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    Kosovo is a small country in the Balkan region that stand on the edge of Southeastern Europe. A new country that gained its independence only 15 years ago and has less than two million population and which is known for its hospitality. There is no sustainable recycling process in Kosovo, so, as a result; we have overflowing landfills. So, you can imagine how Kosovo suffers from dense air pollution. Kosovo’s air pollution is 29% and according to the World Health Organization stated Kosovo with a high risk to the environment. And all these environmental detriments can wreak havoc on the health of Kosovars. But this lack of recycling is not for lack of caring. Our young people do care about the environment, but they rarely learn about recycling process and the impact of landfills. I was told by my teachers that there’s only one day to take care of the environment, on September 17th, World Clean Up Day. So, it is not a lack of caring – Rather it is a lack of education. The goal of this project is to develop a portfolio/guidebook with very detailed instructions for creative activities to raise students’ awareness/expand knowledge for recycling process; and to unfold it during the “Reduse, reuse and Recycle” workshop to 70 teachers, to get familiar on how recycling and environmental curriculum can be incorporated into various subjects. The emphasis will be on improving Kosovo\u27s environment through the education of new generations. Think outside the trash; is a recycling process that focuses on our young generation, especially in teenagers of high school. The Think outside the trash project in Kosovo aims to develop a recycling curriculum for young people, especially teenagers in high school, in order to raise awareness about the impact of landfills and improve the environment through education. The project has three steps: Developing a guidebook for teachers in Pristina, the capital city of Kosovo, with contributions from experts in ecology, recycling, environmental science, and social entrepreneurship. The guidebook will include engaging activities applicable to all areas of study and will feature plans and recommendations for field trips to local recycling institutions. Hosting a Reduce, Reuse, Recycle workshop for 70 teachers to coincide with World Clean Up Day in the fall of 2023. The workshop will be a week-long training session where teachers can learn about the curriculum and receive detailed instructions on how to implement it in their classrooms. Introducing Pristina high school students to the new recycling curriculum and hands-on activities, including recycling competitions between schools, to encourage their active participation in the project. The ultimate goal is to educate and empower young people to become agents of real change and promote a sustainable recycling process in Kosovo. Remember, before they can Reduce, Reuse and Recycle. It is up to us to Advocate, Educate and Empower. Advocate for these changes now. Educate the new generations. Empower them to make improvements in their families and communities. The next generation will become advocates themselves and the (re)cycle will continue

    Dietary Nitrates & Exercise Performance: Influence of Training Status

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    The aim of this study is to determine if peak oxygen consumption (VO2peak)influences the responsiveness to dietary nitrate supplementation (i.e., changes in nitric oxide availability, oxygen cost and exercise performance), and further, to elucidate how this correlates to their training intensity and volumes. Eleven male and three female cyclists between 18 and 45 years of age were recruited. This study is part of a larger study in which the influence of beetroot juice (BRJ) on performance at simulated altitude was also assessed. As a result, this randomized, double-blind, placebo-controlled experiment included four, seven-day experimental phases. For the BRJ trials, subjects consumed 140 milliliters (ml) of concentrated beetroot juice [Beet It; James White Drinks, containing 12.8 millimole (mmol) nitrates] each day for three days (day 5, 6, and 7 of each phase). For the first two days, this dose was separated into a morning and afternoon dose (70 ml each). The final 140 ml dose was consumed three hours prior to the exercise trials, detailed below. For the placebo (PL) trials, subjects consumed 140 ml of nitrate-depleted beetroot juice (James White Drinks, containing 0 mmol nitrates) at the same time points. An incremental cycling test starting at 50 Watts (W) and increasing by 25 W/minute was performed until volitional fatigue during a preliminary trial to assess VO2peak and to determine cycling workloads (Wmax) for the experimental trials. VO2peak was used as one of the criteria to categorize participants as moderately trained cyclists [\u3c 55 ml/kilogram (kg)/minute (min)], or highly trained cyclists (\u3e 60 ml/kg/min). Following the preliminary trial, subjects completed a familiarization trial where participants replicated the VO2peak test described above in the alternative altitude condition to the preliminary test and performed the exercise procedures described below, without supplementation, resting measures, and 10 minutes of constant load cycling at 45% Wmax. On day 7 of each trial phase subjects reported to the Human Performance Lab where upon arrival, subjects rested for 5 minutes and received an expired nitric oxide measurement, blood pressure measurement and blood draw. Following these measurements, they consumed their final supplements, left the laboratory, and returned two and a half hours later. Upon returning, subjects received the same resting measures followed by 20 minutes of constant load cycling; 10 min at 45% and 10 min at 65% Wmax at 80-100 revolutions per minute. Following constant load exercise subjects completed a simulated 4-kilometer time trial as quickly as possible. All experimental trials involved participants breathing through a mask connected to an altitude tent connected to two hypoxic generators. During normoxic trials, inspired air was not modified and in hypoxic conditions, the inspired oxygen was reduced to 15.3%

