Background. Air pollution has a significant effect on human health and there is a broad body of evidence showing that exposure to air pollution is associated with an increased risk of adverse health effects. The main objective of this study was to assess the association of traffic-related air pollutants with fatal AMI during the ten-year period. Methods. The study was conducted in Kaunas city, where the WHO MONICA register included a total of 2273 adult cases of fatal AMI cases during the 10-year study period. We focused on the period between 2006 and 2015. The associations between exposure to traffic-related air pollution and the risk of fatal AMI were evaluated by using a multivariate Poisson regression model, RR presented per an increase in IQR. Results. It was found that the risk of fatal AMI was significantly higher in all subjects (RR 1.06; 95% CI 1.00–1.12) and women (RR 1.12; 95% CI 1.02–1.22) when the concentration of PM₁₀ in the ambient air was increased 5–11 days before the onset of AMI, adjusting for NO₂ concentration. The effect was stronger during spring in all subjects (RR 1.12; 95% CI 1.03–1.22), in men (RR 1.13; 95% CI 1.01–1.26), in younger-aged (RR 1.15; 95% CI 1.03–1.28), and in winter in women (RR 1.24; 95% CI 1.03–1.50). Conclusions. Our findings show that ambient air pollution increases the risk of fatal AMI, and this pertains to PM₁₀ specifically.

The creation and implementation of suicide prevention measures requires an evaluation of the full range of potential risk factors. This study examined the

Background: With the adoption of the Astana Declaration on primary health care, modern approaches are being introduced in the Republic of Kazakhstan. The created national foundations of the nursing management system in Kazakhstan are a visible manifestation of a new organizational culture. In connection with the large-scale reform of nursing and the creation of a new position of nurses that meets modern social challenges and international requirements, the role of nurses in healthcare has increased significantly. In this study, we measured the actual scope of nursing practice among nurses in the medical organizations in the Republic of Kazakhstan. Methods: We performed a cross-sectional descriptive quantification study using electronic questionnaire on the actual scope of nursing practice in the Kazakh and Russian languages. The study group consisted of 146 registered nurses working in state organizations of the Republic of Kazakhstan. Results: Nurses from primary care organizations have demonstrated the high complexity of fulfilling the scope of nursing practice. There were minor differences in the performance of simple nursing tasks depending on the level of education. Nurses with postgraduate training and bachelor's education were significantly more likely to practice high complexity of actual scope of nursing practice than nurses with a college diploma. Conclusion: The overall mean of the actual volume of the nursing practice is 5.09. The actual scope of nursing practice of high complexity was performed more often by primary care nurses (5.65). Nursing education reform in Kazakhstan is demonstrating positive results. Keywords: Nurse training, Scope of nursing practice, Competencies of nurses, Nursing reform, Kazakhstan

Background. Cardiovascular diseases are the leading cause of death globally, accounting for 20.5 million deaths in 2021, according to the World Heart Report, and accounting for almost a third of all deaths in the world. Many cardiovascular disease events can be prevented by changes in behavioral risk factors, such as smoking and diet, as well as pharmacological interventions. One solution addressing this issue is disease management, which seeks to enhance healthcare by lowering the expenses of treating chronically ill individuals. Disease management programs effectively enhance care quality and adherence, ultimately reducing the misuse of resources. Aim. To analyze the results of implementing the Disease Management Program in Kazakhstan using chronic heart failure as an example over the years of implementation. Materials and methods. The necessary statistical data on implementing the Disease Management Program in Kazakhstan were collected using the chronic heart failure example. The research material was the Salidat Kayirbekova National Scientific Research Center for Health Development statistical collections and official reports of the Research Institute of Cardiology and Internal Diseases for 2018-2022. Results. The introduction of a disease management system for the management of chronic heart failure at the end of 2013-2022 contributed to a decrease in mortality from cardiovascular diseases by 4.3%, including from hypertension by 12%, coronary artery disease by 4%, and acute myocardial infarction by 4.8%. Quality of care within the healthcare system has advanced: patient coverage has expanded, and training sessions have been arranged for patients and healthcare professionals. Conclusions. These findings highlight the success of the implemented strategies and underscore the importance of continuous monitoring and evaluation to enhance healthcare outcomes further. Overall, the research underscores the positive trajectory of chronic disease management in Kazakhstan, paving the way for future improvements and sustained health benefits for the population. Введение. Сердечно-сосудистые заболевания являются основной причиной смертности во всем мире, на долю которых в 2021 году пришлось 20,5 миллиона смертей и составили почти треть всех смертей в мире (World Heart Report, 2023). Многие случаи сердечно-сосудистых заболеваний можно предотвратить путем изменения поведенческих рисков, в частности по курению и питанию, а также приверженности лечению. Одним из эффективных решений является управление заболеваниями, направленное на улучшение качества ухода за счет сокращения затрат, связанных с лечением хронических больных. Программы управления заболеваниями являются эффективным средством повышения качества ухода, соблюдения рекомендаций и, в итоге, сокращения нецелевого использования ресурсов. Цель проанализировать результаты реализации Программы управления заболеваниями в Казахстане на примере хронической сердечной недостаточности за годы реализации. Материалы и методы. Произведен сбор необходимых статистических данных по реализации Программы Управления Заболеваниями в Республике Казахстан на примере хронической сердечной недостаточности. Материалом исследования были: статистические сборники ННЦРЗ имени Салидат Каирбековой МЗ РК за 2013-2022 года и официальные отчеты КазНИИКиВБ за 2018-2023 года. Результаты. С 2013 по 2022 годы было достигнуто снижение смертности от сердечно-сосудистых заболеваний на 4,3%; включая снижение смертности от заболеваний, связанных с повышением артериального давления на 12%; ишемической болезни сердца на 4% и острого инфаркта миокарда на 4,8%. В рамках программы управления заболеваниями значительно улучшилось качество медицинской помощи: расширился охват пациентов, проведены обучающие курсы, как для пациентов, так и для работников службы здравоохранения. Заключение. Эти результаты подчеркивают успех реализованных стратегий и подчеркивают важность постоянного мониторинга и оценки для дальнейшего улучшения результатов здравоохранения. В целом, исследование подчеркивает положительную траекторию лечения хронических заболеваний в Казахстане, открывая путь к будущим улучшениям и устойчивым преимуществам для здоровья населения....

