07. School of Medicine
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Item Open Access Undergraduate students’ knowledge, attitude and perceptions of infertility, infertility risks and treatment within universities in Astana, Kazakhstan.(Nazarbayev University School of Medicine, 2018) Abdukhakimova, Diyora; Alibekova, Raushan; Crape, ByronInfertility is a global issue that affects millions (Sami,2006). According to the World Bank, the fertility rate has declining trend in Kazakhstan. Infertility does not have only medical consequences, it also leads to psychosocial and economic issues, thus has public health importance (Rouchou, 2013). Social consequences of infertility consist of stigma, marital instability, social health risks and domestic violence (Rouchou, 2013). This types of social aspects of infertility were detrimental in setting psychological issues in infertile people. The psychological problems included depression, anxiety and identity predicaments (Hasanpoor-Azghdy, 2014). Fertility has immense importance for infertile people. But infertility treatment is costly, thus can bring a financial burden to those who cannot afford it (White, 2005; Boivin, 2007). Knowledge of infertility risks and its treatment options can help to decrease the incidence of infertility by educating youth.Item Open Access Association of problem gambling with psychosocial characteristics among undergraduate students in Astana, Kazakhstan(Nazarbayev University School of Medicine, 2018-04-27) Janabel, GulziraBackground. The prevalence of probable pathological gamblers among college students worldwide doubled in 15 years. While gambling addiction causes financial and social losses, there is lack of studies on gambling involvement in Kazakhstan. Aims. The current research aims to find the prevalence of gambling, explore the link with sociodemographic and psychological variables among college and university students is Astana, Kazakhstan. The study also aims to evaluate the association between gambling and school satisfaction, which was not reported before. Methods. The analysis included questionnaires of 399 students from three universities and three colleges in Astana, using random sampling. The survey consisted of demographic questions, and scales on anxiety and depression, alcohol use, school satisfaction, family cohesion and suicide ideation. Results. From 399 questionnaires analyzed, 5.76% were classified as pathological gamblers according to the gambling scale used. The most popular gambling type was betting on sport events with bookmakers. 12.4% reported placing a bet through bookmakers at present time, and of them 91.5% were male, around half (46.8%) were categorized as some-problem gamblers, and one-third (36.1%) as pathological gamblers. Two-third of them (66%) did not reach legal age for gambling. Pathological gamblers in comparison with non-gamblers/non-problem gamblers are more likely to be male, aged older than 21, have alcohol use disorders, have lower family cohesion, more frequent suicide ideation, and their fathers have no after school education. Some-problem gamblers in comparison with non-gamblers/non-problem gamblers are more likely to be male, have lower school satisfaction, show symptoms of depression, and do not combine work and study. Conclusions. The study gives the first overview for gambling problem and associated problems among undergraduate students in Astana. Associates of problem gambling is consistent with the literature. Since every fourth male in the study places a bet with bookmakers, and majority had a gambling problem, there is need for developing interventions to increase awareness and prevent problem gambling and associated psychosocial problems.Item Open Access Health economics analysis of mammography screening program in the Republic of Kazakhstan(Nazarbayev University School of Medicine, 2018-05) Salikhanov, IslamBreast cancer (hereinafter - BC) is the most frequent type of cancer among women in the Republic of Kazakhstan, accounting for almost 12% of all cases of cancers in the country [1]. Kazakhstan has the highest rates of breast cancer in the Central Asian region. Local physicians associate it with lack of breastfeeding, use of hormonal drugs, and poor ecological conditions [2]. There were 3,400 new cases of BC in Kazakhstan in 2016 [3], while number of deaths in the same year reached 1,022 [4]. The age-adjusted death rate from BC is 21.50 per 100,000, which ranks Kazakhstan 35th in the world [32]. The prevalence of BC reached 22.7 per 100,000 in 2013, and it has been increasing constantly, affecting younger population aged 25-40. It also takes the first place in mortality rates among all cancers in the 45-50-year age group. Between 1990 and 2010 the annual years of healthy life lost from breast cancer in Kazakhstan has increased by 44.0% [5]. In 1990, BC led to 38,000 years of life lost (hereinafter - YLL) in Kazakhstan. In 2010, the prevalence rate of BC has raised by 17% leading to 44,000 YLL [6].Item Open Access Prevalence and associated factors of