Karlygash S. Absattarova

Background/Objectives: Radiation-related fear, anxiety, risk perception, reproductive concern, protective behaviour, and avoidance are conceptually related but not interchangeable. This scoping review mapped how these constructs have been operationalised among healthcare workers and health professions students. Methods: Following JBI guidance and PRISMA-ScR, PubMed, Scopus, Web of Science Core Collection, and the Cochrane Library were searched for English-language records published from 1 January 2000 to 4 September 2026. Of 845 records, 388 duplicates were removed and 457 unique records were screened. Results: Twenty-seven reports underwent full-text assessment; one was excluded because its mixed population and radiation context did not permit a healthcare-specific occupational interpretation, leaving 26 studies. The evidence was dominated by cross-sectional studies and heterogeneous measurement instruments; therefore, study-level percentages were not treated as directly comparable prevalence estimates. Reported outcomes ranged from explicit radiophobia and affective anxiety to cognitive risk appraisal, reproductive concern, protective behaviour, and avoidance. Education was associated with differing changes across settings, while dosimetry, protective equipment, workflow, and safety climate were reported alongside occupational responses. Conclusions: The literature does not support a standardised operational definition or common measurement framework for professional radiophobia. Future research should distinguish affective fear or anxiety from contextually appropriate occupational risk appraisal and protective behaviour, and should evaluate organisational conditions alongside education.

Background: The increasing use of computed tomography (CT) in pediatric populations has raised concerns regarding radiation-induced malignancies due to higher radiosensitivity and longer post-exposure lifespan in children. Objective: This study aimed to synthesize evidence from large-scale cohort studies on the association between pediatric CT exposure and subsequent cancer risk, with a focus on leukemia and brain tumors. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Literature searches were performed in PubMed and the Cochrane Library from database inception to 30 June 2025. Seven large cohort studies, including more than 11 million individuals from Europe, Asia, and Australia, were included. Data on radiation exposure, cancer outcomes, follow-up, effect measures, and methodological quality were extracted independently by two reviewers. Results: A consistent dose-response relationship was observed across studies. Excess relative risk (ERR) per mGy ranged from 0.033 to 0.045 for leukemia and from 0.006 to 0.023 for brain tumors in studies reporting organ-dose estimates. The risk was higher in children exposed at younger ages, particularly under 5 years, and increased with cumulative exposure. Scan-count analyses also suggested higher incidence with repeated CT, although scan count is a proxy for dose and should not be interpreted as equivalent to organ-dose ERR. Although indication bias was identified, adjusted and lagged analyses generally supported a persistent association. Conclusion: Pediatric CT exposure is associated with a small but measurable increase in long-term cancer risk. These findings should be interpreted alongside the diagnostic benefit of CT in trauma, oncology, and life-threatening illness. Clinically justified CT remains essential; the results support strict justification, dose optimization, and the use of non-ionizing alternatives when they can answer the clinical question.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease characterized by irreversible extracellular matrix deposition and high mortality, with aging representing its strongest risk factor. Increasing evidence suggests that cellular senescence is not merely a consequence of tissue injury but a central driver of disease progression. Senescent alveolar epithelial cells and fibroblasts contribute to impaired tissue repair and persistent fibrotic remodeling through the acquisition of a senescence-associated secretory phenotype (SASP), which promotes chronic inflammation and amplifies profibrotic signaling. This review provides a comprehensive synthesis of current evidence on the role of cellular senescence in IPF, focusing on key molecular mechanisms, including telomere attrition, mitochondrial dysfunction, oxidative stress, DNA damage response activation, and dysregulated transforming growth factor-β (TGF-β) signaling. A structured literature search was conducted using the PubMed, Scopus, and Web of Science databases to identify mechanistic, translational, and clinical studies related to cellular senescence in IPF. Relevant studies were selected based on conceptual relevance and scientific quality, and findings were qualitatively synthesized within a narrative-review framework. These interconnected pathways form self-reinforcing feedback loops that stabilize the senescent phenotype and sustain fibroblast activation. In addition, we critically evaluate emerging therapeutic strategies targeting senescence, including senolytic and senomorphic approaches, highlighting their potential to modify fundamental disease mechanisms rather than solely attenuating fibrotic progression. Preclinical and early clinical studies suggest that selective targeting of senescent cells may represent a promising avenue for intervention, although challenges related to specificity, safety, and biomarker development remain. Overall, this review positions cellular senescence as a central mechanistic link between aging and fibrosis and underscores its relevance as a translational target in IPF.