Background: Dental staffing plays a key role in the quality and accessibility of dental care. In Kazakhstan, the number and distribution of dentists, their qualifications, and their level of training remain pressing issues for the healthcare system. This study aims to analyze the staffing of the dental service in Kazakhstan from 2014 to 2024, identifying issues in the distribution and training of dental specialists. Materials and methods: Official statistical data from the Ministry of Health of the Republic of Kazakhstan were examined. Indicators of dentist provision per 10,000 populations were extracted for 2014–2024 across all administrative regions, including newly established areas, with separate analysis of urban and rural populations. Descriptive and comparative statistical methods were applied to identify trends, disparities, and structural changes. Results: The total number of dentists increased from 4812 in 2014 to 5213 in 2024, showing a moderate upward trend. However, significant interregional and settlement-based disparities persist. Large cities such as Astana, Almaty, and Shymkent demonstrated growth and relatively high staffing levels, whereas rural territories remained critically underserved. In 2024, urban areas had on average 3.5 dentists per 10,000 populations, compared to only 1.0 in rural areas. Regions such as Aktobe and Zhambyl showed steady improvement, while Karagandy, East Kazakhstan, and Akmola experienced a pronounced decline. Newly established regions, including Abai, Zhetysu, and Ulytau, revealed unstable dynamics, reflecting structural and organizational challenges. Conclusion: Significant regional differences, insufficient renewal of the material and technical base in peripheral regions, and problems with the distribution of human resources require the development and implementation of targeted state programs and strategies. Введение: Кадровое обеспечение стоматологической службы играет ключевую роль в качестве и доступности стоматологической помощи. В Казахстане актуальными вопросами для системы здравоохранения остаются численность и распределение врачей-стоматологов, их квалификация и уровень подготовки. Целью данного исследования является анализ кадрового обеспечения стоматологической службы в Казахстане с 2014 по 2023 год, выявление проблем в распределении и подготовке стоматологических специалистов. Материалы и методы: Были изучены официальные статистические данные Министерства здравоохранения Республики Казахстан. Показатели обеспеченности стоматологической помощью на 10 000 населения были получены за 2014–2024 годы по всем административным регионам, включая вновь образованные районы, с раздельным анализом городского и сельского населения. Для выявления тенденций, различий и структурных изменений применялись методы описательной и сравнительной статистики. Результаты: Общее количество врачей-стоматологов увеличилось с 4812 в 2014 году до 5213 в 2024 году, демонстрируя умеренную тенденцию к росту. Тем не менее, сохраняются значительные межрегиональные и поселенческие различия. Крупные города, такие как Астана, Алматы и Шымкент, продемонстрировали рост и относительно высокий уровень кадрового обеспечения, в то время как сельские территории оставались критически недообеспеченными. В 2024 году в городах в среднем на 10 000 населения приходилось 3,5 врача-стоматолога, по сравнению с 1,0 в сельской местности. Такие регионы, как Актюбинская и Жамбылская, продемонстрировали устойчивое улучшение, в то время как Карагандинская, Восточно-Казахстанская и Акмолинская области столкнулись с выраженным спадом. Вновь созданные регионы, включая Абайскую, Жетысускую и Улытаускую, продемонстрировали нестабильную динамику, что отражает структурные и организационные проблемы. Заключение: Значительные региональные различия, недостаточное обновление материально-технической базы в периферийных регионах, проблемы с распределением кадровых ресурсов требуют разработки и реализации целевых государственных программ и стратегий. Кіріспе. Стоматологиялық кадрлармен қамтамасыз ету стоматологиялық көмектің сапасы мен қолжетімділігінде...

Relevance. The transition toward risk-oriented occupational safety systems requires modernizing social protection mechanisms for employees exposed to hazardous working conditions. In Kazakhstan, social guarantees are traditionally based on occupational classifications that do not fully reflect actual workplace risk exposure or economic sector characteristics. Objective. To develop and validate an integrated methodological approach for ranking occupations based on professional risk levels and economic activity characteristics. Materials and Methods. This study, conducted in 2024-2025, included an analysis of occupational risk assessment data from pilot enterprises, an evaluation of national labor statistics, and findings from a sociological survey of 312 respondents. An integrated ranking index was developed by calculating a sectoral coefficient reflecting economic activity characteristics. Statistical analysis was performed using SPSS 27.0. Results. Significant variability in occupational risk levels across economic sectors was identified. High and critical risk levels were predominantly observed in mining, metallurgical, and chemical industries, while lower risk levels were characteristic of service and administrative sectors. The proposed integrated ranking model demonstrated the ability to differentiate occupations with similar professional risk exposure by incorporating sector-specific economic indicators, thereby enabling a more precise distribution of social guarantees. Conclusions. The developed model establishes a scientifically justified relationship between occupational risk level and allocation of social guarantees. Implementing the proposed methodology may enhance the effectiveness of occupational safety regulation and support the transition toward a preventive, risk-oriented social protection system in Kazakhstan.