University of Vlorë

To analyse the effect on fasting glucose levels after one month of PTH 1-34 treatment in postmenopausal women with osteoporosis. Twenty-six postmenopausal women treated with PTH 1-34 were enrolled. Patients with glucose ≥ 110mg/dl and/or glycosylated hemoglobin > 48 mmol/mol were excluded. At baseline and after one month treatment, we measured fasting serum glucose, calcium, creatinine, PTH, 25(OH)vitamin D, OPG, RANKL, and BALP. Standardized questionnaires were administered to assess dietary caloric intake and physical activity. After one month, patients were divided according to the increase (group A) or decrease of glucose (group B). We found no difference between these two groups as regards anthropometric, biochemical evaluation, DXA measurements, dietary caloric intake, physical activity and fractures at baseline. There was no difference between groups in the number of patients treated before with bisphosphonates. Dietary caloric intake and physical activity after one month of therapy were not different in both groups. The mean delta glucose decrease after one month was 7%±4% in group B while the delta increase was 8%±5% in group A, p = 0.001. The only statistically significant difference between these groups, after one month, was an increase in mean delta BALP in group B compared to group A (group B:19 ± 23% vs. group A -0.7 ± 7, p = 0.04). Mean delta vitamin D and OPG increased, while mean delta PTH and RANKL decreased in both groups, without statistically significant differences between groups. PTH 1-34 decreases mean serum glucose levels when bone formation is increased, as suggested by a significant increase in BALP in this group.

Background: Medication adherence is essential for managing chronic conditions, while non-adherence remains a widespread issue, leading to poorer health outcomes and higher healthcare costs. This study aimed to identify key adherence barriers, explore their relationship with patient satisfaction, and assess their impact on overall well-being among ambulatory patients in Albania. Methods: A cross-sectional study was conducted in three public urban health centers in Vlora, Albania, between November 2024 and January 2025. A total of 80 ambulatory patients were recruited using convenience sampling. Data were collected through face-to-face interviews using validated questionnaires, including the Adherence Barriers Questionnaire (ABQ), the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), and the Patient Health Questionnaire (PHQ-9) for depression screening. Results: The study included 80 ambulatory patients (mean age 66.7 years; 48.7% female), predominantly diagnosed with diabetes (42.5%) and rheumatic diseases (36.3%). All participants reported at least one adherence barrier, with 92.5% experiencing multiple barriers. The most common were financial burden (91.3%) and fear of side effects (77.5%). A significant positive correlation was found between adherence barriers and depression severity (ρ = 0.518, p < 0.0001), while patient satisfaction did not significantly influence adherence barriers (ρ = -0.217, p = 0.053) or depression severity (ρ = -0.004, p = 0.969). Multiple regression analysis showed that higher depression severity (p = 0.0049) was significantly associated with greater adherence barriers, while postgraduate education was associated with fewer barriers (p = 0.0175). Conclusions: Financial burden, fear of side effects, and psychological distress are key barriers to adherence among Albanian ambulatory patients. Although there are limitations inherent to the cross-sectional design and modest sample size, our findings highlight the potential benefit of routine mental health screening, targeted financial support, and improved patient education on medication management within primary care. These insights may help inform future research and interventions aimed at enhancing adherence and overall well-being. Patient satisfaction did not significantly impact adherence or depression. Targeted interventions focusing on financial support, mental health care, and patient education are needed to improve adherence and patient well-being. These findings underscore the need for integrated mental health and adherence support strategies within routine primary care services.

BackgroundThe European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010.MethodsWe used the Global Burden of Disease 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardised death, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) rates for Level 2 causes, as well as life expectancy and healthy life expectancy (HALE).ResultsIn 2019, the age-standardised death and DALY rates in the EU were 465.8 deaths and 20,251.0 DALYs per 100,000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases in age-standardised death and YLL rates across EU countries. However, YLD rates remained mainly unchanged. The largest decreases in age-standardised DALY rates were observed for “HIV/AIDS and sexually transmitted diseases” and “transport injuries” (each -19%). “Diabetes and kidney diseases” showed a significant increase for age-standardised DALY rates across the EU (3.5%). In addition, “mental disorders” showed an increasing age-standardised YLL rate (14.5%).ConclusionsThere was a clear trend towards improvement in the overall health status of the EU but with differences between countries. EU health policymakers need to address the burden of diseases, paying specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease.

