Thromboembolic complications remain a major public health burden, making antithrombotic agents one of the most widely prescribed groups of medication, but the treatment is often challenging as it... Show moreThromboembolic complications remain a major public health burden, making antithrombotic agents one of the most widely prescribed groups of medication, but the treatment is often challenging as it at the same time increases risk of bleeding. With nationwide data from Statistics Netherlands, antithrombotic therapy and relevant clinical outcomes were comprehensively examined in the patient population of atrial fibrillation, overall or among those with comorbid cancer. The results suggest the patient population was increasingly receiving anticoagulants, driven by the newly introduced medication- direct oral anticoagulant and guided by the CHA2DS2-VASc score, and meanwhile the patient population experienced fewer ischemic stroke and major bleeding. In spite of these promising changes, suboptimal medication adherence and potential underuse of anticoagulants remain directions for further improvement. Antithrombotic agent use during pregnancy was also examined in the general Dutch pregnant population, which featured a surge in antiplatelet prescriptions, and risk of preeclampsia/eclampsia decreased and several newborn outcomes improved simultaneously. Together, the studies presented in this thesis provide an overview of antithrombotic therapy in the Netherlands in recent years, providing insights for further improving this treatment and relevant patient outcomes. Show less
This dissertation examines the educational positions of children of immigrants in the Netherlands from 1980 to 2020. In particular, the influence of migration background and socioeconomic factors... Show moreThis dissertation examines the educational positions of children of immigrants in the Netherlands from 1980 to 2020. In particular, the influence of migration background and socioeconomic factors on educational positions is studied. Findings reveal substantial progress in education for migrant children overall, especially among the second generation, younger cohorts, and girls with a migrant background, indicating promising upward mobility within the education system for many of these children. The family environment impacts educational outcomes, with socioeconomic background playing a crucial role. Higher parental incomes correlate with higher education levels for children in both the short and long term. Additionally, the living environment affects outcomes such as school dropout rates, especially among boys from migrant backgrounds in larger cities. They are more prone to leaving education prematurely than their female or non-migrant peers. Despite institutional barriers and discrimination within the education system, these children demonstrate an upward trend in education, highlighting the need for further research incorporating discrimination as a factor. Show less
The overall aim of this dissertation was to study the contribution of a syndemics framework to understanding and addressing persistent health disparities. Departing from an interdisciplinary... Show moreThe overall aim of this dissertation was to study the contribution of a syndemics framework to understanding and addressing persistent health disparities. Departing from an interdisciplinary approach, the dissertation attends to research questions on syndemics indicators, contextual drivers for syndemics, the intergenerational nature of syndemics, and possibilities for early public health interventions in Katwijk, a former fishing town in the Netherlands. An epidemiological study described the three most prevalent disease clusters in Katwijk. A qualitative life course study found a first indication that syndemic vulnerability is potentially intergenerational, and that syndemic processes can be countered. A mixed method study showed that while challenging, a family-engagement approach can elicit positive effects on families’ health and wellbeing. The ethnographic study described the hurdles for implementing family-focused health promotion for multifaceted health conditions, such as childhood obesity. This dissertation establishes that the syndemics framework provides tools to identify past and present factors on the complex pathways to persistent poor health, which in turn point at directions for breaking patterns of generational health. The findings highlight a need for multisystem approaches in which stakeholders develop a thorough understanding of a community’s history and past legacies with institutions, and professionals are equipped with the necessary knowledge, attitudes and skills for community-based and family-focused interventions. Show less
This thesis researches the profession of the upholsterer – or ‘kamerbehanger’ in Dutch – and the role they played in the creation of interiors in the Dutch Republic, in the long eighteenth century ... Show moreThis thesis researches the profession of the upholsterer – or ‘kamerbehanger’ in Dutch – and the role they played in the creation of interiors in the Dutch Republic, in the long eighteenth century (1680-1810). Its research centers on the cities of Amsterdam, The Hague and Haarlem. A total of 234 shops or individual upholsterers working there in this period were found. Hopefully, the index of their names included in this thesis will advance future research. The first chapter describes the way the profession developed, as well as how upholsterers learned the trade, worked, kept their shops and advertised. In the following four chapters, the relation between upholsterer and client is explored in-depth through case studies from the period 1680-1810.Upholsterers provided bed and wall hangings, curtains of all sorts, upholstered furniture and other textile wares. They were a relatively small but