobacter pylori infection and gastrotoxic medications were relatively little implicated as etiology of that pathology. The prevalence of Helicobacter pylori infection in Indonesian young children is relatively high and points at an early acquisition of the infection. Finally, the resistance of Helicobacter pylori to clarithromycin and metronidazole was assessed for adults and children in the Netherlands. Low resistance rates were found, but the resistance in adults is increasing. We conclude that a test-and-treat regimen is justified for the Netherlands. Show less
The aim of the present study is to examine the transformation of teacher training in Indonesia from 1893 to 1969. Public teacher training altered over time to keep in step with the changing... Show moreThe aim of the present study is to examine the transformation of teacher training in Indonesia from 1893 to 1969. Public teacher training altered over time to keep in step with the changing requirements in public primary school curricula which had been incurred by economic and political factors. In colonial time the government policy was to prepare Indonesian teachers in the Netherlands Indies according to a standard which would gradually be raised so that in the end, they could concur with the level of the training originally designed for their European counterparts. The introduction of the Kweekschoolplan in 1927 heralded the re-organization and transformation of the kweekschool and the Hogere Kweekschool (HKS) into Hollands Inlandse Kweekschool (HIK). Alas, the Great Depression in 1929 dispelled the colonial dream and the Japanese invasion in 1942 completely altered the next chapter in the history of Indonesian society. The post-war period witnessed three essential points: the brain-drain from schools of the Indonesians who had been educated at the HIK; the removal of Dutch from public school; and the influx of American professors to the schools of teacher training. Now the patterns of expectations of teachers in Indonesia drastically changed, but the nature of teacher training remained basically unchanged. This disjunction implies that the transition from colonial to post-colonial State revealed a paradox in which continuity and change were juxtaposed. The switch from the Dutch to the American model of teacher training in the late 1950s reflected a spirit of reform but also created confusion in the Indonesian search for the meaning of independence.The institutional re-organization of teacher training during the 1950s which continued into the 1960s reflected the bigger narrative of Indonesian State formation at the time. Here, the process of regime change displayed the politics of elimination with a startling lack of understanding of historical experience. A dichotomous way of seeing matters, a rigid option of ‘either this or that’ and a perspective which sharply differentiated between ‘we’ and ‘they’ came to the top list of priorities. Show less
Nausea and vomiting are well known side effects related to chemotherapy. Indeed, nausea and vomiting are the most distressing side effects of chemotherapy in cancer patients. Dopamine, serotonin... Show moreNausea and vomiting are well known side effects related to chemotherapy. Indeed, nausea and vomiting are the most distressing side effects of chemotherapy in cancer patients. Dopamine, serotonin and neurokinin1 are thought to be the neurotransmitters that play role in the pathophysiology of Chemotherapy Induced Nausea Vomiting (CINV). Thus, the antagonists of those neurotransmitters are considered as prophylactic antiemetics for CINV. In the 1990s, the use of 5-Hydroxytriptamine receptor antagonists (5-HT3RAs) highly improved the patients__ response rate to antiemetic drugs. In addition, the combination of a neurokinin 1 antagonist, a 5HT3RA and a corticosteroid can further increase the response rate up by 15% in acute phase and 20% in delayed phase. Thus, the international guideline of clinical oncology recommend this combination as prophylactic antiemetic drugs in the acute phase and a combination of dexamethasone __ metoclopramide as prophylactic antiemetics in the delayed phase. However, when the standard antiemetic drug regimens are administered to patients, there are still 20-30% patients in the acute phase and 40% patients in the delayed phase experiencing CINV. Thus, there is a high interindividual variability in response to antiemetic drugs in oncology patients. Some patient characteristics such as female gender, younger patients and history of alcohol drinking could increase the risk of CINV from 20% to 70%. Therefore, individualizing of the use of antiemetics could start by considering the patient characteristics. This thesis focuses on determining the impact of CINV on QoL in Indonesian cancer patients and optimizing the prevention and treatment of CINV by exploration of pharmacogenetic biomarkers. Show less