Qëllimi I këtij punimi është të pasqyroj drejt analizën e shtetit të së drejtës në Shqipëri, të nxjerr në pahë problematikat për instutucionet shqiptare dhe të nxjerr rekomandime dhe sugjerime për mirëfuksionimin e instutucioneve dhe shtetit të së Drejtës në shqipëri.Tiu vij në ndihmë studentëve të drejtësisë me një material të bashkëkohor sipas ndryshimeve Kushtetuese dhe ligjore.Studentët të kenë mundësi të njihen jo vetëm me anën teorike por dhe me vendime të Gjykatave shqiptare dhe të Gjykatës Europiane të Drejtave të Njeriut. Mendoj se ky libër do ti shërbej studentëve të drejtësisë dhe organeve ligjvënëse dhe organeve ligjzbatuese dhe qytetarëve të interesuar

Since the introduction of the Force Concept Inventory (FCI) in 1992, the CI tests have been widely used for measuring conceptual knowledge and for studying teaching issues in almost all disciplines and levels of study. A standard concept inventory analysis includes the design of a qualitative test, adequate realization of testing, calibration procedure, and comprehensive analysis of its findings. Usually, the CI test calibration is carried out through the Rasch sociometric technique, which is also used for calculating crucial indicators of knowledge such as item difficulties, students’ abilities, and many more. Whereas the quality of the tests’ design can be guaranteed by using certified and professional CI tests, the statistical adequacy of the testing merits critical attention before going on to the final step of the analysis. Also, the analysis of CI outcomes can be advanced by contemplating auxiliary tools and complementary techniques. In this framework, we propose to enforce the test index validity requirement for qualifying the CI outcomes as local or global. Specifically, the conclusions of CI analysis are acceptable for the whole population from which the sample has been extracted if the test's indexes comply with the validity requirements provided by the index theory. In the case when test indexes are out of validity range and re-conducting them is impractical for some objective circumstances or research specifics, we suggest injecting some new records into the existing one or mixing the data gathered from different samples until the new indexes are in the desired range. Using this methodology, we have reviewed our previous FCI tests, which were initially intended to demonstrate the impairment of learning in the physics discipline triggered by online learning during the pandemic closure. Through this renormalization procedure, we obtained a credible assessment of the understanding of mechanics and electromagnetism in high school students who followed online lectures during the pandemic closure. Also, by using indexes’ validity as an auxiliary tool, we identified that for measuring the knowledge of electromagnetism in students enrolled in branches where physics is a basic discipline, a shortened version of the BEMA test was a better instrument than the corresponding shortened EMCI test. Next, we used the optimal histogram idea borrowed from distribution fitting procedures to identify the natural levels of students’ abilities for solving a certain CI test. Another intriguing proposal presented in this work consists of combining an ad-hoc Likert scale assignment for usual errors in physics exams with the FCI designation of the basic commonsense confusion in mechanics for identifying their pairing features in common exams. We believe that the methods proposed herein can improve CI analysis in more general senses. Doi: 10.28991/HEF-2023-04-01-08 Full Text: PDF

COVID-19 pandemic remains a public health concern worldwide. Given that, students represent a subgroup of the population with an impact on the pandemic. The aim of this study is to evaluate the knowledge, attitudes, and practices of Albanian students about COVID-19, and to provide a database to plan and implement preventive evidence-based interventions. An online survey was conducted among Albanian university students during April-May 2022, to collect information on their knowledge, attitudes, and practices related to COVID-19, through a structured questionnaire. A total of 906 students, 72.8% females, were included in it. 93.4% of participants knew the ways of transmission of COVID-19; 92.5% had information about preventive measures, but only 30% knew about quarantine and 37.0% knew vaccination as a preventive measure. Regarding attitudes, 54.8% of participants believed that COVID-19 infection is very dangerous. 46.5% have a negative attitude toward covid vaccines. Almost all respondents (93.7%) apply regular hand washing as a preventive measure; 82.8% cover their mouth when coughing or sneezing; but only 28.2% always use a mask indoors. Albanian university students had good knowledge, positive attitudes, and appropriate preventive practices against COVID-19, but the study found that some limitations in terms of information and misconceptions still exist. Raising awareness and providing adequate information, education, and more effective communication programs will have a positive impact on increasing knowledge, improving attitudes, and supporting the required student behavior change.

