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United States-Caribbean trade relations : geopolitical challenges, economic dynamics and policy pathways
Get PDFThe U.S.-Caribbean relationship sits at a crossroads. As power shifts to a multipolar world,
Caribbean states are moving from dependency to strategic multi-alignment to protect autonomy
and widen partnerships. Despite decades of trade preferences, economies remain narrow and
vulnerable to shocks; COVID-19 has accelerated the pivot. We offer a six-pillar framework -
export diversification, regional integration, and institutional strengthening among them - to
recalibrate ties while honouring sovereignty. The analysis shows how small states can reshape
partnerships for stability and shared prosperity, and how renewed U.S.–Caribbean cooperation can
build regional resilience in an interdependent era.peer-reviewe
Book reviews : Small states and big powers : Portugal and Iceland’s foreign relations
No full textThe role of small states in global politics has, for many years, been considered in the shadow of the great powers. Traditionally, these states were characterised as passive and dependent entities with limited influence on the international stage. However, particularly in the post-Cold War period, there has been increasing focus on the foreign policy behaviour of small states, primarily due to the rise of multipolarity and the development of regional cooperation frameworks. Consequently, this has resulted in a theoretical expansion within the field of international relations and an increase in case studies which facilitate the examination of the flexibility, adaptive capacities, and strategic orientations of small states in the realm of foreign policy. Contrary to the traditional alliance theories, shelter theory, which posits that small states pursue cooperative efforts to fulfil their political, security, economic, and social needs, stands out as an emerging theoretical approach in small state studies.peer-reviewe
Examining the determinants of perceived advertising value and attitudes toward fast-food native advertisements
Get PDFPurpose – Despite the growing popularity of native advertisements among organizations and marketers, there
remains limited research on the factors influencing customers’ perceived value of native advertisements,
particularly in the fast-food industry. Consequently, this study aims to identify the factors influencing the
perceived advertising value of fast-food native advertisements and explore the relationship between advertising
value and customer attitudes.Design/methodology/approach – To address the identified research gap, a closed-ended questionnaire was
employed and administered across social networking sites, and the results were analyzed using SPSS and
SmartPLS.Findings – This study revealed that informative, entertaining, personalized, interactive, credible and nonirritating
fast-food native advertisements positively impact customers’ perceived advertising value. Additionally,
higher levels of value generated by these advertisements result in a more positive customer attitude toward them.Originality/value – By addressing the current research gap, this study provides new theoretical insights into the
literature on native advertisements, as no previous studies have collectively tested these six factors within the
context of native advertisements in the fast-food industry.peer-reviewe
Alcohol use disorder and dual diagnosis : professionals’ perspectives on the provision of services to clients in Malta
Get PDFThis study explores the experiences of professionals providing services to clients with Dual Diagnosis
(DD), focusing on Alcohol Use Disorder (AUD) within the Maltese Islands’ unique sociocultural context,
where alcohol occupies a strong cultural foothold. Against this backdrop, the research examines how
professionals address, treat and manage DD. The study also investigates barriers to treatment, opportunities
for intervention, and the most common co-morbid mental health conditions (MHC) accompanying AUD.
Additionally, it examines the perspectives of professionals on the adequacy of local services for DD clients.
Guided by a qualitative methodology and positioned in an interpretivist biopsychosocial framework, this
study aims to capture the experiences and perspectives of Maltese professionals working in the field of
addiction. Five semi-structured interviews were conducted with a psychologist, a therapeutic facilitator,
two social workers and a psychiatric nurse recruited through purposive sampling from treatment services
in Malta and Gozo. Adopting Braun and Clarke’s six-step Thematic Analysis framework key patterns and
themes were generated from the transcribed interviews. This inductive approach allowed themes to emerge
organically, capturing the rich and nuanced perspectives of participants. A lack of resources, stigma, and
institutional delays were the most frequently mentioned systemic barriers, yet embedded within these
challenges were windows of opportunity, and turning points, such as moments of personal insights, small
but significant achievements and external support that underscored the potential for meaningful change and
recovery. The findings also highlight the need for more integrated service provision. Professionals often
face a fragmented service infrastructure that exacerbates gaps in care, highlighting the pressing need for
cohesive, forward-thinking strategies to address the complex needs of this client group. This study
contributes to the limited research on AUD and DD locally, providing a deeper understanding of the
challenges faced by professionals, and identifying opportunities to enhance service provision. The findings
offer valuable recommendations for culturally sensitive, evidence-based strategies to improve treatment
outcomes for individuals with DD.peer-reviewe
Poor performance of large language models based on the diabetes and endocrinology specialty certificate examination of the United Kingdom
