Breast Cancer is not a Pink Ribbon.

20 10 2010

I have always had mixed feelings in case of large happenings like marches and ribbon activities and cancer months. September is the ovarian cancer month (and also a US Prostate Cancer Month and a childhood cancer month) and  October the breast cancer month…. We have only 12 months in a year!

Please, don’t misunderstand me! Awareness is very important, also in the case of breast cancer: Awareness so to recognize breast cancer in an early stage, awareness of preventive measures of cancer,  awareness what women with breast cancer go through, awareness that breast cancer often can be cured, awareness that research is needed, and thus money.

But I also feel that the attention is overdone and often hypocritical, with fancy pink ribbons and “pink”: everywhere. This feeling is strengthened by some recent articles. For instance this article in Health.Chance.org, called Pink Ribbon Hypocrisy: Boozing It Up for Breast Cancer discussing that fast food and alcohol companies Use Breast Cancer as a Marketing Ploy (whereas these items some reputation if it comes to -certain types of- cancer). You can sign a petition here against it.

There is even a book Pink Ribbon Blues – How Breast Cancer Culture Undermines Women’s Health, written by Gayle A. Sulik, that is “thought-provoking and probing argument against the industry of awareness-raising”

From the description:

Pink ribbon paraphernalia saturate shopping malls, billboards, magazines, television, and other venues, all in the name of breast cancer awareness. (…) Gayle Sulik shows that though this “pink ribbon culture” has brought breast cancer advocacy much attention, it has not had the desired effect of improving women’s health. It may, in fact, have done the opposite. Based on eight years of research, analysis of advertisements and breast cancer awareness campaigns, and hundreds of interviews with those affected by the disease, Pink Ribbon Blues highlights the hidden costs of the pink ribbon as an industry, one in which breast cancer has become merely a brand name with a pink logo.

The following quote from a woman who had lost her mother to breast cancer illustrates the feeling of many (see comments):

As the years went by, life provided me with more reasons to hate pink. Frustration over society-defined gender roles piled on as did annoyance at the image of ultimate feminine woman. And then came the big one.

Breast cancer.

My mom passed away after a six-year long battle with breast cancer at the age of 45.

When pink later became symbolic of breast cancer awareness, I wanted to punch some pink piggies. I know that some people choose to wear pink to honor or remember or show support for a loved one. That is not what I get my panties in a bunch about–it’s the way corporate America has grabbed that pink flag and waved it to and fro for their own profit that makes me furious.

I remember once standing in the grocery store and staring at a bag of pink ribbon-adorned M&Ms, my blood boiling harder with every passing second.

She ends her post with:

Everyone has a story. Some have seen the scars of a mastectomy. Some have witnessed the toll that chemotherapy takes on a body. Some have lived the pain. We all know it’s bad.

I, for one, don’t need pink to remind me.

That same is true for me. I’ve seen my mother battling breast cancer -she is a survivor- and I have seen the scars of mastectomy and these are nowhere near pink ribbon.

“Breast Cancer is not a Pink Ribbon” tweeted Gilles Frydman yesterday and he meant a great pictures exhibition that lasted 3 days, showing portraits of young topless breast cancer survivors shot by fashion photographer David Jay.

At first I found it mainly confronting: this is the reality of breast cancer! As described elsewhere (Jezebel):

Seeing scarred and reconstructed mammary glands is not just shocking because of the way breasts are fetishized in our society, but because it speaks to how much we hide, gloss over and tidy up disease. Breasts are one of the defining physical attributes for identifying a woman. Breast cancer eats away at flesh meant to nourish. Surgery is a brutal procedure from which to recover and heal. But cute, clean, pink ribbons have come to symbolize all that.

But at a second and third look, I mainly saw the beauty of the photo’s, the fierceness of the women and their beautiful eyes.

Exactly as put into words at the website of the SCAR project:

Although Jay began shooting The SCAR Project primarily as an awareness raising campaign he was not prepared for something much more immediate . . . and beautiful: “For these young women, having their portrait taken seems to represent their personal victory over this terrifying disease.

SCAR by the way stands for ‘Surviving Cancer. Absolute Reality.”

David Jay was inspired to act when a dear friend was diagnosed with breast cancer at the age of 32.