Background: Pneumoconiosis remains a major occupational lung disease associated with progressive respiratory impairment, reduced functional capacity, and diminished quality of life. Non-pharmacological rehabilitation has been increasingly proposed as a supportive intervention; however, evidence regarding its effectiveness remains heterogeneous. Objective: This study aimed to systematically review and synthesize the available evidence on the effects of non-pharmacological rehabilitation interventions on functional capacity, quality of life, and psychological outcomes in patients with pneumoconiosis. Methods: A systematic literature search was conducted in major electronic databases and grey literature sources in accordance with PRISMA 2020 guidelines. Studies evaluating non-pharmacological rehabilitation interventions in adults with pneumoconiosis were eligible for inclusion. Outcomes of interest included functional capacity, health-related quality of life, and psychological well-being. Due to methodological heterogeneity across studies, a qualitative synthesis was performed. Results: Six studies met the predefined inclusion criteria and were included in the qualitative synthesis. The reviewed evidence suggests that structured rehabilitation interventions were associated with clinically meaningful improvements in functional capacity, particularly in structured rehabilitation programs, most consistently reflected by increases in six-minute walk distance exceeding established minimal clinically important differences in three studies. Improvements in health-related quality of life and selected psychological outcomes were also reported, although outcome measures and intervention protocols varied across studies. Significant improvements in exercise capacity, dyspnea severity, and health-related quality of life were reported. Conclusions: Non-pharmacological rehabilitation may provide clinically meaningful benefits for patients with pneumoconiosis, based on limited and heterogeneous evidence, particularly in terms of functional capacity and quality of life. Nevertheless, the current evidence base is limited by heterogeneity in study design and outcome reporting. Further high-quality, standardized trials are needed to strengthen the evidence and guide the clinical implementation of rehabilitation programs for occupational lung diseases.

Background. Occupational dust-related lung diseases are associated with reduced exercise tolerance, dyspnea, limitations in daily activities, and impaired quality of life. Evidence on the effectiveness of pulmonary and multicomponent rehabilitation in these patients remains limited and heterogeneous. Aim. To systematize the evidence on the effectiveness of pulmonary and multicomponent rehabilitation in adult patients with occupational dust-related lung diseases, with a focus on exercise tolerance, dyspnea, pulmonary function, quality of life, and occupational outcomes. Materials and methods. This systematic review was conducted in accordance with PRISMA 2020. The literature search was performed in PubMed/MEDLINE, Scopus, Web of Science Core Collection, and the Cochrane Library from inception to November 30, 2025, with additional manual searching. A total of 348 records were identified; after duplicate removal and study selection, 12 primary studies were included in the qualitative synthesis. Studies involving adult patients with pneumoconiosis, silicosis, occupational COPD, and other chronic occupational dust-related lung diseases were eligible if they evaluated a rehabilitation intervention and reported at least one relevant outcome. Results. The included studies generally indicate a beneficial effect of pulmonary and multicomponent rehabilitation on exercise tolerance and quality of life. Several studies also reported reductions in dyspnea and improvements in selected pulmonary function parameters, although these findings were less consistent. The most pronounced effects were observed in programs that included inspiratory muscle training. Occupational outcomes were rarely assessed in the available studies. Conclusions. Pulmonary and multicomponent rehabilitation in patients with occupational dust-related lung diseases is primarily associated with improved exercise capacity and quality of life. The main limitations of the current evidence base are clinical and methodological heterogeneity, the small number of studies, and the lack of data on long-term occupational prognosis. Key words: pulmonary rehabilitation, multicomponent rehabilitation, occupational dust-related lung diseases, occupational COPD, inspiratory muscle training, quality of life. Актуальность. Профессиональные пылевые заболевания лёгких ассоциированы со снижением переносимости физической нагрузки, одышкой, ограничением повседневной активности и ухудшением качества жизни. Данные об эффективности лёгочной и многокомпонентной реабилитации у таких пациентов остаются ограниченными и неоднородными. Цель. Систематизировать данные об эффективности лёгочной и многокомпонентной реабилитации у взрослых пациентов с профессиональными пылевыми заболеваниями лёгких с акцентом на переносимость физической нагрузки, одышку, функцию внешнего дыхания, качество жизни и профессионально-трудовые исходы. Материалы и методы.Систематический обзор выполнен в соответствии с PRISMA 2020. Поиск проведён в PubMed/MEDLINE, Scopus, Web of Science Core Collection и Cochrane Library от inception до 30 ноября 2025 года с дополнительным ручным поиском. Выявлено 348 записей; после удаления дубликатов и отбора по критериям включения в качественный синтез вошли 12 первичных исследований. Включались исследования взрослых пациентов с пневмокониозом, силикозом, профессиональной ХОБЛ и другими хроническими пылевыми заболеваниями лёгких, если оценивалось реабилитационное вмешательство и представлялись данные хотя бы по одному релевантному исходу. Результаты. Включённые исследования в целом указывают на благоприятное влияние лёгочной и многокомпонентной реабилитации на переносимость физической нагрузки и качество жизни. В ряде работ отмечалось также уменьшение выраженности одышки и улучшение отдельных показателей функции внешнего дыхания, однако эти результаты были менее однородными. Наиболее выраженные эффекты наблюдались в программах, включавших тренировку инспираторных мышц. Профессионально-трудовые исходы в доступных исследованиях практически не оценивались. Выводы. Лёгочная и многокомпонентная реабилитация у пациентов с профессиональными пылевыми заболеваниями лёгких ассоциирована преимущественно с улучшением переносимости физической нагрузки и качества жизни. Основными ограничениями доказательной базы остаются...

