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Nazarbayev University Repository (NUR) is an institutional electronic archive designed for the long-term preservation, aggregation, and dissemination of scientific research outcomes and intellectual property produced by the Nazarbayev University community and affiliated organizations.

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Recent Submissions

Access status: Embargo ,
Traditional Medicine in Modern Kazakhstan: A Mixed-Methods Analysis of Traditional Chinese and Traditional Kazakh Medicine Utilization and Public Policy Implications
(Nazarbayev University School of Medicine, 2026-04) Assan, Dilda; Crape, Byron
Background: Traditional Chinese Medicine (TCM) and Traditional Kazakh Medicine (TKM) are increasingly prominent in Kazakhstan's healthcare landscape, yet no population-level data exist on their use, public perceptions, or policy attitudes. This study addresses that gap as both TCM — promoted through China's Health Silk Road initiative — and TKM — revived as part of Kazakhstan's post-independence cultural agenda — gain increasing prominence. Methods: A mixed-methods design was employed. Phase 1 consisted of a cross-sectional online survey, from which 121 complete responses were included in the final analysis. Descriptive statistics, chi-square tests, and binary logistic regression were conducted using Stata. Phase 2 included four semi-structured in-depth interviews analyzed through Braun and Clarke's (2006) thematic framework. Results: TKM use was more prevalent (57.0%) than TCM use (42.1%), with 34.7% of respondents using both systems. Age was the only significant demographic predictor: adults aged 35–44 were significantly less likely to use TKM than those aged 18–24 (OR = 0.055, p = 0.014), suggesting a generational rupture in oral knowledge transmission. Cultural heritage was the primary motivation for TKM use (44.9%) and trusted-source recommendation for TCM use (23.5%). Dissatisfaction with conventional medicine was rarely cited (<4%) as a driver for either system. Family and friends were the dominant information source for both; social media was widely accessed but consistently distrusted. Awareness of the Health Silk Road was limited (15.7% very aware) and was not associated with TCM use. Strong public support emerged for regulating both TCM practitioners (66.9%) and TKM practitioners (71.1%). Qualitative findings identified five themes: stepwise navigation of medical pluralism, an epistemological divide between experiential and evidence-based knowledge, family-centered trust networks, a regulatory void characterized by concerns about unqualified practitioners, and complex cultural and geopolitical tensions surrounding TKM's heritage status and TCM's soft power expansion. Conclusion: TCM and TKM function as complementary additions to, rather than replacements for, biomedical care in Kazakhstan. Traditional medicine use is driven primarily by cultural and social motivations, challenging the assumption that alternative medicine use reflects biomedical dissatisfaction. TKM faces a critical "visibility problem" — a documentation deficit relative to TCM rooted in Soviet-era suppression and insufficient post-independence investment. The regulatory void represents the most urgent public health priority. These findings provide the first empirical foundation for evidence-based traditional medicine policy in Kazakhstan, including practitioner regulation, TKM documentation, and evidence-informed health diplomacy with China.
Access status: Embargo ,
Yield Curve Analysis of Kazakhstan’s Government Bonds Using PCA and Time Series
(Nazarbayev University School of Sciences and Humanities, 2026-04) Yemelyev, Adilkhan; Sarsenbayev, Timur; Skrzypacz, Piotr; Otemissov, Adilet
We apply Principal Component Analysis to the monthly panel of Kazakhstan's sovereign zero-coupon yields from June 2018 to January 2026, covering 26 maturities, and find that three principal components explain 99.9% of the cross-sectional variance, with loadings matching the canonical level, slope, and curvature factors documented for developed markets. The factor dynamics align closely with Kazakhstan's 2022 macroeconomic and geopolitical shocks: the level factor accelerates with the National Bank's tightening cycle, the slope plunges sharply after February 2022, and the curvature factor spikes during episodes of elevated uncertainty. Augmented Dickey-Fuller tests and AR(1) estimates reveal a clear persistence hierarchy: the level factor is near unit-root with a half-life of roughly 20 months, while slope and curvature are stationary with half-lives of 3.5 and 1.3 months respectively. In an out-of-sample forecast comparison, our PCA+AR(1) framework outperforms both Principal Components Regression and the Random Walk benchmark at the long end of the curve, with statistical significance at the 26-year maturity under the Diebold-Mariano test.
Access status: Open Access ,
Assessment of Knowledge and Stigmatisation towards Eating Disorders in Nazarbayev University Students in Kazakhstan
(Nazarbayev University School of Medicine, 2025-04-25) Li, Alina; Foster, Faye; Stolyarova, Valentina
Background: Eating disorders (EDs) are serious psychiatric conditions that are frequently misunderstood and underdiagnosed, particularly in non-Western contexts. Despite growing evidence of the importance of early identification and intervention, the majority of eating disorder mental health literacy (ED-MHL) and stigma research assesses adolescents or clinical samples from Western countries. The aim of this study was to assess ED-MHL, endorsement of ED myths, and personal stigma among young adults at Nazarbayev University in Kazakhstan. Method: There was a cross-sectional web-based survey of 121 students between the ages of 18–26 years old from non-medical university programs. Students completed three empirically validated measures: the ED-MHL questionnaire (18 factual items), the ED Myths questionnaire (11 items), and the Universal Stigma Scale (USS) measuring blame/personal responsibility and impairment/distrust. Descriptive, inferential, and correlation analysis examined associations between ED-MHL, stigma, and demographics. Results: Median ED-MHL score was 10/18, indicating moderate knowledge, and higher in female students. Male students endorsed ED myths more and had greater stigma on both USS subscales. No differences were seen across academic programs. Most endorsed myths were regarding family blame and dieting norms. Correlation analysis revealed that greater ED-MHL was associated with lower endorsement of myths and lower stigma, particularly in the blame/personal responsibility dimension. Conclusion: This study establishes moderate ED awareness and presence of ED-related stigma among young adults in Kazakhstan, especially among male students. Educational interventions for debunking widespread myths and stigma are crucial to enable early detection and help-seeking behaviors within university settings. Results highlight the need for culturally targeted interventions to strengthen ED-MHL and remove stigma, ultimately towards better mental health outcomes in young adult samples.
