University of Medicine Tirana

This paper analyzes two of the most important skills in foreign language learning: listening and speaking, which directly influence the development of communicative competence as the main objective of the teaching and learning process in a foreign language. Listening and speaking skills, known as macro-skills, alongside reading and writing, are developed through specific didactic activities centered on the two key actors of the learning process: the student on the one hand and the teacher on the other. Listening constitutes the foundation of language acquisition, as through it students are exposed to linguistic structures, intonation, rhythm, and communicative context. On the other hand, speaking requires not only linguistic knowledge but also the ability to organize thoughts, respond in real time, and interact effectively. The integration of these two skills creates a dynamic and challenging process that leads to the achievement of comprehensive communicative competence — linguistic, emotional, interpretative, critical, and constructive.

Supportive family and peer relationships foster healthy development and enhance adolescents' capacity to thrive despite adverse life circumstances. Our aim was to assess the association of family support and peer support with selected mental health indices of adolescents, controlling for a wide range of sociodemographic characteristics and behavioural factors. A cross-sectional study, conducted in Albania in 2022, included a nationwide representative sample of 5454 adolescents aged 11, 13, and 15 years (≈52% girls; overall response: ≈96%). Data on mental health indices [Cantril's ladder-based life satisfaction measure, WHO-5 wellbeing index, and GAD-7], family support and peer support, and sociodemographic and behavioural factors were collected. General linear model and binary logistic regression were used to assess the independent associations of family support and peer support with mental health indices. In fully-adjusted models, mean values of all three mental health indices were higher (indicating better mental health) among adolescents with high levels of family support and/or peer support compared with their counterparts without high support levels (P < .001 for all). Furthermore, the odds of 'high life satisfaction', 'good mood', and 'little/no anxiety' were all higher among adolescents who reported high family support and/or peer support compared to those without high support levels (P < .001 for all). High peer support levels and especially high family support levels were strongly and independently associated with better mental health outcomes among adolescents in Albania. Our findings highlight the importance of fostering supportive social environments to promote youth mental wellbeing across diverse sociodemographic and behavioural contexts.

Energy generation, transmission, distribution, and consumption are vital activities that promote the growth of Albania's economy.The energy sector is an essential component of this sector, and it is responsible for all of these activities.There is a direct correlation between the dependability of the energy supply and the growth of the economy as well as the safety of its customers.Throughout the course of this article, the significance of implementing environmentally friendly digital skills and robust cybersecurity measures into Albania's energy sector is highlighted.The report analyses the new technologies that are causing industries to undergo transformations, and it demonstrates how these technological advancements are affecting the way people work and the skills they require.As a result of the findings of this study, it is clear that updated training and education programs are required in order to provide workers with the necessary skills to deal with the simultaneous crises of digital security and environmental preservation.In light of these transformations, it is necessary to make modifications to the education and training systems.

Volleyball performance relies on repeated explosive movements such as jumping and spiking, which are determined by the interaction of biomechanical efficiency, neuromuscular coordination, physiological fitness, and body composition; however, comprehensive investigations integrating these determinants remain limited.This study aimed to examine the biomechanical and physiological determinants of jumping and spiking performance in competitive volleyball players, with particular emphasis on the influence of body composition on force-time characteristics and mechanical efficiency.Twenty-four competitive volleyball players participated in a crosssectional design and were classified into lower and higher skinfold groups based on the median value of six skinfold measurements.Anthropometric assessments were conducted, while biomechanical performance was evaluated using force-platform analysis during countermovement and volleyball-specific spike jumps.Performance variables including jump height, peak force, and peak power, expressed in both absolute and relative terms, were analyzed using independent samples t-tests, effect size calculations, and Pearson correlation coefficients.Athletes in the lower skinfold group demonstrated significantly greater countermovement and spike jump heights, along with superior absolute and relative force and power production, compared with players presenting higher subcutaneous fat mass.The largest between-group differences were observed in relative mechanical variables, highlighting the importance of normalizing performance outputs to body mass.Additionally, subcutaneous fat thickness showed strong negative associations with all biomechanical performance indicators, particularly relative peak power.Considering athletic performance within a broader human ecology perspective, environmental factors such as indoor training conditions, air quality, and thermal comfort may further influence neuromuscular efficiency and fatigue resistance during highintensity volleyball activities.Overall, the findings indicate that lower subcutaneous fat mass is strongly associated with improved explosive performance and biomechanical efficiency in volleyball-specific movements.This study provides an integrated biomechanical and anthropometric framework linking body composition to force-platform derived performance variables and supports the systematic integration of body composition monitoring and biomechanical assessment in volleyball training and performance optimization.

