Eliciting Tacit Knowledge with a Grammar-targeted Interview Method

Tacit knowledge represents a challenge to knowledge elicitation due to the assumption that this type of knowledge cannot be articulated. We argue that Polanyi's (1966:4) widely cited notion that “we know more than we can tell” represents a weak model of language that does not acknowledge the grammatical patterns in spoken discourse that we, as speakers, apply tacitly. We investigate the hypothesis that individuals articulate what they know through grammatical patterns, referred to as under-representation, without direct awareness. This thesis develops and pilots a grammar-targeted interview method aimed at unpacking specific grammatical features that occur in spoken discourse. The model of language from which these features are derived is Systemic Functional Linguistics. We report findings from three empirical studies of tacit knowledge in corporate organisations where we used the grammar-targeted interview technique to elicit tacit knowledge in the areas of knowledge management, requirements analysis and performance reviews. We compare this interview method with a content-targeted approach. The results show that the grammar-targeted technique produces less under-represented discourse thus allowing tacit knowledge held by the interviewees to be made visible. Based on the linguistic analyses undertaken in these field studies we propose that Polanyi’s expression “we know more than we tell” be reformulated to “we tell more than we realise we know”

Stikstofmonoxide van belang voor de reumatologie?

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New advances in the treatment of gout: review of pegloticase.

Contains fulltext : 89628.pdf (publisher's version ) (Open Access)Treatment-failure gout (TFG) affects approximately 50,000 patients or about 1% of the overall population of patients with gout in the United States of America. The severity of TFG is manifested by frequent acute attacks of disabling arthritis, chronic deforming joint disease, destructive masses of urate crystals (tophi), progressive physical disability, and poor health-related quality of life. Pegloticase (Krystexxa((R)); Savient Pharmaceuticals, Inc), a novel PEGylated urate oxidase (uricase) enzyme, has been resubmitted for US Food and Drug Administration approval. In a 6-month, placebo-controlled clinical trial, 8 mg of pegloticase for every 2 weeks induced a lytic decrease of serum urate (sUr) concentrations, leading to dissolution of tophi in 40% of patients at final visit. However, 58% were nonresponders to the defined target sUr of 0.36 mmol/L (80% were nonresponders during months 3 and 6), possibly due to anti-body formation. Also, 26%-31% experienced infusion reactions (IRs) and 77% suffered from gout flares. Although long-term data are awaited, an anti-inflammatory strategy, eg, based on glucocorticosteroids, is needed to prevent pegloticase antibody formation leading to IRs and diminished or shortened efficacy, and might also prevent gout flares. According to the current clinical data, pegloticase might have an important role as a (bridging) treatment in sUr-responsive patients for tophi clearance in severe chronic refractory gout

Treat to target in gout by combining two modes of action

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Epidemiology of celiac disease in The Netherlands

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Rheumatology meets hepatology in 2012: a clinician's guideline for TNF inhibitors in hepatitis B/C virus carriers.

Item does not contain fulltextEffective and less toxic biologics have revolutionized rheumatology as well as hepatology over the last decennia resulting in higher therapeutic goals. Traditional disease modifying anti-rheumatic drugs (tDMARDs) failing to achieve a quiescent chronic rheumatoid arthritis (RA) or spondylarthropathic arthritis (SA) inflammatory disease, nowadays are to be switched into a more potent strategy with ultimately a combination of tDMARD plus TNF inhibitors (TNFi) early in disease. Patients with previous microbiological infections however present a challenge for a modern rheumatologist aiming at complete remission, particularly in carriers of viral infections. Hepatologists nowadays, can treat chronic hepatitis B and C virus infections effectively with potent antivirals. In the current issue an overview is given regarding patients in whom TNFi may be indicated, but also have been infected with viral hepatitis.1 april 201

Proton transport in a binary biomimetic solution revealed by molecular dynamics simulation

Item does not contain fulltextWe report the simulation results of the proton transport in a binary mixture of amphiphilic tetramethylurea (TMU) molecules and water. We identify different mechanisms that either facilitate or retard the proton transport. The efficiency of these mechanisms depends on the TMU concentration. The overall picture is more complicated than a recent suggestion that the presence of amphiphilic molecules suppresses the proton mobility by slowing down the reorientation of the surrounding water molecules. It has also been suggested that the hydronium ion induces local water orientational order, which results in an ordered region that has to move along with the proton potentially slowing down the proton transport as suggested by experiment. We find that water-wire like structures formed at low amphiphile concentrations facilitate proton transfer, and reduction of the hydrogen bond connectivity induced at high concentrations retards it

Rituximab in cryoglobulinaemic vasculitis, evidence for its effectivity: a case report and review of literature

Item does not contain fulltextCryoglobulinaemia associated with systemic vasculitis mediated by immune complexes is a rare combination. These immune complexes are composed of immunoglobulins and precipitate when exposed to cold temperature. Cryoglobulinaemic vasculitis, treated or untreated, may lead to substantial morbidity and even mortality. Novel targeted therapies may well provide new therapeutic options following or perhaps even prior to the classical cytotoxic therapies. Systemic B cell depletion with rituximab, a chimeric monoclonal antibody against CD20 antigen, is commonly applied in patients with non-Hodgkin's lymphoma or in refractory rheumatoid factor-positive rheumatoid arthritis. Since B cell clones are the source of cryoglobulins, therapeutic effectiveness of rituximab in cryoglobulinaemic vasculitis may be expected. We describe a 72-year-old woman with mixed cryoglobulinaemia type 2, who has successfully been treated with rituximab infusions after failing on prednisone and azathioprine. We reviewed the literature and found 142 cases of cryoglobulinaemic vasculitis, 138 mixed (type 2 or 3) and four, type 1. Rituximab was applied mostly after failure on other treatments. Significant reduction in levels of rheumatoid factor, cryoglobulins and IgM were reported after rituximab therapy. Of the total 142, cases 119 could be evaluated for the response on rituximab therapy, the other 23 cases only regarding side effects. Of the 119 evaluated patients, 71 (60%) had complete response; 28 (23%), partial response and 20 patients (17%), no response. Data were not blinded or placebo-controlled. Side effects were seen in 27 of the 142 patients. Occurrence of the side effects was associated with high baseline levels of cryoglobulins, with a high dose of rituximab infusion of 1,000 mg and with a high level of complement activation. Death was reported four times and was related with the disease