Access status: Open Access ,
Assessing Neurodiversity Acceptance Among University Students: A Survey Study at Nazarbayev University
(Nazarbayev University School of Medicine, 2025-04) Orazgali, Kamila; Foster, Faye; Stolyarova, Valentina
The prevalence of autism is rising worldwide, leading to different challenges faced by university students. It highlights the need for understanding and promoting autism acceptance in university context. However, there is limited research that addresses this issue in Kazakhstan’s universities. Objectives of this research are to assess the current level of neurodiversity and autistic acceptance among university students and examine the impact of socio-demographic variables on attitudes towards neurodiverse people. A cross-sectional study was conducted in Nazarbayev University between February 2025 and March 2025 using the Autism Attitude Acceptance Scale (AAAS) developed by Kim (2020). The survey included 101 respondents and had 3 parts: socio-demographic data, AAAS subscale questions and questions for neurodiversity awareness. The data was analyzed using descriptive and inferential statistics. Nazarbayev University students showed moderately high General Acceptance (GA) level (M=3.92, SD = 0.68), while the mean score for Attitudes toward Treating Autistic Behavior (ATAB) was lower (M=2.17, SD = 0.80) showing limited acceptance of autism as a condition which should not be cured and accepted as it is. Significant differences were found between local and international students, with international students being more accepting of autism than local students (p = 0.019). Familiarity with neurodiversity concept found to be associated with higher level of General Acceptance score (p = 0.002). No significant difference was found in age, gender, major and previous contact level with autistic individuals.
Access status: Embargo ,
Investigating the role of the genetically modified k.lactis in the treatment of inflammatory bowel disease
(Nazarbayev University School of Medicine, 2026-05-18) Bokayeva, Meruyert; Reithmacher, Eva
Abstract Background: Inflammatory Bowel Disease (IBD) is a major health care problem. It is characterized by chronic and relapsing inflammation of the gastrointestinal tract, causing damage to the cells. The clinical manifestations are heterogeneous and include abdominal pain, rectal bleeding, diarrhea, and weight loss. It includes two predominant clinical forms, such as Crohn’s disease and ulcerative colitis. Modern lifestyle and environmental triggers led to increasing incidence and prevalence rates among the population. In 2019, 4.5 million people were diagnosed with IBD. IBD is a multifactorial disease. Genetic predisposition, environmental factors, immune dysregulation, and microbial flora are key factors in the development of IBD. The pathophysiological mechanism of IBD involves an imbalance between pro-inflammatory and anti-inflammatory chemokines. CCL5 (C-C chemokine ligand 5) is a pro-inflammatory chemokine. It plays the pivotal role in activating multiple inflammatory pathways in IBD, such as PI3K/ATP, NF-kB and Ras/MAPK. Therefore, the CCL5-CCR5 axis is a potential therapeutic target in the treatment of IBD. Currently, existing treatment approaches often have systemic adverse effects. It is known that probiotics restore microbiota, enhance the intestinal barrier, and regulate immune response in the GIT by enhancing differentiation of regulatory T cells. Genetic modification of intestinal bacteria and yeasts are used in order to enhance the therapeutic effect. It offers a local expression of therapeutic molecules or proteins, avoiding the systemic effect on organisms. Kluyveromyces lactis (K.lactis) is an anti-inflammatory probiotic and is used in the food industry. Recent evidence suggests that wild-type K.lactis improves the symptoms in the mouse model of IBD. We developed a genetically modified K.lactis that expresses a CCR5 antagonist to reduce inflammation process. Objective: The objective of this study is to investigate the influence of genetically modified K.lactis expressing CCR5 antagonist on the inflammatory process of IBD, using MMP-10 expression as marker of intestinal inflammation in an IBD mouse model. Methods: The acute form of Crohn’s disease-like colitis in C57BL/6 mice will be induced by rectal administration of TNBS. Mice will additionally be treated by the wild-type K.lactis strain and genetically-modified strains, respectively, while the control group will receive no further treatment. The symptoms of IBD will be evaluated during the experimental period. After the sacrifice, the intestine will be isolated. MMP-10 expression will be analyzed by immunofluorescence to assess the degree of intestinal inflammation and the therapeutic effect of CCL5 antagonist. Results: it is expected that the genetically-modified K.lactis strains will reduce the inflammatory markers in mice by expressing the CCR5 antagonist. Conclusion: The use of genetically-modified probiotics provides an important opportunity to advance the treatment of IBD. The genetically-modified K.lactis serves as a potential new therapeutic approach. By locally expressing a therapeutic molecule in the intestine, such as a CCR5 antagonist, it reduces the inflammatory markers of IBD, including MMP-10 expression, and systemic adverse effects on organisms.