    Juggling between two full-time jobs: Work-life balance experiences of working mothers in Kosovo and the United States

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    The challenge of the work-life balance is rising to the top of many employers’ and employees’ consciousness. Managing these work and life roles and finding a balance between them is vital, particularly as it relates to working mothers. Working mothers perform numerous roles within their work and life worlds, which complicates their chances to reach a balance among roles successfully. Considering these overlapping roles and responsibilities, women’s careers after becoming mothers tend to stagnate, and they are more likely to leave their organizations and quit their careers (Hewlett & Luce, 2005; Stone 2007). Therefore, this research study sought to explore working mothers’ work-life balance experiences. More concisely, it aimed to explore and delve deeper into the life context, work context, and sociocultural context of working mothers’ work-life balance experiences. By doing so, I was keen to provide HRD practitioners with a glance of first-hand information, which can be taken into consideration when designing and implementing interventions to meet working mothers’ needs and ease their challenges. The leading research question and the sub-questions which guided the focus of this study and the interview questions are presented below: The Leading Research Question: ▪ What are the work-life balance experiences of working mothers in Kosovo and the United States? Sub-questions: 1. How does the life context impact the work-life balance of a working mother in Kosovo and the United States? 2. How does the work context impact the work-life balance of a working mother in Kosovo and the United States? 3. How does the sociocultural context impact the work-life balance of a working mother in Kosovo and the United States? Because of my familiarity with Kosovo and the United States contexts, I chose to conduct this study with working mothers from both these countries. There were six working mothers interviewed in total, three in Kosovo and three in the US. In addition, the research followed a qualitative approach and applied the narrative inquiry. The findings of this study showed that each of the contexts consisted of two major themes. The life context consisted of self-care and child-care themes, the work context consisted of the nature of the work and workplace support themes, and lastly, the sociocultural context consisted of gender norms and support systems themes. Most of these findings were strongly supported by the existing literature, and they have implications for the HRD literature and practices

    An overview of the capabilities of an economically successful sustainability leader.