Today, about 1 billion people are estimated to live in ‘slums’ worldwide. This number will only grow and urban poverty worsen unless radical measures are taken. While it is generally acknowledged... Show moreToday, about 1 billion people are estimated to live in ‘slums’ worldwide. This number will only grow and urban poverty worsen unless radical measures are taken. While it is generally acknowledged in the international development debate that breaking the circle of poverty requires multiple strategies, there is renewed attention for approaches that centre on the issue of tenure security. This means landholders are protected against involuntary removal from the land on which they reside, unless through due process of law and payment of proper compensation. The prevailing approach to the provision of tenure security is land registration. And while the land registration approach currently dominates policy, there has been little research into the effects of registration, particularly in urban areas. What research has been conducted, contests the benefits of this approach. As a result, we witness increasing interest in alternative approaches which generally combine protective administrative or legal measures against eviction with the provision of basic services and credit facilities. The author describes and analyses the extent to which formal, semiformal, and informal tenure arrangements that can be found in kampongs (typical low-income settlements) in Indonesia provide tenure security to the country’s urban poor, particularly since 1998, when Indonesia embarked on an ambitious political and legal reform programme. The author reviews the current legal framework that applies to urban land tenure in Indonesia. In addition, based on rich material that was acquired through empirical research in the city of Bandung, there are a number of case studies presented in which the urban poor’s tenure security was put to the test. Finally, drawing on statistical data, the author analyses the urban poor’s perceptions regarding their tenure security and whether and, if so, how this influences their housing investment behaviour. Following this analysis, the author evaluates the socio-economic benefits of current approaches to attaining tenure security. And with these findings, there are policy suggestions and contributions to theory formation presented to further the current international development debate on tenure security. Show less
This study is rooted in the places where daily struggles to make a living in the environment coincide and collide with efforts to save nature and/or the environment through the delineation of... Show moreThis study is rooted in the places where daily struggles to make a living in the environment coincide and collide with efforts to save nature and/or the environment through the delineation of protected areas. In this dissertation the author explores the intertwining of the causes of environmentalism and indigenous peoples rights. She looks into whether this interface lends itself well to both environmentalist causes and indigenous aspirations. It is critical to understand both elements of this dynamic: indigenous peoples, their link with the conservation of biodiversity and their relationship with the implementors/advocates of nature conservation; and the impact of the latter actors and their green vision on indigenous communities and their environments. In this light, this dissertation, in a combination of chapters and published papers, describes and analyzes the ways in which indigenous peoples and environmentalists interact, and the repercussions of these interactions. Show less
The general aim of this ethno-botanical study is to document, describe and analyse the Balinese community members__ knowledge, belief and practices with regard to medicinal, aromatic and cosmetic ... Show moreThe general aim of this ethno-botanical study is to document, describe and analyse the Balinese community members__ knowledge, belief and practices with regard to medicinal, aromatic and cosmetic (MAC) plants in relation to community health and bio-cultural diversity conservation of MAC plants. This study has been conducted in four sample villages in the central-south-eastern part of Bali, Indonesia. The Ethnosystems Approach used in this study places the emic point of view central in studying the human-plant relations in Bali and focuses on the Knowledge-Belief-Practice complex of the health and healing practices. This study acknowledges the __inextricable link__ between nature, society, language and culture, conceptualised in the term bio-cultural diversity, expressing the relationship between biological and cultural diversity. The data collection and analyses using complementary qualitative and quantitative research techniques focuses on the community members__ reported use of fresh MAC plants as home remedies in the wider context of the Balinese pluralistic medical configuration. In addition, it seeks to explain whether their behaviour exhibits a sustainable character towards both the conservation of the diversity of MAC plants in terms of genes, species and ecosystems and to the conservation of the local knowledge, beliefs and practical applications of the MAC plants. Show less
