Examining disparities in cardiovascular disease prevention strategies and incidence rates between urban and rural populations: insights from Kazakhstan.

Kazakhstan is experiencing a high burden of cardiovascular disease (CVD), and the country has implemented a range of strategies aimed at controlling CVD. The study aims to conduct a content analysis of the policies implemented in the country and augment it with an analysis of official statistics over a 15-year period, from 2006 to 2020. The study also includes comparisons of incidence rates between urban and rural areas. A comprehensive search was conducted to identify policy documents that regulate the provision of primary, secondary, and tertiary prevention of cardiovascular diseases. Additionally, official data on the incidence of arterial hypertension, ischemic heart disease, acute myocardial infarction, and cerebrovascular disease were extracted from official statistics, disaggregated by urban and rural areas. Forecast modeling was utilized to project disease incidences up to 2030. The study reveals that Kazakhstan primarily focuses on tertiary prevention of cardiovascular diseases, with less attention given to secondary prevention, and primary prevention is virtually non-existent. In general, screening for arterial hypertension appears to be more successful than for ischemic heart disease. The incidence of arterial hypertension has increased threefold for urban residents and 1.7-fold for rural residents. In urban areas, residents saw a twofold increase in ischemic heart disease incidence, while it remained the same in rural areas. The findings of this study have practical implications for decision-makers, who can use the results to enhance the effectiveness of existing CVD prevention strategies.

Kazakh version of the beck depression inventory: Validation study in female cancer patients.

This study aimed to evaluate the validity of the Beck Depression Inventory (BDI-II) as a screening tool for depression among Kazakh-speaking female cancer patients. A cross-sectional study design with random sampling was used to collect and analyze data from 115 female cancer patients. Means, sensitivity, specificity, and positive and negative predictive values were calculated. An analysis of receiver operating characteristic (ROC) curves was conducted to determine the optimal cut-off score for the BDI-II in this population as a screening tool for depression. Test-retest reliability and internal consistency were also tested. Results showed that using a BDI-II cut score of 15 retained high sensitivity (82.7%), increased specificity (75.0%), and improved positive (86.1%) and negative predictive values (69.8%) of the BDI-II compared to a cut score of 14. Kazakh BDI-II indicated excellent consistency (Cronbach's alpha of 0.86) and reliability (intraclass correlation coefficient (ICC) of 0.92 (95% CI [0.89-0.94])). The use of this valid screening tool can facilitate the diagnosis of depression in female cancer patients.

Endometrial thickness and live birth rates after IVF: a systematic review.

AIM: This study aims to systematically review the current literature on published studies with data on the clinical significance of endometrial thickness on ultrasound for live birth rates after IVF or intracytoplasmic sperm injection (ICSI). METHODS: An extensive systematic review of PubMed, Web of Science, ScienceDirect, Google Scholar, and Open Gray databases, and following hand-search of the reference list of the included studies was performed. RESULTS: We found 20 eligible studies that evaluated 20 546 patients for endometrial thickness, presented risk factors for decreased endometrial receptivity, and IVF outcomes with fresh and frozen embryo transfer (FET) cycles. The mean age of the patients ranged from 28.86 to 41.03 years. Reported endometrial thickness ranged from <4 mm to >15 mm. The clinical pregnancy rate varied from 9,09% to 61,49% in fresh embryo transfer cycles and from 13,3% to 79,31% in FET cycles. Overall, LBR varied between 4,80% and 48,99% in fresh embryo cycles and between 6.06% and 39,19% in FET cycles. LIMITATIONS: Only English-language studies were included; most studies were from the China region; retrospective study design used in most studies; different ET thresholds, which in turn could significantly alter the correlation with pregnancy outcomes; different IVF procedure protocols in fresh or FET cycles. CONCLUSIONS: IVF outcomes in patients with impaired endometrial receptivity do not depend only on the condition of the endometrium. Risk factors and endometrial thickness significantly affect LBR in fresh and FET cycles.

Prevalence of Smoking Various Tobacco Types in the Kazakhstani Adult Population in 2021: A Cross-Sectional Study.