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    1.0 Introduction In 2015, the UN adopted the 2020 agenda with a new focus on sustainable development with the three paradigms of social goals, economic goals as well as environmental goals (THE 17 GOALS | Sustainable Development, n.d.). Many definitions of sustainability exist today, however for this study I will define sustainability as “development which meets the needs of the present without compromising the ability of future generations to meet their own needs” (White, 2013, p. 213). Intentional leaders are therefore an important link between the well-being of organizations and environmental needs which has led to appreciation of a sustainable leader who not only consider profit but also the natural environment (Green & McCann, 2011). It is evident sustainability leadership has been studied in many ways, however several gaps still exist to better understand the field. According to Juknys et al. (2014), working towards economic success while driving environmental sustainability remains a hotly debated topic. The purpose of this study is therefore, to determine the capabilities of an economically successful sustainability leader (ESSL) who not only focuses on sustainability but also the economic success of a firm. The study will contribute to the growing field of sustainability leadership that has been receiving increased interest by researchers since 2017 (Kharchuk & Oleksiv, 2023). 2.0 Literature Review According to Smet et al. (2018), leaders need to transform their mindset to be able to achieve success with consideration of the following capabilities: 1) Shifting from reactive to creative mind sets An ESSL needs to develop agility by shifting their mindsets from reactive to creative (Smet et al., 2018). A creative mindset experiences the world by creating the reality they desire through their passion and purpose unlike a reactive mindset that focusses on what can go wrong causing fear and frustration in the organizations. Organizations alike should own their journey of how they got to where they are with an expression of the passion of those leading and implementing their initiatives (Denning, 2019). According to Joiner (2019, pg 142) leadership agility is defined as “the capacity of an organization’s leaders to foster strategic and operational agility, to create an agile leadership culture, and to adapt personally to changing, interdependent conditions and aspirations on a daily basis.” Agility in leaders is dependent on the clear articulation of vision, mission with organizational support (Theobald et al., 2020). The four types of agility where leaders are most effective include, (1) context setting agility. (2) stakeholder agility. (3) creative agility. (4) self-leadership agility. 3.0 Conclusion It is evident that organizations have a growing need for economical sustainable leaders to guide how to achieve their sustainability goals that are critical to survival of firms while ensuring profitability is achieved in the market today (Green & McCann, 2011). Therefore, a better understanding of the capabilities of an ESSL will be a valuable contribution to both the organizations and leadership to achieve their sustainability goals effectively. References Denning, S. (2019). Lessons learned from mapping successful and unsuccessful Agile transformation journeys. Strategy & Leadership, 47(4), 3–11. https://doi.org/10.1108/SL-04-2019-0052 Green, D. D., & McCann, J. (2011). Benchmarking a leadership model for the green economy. Benchmarking: An International Journal, 18(3), 445–465. https://doi.org/10.1108/14635771111137804 Joiner, B. (2019). Leadership Agility for Organizational Agility. Journal of Creating Value, 5(2), 139–149. https://doi.org/10.1177/2394964319868321 Juknys, R., Liobikiene, G., & Dagiliute, R. (2014). Sustainability of catch-up growth in the extended European Union. Journal of Cleaner Production, 64, 54-63. http://dx.doi.org/10.1016/j.jclepro.2013.07.014 Kharchuk, V., & Oleksiv, I. (2023). The Intellectual Structure of Sustainable Leadership Studies: Bibliometric Analysis. In Z. Hu, Y. Wang, & M. He (Eds.), Advances in Intelligent Systems, Computer Science and Digital Economics IV (pp. 430–442). Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-24475-9_37 Smet, A. D., Lurie, M., & George, A. S. (2018). Leading agile transformation: The new capabilities leaders need to build 21st-century organizations. THE 17 GOALS | Sustainable Development. (n.d.). Sustainable Development Goals. Retrieved September 23, 2022, from https://sdgs.un.org/goals Theobald, S., Prenner, N., Krieg, A., & Schneider, K. (2020). Agile Leadership and Agile Management on Organizational Level—A Systematic Literature Review. In M. Morisio, M. Torchiano, & A. Jedlitschka (Eds.), Product-Focused Software Process Improvement (pp. 20–36). Springer International Publishing. https://doi.org/10.1007/978-3-030-64148-1_2 White, M. A. (2013). Sustainability: I know it when I see it. Ecological Economics, 86, 213–217. https://doi.org/10.1016/j.ecolecon.2012.12.02

    Focused Assessment with Sonography Exams vs CT Scan​

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    Blunt trauma is a common reason patients present to the emergency department. Providers must evaluate these patients quickly to get them the correct treatment, especially for intra-abdominal bleeding. Focused assessment with sonography for trauma (FAST) exams are growing in use to evaluate trauma patients for free fluid in the abdomen. To be valuable to emergency providers, it must be known how FAST exams compare to the gold standard evaluation, computed tomography (CT) scans. Searches were done on Pubmed and Scopus databases using terms “focused assessment with sonography for trauma” and “FAST exam CT blunt abdominal trauma.” Limits were added to only include studies on adults in English, with each FAST being confirmed by CT. The results revealed an average sensitivity and specificity for FAST exams as 54.8% and 92.3% respectively across three quality studies. It can be concluded that positive FAST exams can be used to rule in free fluid in the abdomen, but negative FAST exams must be confirmed by CT scans. Positive FAST exams can reduce the time for a hemodynamically unstable patient to be taken for surgery. In the future, more research must be done to prospectively evaluate FAST exams and to develop training programs for emergency providers

