Master thesis

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Browsing Master thesis by Title

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    Analysis of factors associated with profitability of Kazakhstani state hospitals and polyclinics.
    (Nazarbayev University School of Medicine, 2018-05) Shayakhmetov, Yerassyl
    The following study analyzed factors affecting profitability of medical state enterprises. The primary interest of the study was the effect of corporate governance on financial performance of oblast level hospitals and primary care clinics. It was found that the presence of a supervisory board for the hospital or clinic is associated with decreased probability of producing net positive income (37% less chance) in these organizations. Also it was found that characteristics of supervisory boards like number of people in the board and meetings held by supervisory boards are not associated with profitability of state medical enterprises. The profitability of state medical organizations also differed between regions of the country and between organizations located in cities and rural regions.
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    Analysis of GCIP Function in Rheumatoid Arthritis
    (Nazarbayev University School of Medicine, 2024-04-29) Nessipbekova, Assem
    The global burden of rheumatoid arthritis (RA) is increasing for the ageing population. The disease is characterized by progressive joint inflammation and tissue destruction. One of the key players in the pathogenesis of RA is synovial fibroblasts (SF), which invade and destroy the cartilage in the joints. However, the exact molecular mechanism which explains their abnormal outgrowth is yet to be elucidated. Grap2 cyclin D interacting protein (GCIP), a protein related to Id proteins, plays a role in cell cycle progression and gene expression by blocking interactions between (CREB) binding protein (CBP) and RNA polymerase II complexes. A recent study has shown that Grap2 cyclin D interacting protein (GCIP) has been downregulated in the synovial fibroblasts in rheumatoid arthritis patients, suggesting its involvement in disease progression. The knockdown of the GCIP protein resulted in the increased growth of synovial fibroblasts, consequently leading to the upregulation of Cyclin D1, a crucial cell cycle and cell proliferation player regulated by the CREB. This thesis aimed to explore the role of GCIP in the pathogenesis of rheumatoid arthritis by establishing a mouse model of rheumatoid arthritis and testing how GCIP knockout affects the proliferation of synovial fibroblast during RA. Two cohorts of WT and GCIP KO C57BL/6 mice were utilized to induce RA with 2 different protocols. The protocol 2 resulted in a more pronounced disease phenotype in males. Female mice from both showed no visible signs of RA. The role of GCIP on the proliferation of the synovial fibroblasts was not established necessitating a larger cohort size and choosing male mice as a subject.
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    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, Dinara
    The 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.
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    Association between tap water quality and self-reported gastrointestinal and kidney diseases among residents of Astana
    (Nazarbayev University School of Medicine, 2019) Yessimkulova, Fariza
    Access and supply of safe water are vital for human well-being. Previous studies show that the quality of drinking water may affect human health outcomes. This study is aimed to examine perception regarding tap water quality among Astana city residents and its association with gastrointestinal (GI) tract and kidneys associated diseases. A self-reported questionnaire was used for data collection. The survey was distributed via social media groups and hard copies were given in hands. In total, 371 responses were included in the analysis....
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    Association of a body mass index with an in vitro fertilization outcomes
    (Nazarbayev University School of Medicine, 2019) Rakhimova, Makhabbat
    There is evidence about the association between body mass index (BMI) and reproductive system disorders; however the impact of BMI on in vitro fertilization (IVF) treatment outcomes is still controversial in the literature. Therefore, the aim of our study was to investigate the influence of the full spectrum of body mass index (BMI) on IVF treatment and pregnancy outcomes...
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    Association of climate and weather components with incidence of gastric cancer
    (Nazarbayev University School of Medicine, 2019) Aubakirova, Mina
    Today, climate change and cancer are concurrent epidemics, and while each is under scrutiny in its own field, little research concentrates on the interaction of the two. Among other oncological diseases, stomach cancer is the second most common in males and fourth most common in females in Kazakhstan. The country itself takes the twelfth place in the world for age-standardized gastric cancer incidence rates. Therefore, the purpose of the current study is to examine the association of climate and annual weather with incidence of stomach cancer. Hospital admissions for 2014-2017 were obtained from the Ministry of Health of Kazakhstan, whereas climate and weather data were extracted from publicly available online sources. Kruskal-Wallis test, Pearson’s correlation tests, and multiple linear regression with generalized estimating equation were performed in STATA-12. The analyses were done on town levels. Thus, all 87 towns of Kazakhstan were assessed in climate analysis, and 40 towns were analyzed in terms of annual weather....