postpartum depression in Astana, Kazakhstan(Nazarbayev University School of Medicine, 2018-05) Zhanasbayeva, ZhansayaPostpartum depression (PPD) is recognized as the major public psychological health issue that affects 13% of women at postnatal period worldwide (O’Hara and Swain, 1996). Currently, there is a lack of information about the state of PPD in Kazakhstan, Central Asian country with population of 17.8 million. To bridge this gap, PPD prevalence and risk factors among women in Astana, the capital of Kazakhstan, were evaluated.Item Open Access Prevalence of internet addiction and its association with mood and sleep disorders among young adults in Astana, Kazakhstan(Nazarbayev University School of Medicine, 2018-05) Tolegenova, AkbotaIn recent years, the Internet has become the most essential tool in both studying and entertainment, by giving the fast and easy access to all the information for students. However, uncontrolled excessive use of internet negatively influences a person’s life, leading him to “Internet addiction” (IA) or “Problematic Internet use”. Despite the fact, that more than half of Kazakhstani population (55.8 %), which is approximately 10 million, uses internet on a daily base, there is a lack of studies on internet addiction in Kazakhstan. Therefore, our study aims were: (1) to estimate the prevalence of IA among university and college students; (2) to explore the association of IA with various factors, related to socio-demographics, family relationships, mood and sleep disorders, self-esteem, physical and social activities, and academic performance of the students.Item Open Access Mental health and suicidality among gay and bisexual men in Kazakhstan. A prevalence study.(Nazarbayev University School of Medicine, 2018-05) Seksenbayev, AzamatSuicide is the act of killing yourself. According to WHO about 800,000 people die by suicide annually and many more attempt it. The evidence shows that global burden of suicide lay heavily on low- and middle-income countries. In 2015, 78% of all known suicides occurred in these countries, and suicide accounted for 1.4% of all deaths worldwide, and ranked as 17th leading cause of death (WHO, 2013). Men are more likely to die of suicide than women, and this is more prominent in high-income countries with ratio of three men to every woman.Item Open Access Understanding future career choices of undergraduate medical students and their perceptions towards primary care work life: a national cross-sectional survey(Nazarbayev University School of Medicine, 2018-05) Zhabatayeva, MoldirItem Open Access Patient satisfaction with physician-patient communication in outpatient care: A pilot study(Nazarbayev University School of Medicine, 2018-05) Tursynkhan, AigerimMeasurement of patient satisfaction plays an important role in the health care practice to improve overall health care delivery of health care organizations, to do effective strategic decision making and monitoring of health care performance. There is a shortage of studies conducted about patient satisfaction with health system of former Soviet Union countries, as the range of patient satisfaction studies is limited mainly to countries of the USA and Europe (Footman et.al. 2013). Consequently, there is no standard scale which can be used for studies about patient satisfaction with physician-patient communication. Aim. 1) to identify the level of patient satisfaction with physician – patient communication in outpatient care; 2) to explore factors associated with patients’ satisfaction with physician-patient communication.Item Open Access Determinants of nonadherence to hypertension treatment among patients in Astana city: A pilot study(Nazarbayev University School of Medicine, 2018-05) Salkhayeva, BotagozThe purpose of this study was to assess the level of nonadherence to hypertension treatment and to identify the associated factors among patients with hypertension. This was a cross-sectional study. 48 participants were recruited at the urban polyclinic #8 in Astana city for this pilot study. The study participants were patients enrolled to the therapeutics appointment with diagnosis of hypertension. Overall, 48 patients consented to participate and filled out the self-administered questionnaires. The survey consisted of five sections, including questions on socio-demographic characteristics, health lifestyles, dietary habits, antihypertensive drug adherence, and perceptions of severity and susceptibility to hypertension, perception of barriers and benefits of hypertension treatment. Descriptive, bivariate and multivariate logistic regression analyses were conducted in Stata 12.Item Open Access Prevalence and associated factors of job satisfaction among physicians working in public hospitals in Astana, Kazakhstan(Nazarbayev University School of Medicine, 2018-05) Makhanov, KuatPhysician job satisfaction is an important factor of quality and sustainability of health care provision, as it determines lengths of care and subsequently health care costs. It is also associated with such