    Probiotic Supplementation and Major Depressive Disorder

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    Depression is a term that can both represent a transient emotional state as well as a clinical condition.1 Unipolar major depression is a very common condition with estimated lifetime prevalence of about 21% in the United States.1 In a study of over 36,000 adults in the US, the average age of onset of a first episode of major depression occurs at 29 years old.1 Diagnosing depression in adults requires the near daily presence of at least five of the following nine symptoms which include: depressed mood most of the day, little interest in doing things most of the day, insomnia or hypersomnia, significant weight loss or gain or appetite changes, psychomotor retardation or agitation that is noticed by others, fatigue or low energy, decreased ability to concentrate or make decisions, excessive or inappropriate thoughts of worthlessness or guilt, recurrent thoughts of death, suicidal ideation or attempt.2 Probiotics are living microorganisms and when taken in adequate amounts, interact with host microbiota to suppress pathogens exposed to the human body.3 Probiotics often contain microorganisms such as bacteria including Lactobacillus and Bifidobacterium and yeasts such as Saccharomyces boulardii (NIH).4 Probiotics work in a variety of ways, including helping to maintain the health of the microbiome, produce beneficial substances, and help the immune system (NIH).4 Gut microbes play a large role in many psychiatric disorders as there is a bidirectional communication between the brain and gut called the microbiota-gut-brain axis (MGBA).3 Many studies have shown that bacteria are important for many different physiological processes and transmit and interpret information from the periphery of the body back to the brain and vice versa.3 It involves neural pathways such as the vagus nerve and enteric nervous system along with cytokine and endocrine pathways all of which are found to be altered in psychiatric disorders.3 Once the microbiome senses stress, it influences the hypothalamic pituitary axis to release cortisol.3 Therefore, stress induced cortisol can be altered by taking probiotics.3 While antidepressants may work for some people, there are others who say they have no effect on them with the effect of antidepressants being around 40-60%.5 With the many different types of antidepressants available, there are also many side effects such as dry mouth, headache, dizziness, and sexual dysfunction.5 It was found that there is a significant difference in the gut microbiota composition in those with depression and individuals without clinically diagnosed depression.3 The aim of this literature review is to assess whether probiotic supplementation can improve clinical symptoms of depression in adults

    Symptom Cluster Analysis in DizzyGuide, an Automated Decision-Support Triage System

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    DizzyGuide is a dizziness triage program that uses artificial intelligence to automate and optimize the scheduling of patients presenting with dizziness symptoms. Based on patient input from an online questionnaire, DizzyGuide delivers the symptom clusters, which are recommendations for potential dizziness and instability-related diagnoses. The clinician can then use these results to help decide what tests and/or specialists are needed for their patient. Dizziness is the third most common complaint in primary care settings and accounts for 2-3% of emergency department demands in one year1,2. In addition to these statistics, there is growing evidence that it is not uncommon for patients with dizziness to receive misdiagnoses from emergency department care, emphasizing the need for access to specialized care and increased diagnostic precision3. Dizziness is a common and non-specific symptom often provoked by an underlying disorder or multimorbidity of disorders4,5,6. Despite numerous batteries of tests and medical imagining available, collecting a thorough and accurate case history is critical for differentiating between multiple diagnosis, or when suspecting a multiplicity of overlapping diagnoses3,7. DizzyGuide acts as a decision-support triage program using artificial intelligence to automate and optimize scheduling of patients presenting with dizziness symptoms based on patient input from an online questionnaire. The algorithm designates patients into symptom clusters, designed to reduce time and effort from the healthcare system and improve patient access to care

    Analysis of Predictive Factors for Aggression within Inpatient Psychiatric Hospitalization

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    Aggression is a heavy concern within inpatient psychiatric hospitalization. Previous research has turned to various methods of assessing and predicting aggression risk, including comprehensive psychometric risk assessment tools (e.g., DASA, VRAG-R, PCL:SV) as well as the analysis of specific dynamic and static risk factors (e.g., Patient Demographics, Situational Factors). Previous studies have focused on predicting whether aggression will or will not occur during a patient’s admission, with an ultimate goal of creating interventions to prevent acts of aggression from happening in the first place. However, little research has been done focusing on a solely aggressive sample. The goal of the current study was to determine if various patient and hospital variables cited in the literature to aid in prediction of the occurrence of aggression would maintain predictive utility in assessing whether a patient would be aggressive once (Dependent Variable = 0) or more than once (Dependent Variable = 1) during their admission. Three logistic regression models were created to assess this outcome. Data on 246 aggressive incidents involving patients (MAge = 36.97;SDAge = 13.37) were obtained from a state psychiatric facility on the east coast. The first model contained patient variables, including sex, age, presence of substance abuse disorder, presence of non-mood psychosis disorder, presence of mood disorder, presence of personality disorder, marital status, and legal status. The second model contained hospital/event related variables, including client living area, event date, event time. The third model contained all predictors. It was hypothesized that Model 1 and Model 3 would be significant overall; specifically, it was hypothesized that all patient variables would be significant, and that hospital/event related variables (pertaining to Model 2) would not be significant. Logistic regression analyses showed that no model significantly accounted for the binary outcome variable (Aggressive Once, Aggressive More Than Once). No model did significantly better than an intercept-only model, and there was a significant amount of deviance left unaccounted for by each model. Despite this lack of significance, a series of nested and non-nested model comparisons were utilized to compare model-data fit amongst the three models. Model 3 was shown to not work statistically better than Model 1 or Model 2. Model 1 and Model 2 were compared via their AIC values. While Model 1 had a lower AIC value than Model 2, the difference in AIC value was not substantial. It was concluded that in the context of the current psychiatric hospital from which data were obtained, empirically supported variables did not maintain predictive utility. Limitations and implications are discussed, as well as directions for future study

