Whole-Genome Sequencing Among Kazakhstani Children with Early-Onset Epilepsy Revealed New Gene Variants and Phenotypic Variability.

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.

Burnout syndrome among medical students in Kazakhstan.

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.

Online or Blended Learning: the COVID-19 Pandemic and First-Year Medical Students' Academic Motivation.

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.

Barriers to COVID-19 vaccination among medical students in Kazakhstan: development, validation, and use of a new COVID-19 Vaccine Hesitancy Scale.

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.

Online-Learning due to COVID-19 Improved Mental Health Among Medical Students.

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.

Psychometric Properties of the Copenhagen Burnout Inventory in a Sample of Medical Students in Kazakhstan.

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.