Abstract The effect of natural blue space on subjective well‐being and self‐perceived stress among residents of Përmet, Albania ( N = 203), with 80.3 per cent of whom reside within 1 km of the Vjosa River was examined. Three exposure indicators – visit frequency, proximity and time spent in the river surroundings – were focused on using the PYER framework (PY = physical activity; E = exposure; R = years of residence). Moderation models and structural equation modelling with Emotional Attachment to the River (EAR) as a mediator were included in the analyses. It was indicated by the results that physical activity near the river is strongly associated with stress reduction, whereas the benefits for well‐being depend on interactions among activity, visit frequency and residency duration. Stress reduction was partially mediated by EAR, with visit frequency identified as the strongest predictor. The findings also indicate that frequent and high‐quality interaction with wild rivers are enhanced for mental health, particularly among long‐term residents, by whom stronger emotional bonds are developed through repeated use.

Our aim was to assess the psychometric properties of the “EORTC QLQ-PR25” in Albania and to determine the links between disease characteristics and treatment in men with prostate cancer. A study conducted in Tirana during April 2024–December 2025 included 74 consecutive men diagnosed with prostate cancer who completed the EORTC QLQ-PR25 questionnaire (response: ≈94%). The EORTC QLQ-PR25 demonstrated excellent internal consistency across all subscales (Cronbach’s alpha range: 0.85-0.91), with very high reliability for the overall scale (α=0.94). Higher symptom burden and poorer overall quality-of-life were significantly associated with radical prostatectomy, metastatic disease, high Gleason score (9-10), and extracapsular tumour spread (all P&lt;0.05). Patients undergoing radical prostatectomy reported the worst outcomes across all symptom domains, as well as the lowest general quality-of-life and health status scores. Seemingly, the EORTC QLQ-PR25 is a reliable and clinically valid instrument for assessing prostate cancer-specific quality-of-life among Albanian men. Also, symptom burden and quality-of-life impairment were strongly associated with disease severity and invasive treatment. Our findings support the integration of patient-reported outcomes into routine prostate cancer care in Albanian-speaking countries.

Background/Objectives: Multilayer zirconia restorations can feature a shade gradient or a strength gradient, with layers differing in color or phase composition within the same material. The aim of this in vitro study was to evaluate the color stability in all layers of multilayer zirconia after exposure to staining solutions and artificial aging. Methods: Square-shaped specimens (N = 120) of color A2 were fabricated from 4Y-PSZ and 3Y/4Y-PSZ multilayer zirconia-Katana STML, DD Cube One ML, and Katana YML-and their baseline color values (T0) were measured with a clinical spectrophotometer (VITA Easyshade V). The specimens were randomly divided into four groups (n = 10/gp) and immersed in physiologic solution, 0.2% chlorhexidine gluconate (CHX) mouth rinse, and staining coffee solution. Then, they were measured continuously for 7 (T1), 14 (T2), and 21 days (T3). The last group of specimens underwent accelerated aging in a steam autoclave at 134 °C and 2 bar pressure and measured after 1 (T1), 3 (T2), and 5 h (T3). After the immersion process and artificial aging, discoloration values (ΔE) were calculated using the formula ΔE = [(ΔL*)2 + (Δa*)2 + (Δb*)2]1/2 and analyzed with the SPSS v 23.0 software with a p value < 0.05. Results: All specimens showed significant color differences in the T3 measurements after exposure to coffee and CHX, with the highest ΔE values in the enamel layers. Katana YML showed the most significant differences in ΔE in the cervical layers after exposure to artificial aging. Conclusions: Multilayer zirconia exhibited dependent optical changes, with the enamel layers being the most affected after exposure to staining solutions. Gradient pigmentation and differences in phase composition caused differences in color to the multilayer zirconia layers after exposure to staining solutions and artificial aging.