diverse group working in the luxury industries, with about 10 shops at any one time in Amsterdam and in The Hague, and about 1-5 shops in Haarlem. Some upholsterers did not have a shop but worked their trade from a single room, or worked for others. Most kept a small shop. For some, this was indeed the best profession (‘le meilleur métier’). Upholsterers such as a Pierre Courtonne or Johannes Deel, working for the Stadholders and the elite of their day, were able to amass fortunes of 20,000-50,000 guilders and played a role in designing interiors. Succes was dependent on factors such as seed money, an up-to-date knowledge of current fashions, and maintaining good relations with clients. Most shops went from father to son, and most of the upholsterers working in the Republic were locals. Only a small percentage were foreign-born, and even though France exercised a large influence on the luxury market in the eighteenth century, this is not reflected in the number of French upholsterers settling in the Republic. Only at the end of the century can an increase in their number be seen, and a handful of ‘French upholsterers’ settle in Holland. They seem to have had an advantage over their Dutch colleagues in that they were able to purchase the latest French wares directly through their connections.Regarding the relationship with their clients, it has been found that most upholsterers played the role of advisor and facilitator, when helping their clients buy a new interior or furniture. All-in-all, the case studies show how upholsterers would balance their client’s quest for the newest and most fashionable furniture and interiors with their budget and the available goods. Show less
In response to the shortage of nursing staff and the so-called refugee crisis in 2015, two residential homes invited first-generation immigrants with a refugee background to participate in a... Show moreIn response to the shortage of nursing staff and the so-called refugee crisis in 2015, two residential homes invited first-generation immigrants with a refugee background to participate in a project for nursing education, orientation and internships. Between 2015 and 2018, a group of ten immigrants started working in a Dutch residential home and a group of seventeen immigrants in the German home. This dissertation investigates the social processes when these newcomers start working with the established staff, as well as the extent to which their mutual interactions and values of good care influence the enactment of geriatric care. Using ethnographic observations (305 hours), in-depth interviews (44) and six focus groups (24), the established care workers and immigrants were followed in both homes. The empirical data shows that institutional constraints, such as staff shortage, the imposition of professional norms, gossip used as a ‘weapon of the weak’, mutual suspicions of indifference, and collective images of ‘us’ versus ‘them’ affected the enactment of geriatric care. Their habitus stimulated them to tinker among each other as well as with different, sometimes conflicting, values of good care. However, both groups shared the feeling of ignorance by management, a pain of not mattering. Show less
This study describes how the interpretations, aspirations and school identity development of Islamic primary schools developed in the period 1988-2013. It gives an overview of the most important... Show moreThis study describes how the interpretations, aspirations and school identity development of Islamic primary schools developed in the period 1988-2013. It gives an overview of the most important turning points for Islamic education and how these turning points have influenced identity development.In this study, the administrators and directors of Islamic primary schools who have at least 10 years of experience in identity development are interviewed. This research shows how complex and diverse the identity of Islamic primary schools is. The main internal and external factors and actors that have influenced the development of school identity are discussed. National and international events have led to a social debate in which the role of Islamic primary schools regarding the integration of Muslims has been questioned. Partly because of this negative attention, Islamic schools have changed from introverted to extroverted organisations. This discussion has also led to unequal treatment of these schools. This research shows precisely how important these schools are for the emancipation of Muslims in the Netherlands. After all, Muslims themselves take the responsibility for education. Islamic primary schools are typical Dutch schools that make an important contribution to a safe pedagogical climate. Show less
Although the Netherlands remained neutral during the First World War, its population was nonetheless affected by the war. Already in the 1920s and 1930s, Dutch journalists wrote about the... Show moreAlthough the Netherlands remained neutral during the First World War, its population was nonetheless affected by the war. Already in the 1920s and 1930s, Dutch journalists wrote about the possibility of a war in which the Netherlands would also be involved. From the early 1920s to the German invasion in May 1940, journalists, political commentators, politicians, military officials and civilians were occupied by the question what tomorrow’s war might look like. This book captures their efforts and brings to life the cultural memories of the First World War and the expectations for the war to come.By focusing on the dynamics of cultural memories, predictions for the future, and the resultant fear and anxiety, this book provides a better understanding of the ways in which the cultural memories of the Great War and expectations for a future war were part of Dutch society. It draws from a wide array of sources, ranging from newspaper clippings, novels, films and theatre plays to political cartoons and paintings. Most importantly, this study has a unique perspective. Whereas most existing studies look back from the Second World War, this book instead looks forward from the interbellum. Show less
