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Smart farming technologies are primarily associated with the transformation of agricultural productivity. Despite this, empirical research focusing on farm-level application of smart farming reveals a more complex and nuanced picture characterised by considerable uncertainty over its implementation and use. In this paper we seek to extend farm-level research by investigating two questions: how do perceived uncertainties destabilise meso-scale actors' routines and practices that are critical for 'supporting farmer learning about the nature of digital data and its interpretation' (Eastwood et al., 2019: 8); and, in what ways do meso-scale actors seek to re-establish a sense of stability and, in doing so, manage the uncertainty associated with smart farming implementation, and technological change more broadly? To address these questions we investigate the findings from a qualitative study of 20 meso-scale actors involved in the planning and implementation of smart farming technology in the Australian rice industry through an ontological security lens. We refer to meso-scale actors as farm advisors and agronomists whom we argue play a critical role in the uptake of smart farming technology. In applying this lens we argue that the perceived uncertainties related to smart farming de-stabilise or de-securitise actors' day-to-day roles and routines, impacting on who they are and what they do. We then demonstrate that actors draw upon two specific cultural scripts as a way to re-securitise their uncertainty. The first script seeks to securitise resource uncertainty by drawing upon known discourses surrounding farmer adoption of technology, while the second reproduces the importance of technologies that are easy to adopt while downplaying the importance of smart farming technology. While at face value these scripts can appear to create barriers to smart farming adoption, we argue that they can be a catalyst for developing solutions to uncertainty in terms of making smart farming more workable at the farm-level. • Smart farming technology can be complex, characterised by considerable uncertainty over its implementation and use. • Uncertainties de-stabilise or de-securitise actors' day-to-day roles and routines, impacting on who they are and what they do. • Actors draw upon cultural scripts as a way to re-securitise their uncertainty. • Cultural scripts can enable solutions to uncertainty in terms of making smart farming more workable at the farm-level. [ABSTRACT FROM AUTHOR]

MEDICAL decision making, DECISION making, MEDICAL care, GYNECOLOGY, and MEDICAL care costs

Medicine is, in its essence, decision making under uncertainty; the decisions are made about tests to be performed and treatments to be administered. Traditionally, the uncertainty in decision making was handled using expertise collected by individual providers and, more recently, systematic appraisal of research in the form of evidence-based medicine. The traditional approach has been used successfully in medicine for a very long time. However, it has substantial limitations because of the complexity of the system of the human body and healthcare. The complex systems are a network of highly coupled components intensely interacting with each other. These interactions give those systems redundancy and thus robustness to failure and, at the same time, equifinality, that is, many different causative pathways leading to the same outcome. The equifinality of the complex systems of the human body and healthcare system demand the individualization of medical care, medicine, and medical decision making. Computational models excel in modeling complex systems and, consequently, enabling individualization of medical decision making and medicine. Computational models are theory- or knowledge-based models, data-driven models, or models that combine both approaches. Data are essential, although to a different degree, for computational models to successfully represent complex systems. The individualized decision making, made possible by the computational modeling of complex systems, has the potential to revolutionize the entire spectrum of medicine from individual patient care to policymaking. This approach allows applying tests and treatments to individuals who receive a net benefit from them, for whom benefits outweigh the risk, rather than treating all individuals in a population because, on average, the population benefits. Thus, the computational modeling-enabled individualization of medical decision making has the potential to both improve health outcomes and decrease the costs of healthcare. [ABSTRACT FROM AUTHOR]

CLINICAL trials, JUDGMENT (Psychology), MEDICAL research, HEALTH outcome assessment, UNCERTAINTY, PROPORTIONAL hazards models, and STATISTICAL models

Background: Uncertain ascertainment of events in clinical trials has been noted for decades. To correct possible bias, Clinical Endpoint Committees (CECs) have been employed as a critical element of trials to ensure consistent and high-quality endpoint evaluation, especially for cardiovascular endpoints. However, the efficiency and usefulness of adjudication have been debated. Methods: The multiple imputation (MI) method was proposed to incorporate endpoint event uncertainty. In a simulation conducted to explain this methodology, the dichotomous outcome was imputed each time with subject-specific event probabilities. As the final step, the desired analysis was conducted based on all imputed data. This proposed method was further applied to real trial data from PARADIGM-HF. Results: Compared with the conventional Cox model with adjudicated events only, the Cox MI method had higher power, even with a small number of uncertain events. It yielded more robust inferences regarding treatment effects and required a smaller sample size to achieve the same power. Conclusions: Instead of using dichotomous endpoint data, the MI method enables incorporation of event uncertainty and eliminates the need for categorizing endpoint events. In future trials, assigning a probability of event occurrence for each event may be preferable to a CEC assigning a dichotomous outcome. Considerable resources could be saved if endpoint events can be identified more simply and in a manner that maintains study power. [ABSTRACT FROM AUTHOR]

