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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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    THE EFFECT OF RADIATION ON THE INCIDENCE AND MORTALITY FROM SOLID CANCER IN EAST KAZAKHSTAN AND PAVLODAR REGIONS, KAZAKHSTAN
    (School of Medicine, 2023-04) Akhanov, Ualsher
    Semey (Semipalatinsk) Nuclear Test Site (SNTS) presents a substantive importance for interdisciplinary research in fields of radiology, radiation protection and environmental health. The potential effect of nuclear testing is a great concern for local population and health officials, especially given little evidence on the effect of low-dose ionizing radiation on human health. Despite the importance of evidence in collected from past cohorts, little is known about the effect of ionizing radiation on the population today. The present study attempts to explore potential effects of low-dose background ionizing radiation on the population health today. In particular, it attempts to explore whether alpha and beta particles, radon gas, as well as cesium (Cs 137), radium (Ra 226), thoron (Th 232), potassium (40 K) measured in soil, drinking water, and vegetation has a significant effect on the cumulative incidence and mortality attributed to lung, liver, stomach, esophagus, thyroid and breast carcinomas. Multivariate linear regression results indicate that only radon has a significant dose-distance relationship and can be associated with the SNTS (p = 0.042). Other radioactive elements and ionizing particle measurements are likely to be natural environmental radiation. Breast cancer incidence was associated with Th 232 (p = 0.031) and 40 K (p = 0.004), esophagus cancer incidence showed association with 40 K (p = 0.007), Ra 226 (p = 0.011), Cs 137 (p = 0.01). Ra 226 is also a statistically significant risk factor for thyroid cancer (p = 0.01). Unexpected associations were found on the effect of Ra 226 on lung and stomach cancer, unrelated to radon gas exposure. Further studies on individual level are needed to validate these findings
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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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    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.
  • ItemOpen Access
    Knowledge, use and behavior towards antibiotics and antibiotic resistance among residents of Astana, Kazakhstan
    (Nazarbayev University School of Medicine, 2019) Yerubayev, Zhanibek
    Antibiotic resistance is a huge public health issue and it is continuing to increase. It is estimated that by year 2050 it will cost 100 trillion USD and will kill 10 million people each year. Kazakhstan is among the highest consumers of antibiotics in the world and consumes 25,000 standard units per 1000 population....
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    What are the knowledge, attitudes and perceptions and what are the demographic determinants and previous smoking behavior that is associated with smoking electronic cigarettes among Astana city students?
    (Nazarbayev University School of Medicine, 2019) Ospanova, Zarina
    Electronic cigarettes (e-cigarettes) have become more commonly used tobacco products worldwide. Few studies focused on knowledge, attitudes and perceptions regarding e-cigarettes among university students in Kazakhstani context. This study explores what demographic characteristics and independent factors associated with e-cigarette use....
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    Socio-demographic factors associated with malnutrition of children under-5 years of age in Kazakhstan
    (Nazarbayev University School of Medicine, 2019) Sakko, Yesbolat
    The objective of this study was to determine potential risk factors associated with child malnutrition status. It investigates key predictors of nutrition status such as age, gender, region of origin, nationality, wealth, mother’s education level, number of children in a household with other additional factors...
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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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    Knowledge about health risks of hookah smoking among hookah servers. A mixed-method study.
    (Nazarbayev University School of Medicine, 2019) Yakhiyayeva, Tansholpan
    In recent years there was a sharp proliferation of hookah cafes in Kazakhstan. International fashion, originally coming from the Middle East and through other Central Asian states in the south of Kazakhstan very quickly attracted a lot of young people. This new fashion correlated with the decrease of cigarette smoking. A lot of people saw hookah as a safe alternative to cigarette smoking and this added to their popularity. The whole process was taking place despite the legal restrictions on smoking hookahs. They are at place not without a purpose, because a common belief that hookah is safe is actually wrong. In fact, studies show that hookah smoking is no less harmful than cigarette smoking. These risks may be unknown to the general public and for those who do not smoke hookah a lot. However, unlike cigarettes or many other types of tobacco use, hookah require a special preparation, which involves puffing. In hookah cafes, usually this is the job of a separate specialist – a hookah server. If the general public does not necessarily smoke hookah a lot, these specialists are putting themselves at a constant risk by working with hookah all the time. But what do these people know about the potential health risks? Are they informed about the various risks that they face? This study aims to investigate these questions....
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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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    Knowledge, attitude and practice regarding cross – infection control measures in dentistry among dental outpatients in Astana, Kazakhstan
    (Nazarbayev University School of Medicine, 2019) Bolatkhanova, Meruyert
    Cross-infection is a significant issue in dental care provision. Everyone: patients, seeking care and dentists, providing that care are at risk of contracting infections. Nowadays, infectious diseases pose a serious problem worldwide, especially for developing countries like Kazakhstan, due to scarce financial resources allocated for healthcare. Prevention and control measures are the most efficient methods of combating against infectious diseases. Patients are one of the interested bodies in efficient infection control, thus it is important to raise awareness of the public about infection control measures. This would lead to greater compliance of recommended protocols...