Get PDFIntroduction: The medical knowledge of large language models (LLMs) has been tested using several postgraduate medical examinations. However, it is rarely examined in diabetes and endocrinology. This study aimed to evaluate the performance of LLMs in answering multiple-choice questions using the Diabetes and Endocrinology Speciality Certificate Examination (SCE) of the United Kingdom. Methods: The official diabetes and endocrinology SCE sample questions were used to assess the seven freely accessible and subscription-based commercial LLMs: ChatGPT-o1 Preview (OpenAI, USA), ChatGPT-4o (OpenAI, USA), Gemini (Google, USA), Claude-3.5 Sonnet (Anthropic, USA), Copilot (Microsoft, USA), Perplexity AI (Perplexity, USA), and Meta AI (Meta, USA). The accuracy of LLMs was calculated by comparing outputs against sample answers. Literacy metrics, including Flesch Reading Ease (FRES) and Flesch Kincaid Grade Level (FKGL), were calculated for each response. 83 questions, three of which included photographs, were entered into the LLMs without employing any prompt engineering techniques. Results: A total of 581 responses were generated and captured between August and October 2024. Performance differed significantly between models, with ChatGPT-o1 Preview achieving the highest accuracy (73%). None of the other LLMs achieved the historical pass mark of 65%, with Gemini achieving the lowest accuracy of 33%. Readability metrics also differed significantly between LLMs (p=0.004). LLMs performed better for questions without reference ranges (p<0.001). Conclusions: The performance of LLMs was generally inadequate in the diabetes and endocrinology examination. Of those tested, ChatGPT-o1 Preview achieved the highest score and is likely the most useful model to aid medical education. This may be due to it being an advanced reasoning model with a greater ability to solve complex problems. Nonetheless, continued research is needed to keep pace with the advances in LLMs.peer-reviewe
The International Work Addiction Scale (IWAS) : a screening tool for clinical and organizational applications validated in 85 cultures from six continents
Get PDFBackground and aims: Despite the last decade’s significant development
in the scientific study of work addiction/workaholism, this
area of research is still facing a fundamental challenge, namely
the need for a valid and reliable measurement tool that shows
cross-cultural invariance and, as such, allows for worldwide studies
on this phenomenon. Methods: An initial 16-item questionnaire,
developed within an addiction framework, was administered
alongside job stress, job satisfaction, and self-esteem measures in a
total sample of 31,352 employees from six continents and 85 cultures
(63.5% females, mean age of 39.24 years). Results: Based on
theoretical premises and psychometric testing, the International
Work Addiction Scale (IWAS) was developed as a short measure
representing essential features of work addiction. The seven-item
version (IWAS-7), covering all seven components of work addiction,
showed partial scalar invariance across 81 cultures, while the
five-item version (IWAS-5) showed it across all 85 cultures. Higher
levels of work addiction on both versions were associated with
higher job stress, lower job satisfaction, and lower self-esteem
across cultures. The optimal cut-offs for the IWAS-7 (24 points)
and IWAS-5 (18 points) were established with an overall accuracy
of 96% for both versions. Discussion and conclusions: The IWAS is
a valid, reliable, and short screening scale that can be used in
different cultures and languages, providing comparative and
generalizable results. The scale can be used globally in clinical and
organizational settings, with the IWAS-5 being recommended
for most practical and clinical situations. This is the first study to
provide data supporting the hypothesis that work addiction is a
universal phenomenon worldwide.peer-reviewe
Optimisation of non-contrast CT examinations using tin (Sn) filtration : a systematic review
Get PDFIntroduction: This systematic review explores the impact of Tin (Sn) filtration on radiation dose and image quality improvement in CT. Methods: Using the PICO (Population, Intervention, Comparison, Outcome) framework, the research question was developed: How does the application of Sn filtration as part of an optimisation strategy affect clinical outcomes related to radiation dose and image quality? MeSH search terms derived from this question were input into five databases: PUBMED, Scopus, CINAHL Complete, Cochrane Central, and ProQuest Health & Medical Collection. Studies were independently screened by three experts using PRISMA guidelines. Inclusion criteria focused on adult clinical studies using Sn filtration in non-contrast CT scans alongside iterative reconstruction (IR). Risk of bias was assessed using the JBI critical appraisal tool. Results: A final 39 studies were included for evaluation. Sn with IR was used to optimise scanning in 10 different types of CT examinations. The use of Sn with IR resulted in a significant dose reduction (20–95 %) across all examinations. Most studies did not compare Sn with IR optimised examinations against standard examinations (without Sn) using a consistent, pre-set noise level, and reported an increase in image noise. Conclusion: Sn is an effective dose reduction strategy for non-contrast CT examinations, but its limitations in terms of objective image quality warrant careful consideration by adjusting the IR level. Further studies are needed to confirm this approach. Implications for practice: The findings support broader consideration of Sn filtration beyond its current use in a single CT vendor. However, wider adoption may face barriers such as vendor-specific hardware limitations, cost, and the need for training and protocol optimisation in clinical practice.peer-reviewe
Difficulties and threats related to vessel traffic planning on the Świnoujście–Szczecin fairway
No full textPURPOSE: Commissioning of the dredged Świnoujście–Szczecin fairway in Poland dealt with
the changes in two-way vessel traffic regulations. Currently larger vessels then before can
enter the fairway and may pass each other at the designated passing places. These changes
caused challenges for Vessel Traffic Services operators (VTSOs) who make decisions on
safe vessel traffic planning within the fairway. The aim of the presented study was to
analyze the opinions of VTSOs on the difficulties and threats impacting decision-making
process related to vessel traffic planning on the dredged Świnoujście–Szczecin fairway.DESIGN/METHODOLOGY/APPROACH: The research was carried out using marketing research
