Zhanara Buribayeva

Background: Patient-reported outcome measures are increasingly used to evaluate the quality of palliative care. However, evidence from Kazakhstan remains limited. This study aimed to assess palliative care outcomes among adult patients in Kazakhstan using the Palliative Outcome Scale (POS). Methods: A cross-sectional study was conducted among 134 adult patients receiving palliative care in East Kazakhstan. Data were collected using a socio-demographic and clinical questionnaire and the 10-item POS. Descriptive statistics, Cronbach’s alpha, Spearman correlation, nonparametric tests, and multiple linear regression were performed using IBM SPSS Statistics 26.0. Results: The mean total POS score was 10.13 ± 5.05, indicating a moderate burden of palliative care-related problems. The highest mean scores were observed for self-worth, meaning in life, anxiety, and pain. The POS demonstrated moderate internal consistency (Cronbach’s α = 0.641). Significant differences in total POS scores were found across disease profiles (p < 0.001), whereas no significant differences were observed by gender or age. In multiple linear regression, disease profile was the only variable significantly associated with the total POS score (B = 0.688, β = 0.292, p = 0.001). Conclusions: Patients receiving palliative care in Kazakhstan experience a moderate burden of physical, emotional, and existential concerns. Disease profile was significantly associated with patient-reported outcomes and may represent one of several factors influencing palliative care needs. The POS may be a useful tool for assessing patient-reported palliative care outcomes in Kazakhstan; however, further formal psychometric validation in the local population is required before routine implementation.

Background/Objectives: Mental health problems among university students represent a growing public health concern and are shaped by both psychological and socioeconomic determinants that may act independently and interactively. This systematic review aimed to evaluate the separate and combined effects of these determinants on depression, anxiety, stress, and psychological distress in higher education students. Methods: A structured and targeted search strategy using predefined keyword groups and Boolean combinations across PubMed, Scopus, Web of Science, and Google Scholar identified 99 records, of which 19 duplicates were removed. After screening 80 titles and 52 abstracts, 34 full-text articles were assessed for eligibility, and 30 studies were ultimately included in the final review. Data were extracted on study characteristics, mental health outcomes, psychological determinants, socioeconomic factors, and their interactions. Results: The included studies consistently showed that psychological factors, including resilience, coping strategies, loneliness, self-efficacy, and perceived control, were associated with mental health outcomes, with higher resilience and self-efficacy linked to lower levels of depression and anxiety, and maladaptive coping and loneliness associated with increased psychological distress. Socioeconomic determinants, including financial stress, low socioeconomic status, parental education, housing insecurity, and food insecurity also independently contributed to elevated risks of depression, anxiety, and stress. Importantly, several studies demonstrated an interaction between these domains, where socioeconomic disadvantage amplified the adverse effects of poor coping capacity, low resilience, and social isolation, whereas social support and adaptive coping mitigated these effects. Conclusions: Student mental health is influenced by both distinct and interacting psychological and socioeconomic mechanisms, emphasizing the need for integrated institutional strategies that address structural vulnerabilities alongside individual psychological resilience.