aspects of healthcare as quality of the care and physician work efficiency There is a general tendency in declining job satisfaction among health care workers in many countries; although there were no studies found in the literature on job satisfaction among physicians in Kazakhstan. The purpose of the study is to estimate the prevalence and to determine factors of working conditions associated with job satisfaction among physicians working in public hospitals in Astana city of KazakhstanItem Open Access Costs associated with obesity in Kazakhstan(Nazarbayev University School of Medicine, 2018-05) Kosherova, ZhanarThe aim of this study is to estimate direct medical costs attributable to obesity in Kazakhstan from the governmental perspective for 2008, 2020 and 2030. Cost-of-illness prevalence-based approach was used to estimate the medical direct costs including hospital care, drugs, physician and nursing care covered by the government. There are three types of data required for this study including the actual and predicted estimates of prevalence of the obesity in Kazakhstan for 2008, 2020 and 2030, relative risks for IHD, stroke and T2D and costs on specific disease treatment. All the required information was taken from the secondary data. Thus, the main formula includes multiplying Population Attributable Fraction by the costs for diseases’ treatment.Item Open Access Identifying and measuring associations between dietary factors and the risk of developing gastric cancer in Astana, Kazakhstan: preliminary findings from an ongoing study(Nazarbayev University School of Medicine, 2018-05) Sadykova, GulnazGastric cancer is one of the most common type of cancer in Kazakhstan as well as worldwide with high mortality and morbidity rate. The aim of the study is to identify and measure associations between nutritional risk factors and the risk of having gastric cancer in Astana, Kazakhstan.Item Open Access Factors associated with adult pulmonary TB treatment outcome: East Kazakhstan Region(Nazarbayev University School of Medicine, 2018-05) Magzymova, GulsimKazakhstan is in top 18 countries with the highest TB burden in European region [2, 9]. The tuberculosis burden for Kazakhstan is very high, annual years of healthy life lost per 100,000 people from tuberculosis in Kazakhstan has increased by 19.8% since 1990, an average of 0.9% a year. This research investigated factors associated with treatment outcome failure. The following factors has been examined: age, sex, residence, socio-economic status, year of admission, length of stay in the hospital, drug resistance, medical organization, hospital admission type. It has been found that following factors are associated with increased TB treatment outcome failure: being male by 17%; drug resistance by 206%; being emergency admitted to the hospital by 47%. Factors that are associated with decreased treatment outcome failure: being treated in Ust-Kamenogorsk TB center by 34%; being employed (as compared to being unemployed) by 36%; being student (as compared to being unemployed) by 65%; one additional day of stay by 1%. However, it should be admitted that obtained factors’ association are generalizable for East-Kazakhstan region only due to study design limitations.Item Open Access Awareness, Knowledge and Attitudes about human papillomavirus infection and vaccination among university students in Astana(Nazarbayev University School of Medicine, 2018-05) Shokanbayeva, TorgynHuman Papilloma virus is one of the most common infections caused by a virus. Most importantly is the fact that this infection can lead to cervical cancer, which represents a great burden for Kazakhstani women. There is a vaccine to prevent cervical cancer. Kazakhstan has introduced human papilloma virus vaccination program. However, there are no published public health studies about behavioral perception towards HPV and HPV vaccination that could support and encourage such a vaccination program.Item Open Access Burnout of Medical Workers in Astana, Kazakhstan: Prevalence and Associated Factors.(Nazarbayev University School of Medicine, 2018-05) Abdiorazova, AigerimBurnout is a state of physical, mental, and emotional exhaustion that arises as a result of being involved in emotionally demanding work situations. It has been reported that burnout is associated with high employee turnover, absenteeism, and poor performance. Research suggests that medical workers are more susceptible to burnout due to the challenging nature of their work, compared to other occupations. Health problems, including incapacity to deal with stress and development of major diseases, shortage of medical workforce due to burnt out specialists leaving the field, reduced quality of care and increased risk of medical errors are the risks associated with burnout in medical workers. This cross-sectional study aimed to identify prevalence of burnout among medical workers in Astana, Kazakhstan using Copenhagen Burnout Inventory questionnaire, to determine associated factors, and to give recommendations based on the