Tobacco use was the second-leading risk factor for death, accounting for 15.4% of total deaths in 2019. In 2019, 20.4% (2.7 million) of the adult population in Kazakhstan, 36.5% of men, and 6.0% of women smoked tobacco. A cross-sectional study of a random sample (n = 1201) was conducted between October and December 2021 in accordance with the STEPwise approach. The tobacco-use questions were focused on current and previous smoking status, initiation and duration of smoking, amount of tobacco use, exposure to secondhand smoke, and information related to quitting smoking. From 20.8% of smokers, 93.8% of men and 80.2% of women use tobacco products daily, χ2 = 10.983, p-score < 0.001. The earliest initiation of smoking was 6 years old. The prevalence of smoking tobacco products in Kazakhstan is 20.8%, which means that every fifth adult smokes. In addition, the proportion of smokers among men was 38.5%, and among women, it was 10.1%. A total of 93.8% of men and 80.2% of women smoked daily. The role of healthcare professionals in smoking prevention is very low, and only 16.9% of respondents have been advised to quit smoking in the last 12 months. New interventions for tobacco smoking prevention are urgently needed in Kazakhstan.

Prevalence of Anxiety Symptoms in Women Newly Diagnosed with Breast Cancer in Kazakhstan and Its Associated Factors.

INTRODUCTION: Diagnosis of breast cancer is associated with high psychological distress. There is a lack of studies examining the prevalence of anxiety among newly diagnosed breast cancer patients in Kazakhstan. OBJECTIVE: This study aims to assess the mean prevalence and associated sociodemographic and clinical factors of anxiety symptoms in women newly diagnosed with breast cancer. It also aims to determine independent predictors of anxiety risk. METHODS: An analysis of 162 newly diagnosed breast cancer patients at the oncology institute in Almaty was performed. Data were collected using a structured questionnaire on social, demographic, and clinical information, as well as the Beck Anxiety Inventory. In addition, multiple regression analysis was used to model the relationship between anxiety risk and independent predictors. RESULTS: The average age of the patients was 54.41 years (SD=8.1; min.-max: 32-75). The majority of the patients were married (52%), employed or self-employed (51%), had children (91%), had a bachelor's or a graduate degree (50%), lived in an urban area (54%), did not drink (41%), did not smoke (67%), did not engage in physical activity (54%), and had social support (91%). A total of 48% of patients had symptoms of moderate anxiety, and 33% had symptoms of severe anxiety. Based on the multivariate analysis, factors associated with a lower risk of anxiety symptoms included higher household income (OR -2.21 (95 CI: -1.35, -3.07)) and having reliable social support (OR -2.93 (95% CI: -2.25, -3.61)). CONCLUSION: The prevalence of anxiety symptoms is very high among newly diagnosed breast cancer patients. Anxiety is more likely to develop in patients from low-income households and those without reliable social support.

Prevalence and Associated Factors of Depression Symptoms in Women Newly Diagnosed with Breast Cancer in Kazakhstan.

INTRODUCTION: Diagnosis of breast cancer is associated with the presence of psychological disorders including depression. There is a lack of study examining the prevalence of depression among newly diagnosed breast cancer patients in Kazakhstan. OBJECTIVE: This study aims to assess the prevalence and associated sociodemographic and clinical factors of depression symptoms in women newly diagnosed with breast cancer. METHODS: 162 newly diagnosed breast cancer patients at the oncology center in Almaty were recruited for this study. Data were collected using a structured questionnaire on sociodemographic and clinical information and the Beck Depression Inventory-II scale. RESULTS: The mean age of the patients was 54.41 years (SD=8.1). 95% of participants had unilateral breast cancer, and 79% of participants had stage I or stage II breast cancer. 73% of patients said that they do not have reliable social support. 46% of patients had symptoms of moderate depression, and 31% of patients had symptoms of severe depression. According to the multivariate analysis, factors associated with depression symptoms were: social status, household income level, reliability of social support, and stage of breast cancer. CONCLUSION: The prevalence of depression symptoms is very high among newly diagnosed breast cancer patients. Unemployed or retired patients, with a lower household income, and no reliable social support diagnosed with an advanced stage of breast cancer are especially at high risk for developing depression.