Relevance. Milk provision to employees exposed to hazardous working conditions remains a large-scale social guarantee in Kazakhstan. However, a universal food product does not account for differences in toxicant properties, exposure intensity, occupational risk, nutritional status, or individual contraindications. Objective. To formulate a two-component framework for risk-oriented occupational nutrition that preserves workers’ statutory and contractual guarantees, and to specify its implementation and evaluation requirements. Materials and Methods. This was a critical secondary documentary analysis and conceptual policy study, not a systematic review. The documentary corpus comprised statistical, regulatory, organizational, economic and biomedical materials available to the authors, together with accessible public primary sources used to verify legal and statistical claims. No comprehensive bibliographic search, formal study-selection flow or risk-of-bias assessment was undertaken. Narrative synthesis distinguished externally reported observations, authors’ arithmetic calculations and conceptual proposals. Results. The analysis produced a two-component framework linking preservation of existing guarantees with exposure-specific nutritional assessment and product evaluation. It specified a staged decision process covering exposure characterization, individual suitability, product documentation, worker participation and controlled evaluation. Official statistics record 325,429 recipients of milk or equivalent products in the surveyed enterprise population in 2025. Organizational material identifies implementation issues, while the economic analysis specifies the inputs required for a reproducible future full-cost comparison. Incomplete enterprise documentation limits assessment of implementation outcomes. Historical biomonitoring values attributed to the Kola Mining and Metallurgical Company were excluded from quantitative analysis because the original report and essential methodological information were unavailable. Conclusions. The framework provides a structured basis for developing and testing differentiated occupational nutrition while maintaining mandatory provision. It links legal guarantees with requirements for product selection and evaluation. Preventive efficacy, safety, acceptability and cost-effectiveness require prospective assessment.

Relevance. The transition toward risk-oriented occupational safety systems requires modernizing social protection mechanisms for employees exposed to hazardous working conditions. In Kazakhstan, social guarantees are traditionally based on occupational classifications that do not fully reflect actual workplace risk exposure or economic sector characteristics. Objective. To develop and validate an integrated methodological approach for ranking occupations based on professional risk levels and economic activity characteristics. Materials and Methods. This study, conducted in 2024-2025, included an analysis of occupational risk assessment data from pilot enterprises, an evaluation of national labor statistics, and findings from a sociological survey of 312 respondents. An integrated ranking index was developed by calculating a sectoral coefficient reflecting economic activity characteristics. Statistical analysis was performed using SPSS 27.0. Results. Significant variability in occupational risk levels across economic sectors was identified. High and critical risk levels were predominantly observed in mining, metallurgical, and chemical industries, while lower risk levels were characteristic of service and administrative sectors. The proposed integrated ranking model demonstrated the ability to differentiate occupations with similar professional risk exposure by incorporating sector-specific economic indicators, thereby enabling a more precise distribution of social guarantees. Conclusions. The developed model establishes a scientifically justified relationship between occupational risk level and allocation of social guarantees. Implementing the proposed methodology may enhance the effectiveness of occupational safety regulation and support the transition toward a preventive, risk-oriented social protection system in Kazakhstan.

