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BACKGROUND: The geographical distribution of hepatitis B virus (HBV) and hepatitis D virus (HDV) genotypes is uneven and has its own clinical and organizational implications for health systems. Despite the introduction of vaccination and successful antiviral therapy the prevalence of chronic hepatitis B (with or without delta agent) increased over the past 5 years. This study aimed for the first time to investigate the molecular epidemiology of HBV and HDV in Kazakhstan. METHODS: Total 834 chronic hepatitis B (with or without delta agent) patients were included to the study from November 2017 to June 2019. The material was collected from the regional hepatological Ñenters from 13 cities of Kazakhstan. Genotyping of HBV/HDV isolates was carried out using phylogenetic analysis of null-binary sequences of Kazakhstani isolates, in comparison with the reference sequences. Nucleotide sequence alignment was performed using the ClustalW algorithm, the "neighbor-joining" method was used for the construction of phylogenetic trees and subsequent analysis. RESULTS: Overall 341 samples were PCR-positive and genotyped for HBV. Comparison and phylogenetic analysis of nucleotide sequences of HBV isolates showed that they were represented by genotypes HBV-D (95.9%), HBV-A (3.5%) and HBV-C (0.6%). At the same time, the identity of the nucleotide sequences of Kazakhstani isolates were: HBV-D (95-100%); HBV-A (97.2-100%) and HBV-C (99%). 256 samples were PCR positive and genotyped for HDV, all of them belonged to genotype 1. CONCLUSION: This study describes for the first time the molecular epidemiology of HBV and HDV in Kazakhstan. The data obtained expand the knowledge of the global epidemiology of viruses; have potential implications for public health policy and for further clinical research on chronic hepatitis in Kazakhstan. TRIAL REGISTRATION: ClinicalTrials.gov NCT05095181 (registered on 27/10/2021).
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Hepatite B Crônica , Hepatite B , Hepatite D , Humanos , Genótipo , Hepacivirus , Hepatite B/epidemiologia , Vírus da Hepatite B , Hepatite B Crônica/epidemiologia , Hepatite D/epidemiologia , Vírus Delta da Hepatite , Cazaquistão/epidemiologia , Filogenia , PrevalênciaRESUMO
Type 2 diabetes mellitus (T2DM) is a socially significant disease with increasing prevalence worldwide. It is characterized by heterogeneous metabolic disorders and is associated with various risk factors, including BMI, abnormal lipid levels, hypertension, smoking, dietary preferences, physical inactivity, sedentary lifestyle, family history of diabetes, prediabetes or gestational diabetes, inflammation, intrauterine environment, age, sex, ethnicity, and socioeconomic status. Assessing the genetic risk of developing T2DM in specific populations remains relevant. The ADIPOQ gene, encoding adiponectin, is directly related to the risk of developing T2DM, obesity, and cardiovascular diseases. Our study demonstrated significant associations of ADIPOQ gene polymorphisms with the risk of developing T2DM and obesity, as well as with fasting glucose levels and BMI, in the Kazakh population. Specifically, rs266729 was significantly associated with T2DM and obesity in the Kazakh population, while other studied polymorphisms (rs1501299, rs2241766, and rs17846866) did not show a significant association. These findings suggest that ADIPOQ gene polymorphisms may influence T2DM risk factors and highlight the importance of genetic factors in T2DM development. However, further research in larger cohorts is needed to confirm these associations.