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    Association of nutrition related knowledge and self-efficacy with unhealthy eating behavior among university students of Astana city
    (Nazarbayev University School of Medicine, 2019) Ainabekova, Assel
    Poor diet is associated with risk for obesity, cardiovascular diseases and other noncommunicable diseases, which nowadays are the main causes of death worldwide. The aim of this study was to examine the association of unhealthy-eating behavior with nutrition-knowledge and self-efficacy to resist unhealthy eating among university students. The additional objective of our study was to determine the stages of change towards healthier eating behavior and to identify factors associated with each of the stages.
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    Association of Phase II Drug Metabolizing Enzyme and Hormonal Balance Single Nucleotide Polymorphisms (SNPs) with Autism: A Case Control Study
    (Nazarbayev University School of Medicine, 2019) Izimov, Aidarkhan
    Autism is a neurodevelopmental, chronic disease that is classified under Autism Spectrum Disorder (ASD) group. Considering high prevalence of 14.6 per 1000 children, all of these symptoms and conditions place both physical, emotional and economic burden on patients with autism and their relatives. One of the genetic determinants that affects ASD development is increased oxidative stress as a result of improper phase II drug metabolism enzyme function. Additionally, considering the higher prevalence of autism in males than females with a ratio of 3:1, it is important to understand genetic factors and pathways that play role in the sex difference. Therefore, the aim of this study was to analyze the association between phase II drug metabolism-related and hormonal balance related SNPs with autism. Based on the case control data among 1737 participants from Melbourne, Australia, among 6 statistically significant SNPs based on simple logistic regression, only 3 phase II metabolism related SNPs were statistically significant in final, age and gender adjusted model – GSTP1, QR1 and HO-1. None of the hormonal balance related SNPs were statistically significant at the final model. Considering high power of this study, based on the finding several possible implications can be applied in the future, including early diagnosis and the diet based on genetic profiling.
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    ASSOCIATION OF POSITIVE MENTAL HEALTH LITERACY WITH MENTAL WELL-BEING AMONG UNDERGRADUATE STUDENTS OF NAZARBAYEV UNIVERSITY
    (Nazarbayev University School of Medicine, 2022) Akisheva, Guldana
    Background The increase in the prevalence of mental disorders in young adults requires more attention on improving mental health and mental health literacy (MHL). Although majority of previous studies focused on recognition and prevention of mental illnesses, very few studies were focused on positive mental health literacy (PMeHL), part of MHL which defines knowledge about how to obtain and maintain good mental health. Therefore, the aim of this study was to examine the relationship between positive mental health literacy and mental well-being of undergraduate students in Kazakhstan. Methods The data was obtained from a cross-sectional study based on a survey of 122 undergraduate students aged 18–22 years at Nazarbayev University in Nur-Sultan city. WHO-5 Well-Being Index was utilized to evaluate mental well-being, and Mental Health Promoting Knowledge-10 item scale (MHPK-10) was used to assess PMeHL. The relationship was evaluated using a multiple linear regression model adjusting for possible covariates, including socio-demographic and lifestyle characteristics of students. Statistical threshold was determined at p<0.05. Results The sample included 35% of males and 65% of females, with the mean age of 19.5 years. PMeHL had a positive impact on mental wellbeing, where every increase in the score of PMeHL was significantly associated with increase in the score of mental well-being by 0.23, while adjusting for gender, age, family’s support, father’s education level, and physical exercising behaviour. Additionally, gender differences were observed in mental well-being, where mean of mental well-being was equal to 2.80 for males and 2.27 for females. Gender, physical exercising behaviour, father’s degree of education, family’s support were found to be sufficient in predicting mental wellbeing of undergraduate students. Conclusion Current study determined the positive impact of PMeHL on undergraduate students’ well-being. Additionally, family’s support and physical exercising behaviour have shown an advantageous effect on establishing better mental wellness. The results of the study can be used by stakeholders of Kazakhstan in public health campaigns that are focused on the improvement of adolescents’ mental health. Keywords: mental well-being, positive mental health literacy, undergraduate students, Kazakhstan, survey
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    Association of problem gambling with psychosocial characteristics among undergraduate students in Astana, Kazakhstan
    (Nazarbayev University School of Medicine, 2018-04-27) Janabel, Gulzira
    Background. 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.
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    Athletes of Astana: characteristics and associations of sports related injuries and psychological disorders
    (Nazarbayev University School of Medicine, 2019) Bex, Torekhan
    In addition to the positive effects of sport on the general health of a person, it is also accompanied by a high risk of injury. According to SRITO in 2010 about 10500 athletes sustained sports related injury. Additionally athletes face psychological disorders, like insomnia, depression and anger episodes. Sports related injuries and a psychological disorder affects each other, increasing the risk of developing psychological and physical traumas. The aim of this study is to identify the prevalence and possible risk factors of injuries and mental disorders among athletes of Astana....