Background: Occupational bronchopulmonary diseases (OBPDs)—including pneumoconiosis, silicosis, and occupational COPD—remain a pressing public health issue, especially in regions with intensive mining, metallurgy, and construction industries. Caused by chronic inhalation of fibrogenic dusts, these conditions are often diagnosed at late stages, resulting in irreversible lung damage and diminished work capacity. Methods: A scoping review was performed using the Arksey and O’Malley framework, with methodological refinements from the Joanna Briggs Institute. Following PRISMA-ScR guidelines, we searched PubMed, Scopus, and gray literature for publications from 2014 to 2024. After screening 1761 records and full-text review, nine studies were included in the final synthesis, comprising two systematic reviews, two narrative literature reviews, and five observational studies. Results: Key risk factors identified included prolonged exposure to silica and coal dust, tobacco use, and genetic susceptibility. Diagnostic delays were attributed to the underuse of high-resolution CT and exhaled nitric oxide analysis. Several studies highlighted the diagnostic value of oxidative stress and inflammatory markers (e.g., IL-6, TNF-α). Nutritional rehabilitation and polyphenol-enriched herbal therapies were associated with improved respiratory function and quality of life. However, these strategies remain underutilized, particularly in low-resource settings. Conclusions: A coordinated, biomarker-driven approach integrating early diagnosis, dust exposure control, and tailored rehabilitation is urgently needed. Multidisciplinary models may reduce the clinical and socioeconomic burden of OBPDs.

INTRODUCTION. The profound socio-political and economic changes of the 1990s had a negative impact on people's quality of life and overall health. The constant stress inherent in urbanized society leads to a decline in the functional capabilities of the human body. Developing the health resort complex is a key solution to maintain the population's essential life-support systems and address the challenges associated with urbanization. To better understand the current state of the resort industry in Kazakhstan, it is important to explore its history and development. This will help us understand its characteristics and challenges. AIM. To examine and evaluate the historically significant events in the development of balneology in Kazakhstan, as well as to identify current trends and outlooks for the modernization of the country's resort industry. MATERIALS AND METHODS. In order to conduct a comprehensive literature review, a range of international electronic databases were consulted, including Medline, PubMed, Google Scholar and eLibrary. The period under review extended from 2014 to 2024, with earlier works of seminal importance also included in the analysis. Literature searches were conducted using comprehensive search strategies that were relevant to the development of Kazakhstani balneology during certain historical periods. RESULTS AND DISCUSSION. The history of health resort treatment in Kazakhstan goes back well beyond the thirty years since the country's independence. This traditional form of therapy is used in various fields of medicine for disease prevention. Sanatoriums and resorts offer a wide range of natural resources, including a unique climate, clean mountain air, mineral waters and therapeutic muds. These elements create exceptional conditions for recovery and improved health. This approach combines traditional medical practices with modern technologies, as well as natural and climatic factors. Although Kazakhstan has a significant recreational potential, the demand for these services is still low. This may be due to the fact that the focus is still on the Soviet-style recreation, which emphasizes social interaction and the state engagement. In the past, the government had to cover significant expenses for running sanatoriums, resorts, and providing recreational services, ensuring restorative care for people. CONCLUSION. The development of resorts in Kazakhstan has undergone significant transformations, starting in the pre-socialist period and continuing into the post-Soviet era of modernization. Thanks to its rich natural resources and government support, as well as private investment, Kazakhstan was able to partially maintain its resort industry. However, the modernization of Kazakhstan's resorts and sanatoriums requires government regulation, followed by optimization and digitalization of the health resort network in order to provide high-quality treatment and recreational services that are accessible to all segments of the population.

Introduction: Colorectal cancer (CRC) is the third most common malignant neoplasm among men and the second most common among women. According to the World Cancer Report, the number of people suffering from this disease is growing steadily. In 2012, there were more than 1.36 million new cases of CRC, and approximately 694,000 people died from this disease worldwide.Methods: A sensitive literature search identified 12 relevant publications, including: a CORRECT phase III study assessing the effect of regorafenib in patients with metastatic CRC that continued to progress despite using all standard treatment methods; a CONCUR Phase III study evaluating the clinical effect of regorafenib in Asian patients with metastatic CRC; a CONSIGN study conducted after the CORRECT and CONCUR studies that assessed the safety profile of regorafenib prior to market entry; and various systematic reviews evaluating the safety of regorafenib.Results: The efficacy and safety of regorafenib for treating patients with metastatic CRC was evaluated in two major clinical studies: CORRECT and CONCUR. Although the studies were randomized, double-blind, and placebo-controlled, they were conducted in different patient populations. Before treatment with regorafenib, patients received, depending on the country, fluoropyrimidines, oxaliplatin, irinotecan, or bevacizumab, and patients with the wild-type KRAS gene also received cetuximab and panitumumab. Results from both studies indicated that regorafenib had a clinically significant positive effect on rates of progression-free survival and overall survival in patients with treatment-resistant metastatic CRC.Conclusions: Regorafenib can be recommended as a monotherapy for resistant metastatic CRC when there are no contraindications to use. Considering the safety profile of regorafenib, further research is needed to determine the best dosage of regorafenib and the most appropriate clinical and molecular biomarkers for determining which patients would benefit most from this treatment.