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Adiponectina , Diabetes Mellitus Tipo 2 , Predisposição Genética para Doença , Obesidade , Polimorfismo de Nucleotídeo Único , Humanos , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Adiponectina/genética , Masculino , Obesidade/genética , Pessoa de Meia-Idade , Estudos de Casos e Controles , Adulto , Fatores de Risco , Cazaquistão/epidemiologia , IdosoRESUMO
Coronavirus Anxiety Scale (CAS) is a widely used measure that captures somatic symptoms of coronavirus-related anxiety. In a large-scale collaboration spanning 60 countries (Ntotal = 21,513), we examined the CAS's measurement invariance and assessed the convergent validity of CAS scores in relation to the fear of COVID-19 (FCV-19S) and the satisfaction with life (SWLS-3) scales. We utilized both conventional exact invariance tests and alignment procedures, with results revealing that the single-factor model fit the data well in almost all countries. Partial scalar invariance was supported in a subset of 56 countries. To ensure the robustness of results, given the unbalanced samples, we employed resampling techniques both with and without replacement and found the results were more stable in larger samples. The alignment procedure demonstrated a high degree of measurement invariance with 9% of the parameters exhibiting noninvariance. We also conducted simulations of alignment using the parameters estimated in the current model. Findings demonstrated reliability of the means but indicated challenges in estimating the latent variances. Strong positive correlations between CAS and FCV-19S estimated with all three different approaches were found in most countries. Correlations of CAS and SWLS-3 were weak and negative but significantly differed from zero in several countries. Overall, the study provided support for the measurement invariance of the CAS and offered evidence of its convergent validity while also highlighting issues with variance estimation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Ansiedade , COVID-19 , Humanos , Reprodutibilidade dos Testes , Psicometria/métodos , Ansiedade/diagnóstico , COVID-19/diagnóstico , MedoRESUMO
A theoretical perspective on grandiose narcissism suggests four forms of it (sanctity, admiration, heroism, rivalry) and states that these forms conduce to different ways of thinking and acting. Guided by this perspective, we examined in a multinational and multicultural study (61 countries; N = 15,039) how narcissism forms are linked to cognitions and behaviors prompted by the COVID-19 pandemic. As expected, differences in cognitions and behaviors across narcissism forms emerged. For example, higher narcissistic rivalry predicted lower likelihood of enactment of COVID-19 prevention behaviors, but higher narcissistic sanctity predicted higher likelihood of enactment of COVID-19 prevention behaviors. Further, whereas the heroism, admiration, and rivalry narcissism forms acted in a typically antisocial manner, with high narcissism predicting greater endorsement of unfounded health beliefs, the sanctity form acted in a prosocial manner, with higher narcissism being linked to lower endorsement of unfounded COVID-19 health beliefs. Thus, the findings (a) support the idea of four narcissism forms acting differently, and (b) show that these differences reflect a double-edged sword, sometimes linking to an anti-social orientation, and sometimes linking to a pro-social orientation.
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COVID-19 , Narcisismo , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Masculino , Feminino , Adulto , Pandemias , SARS-CoV-2 , Pessoa de Meia-Idade , Adulto JovemRESUMO
In Kazakhstan, there is insufficient data on genetic epilepsy, which has its own clinical and management implications. Thus, this study aimed to use whole genome sequencing to identify and evaluate genetic variants and genetic structure of early onset epilepsy in the Kazakhstani pediatric population. In this study, for the first time in Kazakhstan, whole genome sequencing was carried out among epilepsy diagnosed children. The study involved 20 pediatric patients with early onset epilepsy and no established cause of the disease during the July-December, 2021. The average age at enrolment was 34.5 months, with a mean age at seizure onset of 6 months. Six patients (30%) were male, and 7 were familial cases. We identified pathogenic and likely pathogenic variants in 14 (70%) cases, among them, 6 novel disease gene variants (KCNQ2, CASK, WWOX, MT-CO3, GRIN2D, and SLC12A5). Other genes associated with the disease were SCN1A (x2), SLC2A1, ARX, CACNA1B, PCDH19, KCNT1, and CHRNA2. Identification of the genetic causes in 70% of cases confirms the general structure of the etiology of early onset epilepsy and the necessity of using NGS in diagnostics. Moreover, the study describes new genotype-phenotypic correlations in genetic epilepsy. Despite certain limitations of the study, it can be concluded that the genetic etiology of pediatric epilepsy in Kazakhstan is very broad and requires further research.
