With increasing age, blood pressure (BP) rises as a consequence of arterial stiffness. It has been debated whether it is beneficial to treat hypertension in old age especially in >75-year... Show moreWith increasing age, blood pressure (BP) rises as a consequence of arterial stiffness. It has been debated whether it is beneficial to treat hypertension in old age especially in >75-year-olds when they have multimorbidity, polypharmacy or frailty. Large trials showed that lowering BP in >60-year-olds is beneficial and lowers the risk for myocardial infarction, stroke and all-cause mortality. However, these trials lack generalizability and typically excluded multimorbid patients that are frail. At the same time, observational studies rose concerns about lowering BP too much since there are several cohort studies showing a reverse association of low BP and increased mortality especially in >75-year-olds. The general aim of this thesis is to increase the scientific knowledge about the effects of treating hypertension in >75-year-olds with frailty. This thesis has three aims: 1) to measure the prevalence of polypharmacy in older patients; 2) to test for an association between low SBP and mortality, cognitive function, daily functioning, and QoL in older patients under antihypertensive treatment; and 3) to understand the role that frailty plays in GP decisions about treating hypertension in old age across countries and see if those differences can be explained by country-specific cardiovascular disease burden and life expectancy. Show less
In deze thesis wordt het argument verdedigd dat de manier waarop geometrische patronen als decoraties functioneren precies laat zien hoe representatie werkt. Het argument ontvouwt zich onder... Show moreIn deze thesis wordt het argument verdedigd dat de manier waarop geometrische patronen als decoraties functioneren precies laat zien hoe representatie werkt. Het argument ontvouwt zich onder meer door middel van een uitgebreide analyse van het recente ‘core knowledge’ paradigma uit de cognitieve psychologie. Core knowledge onderzoekers stellen dat culturele fenomenen zoals muziek, taal en visuele patronen, geworteld zijn in aangeboren kennissystemen bijvoorbeeld op het gebied van geometrie en nummer. Hieruit wordt duidelijk dat iedereen over dezelfde mentale bouwstenen beschikt om abstracte patronen te herkennen en te maken. Een analyse van onderzoek uit de antropologie en de semiotiek toont aan dat ook het vermogen om abstracte tekens als representatie van een ander object, lichaam of idee te zien, in elk mens aanwezig moet zijn. Met behulp van theorieën over representatie uit de kunstgeschiedenis, zoals die van Leon Battista Alberti en Gottfried Semper, wordt ten slotte duidelijk hoe het maakproces verloopt door middel waarvan abstracte tekens representaties worden. Geconcludeerd wordt dat als zodanig geometrisch decoratieve patronen op z’n minst en per definitie altijd naar een menselijke maker verwijzen en daarmee naar intentionaliteit. Show less
Children spend most of their days interacting with their social environment. Emotions form a large part of these interactions and vice versa social emotions become meaningful when interacting... Show moreChildren spend most of their days interacting with their social environment. Emotions form a large part of these interactions and vice versa social emotions become meaningful when interacting with others. Understanding the emotion processes that underlie successful social functioning is important, especially in children that experience difficulties in social-emotional functioning such as children with Autism Spectrum Disorders (ASD). These studies used a unique approach towards understanding the complex mechanisms that are involved in emotion processing, incorporating how emotions are perceived, experienced, regulated, and expressed. Sensitive and direct measures of emotion processing such as eyetracking and physiology revealed for the first time on a neurobiological level that children with ASD have difficulties emotionally resonating with others, use less efficient strategies to regulate their emotions, and provided evidence for a possible discordance between the expression and experience of emotions. The preschool years also presented with a possible window of opportunity; children with ASD do feel emotions when it comes to their own experiences and the development of social attention towards others might be prone to improvements during the preschool years. These findings are important to parents and professional and enhance the understanding of emotion processing during these very early years of life. Show less
