Managing Diversity in a Glocalizing World

Our daily lives are governed by products and images originating from all over the world, through the process of globalization. At the same time, however, globalization creates favourable conditions for all forms of particularization, localization and even fragmentation. While individuals and groups acquire mul-tiple identities, the resulting plurality gives rise to conflicts, controversies and variations, but also to attempts to live peacefully together, to co-ordinate activities, and to balance interests. The paper thus suggests (1) a plea for compatibility – instead of commonality - with regard to cultural values and (2) a strong emphasis on the interaction model in decision making, i.e. a model which does not advocate uniformity, but the compatibility of views, and in particular, practices. It concerns the coordination and combination of the proper interests of the various actors who have to depend on one another for the satisfaction of their demands or the realization of their objectives.Managing diversity, globalization, localization, glocalization, compatibility, interaction model

Living kidney donor evaluation and safety assessment

To be able to safely accept potential living kidney donors, more insight is needed in the effect of nephrectomy on a living donor. In this thesis, we aimed to investigate the role of both established and novel glomerular, tubular, and other donor outcome predictors in donor screening and follow-up. We performed renal function measurements in living kidney donor candidates both before and after living kidney donation. We found that estimated Glomerular Filtration Rate (eGFR) can be used in living kidney donation, but that a proportion of living donors will still require measured GFR (mGFR), both in donor screening and in follow-up, to minimize failure of detection of declining renal function. We also demonstrated that the renal functional reserve capacity is a predictor of short-term renal hemodynamics after donation, but not of long-term GFR. Furthermore, we demonstrated that living donor tubular phosphate handling is a predictor of recipient renal function and that post-transplant hypophosphatemia is associated with beneficial outcomes. Finally, we found that pain after nephrectomy is an important donor outcome parameter. These results show that more insight into living kidney donation may lead to better donor outcomes. Therefore, we call for a study involving all aspects of organ donation and transplantation

Gehechtheid in adoptiegezinnen : intergenerationele overdracht en gedesorganiseerde gehechtheid

This thesis describes a study on 55 adoptive families. The 55 children were internationally adopted, became the first child in their adoptive family and were less than 12 months of age on arrival. Before the arrival of the adopted child in her family the mother's mental representation of attachment was classified with the Adult Attachment Interview (AAI). When the child was 14 months of age, the Strange Situation procedure (SSp) was conducted to classify the attachment relationship of the child with the adoptive mother. Also at 14 months of age, the sensitive responsiveness of the mother in interaction with her child was observed and rated during a home visit. The first question concerned, whether a concordance similar to that found in the Van IJzendoorn (1995) meta-analysis could be found for the classical three-way attachment classification between mother and child; and, when indeed an intergenerational transmission of attachment was found, could the sensitive responsiveness of the mother then be traced as a mediator of this transmission process. The second question specifically concerned the recently discovered insecure disorganised attachment classification. A larger percentage of this category of insecure disorganised attachment was expected to be found for the adopted child as well as for the adoptive mother, compared to the percentages in the standard groups of the meta-studies. The distribution of the classical three-way attachment classifications for the mothers as well as for the children was comparable to those in standard groups. Sixty two per cent of all children were securely attached, for the mothers the percentage of autonomous classifications was 46 per cent. Despite the 'normal' distributions of a three-way attachment classification for mother and child no concordance in attachment classifications was found. Remarkably, the mother's attachment classification was not associated with her sensitive responsiveness. A connection between the sensitive responsiveness of the mother and the attachment classification of the child also was missing. A rather large group of securely attached children (31%) unexpectedly had a mother with a non-autonomous mental representation of attachment. An assumption could be, that just the absence of a genetic link, in combination with the specific constellation of the adoptive family, may have encouraged mothers with an insecure non-autonomous attachment classification to be as sensitive responsive as mothers classified with an autonomous mental representation of attachment. When classified according to the four-way classification system, a higher percentage (58%) of the children was insecurely attached compared to the standard group. As expected the adopted children in this research group were more often (36%) insecurely disorganised attached. The adoptive mothers were more frequently classified as 'unresolved' (24 mothers, 44%) than the standard group according to the original standard questions. With the additional items on miscarriage and infertility treatment the total group classified as 'unresolved' was 51 per cent (28 mothers). No concordance was found between disorganised attachment of the adoptive mother and disorganised attachment of her adopted child