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Epilepsia , Humanos , Criança , Masculino , Pré-Escolar , Lactente , Feminino , Epilepsia/genética , Estudos de Associação Genética , Sequenciamento Completo do Genoma , Variação Biológica da População , Testes Genéticos , Protocaderinas , Canais de Potássio Ativados por Sódio/genética , Proteínas do Tecido Nervoso/genéticaRESUMO
BACKGROUND: Burnout is a serious problem in the training and professional development of medical students. However, there is no known data on the prevalence of burnout among medical students in Kazakhstan. This study aims at investigating burnout and associated factors in a sample of students from Astana Medical University. METHODS: The study included socio-demographic and personal questions, Oldenburg Burnout Inventory for college students (OLBI-S) and Copenhagen Burnout Inventory-Students survey (CBI-S) to measure burnout. Statistical analyses included measures of descriptive statistics and regression analysis for evaluating burnout-associated factors. RESULTS: In total, 736 medical students responded. The prevalence of burnout syndrome was 28% (CBI-S) and 31% (OLBI-S). There was a significant association between the prevalence and the level of burnout and student's gender, year of study, thoughts of dropping out, suicidal ideation, satisfaction with the chosen profession and academic performance, interpersonal relationship problems, the decision to study in medical school, smoking, accommodation, parental expectations, alcohol use, extracurricular activities, part-time job, somatic symptoms, depression, and anxiety. CONCLUSIONS: The factors associated with burnout were identified, which complements and expands the existing data on academic burnout. The data obtained can help in organizing psychological assistance for medical students in Kazakhstan.
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Esgotamento Profissional , Estudantes de Medicina , Ansiedade/epidemiologia , Esgotamento Profissional/complicações , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Humanos , Cazaquistão/epidemiologia , Prevalência , Faculdades de Medicina , Estudantes de Medicina/psicologia , Inquéritos e QuestionáriosRESUMO
The study aimed to investigate the influence of psychological well-being and different study format on the academic motivation of 1st-year medical students during the COVID-19 pandemic. Repeated cross-sectional study carried out in November 2020 (time 1) and March 2021 (time 2). During time 1 (N = 273), all students studied online. In time 2 (N = 159), both students who learned online only (N = 86) and students who were taking (N = 33) or passed offline classes (N = 40) were trained. The mental state of the students was stable overtime of observation. The effect of the level of psychological destruction and quality of life affecting by the COVID-19 pandemic on academic motivation was minimal. The level of academic motivation was higher in time 2; this was especially noticeable among students who underwent blended learning. The mediating role of satisfaction with academic life and college belongingness in the relationship between the learning format and motivation was found. Blended type of education during a pandemic is more favorable for students in terms of their motivation to study. Further epidemiological studies are needed to assess the safety of blended learning. However, we would like to emphasize that no cases of COVID-19 in the blended learning format have been reported.
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The COVID-19 pandemic has triggered health-related anxiety in ways that undermine peoples' mental and physical health. Contextual factors such as living in a high-risk area might further increase the risk of health deterioration. Based on the Social Identity Approach, we argue that social identities can not only be local that are characterized by social interactions, but also be global that are characterized by a symbolic sense of togetherness and that both of these can be a basis for health. In line with these ideas, we tested how identification with one's family and with humankind relates to stress and physical symptoms while experiencing health-related anxiety and being exposed to contextual risk factors. We tested our assumptions in a representative sample (N = 974) two-wave survey study with a 4-week time lag. The results show that anxiety at Time 1 was positively related to stress and physical symptoms at Time 2. Feeling exposed to risk factors related to lower physical health, but was unrelated to stress. Family identification and identification with humankind were both negatively associated with subsequent stress and family identification was negatively associated with subsequent physical symptoms. These findings suggest that for social identities to be beneficial for mental health, they can be embodied as well as symbolic.