Background: Myopia in children is one of the key issues in paediatric ophthalmology, due to its high prevalence, tendency to progress, and the risk of serious complications. Despite the widespread use of spectacle correction, the question of the optimal degree of correction remains a matter of debate. Purpose: To assess the effect of various methods of spectacle correction on the rate of myopia progression in children. Materials and methods: A prospective comparative study was conducted involving 73 patients (146 eyes) aged 7–15 years. Patients were divided into three groups: full correction of the spherical and cylindrical components, incomplete spherical correction, and incomplete cylindrical correction. The primary outcome measure was the annual rate of myopia progression (D/year), calculated based on the change in the spherical equivalent of refraction. Statistical analysis included one-way analysis of variance (ANOVA), Tukey’s post-hoc test and the Kruskal–Wallis test. Results: The lowest rate of myopia progression was observed in the full correction group (−1.08 ± 0.53 D/year) compared with the incomplete spherical (−2.03 ± 1.13 D/year) and incomplete cylindrical correction groups (−1.99 ± 0.83 D/year). The differences between the groups were statistically significant (F = 10.824; p < 0.001). The effect size was η² = 0.24, corresponding to a large effect. Additional non-parametric analysis confirmed the results (p < 0.001). Conclusion: Full spectacle correction of myopia in children significantly reduces the rate of disease progression compared with partial correction and may be considered the preferred management strategy in clinical practice. Актуальность: Миопия у детей является одной из ключевых проблем детской офтальмологии, что обусловлено её высокой распространённостью, склонностью к прогрессированию и риском развития серьёзных осложнений. Несмотря на широкое применение очковой коррекции, вопрос оптимального объёма коррекции остаётся дискуссионным. Цель: Оценить влияние различных методов очковой коррекции на скорость прогрессирования миопии у детей. Материалы и методы: Проведено проспективное сравнительное исследование, включающее 73 пациента (146 глаз) в возрасте 7–15 лет. Пациенты были распределены на три группы: полная коррекция сферического и цилиндрического компонентов, неполная сферическая коррекция и неполная цилиндрическая коррекция. Основным показателем являлась годовая скорость прогрессирования миопии (D/год), рассчитанная по изменению сфероэквивалента рефракции. Статистический анализ включал однофакторный дисперсионный анализ (ANOVA), апостериорный анализ Tukey и критерий Краскала–Уоллиса. Результаты: Наименьшая скорость прогрессирования миопии выявлена в группе полной коррекции (−1,08 ± 0,53 D/год) по сравнению с неполной сферической (−2,03 ± 1,13 D/год) и неполной цилиндрической коррекцией (−1,99 ± 0,83 D/год) . Различия между группами статистически значимы (F = 10,824; p < 0,001). Величина эффекта составила η² = 0,24, что соответствует большому эффекту. Дополнительный непараметрический анализ подтвердил полученные результаты (p < 0,001). Заключение: Полная очковая коррекция миопии у детей ассоциирована со статистически значимо более низкой скоростью прогрессирования по сравнению с неполной коррекцией и может рассматриваться как предпочтительная стратегия ведения пациентов в клинической практике. Кіріспе: Балалардағы миопия – жоғары таралуы, өршу тенденциясы және ауыр асқынулардың қаупіне байланысты балалар офтальмологиясының басты мәселелерінің бірі. Көзілдірікпен түзетудің кеңінен қолданылуына қарамастан, түзетудің оңтайлы дәрежесін анықтау мәселесі әлі күнге дейін даулы болып отыр. Мақсаты: балалардағы миопияның өршу жылдамдығына әртүрлі көзілдірік түзету әдістерінің әсерін бағалау. Материалдар мен әдістер: 7–15 жас аралығындағы 73 науқас (146 көз) қатысқан проспективті салыстырмалы зерттеу жүргізілді. Науқастар сфералық және цилиндрлік компоненттерді толық түзету, сфералық түзетудің толық емес түрі және цилиндрлік түзетудің...

