The Acquisition of High Quality Experience

The search for knowledge has continued to expand to new domains since its start in the seventeenth century. Some of them have proved unusually resistant. Methods have had to proliferate to deal with the obstacles, for example in the social domain. There also have been ideological reactions. Surprisingly frequently, methods and activities that appear to be effective in dealing with such domains are classified as "preliminary" or are distinguished by a "point of view" that has yet to be transcended to achieve "true" knowledge. One such activity is the acquisition of high quality experience. It is argued in the paper that it does not deserve being treated as a poor relative. It has a history of its own and can point to many successes, for example in the development of new values and emotions. Its only drawback seems to be that the search for high quality experiences has tended to be heuristic, or if one wishes, artistic. This situation is changing, however. In the paper the differences between the acquisition of knowledge and that of high quality experience are delineated. It is argued that facilitation of the latter's searches requires the development of interactions between entities that generate and structure experiences--i.e., of human collectives that stabilise sufficiently to execute a collective action in their environment. They are characterised by the use of coordinating languages

Improving Non-observational Experiences: Channelling and Ordering

That the present day society profits from research in many areas is evident. This has stimulated a keen desire to emulate similarly advantageous contributions in other areas. It appears to imply not only a need to know how to (better) support action in general or any action, but also how to support the act of making "better" itself (better businesses, better houses, better emotions, better objectives, etc.). Developing the latter type of knowledge has proved to pose a major challenge, however. Although the challenge has been taken up in areas such as social policy, economics, therapy, management, architecture, design, and others, leading to a number of responses, a complete characterisation seems still to be lacking. Such a characterisation is attempted in this article. Typical characteristics are the inclusion of non-observational experiences and a simultaneous striving for individual and collective high quality

Immaculateness and Research Practice

Notions of purity, perfection, or immaculateness have powered our imagination over the ages. Various images of perfection have held sway in their hallowed times, providing secure streams for channelling human energy. Unfortunately, with the unfolding of the human drama on the world stage, all the images of perfection have suffered damage, epoch on epoch. Different responses have emerged to attempt a restoration. Revival of some of the old images is one such response. Production of new images to serve as worthwhile anchors of value and meaning is another common response. For reasons possibly known only to philosophers and historians, the enterprise called modern science has got thickly embroiled in this civilisational process--first, as the culprit behind the decline of some of the established images, then as the producer of new images, and now, perhaps, as a constant reminder of the perpetual lack of purity and immaculateness in all things human

Making friends with windmills: building territorial capital

The role of community engagement in the development of sustainable territorial capital and territory-based governance is explored. The aim is firstly, to describe the development of a community that started in 2006 in a Nottinghamshire village1 and secondly, to identify what might be learned. The latter is argued to take the form of research principles. The challenges to the development of the community included the coordination of the variety of purposes of the participants. The central tenet of the research principles is the initiation of sustainable interactions that support the improvement of individual life. The principles differ from those of traditional research, but they are shown to belong to the same class as the latter. In the example a sustainable support system was described that enhanced individual activities without the need for a collective preference or some individual’s dominance

Micro-businesses' contributions to territorial capital: visiting different research approaches

This paper is part of an ongoing research. Throughout it, different approaches to link micro-businesses activities with the development of territorial capital are visited. Five vignettes are provided to illustrate how these research approaches operate. Reflecting on each approach provides practical implications about the building and maintenance of some of the collective resources associated to ‘territorial capital’. Adding on previous economists’ understandings of territorial capital, this paper identifies an alternative research procedure that suggests how to develop and maintain some elusive dimensions of territorial capital, such as social, relational and human capital, and cooperation networks

Cerebellar transcranial direct current stimulation interacts with BDNF Val66Met in motor learning

Background: Cerebellar transcranial direct current stimulation has been reported to enhance motor associative learning and motor adaptation, holding promise for clinical application in patients with movement disorders. However, behavioral benefits from cerebellar tDCS have been inconsistent. Objective: Identifying determinants of treatment success is necessary. BDNF Val66Met is a candidate determinant, because the polymorphism is associated with motor skill learning and BDNF is thought to mediate tDCS effects. Methods: We undertook two cerebellar tDCS studies in subjects genotyped for BDNF Val66Met. Subjects performed an eyeblink conditioning task and received sham, anodal or cathodal tDCS (N = 117, between-subjects design) or a vestibulo-ocular reflex adaptation task and received sham and anodal tDCS (N = 51 subjects, within-subjects design). Performance was quantified as a learning parameter from 0 to 100%. We investigated (1) the distribution of the learning parameter with mixture modeling presented as the mean (M), standard deviation (S) and proportion (P) of the groups, and (2) the role of BDNF Val66Met and cerebellar tDCS using linear regression presented as the regression coefficients (B) and odds ratios (OR) with equally-tailed intervals (ETIs). Results: For the eyeblink conditioning task, we found distinct groups of learners (MLearner = 67.2%; SLearner = 14.7%; PLearner = 61.6%) and non-learners (MNon-learner = 14.2%; SNon-learner = 8.0%; PNon-learner = 38.4%). Carriers of the BDNF Val66Met polymorphism were more likely to be learners (OR = 2.7 [1.2 6.2]). Within the group of learners, anodal tDCS supported eyeblink conditioning in BDNF Val66Met non-carriers (B = 11.9% 95%ETI = [0.8 23.0]%), but not in carriers (B = 1.0% 95%ETI = [-10.2 12.1]%). For the vestibulo-ocular reflex adaptation task, we found no effect of BDNF Val66Met (B = −2.0% 95%ETI = [-8.7 4.7]%) or anodal tDCS in either carriers (B = 3.4% 95%ETI = [-3.2 9.5]%) or non-carriers (B = 0.6% 95%ETI = [-3.4 4.8]%). Finally, we performed additional saccade and visuomotor adaptation experiments (N = 72) to investigate the general role of BDNF Val66Met in cerebellum-dependent learning and found no difference between carriers and non-carriers for both saccade (B = 1.0% 95%ETI = [-8.6 10.6]%) and visuomotor adaptation (B = 2.7% 95%ETI = [-2.5 7.9]%). Conclusions: The specific role for BDNF Val66Met in eyeblink conditioning, but not vestibulo-ocular reflex adaptation, saccade adaptation or visuomotor adaptation could be related to dominance of the role of simple spike suppression of cerebellar Purkinje cells with a high baseline firing frequency in eyeblink conditioning. Susceptibility of non-carriers to anodal tDCS in eyeblink conditioning might be explained by a relatively larger effect of tDCS-induced subthreshold depolarization in this group, which might increase the spontaneous firing frequency up to the level of that of the carriers

Gender differences in the use of cardiovascular interventions in HIV-positive persons; the D:A:D Study

Peer reviewe

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe