This article addresses cases of remarkable recoveries related to healing after prayer. We sought to investigate how people who experienced remarkable recoveries re-construct and give meaning to... Show moreThis article addresses cases of remarkable recoveries related to healing after prayer. We sought to investigate how people who experienced remarkable recoveries re-construct and give meaning to these experiences, and examine the role that epistemic frameworks available to them, play in this process. Basing ourselves on horizontal epistemology and using grounded theory, we conducted this qualitative empirical research in the Netherlands in 2016–2021. It draws on 14 in-depth interviews. These 14 cases were selected from a group of 27 cases, which were evaluated by a medical assessment team at the Amsterdam University Medical Centre. Each of the participants had experienced a remarkable recovery during or after prayer. The analysis of the interviews, which is based on the grounded theory approach, resulted in three overarching themes, placing possible explanations of the recoveries within (1) the medical discourse, (2) biographical discourse, and (3) a discourse of spiritual and religious transformation. Juxtaposition of these explanatory frameworks provides a way to understand better the transformative experience that underlies remarkable recoveries. Uncertainty regarding an explanation is a component of knowing and can facilitate a dialogue between various domains of knowledge. Show less
Low-value care is increasingly recognized as a global problem that places strain on healthcare systems and has no quick fix. Verkerk et al. have identified key factors promoting low-value care on a... Show moreLow-value care is increasingly recognized as a global problem that places strain on healthcare systems and has no quick fix. Verkerk et al. have identified key factors promoting low-value care on a national level, proposed strategies to address these and create a healthcare system facilitating delivery of high-value care. In this commentary, we reflect on the results of Verkerk et al. and argue that uncertainty has a crucial role when it comes to reducing low value care. This uncertainty is reflected in lack of a shared view between stakeholders, with clear criteria and thresholds on what constitutes low-value care, and a cross-cutting theme related to the key factors identified. We suggest to work on such a shared view of low-value care and different from implementation efforts to explicitly address uncertainty and its driving cognitive biases grounded in human decision making psychology, to reduce low-value care. Show less
Multigene panel testing is mainly used to improve identification of genetic causes in families with characteristics fitting multiple possible cancer syndromes. This technique may yield uncertainty,... Show moreMultigene panel testing is mainly used to improve identification of genetic causes in families with characteristics fitting multiple possible cancer syndromes. This technique may yield uncertainty, for example when variants of unknown significance are identified. This study explores counsellors' and counselees' experiences with uncertainty, and how they discuss uncertainties and decide about multigene panel testing. Six focus groups were conducted including 38 counsellors. Twelve counselees who had received genetic counselling about a multigene panel test were interviewed. The focus group sessions and interviews were audio-recorded and transcribed verbatim. Transcripts were analysed inductively by two independent coders and data were examined to obtain a comprehensive list of themes. Counsellors identified several uncertainties, e.g. finding a variant of unknown significance, or detecting an unsolicited finding. Most difficulty was experienced in deciding what uncertain information to communicate to counselees and how to do so. The extent and manner of providing uncertain information differed between centres and between counsellors. Counsellors attached more value to counselees' preferences in decision making compared to less extended tests. Counselees experienced difficulty in recalling which uncertainties had been discussed during genetic counselling. They primarily reported to have experienced uncertainty about their own and their relatives' risk of developing cancer. Counselees felt they had had a say in the decision. This study showed that counsellors need more guidance on whether and how to convey uncertainty. Undesirable practice variation in the communication of uncertainty may be prevented by determining what information should minimally be discussed to enable informed decision making. Show less
Worldwide, refugees are increasingly living in uncertainty for undetermined periods of time, waiting for an enduring legal and social solution. In this article, I consider how this experience of... Show moreWorldwide, refugees are increasingly living in uncertainty for undetermined periods of time, waiting for an enduring legal and social solution. In this article, I consider how this experience of waiting is perceived through and influenced by the ubiquity of transnational digital connections, which play a central role in Iraqi refugee households in Jordan. I draw on ethnographic fieldwork conducted among Iraqi refugees in Jordan’s capital Amman to further understand the use of digital technologies in everyday experiences of prolonged displacement. Waiting is an intrinsic affective phenomenon, colored by hope and anxiety. I argue that affective affordances—the potential of different media forms to bring about affects like hope and anxiety—enable Iraqi refugees to reorient themselves to particular places and people. As “no futures” are deemed possible in Jordan or Iraq, digital technologies serve as orientation devices enabling them to imagine futures elsewhere. Through the interplay of media forms, the Iraqi refugees refract their own lives via the experiences of friends and family members who have already traveled onward and who in their perception are able to rebuild a dignified life. Transnational digital connections not only provide a space for hope and optimistic ideas of futures elsewhere but also help to sustain one’s experience of immobility. I argue that using the imagination can be understood as an act of not giving in to structural constraints and might be crucial to making Iraqi refugee life in Jordan bearable. Show less
This study examines the kind of uncertainties frontline tax officials working with a trust based inspection approach experience in interacting with citizen-clients. The classical literature on... Show moreThis study examines the kind of uncertainties frontline tax officials working with a trust based inspection approach experience in interacting with citizen-clients. The classical literature on bureaucracy and the street-level bureaucracy literature suggest frontline officials face two kinds of uncertainties: information and interpretation problems. Analysing stories of Dutch frontline tax officials collected through in-depth interviews, this article shows that these two kinds of uncertainty only explain a part of the uncertainties experienced. Respondents also face action problems requiring improvisational judgements. The study furthermore finds that different sources underlie these uncertainties, pointing to possible explanations. Show less
Background Psychopathy has repeatedly been linked to disturbed associative learning from aversive events (i.e., threat conditioning). Optimal threat conditioning requires the generation of internal... Show moreBackground Psychopathy has repeatedly been linked to disturbed associative learning from aversive events (i.e., threat conditioning). Optimal threat conditioning requires the generation of internal representations of stimulus–outcome contingencies and the rate with which these may change. Because mental representations are imperfect, there will always be uncertainty about the accuracy of representations in the brain (i.e., representational uncertainty). However, it remains unclear 1) to what extent threat conditioning is susceptible to different types of uncertainty in representations about contingencies during the acquisition phase and 2) how representational uncertainty relates to psychopathic features. Methods A computational model was applied to functional neuroimaging data to estimate uncertainty in representations of contingencies (CoUn) and the rate of change of contingencies (RUn), respectively, from brain activation during the acquisition phase of threat conditioning in 132 adolescents at risk of developing antisocial personality profiles. Next, the associations between these two types of representational uncertainty and psychopathy-related dimensions were examined. Results The left and right amygdala activations were associated with CoUn, while the bilateral insula and the right amygdala were associated with RUn. Different patterns of relationships were found between psychopathic features and each type of uncertainty. Callous-unemotional traits and impulsive-irresponsible traits uniquely predicted increased CoUn, while only impulsive-irresponsible traits predicted increased RUn. Conclusions The findings suggest that 1) the insula and amygdala differ in how these regions are affected by different types of representational uncertainty during threat conditioning and 2) CoUn and RUn have different patterns of relationships with psychopathy-related dimensions. Show less
Steen, S.L. van der; Riedijk, S.R.; Verhagen-Visser, J.; Govaerts, L.C.P.; Srebniak, M.I.; Opstal, D. van; ... ; Galjaard, R.J.H. 2016