Between 1960 and 1983 the Dutch economist Dr. Albert Winsemius (1910-1996) was the most influential economic adviser to the government of Singapore and one of the leading architects of Singapore’s... Show moreBetween 1960 and 1983 the Dutch economist Dr. Albert Winsemius (1910-1996) was the most influential economic adviser to the government of Singapore and one of the leading architects of Singapore’s highly successful development model. Winsemius' beliefs and recommendations chimed with the views of Singapore’s first-generation postcolonial political leaders and quickly grew in popular appeal once they started yielding impressive economic results. Winsemius’ uncompromising hostility to communism, and at the same time his sympathy toward moderate trade unionism, were of particular importance here.This research identifies strategies and policies that contributed to Singapore's development, and that can be traced to Albert Winsemius as a historical principal. It concludes that in essence, many of these successful strategies and policies were based on Winsemius’ experiences in his earlier life and career: the economic reconstruction in the Netherlands in the years after World War Two, in which he played a key role, his empathy toward the United States and the American way of life, his contacts with other right-wing governments, and his involvement during the Cold War in the production of arms. Show less
Annually around 5 million people die as a consequence of injuries and many more suffer from livelong disabilities. Although implementation of trauma care systems and structured trauma training has... Show moreAnnually around 5 million people die as a consequence of injuries and many more suffer from livelong disabilities. Although implementation of trauma care systems and structured trauma training has led to decreased mortality and disability in several countries, controversies remain to exist. The awareness of the current trauma burden and its expected increase has led to new initiatives for scientific research in an attempt to eventually improve trauma care worldwide. Despite the improvements there is room for further optimization of care. The primary aim of this thesis is to analyze the presence and structure of trauma systems, evaluate specific care-delivery processes, and focus on patient-centered and clinically important parameters and outcomes. The second aim is to evaluate one of these parameters, the role of the nutritional status in the outcome of polytrauma patients. Show less
Why did people decide to found political parties? How did they convince others to become members of this new organizational model? In the second half of the nineteenth century, the first party... Show moreWhy did people decide to found political parties? How did they convince others to become members of this new organizational model? In the second half of the nineteenth century, the first party organizations differed from previously existing mass political organizations, because they aimed for and had direct access to parliamentary representation. In contrast to previously existing parties that loosely organized the traditional political elite in parliament, the new mass parties were based on an extensive organizational body that included previously excluded social groups in politics. Combining political history with social science theory, this dissertation studies the ideas and practices of political activists who founded the first party organizations. The comparison of three case studies (the German Social Democratic Workers’ Party, the British National Liberal Federation and the Dutch Anti-Revolutionary Party) is based on primary sources including letters, diaries, autobiographies, minutes of meetings, brochures, newspapers and political programs in three different languages. Show less
Al sinds de oprichting in 1988 is het islamitisch basisonderwijs in Nederland een bron van discussie. De ontwikkeling ervan heeft de afgelopen dertig jaar niet stilgestaan en geeft aanleiding tot... Show moreAl sinds de oprichting in 1988 is het islamitisch basisonderwijs in Nederland een bron van discussie. De ontwikkeling ervan heeft de afgelopen dertig jaar niet stilgestaan en geeft aanleiding tot nieuwe inzichten. Toch worden in de discussie al jarenlang dezelfde argumenten gebruikt.Hoe geven de verschillende islamitische basisscholen vandaag de dag vorm aan hun identiteit? En hoe wegen zij de verschillende maatschappelijkedebatten over de islam daarin af?Dit boek laat – met een focus op de identiteitsvorming - de leerkrachten en directieleden zelf aan het woord en probeert de verschillen in waarden, normen en gewoonten van binnenuit te duiden.Islamitische basisscholen blijken steeds meer aandacht te hebben voor de maatschappelijke context. Ook wordt inzichtelijk dat islamitische basisscholen zich van andere basisscholen onderscheiden vanwege hun interne diversiteit en de continue dialoog met die maatschappelijke context.Dit boek is een pleidooi voor genuanceerder denken over en handelen rond het islamitisch basisonderwijs in Nederland. Show less
This dissertation focuses on the workings of popular national agency in late nineteenth-century Amsterdam and the question in what ways and to what extent ‘ordinary’ citizens constructed and... Show moreThis dissertation focuses on the workings of popular national agency in late nineteenth-century Amsterdam and the question in what ways and to what extent ‘ordinary’ citizens constructed and experienced ‘the Netherlands’ through their urban surroundings. It steers away from a top-down perspective and considers the lower and middle social classes as actual actors in the process of democratising the nation. The argument of the book is centred around five case studies: the popular experience of public monuments and statues; the singing of the national anthem; popular Orangism; the public response to the Boer Wars; and the commercialisation of the nation in an urban context. Show less