Relevance. The growing prevalence of synthetic psychoactive substance use, particularly among young people, is accompanied by an increase in patients with severe forms of dependence and comorbid mental disorders, including borderline personality disorders. Identifying the psychological and social characteristics of this group is crucial for developing targeted support programs. Objective: to conduct a comparative analysis of synthetic psychoactive substance users with and without signs of borderline personality disorders and to identify key psychological and social differences between the groups. Materials and Methods. The present study employed a cross-sectional comparative design and was conducted over the period from January 2023 to December 2024 at the Almaty City Mental Health Center, Republic of Kazakhstan. The study was conducted in 2023–2024 at the Mental Health Center in Almaty. A total of 500 respondents were surveyed using a structured questionnaire. The sample was divided into two equal groups: individuals with borderline personality disorders (n=250) and those without (n=250). Data were analyzed using Spearman's rank correlation method. Results. In the group with BPD, emotional disorders (88%), psychotic symptoms (40%), panic attacks (84%), suicidal thoughts (72%) and attempts (44%) were significantly more common. Significant correlations have been established between the frequency of use, the severity of addiction symptoms, mood changes, and the risks of suicidal behavior. The effectiveness of treatment in patients with BPD was lower (20% versus 36% in the group without BPD). Conclusion. Users of synthetic psychoactive substances with borderline personality disorders demonstrate a more severe clinical profile and a lower response to therapy. These findings highlight the need for integrated assistance programs that include psychotherapeutic and social interventions, with a focus on prevention, early detection, and motivation enhancement. Актуальность. Рост распространённости синтетических психоактивных веществ, особенно среди молодёжи, сопровождается увеличением числа пациентов с тяжёлыми формами зависимости и сопутствующими психическими расстройствами, включая пограничные расстройства личности. Выявление психологических и социальных особенностей этой группы имеет важное значение для разработки целевых программ помощи. Цель: провести сравнительный анализ потребителей синтетических психоактивных веществ с признаками пограничных психических расстройств личности и без таковых, выявить ключевые психологические и социальные отличия между группами. Материалы и методы. Настоящее исследование представляло собой кросс-секционное (поперечное) сравнительное исследование, проведённое в период с января 2023 по декабрь 2024 года на базе Центра психического здоровья города Алматы, Республика Казахстан. Анкетирование охватило 500 респондентов, разделённых на две равные группы: с пограничными расстройствами личности (n=250) и без таковых (n=250). Использовалась структурированная анкета. Применён корреляционный анализ по Спирмену. Результаты. В группе с ПРЛ достоверно чаще встречались эмоциональные нарушения (88%), психотические симптомы (40%), панические атаки (84%), суицидальные мысли (72%) и попытки (44%). Установлены значимые корреляции между частотой употребления, выраженностью симптомов зависимости, изменениями настроения и рисками суицидального поведения. Эффективность лечения у пациентов с ПРЛ была ниже (20% против 36% в группе без ПРЛ). Заключение. Потребители синтетических ПАВ с пограничными психическими расстройствами личности демонстрируют более тяжёлую клиническую картину и низкий отклик на терапию. Это подчёркивает необходимость внедрения комплексных программ помощи, включающих психотерапевтические и социальные интервенции, с акцентом на профилактику, раннее выявление и поддержку мотивации к лечению. Өзектілігі. Синтетикалық психоактивті заттарды, әсіресе жастар арасында қолданудың өсіп келе жатқан таралуы — тәуелділіктің ауыр түрлерімен және қатар жүретін психикалық бұзылулармен, соның ішінде шекаралық тұлғалық бұзылулармен ауыратын науқастар санының артуымен қатар жүреді....

Background/Objectives: Cardiovascular diseases (CVDs) remain a leading cause of mortality worldwide, with a particularly high burden in Central Asian countries. Despite ongoing urbanization, rural populations constitute a significant demographic in this region, yet epidemiological data stratified by urban and rural residence are limited and fragmented. This systematic review aimed to synthesize current evidence on the incidence, prevalence, mortality, and risk factor profiles of CVDs among urban and rural populations in Central Asia, identify disparities, and inform targeted prevention and control strategies. Methods: A systematic literature search was conducted across the PubMed, Science Direct, Web of Science, and Google Scholar databases for studies published between 2015 and 2025. Included studies reported cardiovascular health indicators with urban–rural stratification in Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, and Turkmenistan. Data extraction and qualitative synthesis were performed, with methodological quality assessed using the Newcastle–Ottawa Scale. Results: Eight original studies met the inclusion criteria, encompassing national and regional datasets with diverse designs, including retrospective analyses, cross-sectional surveys, and registry data. Overall, CVD incidence and prevalence showed increasing trends in both urban and rural areas, with consistently higher mortality rates in urban populations. Key modifiable risk factors—hypertension, obesity, dyslipidemia, and smoking—were prevalent, particularly in rural settings. Variability in healthcare access and preventive program implementation contributed to the observed disparities. Limited data from some countries, particularly Tajikistan and Turkmenistan, highlight gaps in epidemiological surveillance. Conclusions: The cardiovascular disease burden in Central Asia demonstrates significant urban–rural disparities, underscoring the need for tailored public health interventions and enhanced healthcare resource allocation in rural regions. Strengthening epidemiological monitoring and implementing region-specific prevention programs targeting modifiable risk factors are imperative for reducing CVD morbidity and mortality. Further high-quality research is necessary to address existing data gaps and optimize cardiovascular health strategies across the region.