    The experiences of elementary school students participating in Paralympic School Day

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    The integration of students with disabilities in general physical education is becoming more popular in public schools in comparison to self-contained adapted physical education. However, integration is not always inclusive for all students. The International Paralympic Committee’s Paralympic School Day (PSD) program is an example of an inclusion grounded curricula which has been used in educational settings to impact the attitudes and perceptions of participants related to disability and disability sport. The Paralympic School Day (PSD) program is designed to increase student understanding of Paralympic sport and the experiences of individuals with disabilities. Through PSD, students experience changed perceptions and an increased awareness about disability and disability sport. The purpose of this study was to examine student experiences in PSD at the elementary level. This qualitative study utilized a thematic phenomenological approach. Participants included 77 students in grades third through fifth who participated in a PSD event during a physical education class. The school selected has socioeconomic and ethnic diversity. Data were collected via reflective writing responses. Written materials were analyzed inductively using a three-step process: immersion in the data, bracketing the data, and determining emergent themes. Analysis revealed three themes related to the participants’ experiences during the PSD event. In the first theme, “First I thought disabled people could do nothing, but after I went to class my whole mind changed…”: Change of perspective though experience, participants described the way the PSD experience supported their changed perspectives. The second theme, “I was sad that he didn’t have legs”: Experiencing negative thoughts, concerned participants’ experiences of negative thoughts related to PSD. The third theme, “It was hard to move sideways on the floor”: Perspectives on skill development, dealt with the participants’ experiences practicing new skills during PSD. Through participating in different Parasport stations with Parasport athletes, students were able to form inclusive perceptions related to disability, and were able to challenge preconceived notions about disability and Parasport. These positive meaningful experiences play a role in shaping thoughts and ideas towards individuals with disabilities as explained and explored through contact theory. By exploring the experiences elementary aged students had with PSD through the qualitative lens, this study broadened the understanding of perceptions of the PSD curriculum and provided thematic insight to the idea of inclusion and integration in the physical education setting. The findings of this study revealed that PSD is a valuable tool for positively influencing student perceptions about Parasport and individuals with disabilities

    IORT: the future of breast cancer treatment?

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    Introduction: Research focus: unifocal, invasive breast cancers classified as T1-T2, N0-N1, and M0. These tumors measure less than 5 cm, have not spread beyond the axillary lymph nodes, and have not spread to distant organs. Treatment includes lumpectomy of the tumor followed by radiation. Whole breast external beam radiotherapy (EBRT): traditional treatment; three-to-four-week course, five days a week. Intraoperative radiotherapy (IORT): single dose of radiation directly to the tumor bed immediately post-lumpectomy, allowing both surgery and radiation to be completed in one day. Objective: Assess the 5 year local recurrence rate of intraoperative radiotherapy (IORT) in relation to the conventional treatment of external breast radiotherapy (EBRT) in eligible females diagnosed with breast cancer over age 40. Design: Systematic literature review. Methods: PubMed was searched using the following limits and terms: breast neoplasms, intraoperative radiotherapy, randomized control trial, clinical trial, females, English, and published in the last 10 years. Results: Upon this search, three studies were found to directly compare IORT and EBRT regarding 5 year local recurrence rates. Study #1 showed no significant difference between women who received IORT and those who received EBRT when looking at local tumor recurrence. However, a very small number of participants were in the IORT group: only 77 compared to 170 women in the control group. Further, women less than 48 years old were given both IORT and EBRT, thus cannot be included in the analysis. The study was also non-randomized. Study #2 showed that intraoperative radiotherapy resulted in significantly higher local recurrence, although still within the equivalence margin. However, there was no blinding or masking noted. Study #3 showed more local recurrences in the TARGIT group than EBRT, but within the non-inferiority margins set prior to the study. However, the TARGIT group received supplemental EBRT if unforeseen adverse features were detected on final pathology, and there was no stated attempt to blind patients. Conclusion: IORT was shown to be non-inferior to EBRT in two of the three studies that were examined; however, more research is necessary to confidently establish this. The benefits of IORT, including convenience, length of treatment, and side effect profile, deem further study worthwhile. The full risk-benefit profile of both radiotherapy options should be discussed with eligible patients in shared decision-making tailored to each individual. The significant benefits of IORT, including convenience and minimization of side effects, make it a reasonable alternative to EBRT. If studies continue to prove non-inferiority, IORT could become standard of care for breast cancer patients post-lumpectomy


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