For South Asian adults lowered BMI cut-offs for overweight and obesity are recommended as these are more in agreement with their body composition (low muscle mass, high fat mass) and the... Show moreFor South Asian adults lowered BMI cut-offs for overweight and obesity are recommended as these are more in agreement with their body composition (low muscle mass, high fat mass) and the considerably higher risk of cardiovascuar and metabolic disease. For South Asian children living in a Western country lowered BMI norms have not been established, nor other ethnic specific growth standards. The aims of this thesis are 1. to gain more insight into the normal physical growth of South Asian children 2. to develop South Asian specific height-for-age (0-21 years) and BMI-for-age (2-18 years) references, including BMI cut-offs. The studies in this thesis show that South Asian children are generally lighter and shorter than other ethnic groups. The mean birth weight is at 3012 grams around 450 grams lower than of Dutch babies and has remained unchanged for the past 35 years. In children 3-15 years thinness is highly prevalent and overweight prevalence is relatively low. Application of the developed height-for-age charts and lowered BMI cut-offs will expectedly lead to a better assessment of height and nutritional status (thinness, overweight) in this group. Consequently, thinness rates will be lower while overweight will be detected earlier, leading to earlier preventive interventions. Show less
This dissertation contains a history of public financial student support policies in the Kingdom of the Netherlands, from their establishment in 1815 until today. It focuses especially on the... Show moreThis dissertation contains a history of public financial student support policies in the Kingdom of the Netherlands, from their establishment in 1815 until today. It focuses especially on the political and administrative decisions that led to actual policies. This history is divided in seven episodes during which policies had different goals and took different shapes. This way, the episodes reflect the changing role of the national government in Dutch society. Policy makers used financial student support as an instrument in their efforts to influence the course of social developments, with varying success. They tried to influence supply on the job market, to stimulate the development of individual talents and to advance social justice. Larger objectives were state formation, economic and cultural development and the emancipation of particular groups in society. Ever since the introduction of child benefits in the system in 1953, it has been impossible to tell whether student support is a form of education policy, income policy or social support. It has had close links with all three of them, causing reforms in one of these aspects to have unacceptable effects in the other. Public student support policy has become a complex administrative knot, still struggled with today. Show less
Approximately 2.5% of the electorate in the Netherlands is member of a political party. This modestly sized group plays an important role in representative democracies: members are part of the... Show moreApproximately 2.5% of the electorate in the Netherlands is member of a political party. This modestly sized group plays an important role in representative democracies: members are part of the electorate and of their party and function as intermediaries between voters and elected officials. There is, however, debate as to the role of party members. The impression exists that members of the same party are internally divided over important political issues, that it is largely impossible to distinguish between members of different parties substantively, and that members differ in terms of views and backgrounds, and thereby drive a wedge between voters and elected officials. Based on the Leyden Party Member Survey, this study investigates how internally cohesive, externally different and representative in terms of membership Dutch parties are. This study's findings suggest, at least for the Netherlands, that the view that party members are obstacles is factually incorrect. In general, party members are internally quite cohesive and adopt a shared, substantive position that differentiates from the position of members of other parties. Although their demographic profile deviates, members' substantive views are congruent with those of the voters and MPs of their party. Show less
In this thesis, the primary aim was to gain insight into management of obstetric emergencies occurring in primary midwifery care in the Netherlands. Secondly, we aimed to develop preventative... Show moreIn this thesis, the primary aim was to gain insight into management of obstetric emergencies occurring in primary midwifery care in the Netherlands. Secondly, we aimed to develop preventative strategies and tools to optimise care in case of an obstetric emergency. From 2008-2010, a unique dataset of 198 cases of obstetric emergencies was provided by midwives working in primary care who participated in the __CAVE-Study__. We used both qualitative research (audit) as well as quantitative research methods. We studied preventative tools such as pulse oximetry in primary midwifery care and developed and assessed 25 quality indicators for the development of a multidisciplinary guideline for post-partum haemorrhage (PPH, defined as __ 1000 mL blood loss after childbirth) in the Netherlands. We have summarised and discussed the studies performed in relation to each other, both from the perspective of midwifery care in the Netherlands, but also as embedded in the Dutch obstetrical care system. Finally, we have made specific recommendations concerning the development of guidelines, cooporation and the use of technology in primary midwifery care Show less