Background. Cardiovascular diseases remain a major public health challenge. In predominantly rural regions, the geographical distribution of healthcare resources may limit access to specialist care. Objective. To assess trends in registered cardiovascular morbidity and cardiology service capacity in the Almaty Region and estimate cardiologist workforce requirements for 2026. Materials and methods. A retrospective population-based analytical study used aggregated administrative data. Regional morbidity was assessed for 2019–2024; territorial morbidity, workforce, and bed capacity for 10 territorial units during 2022–2024; and urban and rural hospitalizations for 2022–2025. Surgical and high-technology care indicators were assessed for the available periods. Analyses included descriptive statistics, coefficients of variation, and Pearson correlations. Workforce requirements were estimated using the 2024 dispensary-registered patient population, annual growth, and a planning assumption of one cardiologist per 2,000 patients. Results. Regional registered cardiovascular morbidity increased from 2,319.7 to 2,497.3 per 100,000 population (+7.7%), with the largest increase observed for ischemic heart disease. In 2024, the mean rate across the 10 territories was 5,101.4 per 100,000, with a coefficient of variation of 65.3%. Rural hospitalizations increased from 1,756 to 2,325 (+32.4%). None of the three correlations reached statistical significance (p > 0.05). The projected requirement for 2026 was 84 cardiologists compared with 71 reported in 2024, yielding a net model-based gap of 13. Conclusions. Registered cardiovascular morbidity increased, and substantial territorial variability was observed. Correlations remain exploratory. The workforce projection is a planning estimate rather than a confirmed future shortage. Further assessment of workforce distribution, referral pathways, and access to specialist care is warranted.

Introduction:Allergic rhinitis (AR) is a common IgE-mediated condition that significantly reduces quality of life. Conventional diagnostic methods do not always allow for the accurate identification of causative allergens, especially in cases of polysensitization. Objective: A comparative evaluation of the effectiveness of two molecular allergy diagnostic methods—ImmunoCAP and immunochemiluminescent assay (ICLA)—in patients with allergic rhinitis. Methods: A retrospective study involving 60 patients with confirmed AR was conducted. Sensitivity, specificity, predictive values, and overall diagnostic performance of the methods were analyzed. Pearson’s chi-squared test, ROC analysis, and calculation of AUC were applied. Results: ImmunoCAP demonstrated a sensitivity of 87.8% and an AUC of 0.88. ICLA showed higher specificity (61.3%) and an AUC of 0.79. PPV was comparable (66.7% vs. 65.7%), whereas NPV was higher for ICLA (76.0% vs. 16.7%). The differences between the methods were statistically significant (p = 0.001). Conclusions:Both methods are valuable tools in the diagnosis of AR. ImmunoCAP is preferable for the initial detection of sensitization, while ICLA is more suitable for confirming clinically relevant allergy and minimizing false-positive results. Введение: Аллергический ринит (АР) — распространённое IgE-опосредованное заболевание, существенно снижающее качество жизни. Традиционные методы диагностики не всегда позволяют точно определить причинно-значимые аллергены, особенно при полисенсибилизации. Цель: Сравнительная оценка эффективности молекулярных методов диагностики аллергии ImmunoCAP и иммунохемилюминесцентного анализа (ИХЛА) у пациентов с аллергическим ринитом. Методы: Ретроспективное исследование с участием 60 пациентов с подтверждённым АР. Проанализированы чувствительность, специфичность, прогностические значения и диагностическая эффективность методов. Применялись χ²-критерий, ROC-анализ и расчёт AUC. Результаты: Чувствительность ImmunoCAP составила 87,8%, AUC – 0,88. ИХЛА показал большую специфичность (61,3%) и AUC – 0,79. PPV был сопоставимым (66,7% vs. 65,7%), тогда как NPV выше у ИХЛА (76,0% vs. 16,7%). Различия между методами статистически значимы (p = 0,001). Выводы: Оба метода являются ценными инструментами диагностики АР. ImmunoCAP предпочтителен при первичном выявлении сенсибилизации, ИХЛА — для подтверждения клинически значимой аллергии и снижения количества ложноположительных результатов. Кіріспе: Аллергиялық ринит – IgE-делдалды созылмалы қабыну ауруы. Көп жағдайда дәстүрлі диагностикалық әдістер себепші аллергенді дәл анықтауға мүмкіндік бермейді. Зерттеу мақсаты: Аллергиялық ринитпен ауыратын науқастарда ImmunoCAP және иммунды-хемилюминесценттік талдау (ИХЛА) әдістерінің диагностикалық тиімділігін салыстырып бағалау. Зерттеу әдістері: Алматы қаласындағы клиникада 60 науқасқа ретроспективті зерттеу жүргізілді. ROC-анализ, χ²-сынамасы, AUC, диагностикалық көрсеткіштер есептелді. Нәтижелері: ImmunoCAP сезімталдығы – 87,8%, AUC – 0,88. ИХЛА спецификалығы – 61,3%, AUC – 0,79. PPV салыстырмалы (66,7% пен 65,7%), ал NPV ИХЛА-да жоғары (76,0% пен 16,7%). Айырмашылықтар статистикалық тұрғыдан маңызды (p = 0,001). Қорытынды: Екі әдіс те аллергиялық ринитті диагностикалауда құнды. ImmunoCAP бастапқы скринингке лайық, ал ИХЛА нақты сенсибилизацияны растау үшін тиімді.