<i>Background: </i>Chronic kidney disease affects more than 10% of people globally. The aim of the study was to assess oral health in patients with chronic kidney disease. The sample was composed of 233 patients, of which 147 (63%) were males and 86 (37%) were females. Participants' age varied from 31 to 70 years old. We divided the participants into four age groups: 31-40, 41-50, 51-60, and 61-70 years old. Data were analyzed by using (IBM, New York, USA, SPSS Statistics for Windows), Version 23.0. The significance level (α) was set at 0.05, with a confidence interval (CI) of 95%. The prevailing age range was from 51 to 60 years old, with 31.8% of the participants. A considerable number of patients with chronic kidney disease had low incomes, respectively 42.4% of them. 80.7% of the patients were current smokers and 73.4% of them consumed alcohol. A large proportion of respondents 83.7% of them were diabetic patients. 63.1% of the participants reported that they had hypertension. According to our findings, 55.8% of the participants brush their teeth only once a day. The study found a strong correlation between chronic kidney disease and diabetes mellitus (CI 95; 1.17-1.33, P-value ˂.0001), hypertension (P ˂.0001), alcohol consumption (P=.001), and smoking (P =.000). Gingivitis was the most common oral disease which affected 73.4% of the participants, followed by 56.7% of them who had dental caries.

The main feature of the political relations, developed among the coastal states with strong interests over the North Pole region and the Arctic Ocean, have been the frequent interstate disputes over the last fifty years, as well as the efforts of these Arctic states during this period to cooperate in so that the sovereignty and sovereign rights of each coastal state over this region turn into a common benefit for the entire international community. Consequently, sovereignty and sovereign rights are considered fundamental factors for interstate relations in the Arctic Ocean region, for which coastal states have historically been willing to engage in political or military conflicts. The Arctic Ocean, including North Pole maritime region, is governed by customary international law and the law of the sea, which are largely represented by UNCLOS (1982) and the Geneva Conventions on the Law of the Sea (1958). Four Arctic coastal states, Canada, Norway, Denmark, and Russia have ratified these international conventions, while the US accepts its main provisions as norms of customary international law, but is also in the process of ratifying UNCLOS. The purpose of this article is to analyze and discuss the legal, practical, and political situation regarding the delimitation of maritime zones in the North Pole region and the Arctic Ocean, addressing interstate disputes over the major economic, strategic and geopolitical interests of this maritime area in the context of international security.

Over the years, international organizations have played critical roles in the interactions and relationships that develop within the international system between and among states. The Russian Federation joined the Council of Europe in 1996 to strengthen its democratic policies. The nature of Russia’s membership in the Council of Europe is somewhat paradoxical, given how far it strayed from the organization’s objectives and principles. This also includes the organization's credibility and ability to promote democratic values throughout the Russian Federation by applying the European Convention on Human Rights. In light of the latest developments in the conflict with Russia, the issue of the protection of human rights and fundamental freedoms, on which the Council of Europe is mainly focused, seems to be a key point in the European debate and beyond. This paper summarized all points where the Council of Europe deviated from its principles and objectives. The Council of Europe, among others, has to strengthen its authority and become more resilient to afford future crises. The main question of this paper is directly related to the research strategy which is the first element. The general question of this paper is as follows: Can the mission and purpose of the Council of Europe be considered fulfilled in any case of the existence of this organization?

The aim of this paper is to introduce a new class of functions called strongly exponentially generalized $(m,\nu_{1},\nu_{2},g_{1},g_{2})$.Some new integral inequalities of trapezium-type for strongly exponentially generalized $(m,\nu_{1},\nu_{2},g_{1},g_{2})$ functions with modulus $c$ via Riemann-Liouville fractional integral are established. Also, some new estimates with respect to trapezium-type integral inequalities for strongly exponentially generalized $(m,\nu_{1},\nu_{2},g_{1},g_{2})$ functions with modulus $c$ via general fractional integrals are obtained. We show that the strongly exponentially generalized $(m,\nu_{1},\nu_{2},g_{1},g_{2})$ functions with modulus $c$ includes several other classes of functions. At the end, some new error estimates for trapezoidal quadrature formula are provided as well. This results may stimulate further research in different areas of pure and applied sciences.