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    Awareness, Knowledge and Attitudes about human papillomavirus infection and vaccination among university students in Astana
    (Nazarbayev University School of Medicine, 2018-05) Shokanbayeva, Torgyn
    Human 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.
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    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.
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    Bullying among adolescents in Astana, Kazakhstan: Prevalence and Associated Factors
    (Nazarbayev University School of Medicine, 2018-05) Turegeldiyeva, Madina
    Bullying 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.
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    Burnout of Medical Workers in Astana, Kazakhstan: Prevalence and Associated Factors.
    (Nazarbayev University School of Medicine, 2018-05) Abdiorazova, Aigerim
    Burnout 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.
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    Caregiving burden among family members/informal caregivers of cancer patients in Nur-Sultan city, Kazakhstan: A Qualitative Research Study
    (Nazarbayev University School of Medicine, 2020-05) Sarkyt, Kaznagul
    Introduction: When a person develops cancer, it is family members who provide the context for this experience, but they themselves are often profoundly affected by the disease. In Kazakhstan, a post-Soviet state, accessing quality services and effective interventions for caregivers of cancer patients is challenging due to the shortage of support services, and lack of research in this area. So, to better facilitate adequate and effective interventions, it is crucial to unravel caregivers’ burden experiences of caring for cancer patients. Aims: 1) To determine what burdens caregivers of cancer patients carry due to their caregiving responsibilities in Nur-Sultan; 2) To define what kind of social support caregivers perceive in Nur-Sultan; 3) To understand caregivers’ needs of informal caregivers in Nur-Sultan; 4) To examine the caregiver perceptions regarding the healthcare and patient management for cancer patients in Kazakhstan. Methods: A qualitative research study was conducted with two male and seven female informal caregivers of cancer patients in Nur-Sultan city. The sample size was determined through achieving saturation. Each participant was involved in 30-45 minutes semi-structured in-depth interview. Each interview was audio-taped, transcribed, translated from Russian and Kazakh languages to English, and analyzed using the framework approach, which is based on thematic analysis. The research was approved by Institutional Research Ethics Committee of the Nazarbayev University School. Informed consent was taken from each participant before the interview. Results: Caregiving burden is used to describe multiple dimensions of distress that result from an imbalance between care demands and the availability of resources to meet those demands. Caregiving leads to many physical and psychological problems. People in Kazakhstan addressed their emotions with stoicism and positivity, they feel reluctant to show their feelings of exhaustion, sadness, anxiety and depression. In the effort to provide the best care, caregivers usually neglect their own health and needs. There is a total absence of support for caregivers from the state in Kazakhstan. People receive social and mental support from their family members and friends. Discussion: Most results were similar to previous findings in other countries. Caregivers’ quality of life is compromised due to the physical and emotional burden due to the shortage of time, change in roles and high level of caregiving responsibilities. Caregiving lead to positive experiences as well, such as increased feeling of love, compassion, religious and spiritual development. In our country, there are no family caregivers support programs available, and Healthcare management is not well-developed and has many problems. Those all challenges may be due to that Kazakhstan is still developing in medicine. Conclusion: This study introduced the first qualitative research on caregiving burden among informal caregivers of cancer patients in Kazakhstan. The findings revealed caregiving issues experienced by family caregivers of cancer patients in Nur-Sultan, their changing social and spiritual lives. It also underlined caregivers’ social and financial support needs from the state.
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    Compliance of antibiotic prophylaxis therapy with clinical protocols.
    (Nazarbayev University School of Medicine, 2018-05) Bizhigitova, Raushan
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    Costs associated with obesity in Kazakhstan
    (Nazarbayev University School of Medicine, 2018-05) Kosherova, Zhanar
    The 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.
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    Depression and stress among medical students in Kazakhstan
    (Nazarbayev University School of Medicine, 2019) Ismailova, Leilya
    There is accumulated evidence about the increased level of stress and depression among medical students, which may negatively affect their academic performance, health status, and, possibly may eventually compromise future clinical practice and quality of patient care. Our study aim was to evaluate the prevalence of depression and its association with academic stress and other potential risk factors among medical students of Kazakhstan....
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    Determinants of nonadherence to hypertension treatment among patients in Astana city: A pilot study
    (Nazarbayev University School of Medicine, 2018-05) Salkhayeva, Botagoz
    The 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.