COMMUNICATION, DIAGNOSTIC imaging, LANGUAGE & languages, PATIENT-professional relations, CULTURAL pluralism, PROFESSIONS, RADIOGRAPHY, RADIOLOGIC technologists, UNCERTAINTY, JOB performance, OCCUPATIONAL roles, PSYCHOSOCIAL factors, COMMUNICATION barriers, and CULTURAL competence

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

CANCER patients, SERVICES for caregivers, PALLIATIVE treatment, QUALITY of life, QUESTIONNAIRES, STATISTICAL sampling, SATISFACTION, T-test (Statistics), UNCERTAINTY, PILOT projects, WELL-being, RANDOMIZED controlled trials, TREATMENT effectiveness, CAREGIVER attitudes, DATA analysis software, DESCRIPTIVE statistics, NURSING interventions, and ATTITUDES toward illness

This pilot study aimed to assess the feasibility and possible effects of the "PalliActive Caregivers," nursing intervention, on the uncertainty in illness and quality of life of family caregivers of patients with cancer receiving palliative care. This pilot study used a randomized controlled design. The participants were 80 family caregivers. The experimental group received the novel "PalliActive Caregivers" intervention. Data were collected using a sociodemographic form, the Uncertainty in Illness Scale, the Quality of Life scale, and an Intervention satisfaction questionnaire. The caregivers who received the intervention "PalliActive Caregivers" reported a high degree of satisfaction (9.74 on a 10-point scale). The intervention showed a significant decrease in uncertainty regarding illness in the experimental group (P =.009), as well as a significant decrease in the psychological well-being of quality of life within the experimental and control groups, before and after the intervention (P =.013, P =.010). It is recommended that future studies using the "PalliActive Caregivers" intervention examine the effects on other variables such as the burden of patient's symptoms, caregiver burden and rewards, self-efficacy in symptom management, competence, unmet needs, and satisfaction with care. [ABSTRACT FROM AUTHOR]

DIGNITY, DISCUSSION, EXPERIENCE, PHENOMENOLOGY, PSYCHOLOGY of refugees, UNCERTAINTY, QUALITATIVE research, and THEMATIC analysis

For newly arrived asylum seekers, a health examination is common practice in many countries. For asylum seekers, this part of the asylum-seeking process can be experienced as a burden due to communication barriers, feelings of mistrust and insecurity and the experience of being an object rather than an individual. The aim of this study was to explore asylum seekers' lived experiences of dignity while undergoing a health examination. Eight asylum seekers participated in individual in-depth interviews. A phenomenological hermeneutical approach was used to analyse the collected data. The study is reported in accordance with COREQ guidelines. The lived experience of dignity was linked to dignity violation as well as to dignity safeguarded. The participants experienced anxiety about how they would be received. Some were met with kindness and care, but there were also many incidents of demeaning behaviour. With an interpreter present, the participants experienced that they could not speak freely. Numerous healthcare personnel and frequent transfers caused confusion and insecurity. Well-organised health centres made participants experience a sense of safety and respect. The results can be understood as a pattern consisting of four categories: rights-related, care-related, communication-related and system-related. This small study, which limits the conclusions that can be drawn, conveys that ethical awareness and professional expertise may contribute to safeguarding asylum seekers' dignity in the above categories during a health examination. [ABSTRACT FROM AUTHOR]

PETROLEUM sales & prices, PETROLEUM, CHINA-United States relations, UNCERTAINTY, and INDUSTRIAL capacity

The contribution of this paper is threefold: first, it introduces a new geopolitical risk index that incorporates recent geopolitical events ignored in Caldara and Iacoviello (2018)'s index. In addition to war threats and acts, terrorist threats and acts and nuclear threats, the new indicator accounts for global trade tensions, the changing fundamentals of U.S.-China relations, the escalated U.S.-Iran conflict, Saudi Arabia's uncertainty, Venezuela's crisis, and OPEC news that rise in response to important OPEC meetings and events connected with OPEC production levels. Second, it addresses how the volatility of six oil prices (the Nigerian Bonny Light, Brent, Dubai, OPEC, Tapis, and WTI) behave when the developed geopolitical risk index unexpectedly changes. Third, it examines whether OPEC maintains a buffer of spare capacity that it uses to respond to potential crises that reduce oil supplies. We show that an increase in the geopolitical risk index is significantly associated with unanticipated oil price changes, though with varying sensitivities. Our findings also reveal that OPEC's use of spare capacity reduces the reaction of oil price to geopolitical risks but moderately, thus suggesting a limited stabilizing influence on the oil market. The limited amount of spare production capacity leaves the oil market on a knife's edge as it deals with a host of potential supply disruptions stemming from geopolitical issues. [ABSTRACT FROM AUTHOR]