findings. The final sample of data collected from an online survey included 363 responses in total. Prevalence of high personal burnout showed to be 82.1% among Astana medical workers, high work-related burnout – 66.9%, and high patient-related burnout – 53.1%. Multiple logistic regression analysis showed that self-rated health status and overwork were the factors statistically significantly associated with personal burnout; age, self-rated health status and overwork were associated with work-related burnout; and overwork was associated with patient-related burnout. It is recommended that healthcare organizations promote healthy lifestyle among their workers, and trainings on burnout could be provided for staff as a measure of identifying and preventing burnout.Item Open Access Awareness, perceptions and understanding of postpartum women and healthcare providers about the postpartum depression: a qualitative study(Nazarbayev University School of Medicine, 2018-05) Kanderzhanova, Akbota;Postpartum depression is a major public health problem and linked to mothers’ reduced ability of sensitive parenting and increased risk of developmental delays of children. Its prevalence was estimated as 13% in Western countries and 19.8% in lower and middle-income countries. No previous studies have explored the perspectives of postpartum women and healthcare providers regarding postpartum depression in Kazakhstan. The aim of this research is to explore postpartum women’s and healthcare providers’ awareness, understanding and perceptions of postpartum depression, acceptability of the Edinburgh Postnatal Depression Scale (EPDS), and postpartum mental healthcare practices in Kazakhstani context.Item Open Access Antibiotic/antimicrobial resistance patterns of bacterial pathogens isolates from national research center for mother and child health in Astana, Kazakhstan(Nazarbayev University School of Medicine, 2018-05) Iskhakova, DinaraThe rapid emergence of drug resistant bacteria is occurring worldwide, endangering the efficacy of antibiotics, which have transformed medicine and saved millions of lives (1-6). Many decades after the first patients were treated with antibiotics, bacterial infections have again become a threat (7). The antibiotic resistance crisis has been attributed to the overuse and misuse of these medications, as well as a lack of new drug development by the pharmaceutical industry due to reduced economic incentives and challenging regulatory requirements.Item Open Access Bullying among adolescents in Astana, Kazakhstan: Prevalence and Associated Factors(Nazarbayev University School of Medicine, 2018-05) Turegeldiyeva, MadinaBullying is one of the main negative phenomenon in children’s mental health development. Studies worldwide showed the association of bullying with different factors, such as gender, race, family and peer relationships, perceptions related to life, health etc. The situation of bullying is not yet explored in Kazakhstan due to absence of proper monitoring tools. The aim of this study was to (1) assess the prevalence of the bullying among school children aged 11-15 years old, and (2) examine patterns of the association between bullying and socio-demographic, mental and physical health characteristics among schoolchildren of Astana city, Kazakhstan.Item Open Access Obstacles and Opportunities of Pursuing a Career of a Surgeon for a Female Physician in Kazakhstan: A Qualitative Research Study(Nazarbayev University School of Medicine, 2018-05) Zhumagali, YenglikAn important factor to consider the effectiveness of a healthcare workforce is a gender balance. A gender imbalance in an organizational structure can lead to poor performance of a health service organization. Determinants of women being underrepresented in a health service organization are discrimination, sexism, stereotyping, glass ceiling phenomenon, and inability to manage job and family. Though Kazakhstan is considered to be rated highly for human development, women are underrepresented in such medical specialties as surgery. To our knowledge, there have been no studies conducted on obstacles and opportunities for careers of women in medicine, specifically in surgery, in Kazakhstan.Item Open Access Prognostic capacity of preoperative levels of selected blood inflammatory markers for glioma patient’s survival(Nazarbayev University School of Medicine, 2018-05) Yelaman, KonysbekGlioma is considered to be a rare type of cancer of the central nervous system (CNS) with the average age-adjusted incidence rate of 3.4 per 100, 000 population. Moreover, gliomas are the most common type of malignant brain tumors among adult population. They account for about 80% of all diagnosed brain tumors originating from brain parenchyma. Despite achievements in medical treatment and technologies glioblastoma patients still have poor prognosis with 3-5% of surviving patients after 12-15 months following standard therapy. In addition, recent studies highlight importance of blood, and molecular markers in predicting presence of gliomas.