The SCAR-project is “dedicated to the more than 10,000 women under the age of 40 who will be diagnosed this year alone The SCAR Project is an exercise in awareness, hope, reflection and healing. The mission is three-fold: Raise public consciousness of early-onset breast cancer, raise funds for breast cancer research/outreach programs and help young survivors see their scars, faces, figures and experiences through a new, honest and ultimately empowering lens.”

The exhibition was last week in New York, but you can still see the photographs at the website of the SCAR-project.

Furthermore, you can participate in the project and/or buy the (signed) SCAR project book ($55).

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Silly Saturday #22 – A Picture is Worth a 1000 Words.

17 04 2010

This post is my submission for the Grand Rounds to be hosted at Sterile Eye.
This upcoming edition has the theme VISUAL COMMUNICATION.

You know I love visualizations, they are so easy to understand.

No lengthy post here, because a picture is worth a 1000 words…..

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I

250lbs versus 120 lbs

The body scans side by side of 250 lb. woman versus 120 lb. woman.
Source: Bored Panda

Hattip: @EvidenceMatters, @rlbates & @streetanatomy who referred to a repost on LikeCool

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II

Planes or Volcano?

We were wondering this today (April 16, 2010)

Source: Information is Beautiful

Hattip: Bitethedust & @mpesce “Turns out that a little volcanic action is surprisingly good for planet Earth They referred to a repost at The Daily Wh.at.

I’m a real fan of Information is Beautiful with its beautiful visualizations. See previous post on evidence for health supplements

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III

Real Eyeballing

Source: Wolfram Demonstrations Project

Contributed to Sterile Eye ;) : An interactive project showing hows the interaction between an eyeball and two of the muscles connected to it. Muscles deform as the eyeball rotates. You can download a live version.





Friday Foolery #7 Play Doh World, the Safe and Unexpected

16 10 2009

Seen at the Loom of Carl Zimmer: using Play Doh, Sophia Tintori and Cassandra Extavour talk about multicellularity and the specialization of reproductive cells.

The video, made by the evolutionary biologist Casey Dunn, is from Creature Cast, a collaborative blog produced by members of the Dunn Lab at Brown University. The Dunn Lab investigates how evolution has produced a diversity of life. On this newly evoluted “Creature Cast” you can find short, original and  good quality posts on zoology in the broad sense often with beautiful photos or videos. You can now subscribe to the CreatureCast video podcast through Brown University at  iTunes U.

more about “CreatureCast Episode 2 on Vimeo“, posted with vodpod
Work provided under a Creative Commons Attribution-Noncommercial-Share Alike license.

Another example of a great post on Creature Cast is the Tale of two holes about why some animals have one hole and others two. Does the single hole in one-holed animals correspond to the mouth or anus of animals with two holes?  Apparently the same sets of genes appear in many different contexts within and across species. In this case there are two distinct modules for mouth and blastopore (the first hole developed in animals during their development) and they can be decoupled. Again there is a terrific photo made by Dunn showing a sea anemone with a single hole for eating, excreting, and shedding eggs and sperm, and an annelid worm with two holes.

This is a Friday Foolery post, thus permit me to show me something completely different: a successful Play-Doh ad-campaign started in Singapore (what a coincidence, the city I left 26 h ago). These ads talk to parents directly, reminding them about the thousand of possible things you can make with the product, but even more so about how safe it is to play with it. (although someone commented: “what if kids eat those pills? Although Play-Doh is non-toxic…)

16-10-2009 16-48-15 play doh ads





Anatomy Lesson 2008: Living in Fear

30 11 2008

You may want to play this music while reading this post: Bach: Gottes Zeit ist die allerbeste Zeit (BWV 106)

amc-homepage

The “Anatomy Lesson” has several meanings:

  1. A lesson in Anatomy
  2. A famous painting of Rembrandt van Rijn (of Nicolaes Tulp) (1632).
  3. The homepage of the AMC, the Academic Medical Center in Amsterdam, inspired on the painting of Rembrandt.
  4. A yearly symposium at the intersecting plane of medicine, art and society, organized by the AMC and the Volkskrant, a Dutch newspaper.