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COVID-19 , Pandemias , Ansiedade , Depressão , Humanos , SARS-CoV-2RESUMO
OBJECTIVES: To investigate whether citizens' adherence to health-protective non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic is predicted by identity leadership, wherein leaders are perceived to create a sense of shared national identity. DESIGN: Observational two-wave study. Hypotheses testing was conducted with structural equation modelling. SETTING: Data collection during the COVID-19 pandemic in China, Germany, Israel and the USA in April/May 2020 and four weeks later. PARTICIPANTS: Adults in China (n=548, 66.6% women), Germany (n=182, 78% women), Israel (n=198, 51.0% women) and the USA (n=108, 58.3% women). MEASURES: Identity leadership (assessed by the four-item Identity Leadership Inventory Short-Form) at Time 1, perceived shared national identification (PSNI; assessed with four items) and adherence to health-protective NPIs (assessed with 10 items that describe different health-protective interventions; for example, wearing face masks) at Time 2. RESULTS: Identity leadership was positively associated with PSNI (95% CI 0.11 to 0.30, p<0.001) in all countries. This, in turn, was related to more adherence to health-protective NPIs in all countries (95% CI 0.03 to 0.36, 0.001≤p≤0.017) except Israel (95% CI -0.03 to 0.27, p=0.119). In Germany, the more people saw Chancellor Merkel as engaging in identity leadership, the more they adhered to health-protective NPIs (95% CI 0.04 to 0.18, p=0.002). In the USA, in contrast, the more people perceived President Trump as engaging in identity leadership, the less they adhered to health-protective NPIs (95% CI -0.17 to -0.04, p=0.002). CONCLUSIONS: National leaders can make a difference by promoting a sense of shared identity among their citizens because people are more inclined to follow health-protective NPIs to the extent that they feel part of a united 'us'. However, the content of identity leadership (perceptions of what it means to be a nation's citizen) is essential, because this can also encourage people to disregard such recommendations.
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COVID-19 , Adulto , COVID-19/prevenção & controle , Feminino , Humanos , Liderança , Masculino , Máscaras , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
It is crucial to understand why people comply with measures to contain viruses and their effects during pandemics. We provide evidence from 35 countries (Ntotal = 12,553) from 6 continents during the COVID-19 pandemic (between 2021 and 2022) obtained via cross-sectional surveys that the social perception of key protagonists on two basic dimensions-warmth and competence-plays a crucial role in shaping pandemic-related behaviors. Firstly, when asked in an open question format, heads of state, physicians, and protest movements were universally identified as key protagonists across countries. Secondly, multiple-group confirmatory factor analyses revealed that warmth and competence perceptions of these and other protagonists differed significantly within and between countries. Thirdly, internal meta-analyses showed that warmth and competence perceptions of heads of state, physicians, and protest movements were associated with support and opposition intentions, containment and prevention behaviors, as well as vaccination uptake. Our results have important implications for designing effective interventions to motivate desirable health outcomes and coping with future health crises and other global challenges.
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COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Pandemias/prevenção & controleRESUMO
The purpose of this study was to identify the main barriers to vaccine acceptance among medical students in Kazakhstan and to develop the COVID-19 Vaccine Hesitancy Scale (COV-VHS). A cross-sectional study was carried out among students at Astana Medical University (N = 888, Kazakhstan) in March 2021. Only 2% of the participants were currently vaccinated, and 22.4% showed the potential for COVID-19 vaccine acceptance. The following barriers were the most important in COVID-19 vaccine acceptance: concern about possible side effects of vaccination (73%), absence of sufficient evidence on the effectiveness and safety (57%) and quality (42%), the belief that the immune system will cope with COVID-19 even without vaccination (38%), and lack of trust in the effectiveness of vaccination against COVID-19 (33%). Moreover, this study identified the following factors associated with COVID-19 vaccine acceptance: contextual influences (e.g., communication and media environment, socio-demographic factors, vaccination policies, and perception of the pharmaceutical industry), individual and group influences (e.g., personal experience with vaccination, attitudes about health and prevention, trust in the health system and providers, perceived risk), and specific issues on COVID-19 vaccine/vaccination (e.g., choice of vaccine can reduce vaccine hesitancy by 30%). A developed 12-item 6-factor model of COV-VHS showed good validity and reliability. In conclusion, there was a low-level potential for COVID-19 vaccine acceptance among medical students in Kazakhstan. Thus, an effective vaccination education and policy are needed to combat the COVID-19 pandemic.