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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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    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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    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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    Living with celiac disease in Kazakhstan: a qualitative study
    (Nazarbayev University School of Medicine, 2019) Kaniyev, Daniyar
    Celiac disease represents a problem to Kazakhstani population not only because of its growing prevalence in children, clinical manifestations and possible health complications. Another issue celiac disease poses to society is a diminished quality of life in patients and their families. This study aims to explore what people with celiac disease are going through, and what are the main obstacles to maintain a gluten-free diet...
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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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    Efficacy and safety of Actovegin for stroke rehabilitation: systematic review.
    (Nazarbayev University School of Medicine, 2019) Baizhaxynova, Ardak
    Stroke is a non-communicable disease, which causes death and morbidity worldwide with 68 per cent incidence of the ischemic stroke and 32 per cent incidence of hemorrhagic stroke (intracerebral haemorrhage and subarachnoid haemorrhage combined) (Institute for Health Metrics and Evaluation, 2018). In Kazakhstan stroke is both the second leading cause of premature death and loss of disability-adjusted life years ("Kazakhstan", 2017). The condition causes a broad umbrella of complications including deep vein thrombosis, seizures, pneumonia, cognitive decline, depression, cerebral oedema, bladder problems, pressure sores, neurologic deficits and contractures (Oliveira Filho & T Mullen, 2019).
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    Knowledge, attitudes and perceptions on Point of Sale advertising and promotion of tobacco bans among parents and expert group: a cross-sectional study in Astana, Kazakhstan.
    (Nazarbayev University School of Medicine, 2019) Nurmasheva, Arailym
    In Kazakhstan in 2004, the percent out of all deaths that were due to smoking was 24%, twice the worldwide percent (12.0%) and about 50% higher than the percentages in the Russian Federation and Eurasia as a whole (both 16%). Based on the Global Youth Tobacco Survey (GYTS) among those who visited a point of sale (where products are purchased) in the past 30 days, overall 13.6% (14.3%=boys, 13.0%=girls) noticed tobacco advertisements or promotions. Studies have shown that exposure to Point of Sale (PoS) advertising and promotion of tobacco products is associated with increased youth smoking initiation. Nonetheless, to the best of our knowledge, there are no studies that examine the perceptions and attitudes of the parents of these youth towards PoS Tobacco Advertising Promotion and Sponsorship (TAPS) ban. The study objectives include: (1) determining parents’ perceptions of PoS advertising and promotion of tobacco bans; (2) assessing parents’ and experts’ knowledge on PoS TAPS ban definitions and regulations. 15 public schools in Astana were randomly selected for this study. 514 parents of middle and high school students (5-11 grades) and 3 experts were recruited to participate in the study. Parents’ data was obtained through self-administered and anonymous questionnaires. Experts were surveyed via email. 68.3% of parents opposed current state of tobacco products’ display at PoS in Kazakhstan. Statistical analyses showed that regardless of smoking status, regardless of whether or not parents perceived that PoS tobacco product displays motivated youth to smoke, regardless of whether or not parents perceived PoS displays of tobacco products as advertising, and regardless of how parents perceived the level of importance of exposure to PoS tobacco product displays for influencing youth, the large majority of parents did not favor display of tobacco products at PoS. Strong support by parents strengthens the position of the government to regulate PoS TAPS through building public awareness, advocacy with stakeholders and enforcement of law.
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    Factors associated with successful passing test for medical certificate in 5 specialties
    (Nazarbayev University School of Medicine, 2019) Mussagazin, Anuar
    The efficiency of the health-care system and the quality of medical services are directly related to the performance of medical professionals. Examination for obtaining a medical license allows the protection of the public by ensuring high-quality medical care from skilled specialists. This research will analyze the stratified data in passing rate (more than 50%) by demographic factors (region, nationality, age, gender) and 5 the most common specialties (general surgery, therapeutics, pediatrics, obstetrics, general practice). The identification of the risk groups will help them to prepare and successfully pass the exam for medical certification.
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    Risk factors associated with stroke mortality and ischemic vs hemorrhagic stroke
    (Nazarbayev University School of Medicine, 2019) Agibayeva, Akmaral
    Stroke (I63.9) is defined as brain injury that occurs due to interruption of the blood supply in part of the brain. Two main types of stroke include ischemic and hemorrhagic strokes. In ischemic stroke blood clots block the brain arteries and thus prevent blood supply. Hemorrhagic stroke occurs due to the rupture of blood vessels in the brain (hemorrhage) with subsequent bleeding and pressure building up. There are 15 million incidence of stroke worldwide annually, 5 million mortality cases due to this condition and 113 million DALYs (disability-adjusted life years) as a result of stroke. In Kazakhstan, the prevalence of stroke ranges from 2.5 to 3.7 cases per 1000 people and mortality rate was the highest in Karagandinskaya oblast in 2017.