method. Difficulties and threats related to vessel traffic planning within the fairway were
identified. A questionnaire survey was carried out among VTSOs working in Vessel Traffic
Services centers in Szczecin and Świnoujście. The achieved results were analyzed and
compared to outcomes of survey carried out in 2022.FINDINGS: Research results analysis revealed that VTSOs consider the accuracy of weather
forecasts, variability of input data for ship traffic planning, as well as variable weather
conditions as the most significant difficulties during vessel traffic planning. According to
practitioners, the major threats were related to failure of VHF communication and
software, as well as delays in vessel maneuvers.PRACTICAL IMPLICATIONS: The research results may be interesting to VTSOs, pilots, employee of
seaports authorities and other entities involved in the planning and organization of vessel
traffic on waterways.ORIGINALITY/VALUE: Difficulties and threats impacting decision-making process related to
vessel traffic planning on the dredged Świnoujście–Szczecin fairway were analysed. The
research results fill in the gap on aspects impacting planning safe navigation of ships within
considered fairway. Recommendations to reduce the impact of selected difficulties and
threats on decision-making process related to vessel traffic planning carried out by VTSOs
were proposed.The authors would like to acknowledge Ministry of Education and
Science (Poland) for financial support of the research conducted within the project
DWD/6/0570/2022.peer-reviewe
ESR Essentials : response assessment criteria in oncologic imaging — practice recommendations by the European Society of Oncologic Imaging
Get PDFAssessing the response to oncological treatments is paramount for determining the prognosis and defining the best
treatment for each patient. Several biomarkers, including imaging, can be used, but standardization is fundamental for
consistency and reliability. Tumor response evaluation criteria have been defined by international groups for
application in pharmaceutical clinical trials evaluating new drugs or therapeutic strategies. RECIST 1.1 criteria are
exclusively based on unidimensional lesion measurements; changes in tumor size are used as surrogate imaging
biomarkers to correlate with patient outcomes. However, increased tumor size does not always reflect tumor
progression. The introduction of immunotherapy has led to the development of new criteria (iRECIST, Level of
Evidence (LoE) Ib) that consider the possibility that an increase in disease burden is secondary to the immune response
instead of progression, with the new concept of Unconfirmed Progressive Disease (a first progression event which
must be confirmed on follow-up). Specific criteria were devised for HCC (mRECIST, LoE IV), which measure only
enhancing HCC portions to account for changes after local therapy. For GIST treated with imatinib, criteria were
developed to account for the possible increase in size reflecting a response rather than a progression by assessing
both tumor size and density on CT (Choi, LoE II). This article provides concise and relevant practice recommendations
aimed at general radiologists to help choose and apply the most appropriate criteria for assessing response to
treatment in different oncologic scenarios. Though these criteria were developed for clinical trials, they may be applied
in clinical practice as a guide for day-to-day interpretation.peer-reviewe
Enhancing workplace safety : addressing psychosocial hazards in modern organizations
Get PDFPURPOSE: The purpose of this article is to analyse the impact of psychosocial hazards on
safety management in organizations, identify key challenges related to minimizing them, and
indicate effective strategies and best practices that support creating a safe work
environment. The article focuses on the significance of psychosocial factors such as
occupational stress, time pressure, interpersonal conflicts, and bullying, and their impact on
the effectiveness of occupational health and safety measures.DESIGN/METHODOLOGY/APPROACH: The study is based on a literature review, an analysis of
legal regulations concerning psychosocial safety, and case studies of organizations
implementing strategies to minimize psychosocial risks. The article attempts to answer the
research question: How do psychosocial risks affect the effectiveness of workplace safety
management, and what preventive mechanisms are most effective in reducing them? The
proposed hypothesis assumes that integrating stress management strategies, developing an
organizational culture that promotes employee well-being, and implementing modern
technologies to monitor psychosocial factors significantly improve the level of safety in the
organization, reduce operational risk, and increase employee engagement and efficiency.FINDINGS: The analysis results indicate that effective organizational safety management
requires considering psychosocial hazards on par with physical and operational risks. Work-related stress, imbalance between professional and private life, and ineffective
communication can lead to increased absenteeism, decreased productivity, and heightened
risk of workplace accidents. The main challenges include a lack of awareness among
management about the consequences of psychosocial hazards, insufficient stress monitoring
mechanisms, and difficulties in integrating well-being policies with organizational business
goals. Among best practices, systematic employee training, promoting open communication,
and implementing digital tools to monitor stress levels and team engagement stand out.PRACTICAL IMPLICATIONS: The practical implications of the study provide organizations with
practical recommendations for more effective management of safety in the context of
psychosocial hazards. Implementing stress management programs, work-life balance
policies, and developing soft skills among managers can contribute to improving employee
well-being and increasing their productivity. The article also emphasizes the need for further
research on the impact of new work models, including hybrid and remote work, on stress
levels and their consequences for organizational safety. In particular, it is important to
develop methods for assessing psychosocial risk and utilizing advanced technologies to
monitor and reduce it.peer-reviewe