This year I was invited to the yearly “Anatomische Les” in the concertgebouw, Amsterdam’s beautiful concert hall (see Wikipedia). It is a very official happening. The audience had to take their seats long before the start. It took more than 2 hours without any break.

zaal-concertgebouw-anatomische-les

Anatomy Lesson 2008 in the Concertgebouw

This year’s theme was FEAR. The program was as follows:

  • Welcome – Rinnooy Kan
  • Presentation of new work of art of Albert van Westing (1960), recently bought by the AMC – Wim Pybes, director of the “RijksMuseum”
  • “Mit Freud und Freud ich fahr dahin”- Johan Sebastian Bach. 1.”O Jesu Christ, mein’s Lebens Licht” 2. Gottes zeit ist die allerbeste Zeit – Baroque Ensemble “Follia d’ Amsterdam” together with the choir “Nuovo Musico” , conducted by Gustav Leonhardt (above is another version). The cantatas express both fear for death and faith in God.
  • Audiovisual presentation of the assay ” de vertrouwenscrisis” (what went wrong with the fundamental trust in the Dutch society?), written by 19 different publicists.
  • Audiovisual impression of pupils of Amsterdam High Schools attending lectures in psychiatry: funny and disarming.
  • And the climax: a 50 min lecture of Prof. Arieh Y. Shalev, M.D. (Head Department of Psychiatry at the Hadassah University Hospital of Jerusalem, Israel) about living with fear.

I will try to summarize the main points of Shalev’s lecture as I remember them (no notes).

There are several factors that may influence how people react to fear:

  1. DNA (fixed), inherited differences – (written composition in musical notation)
  2. Epigenetic Mechanisms (mostly but not exclusively determined postnatally). (tuning of the piano, quenching the middle register)
  3. (Gene) Expression (Accordion register determining ranks and timbres, determined by the accordionist)
  4. Exogenous factors (i.e. empathy and affection) (the people singing, the acoustics)

Fear is an emotional response to threats and danger, meant to protect against a threat (fright-fight-or-flight). It is a basic survival mechanism occurring in response to a specific stimulus, such as pain or the threat of pain. Recognizing a person in agony is easy. The facial expression of fear includes the widening of the eyes (out of anticipation for what will happen next); the pupils dilate (to take in more light); the upper lip rises, the brows draw together, and the lips stretch horizontally. Muscles used for physical movement are tightened and primed with oxygen, in preparation for a physical fight-or-flight response. When the stimulus is shocking or abrupt, a common reaction is to protect vulnerable parts of the anatomy, particularly the face and head. When a fear stimulus occurs unexpectedly, the victim of the fear response could possibly jump or give a small start. The person’s heart-rate and heartbeat may quicken (from Wikipedia).

brain-amygdalaThe amygdala, an almond shaped complex of related nuclei, located in the middle of the brain, is a critical processor area for fear. Connected to the hippocampus, it plays a role in emotionally laden memories. It is part of the limbic system.

Fear, begins with arousal. For instance:

  1. You hear a sound. The amygdala is alerted.
  2. You see a face, the amygdala is alerted to a greater extent. Your pupils enlarge, your breathing and hartbeat quicken.
  3. You recognize the face; it is nobody to be afraid of: the fear response is dampened. The heartbeat drops to normal levels, because you are reassured that there was no danger.

But suppose (1) you’re walking in a dark alley and (2) you see a gun. (3) Next you see a man holding that gun. (4) He shouts something threatening. There are no breaks anymore (by prefrontal cortex/hippocampus on the amygdala) and the fear machine starts running at full speed. Thus, in case of a major threat, in a split second all alarm bells ring: the abovementioned reflexes occur immediately and with no point of return.

One’s memory of what happens consists of separate “pictures”: (1) the alley, (2) the gun, (3) the man, (4) a loud voice (and perhaps smell). Normally, moments of fear will takes it’s place along other memories, although this may take some time.

However, depending on the kind of fear, your personality and external factors, memories to the incident causing fear may stay at the foreground. It may become a memory that comes to the mind frequently and spontaneously or evoked by one of the remembered associations. For instance any alley may cause the full blown fear response again in the abovementioned example.