CAREGIVERS, PSYCHOLOGY of caregivers, CONFIDENCE, COUGH, HEALTH education, HEALTH services accessibility, HOME care services, INTERVIEWING, RESEARCH methodology, NEUROMUSCULAR diseases, PATIENT satisfaction, PROFESSIONS, RESEARCH funding, RESPIRATORY insufficiency, SELF-management (Psychology), TEACHING, UNCERTAINTY, QUALITATIVE research, JUDGMENT sampling, THEMATIC analysis, INSUFFLATION, DATA analysis software, DESCRIPTIVE statistics, and ADULTS

BACKGROUND: In 2014, the Ministry of Health of Ontario, Canada, approved a program of public funding for specialist-prescribed mechanical insufflation-exsufflation (MI-E) devices for home use by individuals with neuromuscular respiratory insufficiency. Since 2014, 1,926 MI-E devices have been provided, exceeding device-use projections. Few studies describe the initial and ongoing education and support needs of home MI-E users and their family caregivers. This study aimed to explore the requirements of initial and ongoing education and support for MI-E device use, user confidence, and barriers and facilitators to home MI-E. METHODS: We conducted semi-structured interviews with new (< 6 months) and established (6-48 months) MI-E users and family caregivers. Device users rated their confidence on a numeric rating scale of 1 (not confident) to 10 (very confident). RESULTS: We recruited 14 new and 14 established MI-E users and caregivers (including 9 dyads), and we conducted 28 interviews. Both new and established users were highly confident in use of MI-E (mean ± SD scores were 8.8 ± 1.2 and 8.3 ± 2.1, respectively). Overall, the subjects were satisfied with their initial education, which consisted of a 1-2 h one-on-one session at home or in the clinic with a device demonstration and hands-on practice. Subjects viewed hands-on practice and teaching of caregivers as more beneficial than written materials. Ongoing support for device use was variable. Most subjects indicated a lack of specific follow-up, which resulted in uncertainty about whether they were using the MI-E device correctly or whether MI-E was effective. Facilitators to device utilization were ease of use, initial training, support from formal or informal caregivers, and symptom relief. Barriers were inadequate education on MI-E purpose, technique, and benefit; lack of follow-up; and inadequate knowledge of MI-E by nonspecialist health providers. CONCLUSIONS: The current model of home MI-E education at initiation meets user and caregiver needs. Better ongoing education and follow-up are needed to sustain the benefits through assessment of MI-E technique and its effectiveness. [ABSTRACT FROM AUTHOR]

SERVICE sector, HEISENBERG uncertainty principle, UNCERTAINTY, BUSINESS development, and TECHNOLOGICAL innovations

• Detailed view to a water innovation process in a resource-constrained environment. • Diversity of resource-constrained innovation uncertainties described and identified. • Capabilities of different partners leveraged to manage uncertainties. • Partners can be multiple and differ depending on the need and process stage. • Successful innovation management is needed to foster sustainability in water sector. Innovation processes face significant and not well-understood uncertainties in resource-constrained environments in developing countries. Through a case study of a water innovation process focused on Kenya, this article studies the prevailing uncertainties and management principles. With the help of a framework that combines information on technological, organizational, commercial and social aspects, our study identifies uncertainties in four distinctive stages of resource-constrained innovation: (1) Ideation and conceptualization, (2) Learning-based product and business development, (3) Scrutinized product and business development and (4) Commercialization. We recognize three principles required to manage uncertainties and develop successful resource-constrained innovations: (1) the utilization of versatile research and development approaches, (2) building internal acceptability, trust and legitimacy and (3) leveraging range of partnerships and networks to access complementary resources and capabilities in different process stages. Our findings suggest that management of uncertainties requires proactive utilization of partner networks and context-specific strategies in different stages. With this research, we contribute to the understanding of innovation processes by advancing process-based knowledge of water innovation, uncertainties and related management strategies in resource-constrained environments. [ABSTRACT FROM AUTHOR]

ECONOMIC policy, ENERGY consumption, ECONOMIC expansion, UNCERTAINTY, and ENERGY policy

The study uses the World Uncertainty Index to analyze the long-run relationship of economic policy uncertainty and energy consumption for countries with high geopolitical risk over the period 1996–2017. The Kao test shows a cointegration association between energy consumption, economic growth, geopolitical risk, economic policy uncertainty, and carbon dioxide (CO 2) emissions. The results based on the Panel Pooled Mean Group-Autoregressive Distributed lag model (PMG-ARDL) show that energy consumption and economic growth contribute to (CO 2) emissions. Additionally, there is a significant association between economic uncertainty and CO 2 emissions in the long-run. The panel causality analysis by Dumitrescu and Hurlin (2012) shows a bidirectional relationship between CO 2 emissions and energy consumption, economic policy uncertainty and CO 2 emissions, economic growth and CO 2 emissions, but a unidirectional causality from CO 2 emissions to geopolitical risks. The findings call for vital changes in energy policies to accommodate economic policy uncertainties and geopolitical risks. [ABSTRACT FROM AUTHOR]