In the investigation, the domestic sources of foreign policy analytical framework were used to analyze the dynamics of elites in foreign policy making. After analyses of the results of mostly... Show moreIn the investigation, the domestic sources of foreign policy analytical framework were used to analyze the dynamics of elites in foreign policy making. After analyses of the results of mostly personal interviews and historical materials, it was determined that political elites do matter in foreign policy making. However, the elite group that mattered most was still the bureaucratic elite. The non-governing political elites were influential in foreign policy making during the formulation stage but not in the implementation stage. This finding was surprising and was contrary to what has been at the onset embraced by conventional wisdom among policy analysts and policy makers in the analysis of foreign policy in democratizing countries. With democratization, it was thought at the outset that the non-governmental political elites such as Parliament, members of the civil society such as religious, academia, and media, and the military both each as a group and collectively as being not in executive power play a significant role in influencing foreign policy. Moreover, it was found that nationalist ideology, though adapted to the contemporary situation, is embraced by everyone else except by the decision makers when making foreign policy decisions. Decision makers continue to embrace realpolitik as the basis upon which to decide on foreign policy. However, ideology was instrumental during the formulation phase of foreign policy making for the four political elite groups under study. Show less
The studies in this thesis were performed as part of the AMRIN (Antimicrobial Resistance in Indonesia) study that addressed antimicrobial resistance, antibiotic usage and infection control in... Show moreThe studies in this thesis were performed as part of the AMRIN (Antimicrobial Resistance in Indonesia) study that addressed antimicrobial resistance, antibiotic usage and infection control in Indonesia. They are the first studies that give insight into the incidence of healthcare-associated infections, determinants for carriage of resistant bacteria in Indonesian individuals and the implementation of measures for the prevention of the spread of bacteria and nosocomial infections in Indonesian hospitals. Show less
Antimicrobial resistance of bacteria is a worldwide and ever-growing problem, directly linked to the use of antimicrobial drugs. Resistant bacteria emerge under the selective pressure of... Show moreAntimicrobial resistance of bacteria is a worldwide and ever-growing problem, directly linked to the use of antimicrobial drugs. Resistant bacteria emerge under the selective pressure of antibiotics. In hospitals, where large-scale usage of antibiotics is common, bacteria frequently become resistant to several antibiotics which causes serious problems for the treatment of patients with infections by these microorganisms. Well-known (multi)-resistant bacteria causing problems in many countries all over the world are methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, penicillin-resistant pneumococci, extended-spectrum betalactamase-producing Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii, and multiresistant Mycobacterium tuberculosis Show less
Tuberculosis (TB) is an infectious disease, caused by Mycobacterium tuberculosis. MTB infection does not necessarily progress to TB. Only 5-10% of exposed individuals develop clinical signs and... Show moreTuberculosis (TB) is an infectious disease, caused by Mycobacterium tuberculosis. MTB infection does not necessarily progress to TB. Only 5-10% of exposed individuals develop clinical signs and symptoms of TB. Given the impact of mycobacterial exposure and the immunoregulatory consequences for host immunity, it is important to study the integrity and the regulation of immune responses and their downstream signaling pathways in TB endemic areas. Indonesia is a highly TB-burdened country and ranks third globally in TB cases. This thesis, consisting of six studies, explored variation in host immune responses to TB and their genetic background, and variation in clinical presentation. (1) MTB-specific stimulation of IFN-_ production as well as IFN-_ receptor signaling was significantly down-regulated during active TB, correlated with disease severity and __activity. (2) Concentrations of plasma granulysin of active TB patients were found to be low during acute disease. (3) Several genetic markers have been identified to affect susceptibility to TB (IL12B, IL12RB1, IFNG and IFNGR1) and (4) TLR8, DC-SIGN, complement component and scavenger receptor. (5) NRAMP polymorphisms were, however, not associated with susceptibility to TB. (6) TB with concomitant type2 DM presented more symptoms; screening fasting blood glucose in TB patients is clinically important. Show less
Family business groups are ubiquitous in most emerging markets. This book provides a richly documented analysis of the strategy of the Salim Group, one of the largest family conglomerates in... Show moreFamily business groups are ubiquitous in most emerging markets. This book provides a richly documented analysis of the strategy of the Salim Group, one of the largest family conglomerates in Southeast Asia. It argues that the strategy of this group oscillated irregularly between a business model built on connections and a professional business model adapted to markets. Due to its size and closeness to the Suharto regime, the Salim Group played an important role in shaping Indonesia’s economy. Show less