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COVID-19 , Estudantes de Medicina , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Estudos Transversais , Humanos , Cazaquistão , Pandemias , Reprodutibilidade dos Testes , SARS-CoV-2 , Vacinação , Hesitação VacinalRESUMO
Background: The Copenhagen Burnout Inventory (CBI) has demonstrated good psychometric properties among different populations, but there is no known data on its validity among Russian-speaking medical students. The CBI-Student Survey focuses only on fatigue, but measures exhaustion in four different life domains: Personal Burnout (PB), Studies-Related Burnout (SRB), Colleague-Related Burnout (CRB), and Teacher-Related Burnout (TRB). Objective: To investigate the psychometric properties of the Russian version of the Copenhagen Burnout Inventory-Student Survey (R-CBI-S). Design: A cross-sectional study was carried out among 771 medical students at Astana Medical University (Nur-Sultan, Kazakhstan). Statistical analyses included test-retest reliability, internal consistency, item analysis, convergent and concurrent validity, and confirmatory factor analysis. Concurrent validity was evaluated by bivariate correlations of R-CBI-S with anxiety, depression, and satisfaction with the study. Results: Test-retest reliability showed an ICC of 0.81. All item-total correlations for the total scale were positive (range 0.31-0.76). The Cronbach's alpha coefficient was 0.94 (0.896 for PB, 0.884 for SRB, 0.874 for CRB, and 0.926 for TRB). The Barlett's sphericity test result was significant (p < 0.001), and the KMO measure of sampling adequacy exceeded 0.947. Convergent validity analysis results: PB (AVE = 0.52, CR = 0.87), SRB (AVE = 0.50, CR = 0.87), CRB (AVE = 0.51, CR = 0.86), TRB (AVE = 0.56, CR = 0.88). The R-CBI-S achieved good levels of goodness-of-fit indices (RMSEA = 0.0611; CFI= 0.940; TLI = 0.933). Conclusion: The test results indicated that the R-CBI-S scale appears to be a reliable and valid instrument. The R-CBI-S may be a useful tool in future research to identify burnout factors based on specific life domains for developing effective prevention measures among medical students.
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In reference to the announcement of the pandemic of the new coronavirus 2019-(nCoV), all educational institutions in the Republic of Kazakhstan have switched to online learning (OL). The purpose of this study was to investigate the mental state of the medical students switching to OL in comparison with the mental state of the students who had traditional learning (TL). A repeated questionnaire-based cross-sectional study was conducted among medical students ranging from 1st year to 5th year at Astana Medical University in the 2019-2020 academic year. The first study was conducted during the TL (October-November 2019, N = 619), and the second study was conducted during the OL period (April 2020, N = 798). Burnout syndrome, depression, anxiety, somatic symptoms, and satisfaction with academic performance have been studied. The findings revealed that prevalence of the burnout syndrome, depression, anxiety, and somatic symptoms decreased after transitioning from TL to OL. However, during the OL period, the prevalence of colleague-related burnout increased, which tells us about the negative impact of OL on students' communication and interpersonal relationships. The most common depression and anxiety symptoms, dissatisfaction with academic performance were among students who indicated a decrease in academic performance during OL. Students who lived alone during the quarantine were more prone to depression during OL. In conclusion, during the quarantine period after the transition from TL to OL, the mental health state of medical students improved, despite the severe conditions of the pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-020-01165-y.