The subject of the thesis is the administration and logistics on board Dutch men-of-war during the 17th and 18th centuries. The sailor or ship's clerk who was in charge with this shipboard... Show moreThe subject of the thesis is the administration and logistics on board Dutch men-of-war during the 17th and 18th centuries. The sailor or ship's clerk who was in charge with this shipboard activities was the so called (scheeps)schrijver. His background, appointment, work, earnings and importance for the Dutch navy are the central topics. This non-commissioned officer occupied an important position both on board and on shore. Indeed, he was a key figure in many respects. It is this figure who forms the focus of this study, considered within the context of the warship as a seafaring enterprise. Show less
This dissertation examines the memory cultures of Netherlandish migrants who left their homes during the Dutch Revolt (ca. 1568-1648) and the religious persecutions preceding it. It shows how... Show moreThis dissertation examines the memory cultures of Netherlandish migrants who left their homes during the Dutch Revolt (ca. 1568-1648) and the religious persecutions preceding it. It shows how narratives of exile and victimhood were transmitted between generations and cultivated in various social and religious settings until the eighteenth century. The consciousness of a shared past connected Netherlandish diaspora groups all over Europe and at the same time provided them with models of identification with their various local host societies. Integration into the various host societies in Germany, England and the Dutch Republic did not inhibit the commemoration of the refugee past, but led to an incorporation of exile narrative into new memory canons. New generations could often benefit from identifying with the fate of persecuted ancestors, especially in pietist and puritan circles in Germany and England. Having suffered for one’s faith served as a proof of religious steadfastness and the identification with the persecuted ‘small flock of true Christians’ appealed to many pietists without a migrant background. Exile narratives were increasingly shared by migrants and non-migrants and allowed individuals to participate in cultures of religious exclusivity Show less
This dissertation analyses the use of the Leiden anatomical collections in the nineteenth century. It investigates what happened to anatomical preparations after they were added to institutional... Show moreThis dissertation analyses the use of the Leiden anatomical collections in the nineteenth century. It investigates what happened to anatomical preparations after they were added to institutional collections. Four chapters discuss the four main audiences of the Leiden collections: students, researchers, lay visitors, and university governors. The medical audiences (students and researchers) kept using the collections throughout the nineteenth century; the non-medical audiences (visitors and governors) stopped using the collections in the second half of the century. The dissertation argues that, to understand these developments, we need to see anatomical collections as dynamic entities: intended for active, hands-on use and containing objects that, as philosopher of biology Hans-J_rg Rheinberger has put it, are made of what they represent. These properties enabled researchers and students to continuously reinterpret the preparations as medical theories and practices changed. In the new medicine, the collections were placed in a closed laboratory environment, and the reinterpretations disconnected the preparations from their past and the moral stories once attached to them. Hence, they became hard to access and use for lay visitors and university governors. Even today, old preparations linger in hospitals and laboratories, waiting for new uses __ as do newly built collections of bodily material. Show less
Myasthenia gravis (MG) is hallmarked by acquired and fluctuating weakness of voluntary muscles. In the majority of patients, weakness is caused by autoantibodies to the postsynaptic acetylcholine... Show moreMyasthenia gravis (MG) is hallmarked by acquired and fluctuating weakness of voluntary muscles. In the majority of patients, weakness is caused by autoantibodies to the postsynaptic acetylcholine receptor (AChR) in the neuromuscular junction. Approximately 10% of MG patients are seronegative (SNMG). In 2001, antibodies to muscle-specific kinase (MuSK) were discovered within this group. This dissertation describes the epidemiology, clinical characteristics and immunological aspects of this new disease. In the Netherlands, MuSK MG is rare. Incidence was 0.17 per million person-years. Prevalence was 2.8 per million on January 1st 2004. Weakness was more often bulbar, and lead to frequent respiratory crises. MuSK MG was linked to the HLA-DR14-DQ5 haplotype and the disease severity was associated to antigen-specific IgG4 antibodies instead of IgG1. This is in contrast to AChR MG in which autoantibodies are mainly of the IgG1 and IgG3 subclass, and the disease is linked to HLA-B8-DR3. In SNMG patients, no antibodies to postsynaptic ErbB receptors were found. A case-report describes the transmission of MuSK autoantibodies from mother to her newborn child, causing transient weakness in the infant. A second case-report illustrates the effect of MuSK antibodies on both pre- and postsynaptic signal transmission in the neuromuscular junction. Show less