This dissertation deals with Mualang, an Ibanic (Malayic-Dayak) language spoken in the interior of western Kalimantan (Borneo), Indonesia. Given the relatively large number of speakers ... Show moreThis dissertation deals with Mualang, an Ibanic (Malayic-Dayak) language spoken in the interior of western Kalimantan (Borneo), Indonesia. Given the relatively large number of speakers (approximately 40,000 people), and due to its fairly isolated geography and some well-maintained socio-cultural traditions, the study of the language considerably broadens our knowledge of the Ibanic language family and the Malayic language group in general. Western Borneo has been posited as a possible homeland-candidate of Proto Malayic speakers. Therefore, linguistic contributions about inland languages in areas such as that of the Mualang language and people will provide Austronesian linguists with more information regarding this issue. This study presents a descriptive account of the grammar of Mualang covering the major features of its sound system, word and sentence structure as well as text grammar topics. The description results from a combination of textual analysis, elicitation and participant observation. The grammar is supplemented by wordlists and an extensive collection of glossed and translated texts. Show less
This book focuses on several Javanese theatre companies and more specifically on the way these groups shape and use their play texts. By looking at the different stages and dimensions of Javanese... Show moreThis book focuses on several Javanese theatre companies and more specifically on the way these groups shape and use their play texts. By looking at the different stages and dimensions of Javanese theatre productions various manifestations of the script and ‘script-like phenomena’ are encountered. All these phenomena play an important role in the production process as a whole. They are mnemonic and structuring devices employed by the participants of the production process. In case studies is explained how the playwright-director creates these tools and how he and the actors apply them. Furthermore, it is shown how ‘shaping agents’ such as the playwright-director, his assistant, the guest star and the companion of the guest star are at work during the performance. These agents influence the way the actors apply the mnemonic and structuring devices that form part of the production process. The interaction between shaping agents is characterised by multiple (humorous) misunderstandings. These misunderstandings eventually lead to collisions and call for multiple creative solutions in response. As a result the Javanese staging process has a lively, spontaneous and creative character. Show less
In the last two decades El-Niño-induced fires have caused widespread destruction of forests in East Kalimantan. The 1997-98 fires were the most extensive yet. The post-fire situation was studied in... Show moreIn the last two decades El-Niño-induced fires have caused widespread destruction of forests in East Kalimantan. The 1997-98 fires were the most extensive yet. The post-fire situation was studied in detail by field assessments and high-resolution SAR-images. My results show that rain forests are better able to conserve their high plant diversity than has been assumed because of the network of unburnt remnant forest, large remnant trees, and abundant tree regeneration. These elements were present in burnt forests throughout the burnt region. Subsequent destructive human activities, rather than El-Niño fires themselves, are the major threat to these forests' plant diversity. Show less
Focus of the study is the potential role of local institutions in fisheries management. As world-wide marine resources deteriorate, the call for better management urges national governments to... Show moreFocus of the study is the potential role of local institutions in fisheries management. As world-wide marine resources deteriorate, the call for better management urges national governments to decentralise management authority to local and lower government levels. Ownership and long-term access to resources are important incentives to manage resources for sustainability, while proximity to the resource, relevant local knowledge and local management institutions allow for effective and more equitable management that is both adaptive and resilient. Sasi in Maluku, Indonesia, is such an institution and has often been heralded as an example of successful local resource management. The extent to which it was still active and functional, however, was not known. This thesis contains an inventory of sasi and an analysis of its performance in terms of equity, efficiency, biological and social sustainability, and is illustrated by an elaborate description of sasi in Nolloth village. The study of sasi has been put in the wider context of decentralisation in Indonesia which is compared to the process in the Philippines. The results have also been used to identify the factors that enhance success of co-management in Southeast Asia. Finally a methodology is proposed to measure this success in an appropriate way. Show less