Shalev telling this, I suddenly understood my reactions to a car accident. While driving on the highway, the driver lost control of the vehicle, causing it to skid and finally ending against a huge concrete wall. I was sitting in the back and while the car was turning I saw “the wall hitting us”. My “last thought” was “that was it”. The car was total loss, but luckily all 5 (members of a dancing group) survived. Apparently because of the “fear of death”, the impression of that very moment staid long with me. For almost a year I felt frightened not only in a car, but also when I saw a car or motor turning fast around the corner or when moving sideways in an airplane during landing. It must have been a similar feeling as when the car turned and hit the wall. The resemblance of that moment brought the memory and the fear back in quite un uncontrollable way. But as time passed by, so did this emotional reaction. The memory itself was still there, but at the background and slowly all intense associations with that frightful moment faded.

hapThis is what normally happens with frigtening experiences. Fear can be retriggered by a memory (smell, picture, situation) linked to what happened, but can extinguish over time. Thus responding to a conditioned stimulus (CS) spontaneously recovers with the passage of time indicated that extinction does not erase the conditioned memory, but is a form of (active) inhibition. The brain (prefrontal cortex/hippocampus) learns how to coop with it and suppress the emotional fear reflex (amygdala).

However, some fears don’t extinguish and have a lifelong impact. For instance in post-traumatic stress disorder (PTSD), which is a severe and ongoing emotional reaction to extreme physical or psychological trauma.

Shalev gave several examples of people with PTSD other than PTSD in war veterans . For instance, a mother who lost her daughter on the complications of a simple (and unnecesary) intervention. The daughter died of sepsis and from that moment on the mother continued to live in the past, persistently reexperiencing the traumatic event.

This was what the mother remembers as the most frightful moment:

I entered the door, my hand still holding the knob. There she lied staring with pupils so dilatated that her irisses were no longer visible. Death was inevitably approaching. I wanted to scream for help, but there were no doctors present and nurses were all running around. I could do nothing about it.

That was a recurrent theme in all examples: feeling desparate and helpless while facing the inevitable.

In PTSD patients the normal extinction mechanisms don’t work. PTSD patients remain in a state of arousal.

In a longitudinal MRI study Shalev showed that a smaller hippocampal volume is not a necessary risk factor for developing PTSD and does not occur within 6 months of expressing the disorder, thereby dismissing the widely held belief that the volume of the hippocampus is reduced in PTSD patients . (Bonne O et al. Am J Psychiatry. 2001 Aug;158(8):1248-51. Longitudinal MRI study of hippocampal volume in trauma survivors with PTSD.)

Shalev also emphasized that the mere reiteratation of the traumatic event doesn’t help the patient. If the patient is in fear it doesn’t help to bring him to an alley all over again, and to leave the alley again as soon as the patient gets frightened. This only reinforces fear. What should be done is to learn the patient to associate the alley with positive events through psychotherapy. Trust, empathy, friendship can all help as well.

Because extinction is a form of learning some medical treatments given soon after the trauma will not help to reduce the PTSD. In a Randomized Controlled Trial presented at the American College of Neuropsychopharmacology 46th Annual Meeting (December 8-12, 2007), Shalev and coworkers showed that cognitive therapy or prolonged exposure therapy (a type of cognitive behavioral therapy) within 1 month had a reduced prevalence and severity of PTSD at 5 months to 20%, whereas early treatment with a selective serotonin reuptake inhibitor (SSRI) fared no better than individuals randomized to placebo or spontaneous recovery (wait-list) groups (60%). According to Shalev this is a phantastic effect. (Source: Medscape ).

Still, although cognitive therapy is effective, many PTSD patients remain symptomatic despite initial treatment.
————-

This post was (also) written for next Grand Round hosted by Mexican Medical Student. Enrico had a tentative theme in mind (with some flexibility to change it ;) ) but these words should be applicable: renewal, metamorphosis, change, transformation. Well, this story was about how extreme fear can transform you in another person. Furthermore death, referred to in the Bach cantate, is our ultimate transformation.
Finally I hope that Enrico, being both a medical student and a
classical pianist likes Bach.





Visualize your blog (words) with Wordle

3 08 2008

I just discovered Wordle through Thomas of “Biomedicine on Display” (blog of Medical Museion, University of Copenhagen), who wrote several posts on this new web toy. Thomas created a cloud of his own blog links, and of the World top blogs on Health and Medicine. I’m on these clouds, but couldn’t find my name. Can you? (it is weighted according to importance ;) ).

Wordle is a free online Java ap created by Jonathan Feinberg, which generates word clouds from any given URL, RSS-feed, del.icio.us user names, or text you provide. The nice thing is you can tweak your clouds with different fonts, layouts (horizontal, vertical, random etc) and color schemes.

1. Laika’s URL – no english stopwords
2. Laika’s URL – no dutch stopwords

Above are two word-clouds of my blog, created by entering the URL of my blog and removing common words. However, since my blog is bilingual, removing English stop words leaves Dutch stop words and vice versa. Thus the two versions shown above most prominently show the stopwords of the other language, but that gives a funny effect. Wordle only shows the words of recent posts, those posts which show up when you type in the URL.
The variation is endless. Even when you refresh, you get a different picture.

Pictures can be saved online in the “the Gallery”.

3. Laika’s old category cloud – not weighted

Next I created a category cloud from my (old) categories (I need to update them). First I didn’t weight the words, entering each word once (3). But in the next series I gave the categories weight by repeating them as many times as they were used in my blog (4,5). I just show fig. 4, because ‘Social Networking’ was completely out of the cloud, which is -I think- a contradictio in terminis. Really amusing.

5. Category Cloud - weighted

Cat-cloud - weighted

4. Cat-cloud - weighted

Addison's disease info (nvacp)

6. Addison's disease info (NVACP)

Finally I copied the text from a Dutch Patient website (the NVACP) about Addison’s disease (which I have). This illustrate one of the applications of World: you can immediately grasp what the text is about. It can be used to visualize your presentation or even as an educational tool. (e.g. in this post Wordle is used to prepare a school lesson on the environment). But you can use Wordl for many purposes, i.e. make postcards, write a poem etcetera (see this post for some ideas).

Well anyway, playing with Wordle is great fun and a bit addicting.

Want to create your own: click here

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Een heel leuk nieuw web-speeltje: Wordle.
Toevallig leerde ik het kennen via Biomedicine on Display” (blog van het Medical Museion, Universiteit van Copenhagen), waar Thomas enkele berichten over deze applicatie plaatste.

Thomas maakte een woordwolk van zijn blogroll, en van de “Top Health and Medicine Blogs”. Ik sta ergens op deze wolkjes, maar heb ze nog niet kunnen localiseren. Nu ja wat wil je met meer dan 800 blogs, naar belang gerangschikt ;)

Wordle is een gratis Java applicatie, ontwikkeld door Jonathan Feinberg.
World genereert woordwolken vanuit een
URL, RSS-feed, del.icio.us gebruikersnaam of aangeleverde tekst. Het mooie eraan is dat je de wolken op verschillende manieren kunt opleuken. Je kunt heel veel verschillende lettertypen, lay-outs (verticaal horizontaal, kris-kras) en kleurenschema’s toepassen. Plaatjes kun je bewaren in “the Gallery”.

Ik heb eerst woordenwolken van mijn blog gemaakt door de URL in te voeren en de opdracht te geven stopwoorden te verwijderen. Maar mijn blog is twee-talig. Verwijder ik de nederlandse stopwoorden, dan komen juist de engelse stopwoorden prominent in beeld, en vice versa. Maar ach, dat is eigenlijk wel grappig. Wordle toont trouwens alleen een wolk van de laatste berichten, d.w.z. díe berichten die je ziet als je de url intypt. Bij mij gingen de laatste berichten juist over Twitter en PubMed.
Je kunt eindeloos varieren. En zelfs als je ‘refresht’ wordt het plaatje weer helemaal anders qua kleur-compositie.

Vervolgens maakte ik een wolk van mijn (oude) categoriën (althans het is het plan ze drastisch te vernieuwen, er komen nog teveel woorden van de Spoetnikcursus in voor die ik niet meer zal gebruiken). Eerst voerde ik de termen in enkelvoud in (3). Maar daarna gaf ik er gewicht aan door ze zo vaak te kopiëren als ze op mijn blog voorkomen (4,5). Fig 4 laat ik zien omdat ‘Social Networking’ er helemaal buitenhangt, eigenlijk een contradictio in terminis, maar wel amusant.

