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Diabetic retinopathy is a common ocular complication of diabetes. It is the most frequent cause of blindness in the working population of the United States and the European Union. Early diagnosis, and treatment can prevent vision loss in the majority of cases. Yet only approximately 50% of people with diabetes are regularly screened for the presence of signs of diabetic retinopathy. Computer aided diagnosis technology and digital retinal imaging could help to facilitate a large scale screening of people with diabetes. The research in this thesis is focused on the development of an automatic diabetic retinopathy detection system. This system would select exams which possibly contain signs of the presence of diabetic retinopathy and present only those to an ophthalmologist. In this manner the total workload of the ophthalmologist could be reduced. A number of different automatic screening system components are described and evaluated: An automatic system for the quantification of retinal image quality. Image quality is an important issue in large scale screening programs where images are acquired at many different sites, using different cameras and operators. It forms an essential component of an automatic screening system. Several different techniques for the automatic detection of the vasculature in retinal images are compared. A new technique is proposed and shown to exhibit good performance in comparison with the techniques from the literature. In addition to the vasculature, other anatomical landmarks are present on the retina, in particular the optic disc, the macula and the vascular arch. The location of these anatomical landmarks can be used to determine a relative position on the retina, and this spatial information about potential lesions can be used to remove false positive lesion detections and provide important diagnostic information. A system which is able to automatically find a set of points in a retinal image and thereby identify the location of the most important retinal anatomy is described. Red lesions are amongst the first signs of the presence of diabetic retinopathy and are therefore important to detect. An automatic red lesion detection system, based on a pixel classification approach, is described. When diabetic retinopathy progresses also bright lesions appear. An automatic detection system for these lesions is also presented. The individual system components are combined into a comprehensive screening system. This system is evaluated on a large dataset containing 40,000 images obtained in 10,000 eye examinations. A novel method is proposed to combine the outputs of the various system components into a single opinion about the complete examination. The results shown that the system is able to detect the majority of suspect exams at a specificity above 50%.

ABSTRACTMuch of our present day perception of African agriculture is still indirectly based on the coloured accounts of the early explorers and administrators. It involves an often very static conception of 'traditional' African agriculture. Not only does this fail to dojustice to the rich and dynamic history of African agriculture, it has also led to an inappropriate research and development paradigm which treats African agriculture as a disrupted equilibrial system that needs readjustment to return to an equilibrial and productivestate. A diachronic study of African agricultural history reveals that many of our preconceptions of African society and agriculture are invalid: agriculturists are not inert, but respond in innovative and dynamic ways to the perturbations of their natural and socialenvironment. It appears that their survival is not so much dependent on the establishmentof a fine‐tuned equilibrium, but rather on the dynamic responses to these external disturbances. It is very likely that the agro‐ecosystems in large parts of Africa function mainly as non‐equilibrial (unstable), but nevertheless persistent systems. This has importantimplications for development interventions and agricultural research. It requires a shiftfrom a synchronic approach to a diachronic approach that is firmly based on an understaning of the past.

In the Netherlands, the system of rules concerning land‐use and building at first sight seems rigid. A closer look, however, discloses a remarkable amount of flexibility partly authorized by 'hidden' legal possibilities. In assessing applications for building permits officials generally rely primarily not on the rules of building ordinances but on professional norms of good construction practice. A case‐study of land‐use planning shows a decision‐process characterized by coalition‐building which produces plans that are constantly changed to meet shifting external political and economic constraints. Such practices tend to endanger the normative goals of legal certainty and public accountability. To characterize the decision‐processes involved as 'rule‐application' or 'rule‐enforcement' is not adequate. Firstly, because it tends to reduce the complex working of a rule to the imposition of pre‐existing legal standards. Secondly, because the structure of the actors and their relationships is far more complex than a dichotomy of the 'regulator' and 'the regulated' suggests.

This disseration, War in the Classroom: A Qualitative Model for the English Literature Curriculum shows how war and trauma – past and present – are a pervasive presence in pupils' lives. This book proposes how secondary school teachers can overcome their anxieties about discussing sensitive topics such as war in the classroom. Rather than ignore these, it is important for the teacher to foreground these calamities and connect them to canonical and non-canonical multimodal literature in their classrooms. This disseration outlines how the forces in society, politics, and science aim to establish calm control in and of the conflicting world we live in. Each of these force fields seek out schools, as they are one of the last strongholds of collective memory and bastion of shared culture that can affect this. This book shows how teachers can empower themselves vis-à-vis the force fields' influence by accepting the central role they play in maintaining and preserving society's collective cultural memory. Teachers have an obligation to overcome their anxiety to act and engage with humanity's violent past and present. This disseration will help them to do so. Though its focus is on English literature, this book is also valid for teachers of other subjects, such as Dutch, French, and German language and literature, and to a lesser extent history and social sciences. It is an answer to the widespread and urgent call for value-driven education. This book shows how current curricula can be reshaped in such a way that they accommodate and incorporate the concerns and demands of society, science, and politics. It shows that English literature, part of a larger English language and culture curriculum at secondary schools in the Netherlands, and war narratives specifically, is an appropriate platform to addressing the wider social, political, and scientific picture, involving current global conflicts. This dissertation suggests a multimodal approach to literature in the classroom and analyses poetry, prose, movies, and blogs; chronologically tracing art that has sprung from the ashes of the major wars of the 20th and 21st centuries, World Wars I and II, the Vietnam War, the Iraq War, and the War on Terror. Doing so broadens the required curricula extensively, moving beyond the remit of what is required of modern language and literature teachers in the Netherlands. However, this book shows that a different, more creative and expansive design of the (language) curriculum is urgently needed, to rise up to the increasing demands upon teachers, and the challenge of involving society's pressing issues of citizenship at schools, as well as being forerunner to the general curricular overhaul in the Netherlands. This book is aimed to function as a flywheel to achieve this. It suggests an extensive re-draft of the English language curriculum, emphasising the importance and strengthening the position of literature and literature education in schools. Ultimately, the broad range of literary classroom interventions this dissertation describes culminates in a qualitative literary model for the English literature curriculum, as formulated in the conclusion. This is meant to serve as a guideline for the teacher-reader of this book in their ambition to design their own literary interventions. This book aims to motivate teachers to explore similar pathways, such as taking students on excursions to Ypres, venturing away from Owen to more diverse, non-canonical war poetry in the classroom (chapter 2), moving beyond Anne Frank's diary and visiting Bergen-Belsen with pupils (chapter 3), or as inspiration to putting Vietnam War Movies on the curriculum in troublesome classes (chapter 4), or even inviting a veteran to the classroom (chapter 5).

The Royal Chronicles of Ayutthaya are occupied by events like ceremonies for the Supreme-Holy-Lord-Omnipotent, and by the King's holy compassions and angers concerning his beloved Siam, especially at times of conspiracy. Westerners, in the times of kings like the famous Narai (1656-1688), appear only in the extreme margins of the Thai records. The Dutch are only mentioned twice, in particular when their ships were destroyed in the Burmese invasion of 1766.1 How did the Thai court perceive Westerners?