This retrospective study evaluates the efficacy of peritoneal dialysis (PD) in mitigating acute kidney injury (AKI) associated with cardiac surgery in newborns. We analyzed data from 120 neonates up to 28 days old who developed AKI post-cardiac surgery and required PD. Statistical analysis was performed using SPSS 26. Results indicated that PD patients were predominantly male (p = 0,007) with an average age of 12,87 days versus 9,32 days (p = 0,015), and an average weight of 3,06 kg compared to 2,76 kg (p = 0,040). Multivariate regression highlighted age (OR = 1,083, p = 0,032), cardiopulmonary bypass duration (OR = 1,081, p = 0,030), and RACHS-1 scores (OR = 4,785, p = 0,037) as significant predictors of PD initiation. Among PD patients, non-survivors had an average age of 10,31 days versus 18,00 days for survivors (p = 0,045), and an average weight of 2,94 kg versus 3,54 kg (p = 0,040). Non-survivors also had shorter cardiopulmonary bypass times (33,63 minutes versus 50,60 minutes, p = 0,036) and aortic cross-clamp times (22,77 minutes versus 26,50 minutes, p = 0,015). Multivariate analysis also showed that younger age (OR = 0,927, p = 0,009), lower weight (OR = 0,597, p = 0,006), higher RACHS-1 scores (OR = 0,432, p = 0,002), longer bypass (OR = 0,969, p = 0,001), and longer cross-clamp times (OR = 0,871, p = 0,007) predicted decreased survival. PD benefits include reduced AKI severity and enhanced survival, particularly in complex cases, despite an increased sepsis risk

Many countries have actively implemented reforms over the last two decades to incrеase the productivity of their healthcare systems and the effectiveness of treatment and prevention activities. And the classical indicators of hospital performance such as the use of hospital beds and the quality of hospital care are the main indicators of good management in a hospital. Material and methods. The object of the study is the medical and statistical performance indicators of the surgical department and the surgical day hospital of the multidisciplinary hospital in Almaty for 5 years (2017–2021). As a source of information, an electronic database of the statistical department of the hospital was used. Medical statistical analysis was applied as a method of study. This type of study is a cross-sectional study based on a retrospective descriptive analysis of official statistics. Results. In terms of dynamics, the structure of those treated in the surgical department does not change. However, there is a significant decrease in the amount of planned surgical pathology compared to the slight drop in hospitalization (a decrease of -40%), possibly due to a decrease in the volume of government orders (a decrease of -43.4%). Within the framework of the state order, the indicator of the average length of stay of a patient in a hospital, in general, tends to decrease from 8,5 in 2017 to 8,2 in 2021. A higher level of surgical activity in the surgical department (76,4% vs. 62,6% in surgical departments in 2021), a lower postoperative complication rate (0,2% vs. 0,3%), and a lower postoperative mortality (0,7% vs. 1,1%) were stated as positive indicators of surgical service. In 2021, the frequency of emergency operations in the surgical department was roughly the same, at 19,1%; the total share of outpatient surgery (for all profiles) in the structure of all surgery was 11,3%. Conclusion. The identified deterioration in the use of hospital beds in the surgical department (decrease in bed turnover, increase in the average duration of one case of hospitalization, decrease in the planned number of bed days) requires improvement of the planning and control system for hospitalization. Perhaps this problem is relevant for many multidisciplinary hospitals

Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan.Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires.Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners.Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees’ working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.