Addison's disease info (nvacp)

6. Addison's disease info (NVACP)

Tenslotte kopieerde ik tekst over de ziekte van Addison van de Nederlandse Vereniging van Addison en Cushingpatienten (NVACP). Dit illusteert meteen een van de mogelijkheden van Wordle: je ziet in een oogopslag waar de tekst over gaat. Daarom kun je met deze tool gebruiken je presentatie visualiseren, of het als een leermiddel inzetten (zie bijvoorbeeld dit bericht, waar Wordle is gebruikt voor een les over het milieu).

Maar je kunt Wordl op veel manieren toepassen, je kunt er bijvoorbeeld ansichtkaarten mee maken of een gedicht. (zie dit bericht voor enkele ideeen).

Nou, hoe dan ook, een beetje spelen met Wordle is erg leuk èn verslavend.

Wil je zelf aan de slag, klik dan hier!

Binnenkort meer…





Design van de toekomst

21 03 2008

DNA origami
DNA-smileys van Paul Rothemund

Wederom werd mijn oog getrokken door prachtige foto’s op het grensgebied van wetenschap, kunst en design in het NRC van afgelopen vrijdag (Warna Oosterbaan, 14-03-2008). Wat vreemde, maar prikkelende foto’s werden getoond van DNA-smileys gemaakt met behulp van nano-technologie, een bord met vleescreaties uit stamcellen op een bedje van rode kool en runderleer dat in een erlenmeyer op het lab gemaakt wordt. Ik werd een beetje op het verkeerde been gezet door de titel: boetseren met DNA en sperma. Het gaat niet om enge cloneringsexperimenten, maar om een tentoonstelling “Design and the Elastic Mind’ in het Museum of Modern Art (MoMA) in New York. Het thema is veel breder dan een futuristische kijk op de gen-technologie, het gaat erom dat een een elastieken geest (aanpassing!) en intelligent design nodig zijn om het moderne leven te kunnen volgen. Op de website is het volgende te lezen onder het kopje “People and Objects”: “Design has expanded into new fields, including the interactions between people and objects. Responsive design features objects that respond to our needs rather than awaiting our instructions. The tagging of information in our environment makes the world into a live information platform. New interfaces incorporate instinctive human traits, expanding our relationships with the objects they enable us to access. Wel weer ontzettend toevallig dat ik daar net nu tegen aanloop.moma 2

Onderwerpen liggen ook geheel buiten de biologie, zoals bijvoorbeeld cabspotting, het ritme van de wereldstad, grafisch verbeeld door een animatie van het taxiverkeer in San Francisco. Veel op het gebied van de biologie is futuristisch, maar het maken van DNA-smileys met behulp van nanotechnologie blijkt werkelijkheid (zie artikel in Nature over DNA origami (maart 2006)

Voor wie niet naar New York kan afreizen is hier de prachtige website. Goed zijn de tagging en links verbeeld met dwarsverbanden op de overzichtspagina. Elke afzonderlijke foto is getagt en via tags kun je naar andere foto’s met dezelfde tag.





Seeing Science

12 03 2008

seeing science winnaar

Vorige week toen ik me net over Flickr boog en welke foto’s ik nou moest uploaden viel mijn oog op deze prachtige foto, als blikvanger op onze AMC-homepage. Het bleek te gaan om de winnende ‘Seeing science’ foto. ‘Seeing Science’ trok ook al mijn aandacht, het prikkelt mijn fantasie. Het blijkt te gaan om een internationale fotowedstrijd ter gelegenheid van het tweehonderdjarig bestaan van De Koninklijke Nederlandse Akademie van Wetenschap (KNAW) met als motto ‘Magie van wetenschap’.

De foto ‘Fruitvlieglarve in een druppel water’ van de Hongaar Robert Markus combineert volgens juryvoorzitter Frits van Oostrom wetenschap, schoonheid, magie, originaliteit en kunst. Het is een krachtig beeld met een natuurlijke schoonheid en een prachtig voorbeeld van state-of-the-art wetenschap. Robert Markus is onderzoeker aan het Biological Research Center van de Hongaarse Academie van Wetenschappen.

Voor enkele andere geselecteerde foto’s (ook van de andere finalisten): http://www.knaw200.nl/Pages/DEF/155.html

Hier zitten ook enkele juweeltjes bij, zoals ‘Dansende kristallen in de nacht’ van Anna Kozhevnikova en de publieksprijs ‘Conflictmanagement / communicatie’ van Chris Timmers.








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