An assessment of the level of adherence of patients diagnosed with hypertension to therapy has not been conducted in Central Asia yet. It includes the lack the information on the impact of digital technologies on hypertension management. The study aimed at the evaluation of the effect of using a mobile application on adherence to therapy in patients with diagnosed arterial hypertension. A multi-centre randomized controlled study was conducted on 517 patients with diagnosed arterial hypertension (in the out-patient clinic, Almaty, Kazakhstan). Patients were randomly assigned to intervention (IG) and control (CG) groups. IG patients used a mobile application, which allowed creating an individual schedule for taking medications, including visual and audio notifications. The assessment of adherence to antihypertensive treatment was carried out using the Lebanese Medication Adherence Scale-14 (LMAS-14), consisting of 14 items. Data were collected before therapy (T1), 3 months (T2), 6 months (T3) and 12 months (T4) followed the first dose. Adherence was assessed on 101 patients in the CG group and 165 respondents in the IG group. In the period T1 in both groups CG and IG, a moderate adherence to treatment was recorded with indices equal to 35.9 ± 1.2 and 35.9 ± 1.3, respectively (p ≤ 0.05). A decrease in adherence in the CG group was determined after 3 months (35.9 ± 1.2) (p ≤ 0.05) and six months later (36.5 ± 3.2) in comparison with relatively high adherence among respondents in the IG group in periods T2 (39.5 ± 1.2) and T3 (40.5 ± 1.2) (p ≤ 0.001). After 12 months (T4) on the adherence scale in patients who used the mobile application “MyTherapy” (IG), despite a slight decrease in scores, the results were relatively higher (40.3 ± 1.3) compared with the CG group (33.6 ± 1.9) (p ≤ 0.001). The analysis of adherence of patients with primary health care in Almaty (Kazakhstan) with chronic arterial hypertension showed the effectiveness of using the ‘MyTherapy’ mobile application in increasing patient adherence. The obtained data on the positive effect of the use of digital technologies require further research to assess the possibility of wider implementation in healthcare.

Purpose of the article is to identify the relationship between willingness to support, family living standards and individual’s health self-assessment within the framework of the Kazakhstani population participation of in health insurance. The empirical basis of the study was the archive of sociological survey data, which is based on the population responses, taking into account the opinions in the pharmaceutical industry experts, medical workers and specialists in the insurance market. The results of the statistical analysis showed the presence of significant links between “Willingness to support” and “Self-assessment of individual health”, between “Willingness to support” and “Average monthly income per capita in the family”, as well as between “Willingness to support” and “Family living standards”. It was also found that the willingness to support is different for different strata of the population: among the population with a high self-assessment of health, a high standard of living and a high level of per capita income in the family, it is higher. In addition, the article analyzes the current state of health insurance market in the Republic of Kazakhstan, where, as a result, it was revealed that due to quarantine measures, the number of concluded insurance contracts has almost halved. The results obtained can be used by authorized state bodies in the development of health insurance programs, as well as measures to ensure the safety of the health care system of the Republic of Kazakhstan and policies in the field of effective health care.

Background: The severe acute respiratory syndrome-related coronavirus 2 pandemic continues to this day worldwide. Individuals with COPD are at increased risk of contracting SARS-CoV-2. Most of the conducted studies are based on the clinical assessment of COVID-19 infection with different comorbidities. The specific contribution of COPD to the severity of the disease and outcome still remains the point of investigation. The main goals of our study are to assess COPD’s influence on the severity of clinical and CT characteristics of COVID-19 pneumonia and associated in-hospital mortality. Results: This is a retrospective study on 281 patients with RT-PCR-confirmed COVID-19 infection and CT spectrum of COVID-19 pneumonia. Fifty patients have COPD based on CT criteria. No significant difference was observed in the mean hospital length of stay, arterial oxygen saturation on admission or in-hospital mortality between COPD and non-COPD groups. Patients with COPD were two times less likely to have fever less than 37.9 °C (RR = 2.037; 95% CI 1.114–3.724, p = 0.016), but higher absolute neutrophil count (p = 0.033) and median level of neutrophil/lymphocyte ratio (p = 0.029). The COPD group was presented with milder CT severity score (especially CT1, less than 25% of lung involvement) (p = 0.022), less likely to have bilateral (RR = 2.601; 95% CI: 1.341–5.044, p = 0.023) or central (RR = 1.754; 95% CI 1.024–3.003, p = 0.046) distribution of ground-glass opacities, right lower lobe (RR = 2.887; 95% CI 1.574–5.293, p = 0.008) or left lung (RR = 2.627; 95% CI 1.448–4.765, p = 0.009) involvement, and “crazy-paving” pattern (RR = 2.208; 95% CI 1.292–3.774, p = 0.003). Both moderate positive and negative relationship was observed between CT1, CT4, hypoxia and in-hospital mortality in the COPD group (r = − 0.383, p = 0.033; r = 0.486, p = 0.007; r = − 0,354, p = 0,022, respectively). Conclusion: The presence of COPD by imaging criteria in the settings of COVID-19-associated pneumonia did not significantly influence the clinical or imaging performance of the patients, nor was it linked to the increased in-hospital mortality.

The paper is devoted to calculation of a first regularized trace of one integro-differential operator with the main part of the Sturm-Liouville type on a segment with punctured points at integral perturbation of “transmission” conditions. The Sturm-Liouville operator − y ″ ( x ) + q ( x ) y ( x ) + γ ∫ 0 π y ( t ) d t = λ y ( x ) given on the segments π n ( k − 1 ) < x < π n k , k = 1 , n ¯ ; n ≥ 2 is considered. Boundary conditions of the Dirichlet type: y(0) = 0, y(π) = 0 are given on the left-hand and right-hand ends of the segment [0, π]. The functions are continuous on [0, π], the first derivatives of which have jumps at the points x = π n k are solutions. The value of jumps is expressed by the formula y ′ ( π k n − 0 ) = y ′ ( π k n + 0 ) − β k ∫ 0 π y ( t ) d t , k = 1 , n − 1 ¯ . The basic result of the paper is the exact formula of the first regularized trace of the considered differential operator.

Background This article focuses on the importance of nurses’ work in the field of palliative care, emphasizing their role in providing comprehensive care and support to patients with incurable diseases. Purpose The researchers analyzed both international and local scientific articles over the past 15 years to assess the importance of nurses’ role in patient care in palliative medicine. Method and materials Then, in the period from September to November 2022, a crosssectional study was conducted.The aim of the study was to evaluate the activities of nurses in palliative care centers in Kazakhstan and determine the level of patient satisfaction with this care. Result To do this, 99 patients from three palliative care centers in Kazakhstan were interviewed.In the second stage, Pearson’s chi-squared (χ2) statistical method was used to analyze potential relationships between various variables and patient satisfaction levels in relation to the work of nurses in palliative care centers. The third stage included a binary logistic regression analysis to assess the impact of nurses’ behavior on patient satisfaction. The results of the statistical analysis indicate that the amount of information provided by nurses has an impact on the level of patient satisfaction with the quality of nurses’ work. This assistance includes an integrated approach, which includes both medical care and psychological, social and spiritual support, providing comprehensive care for the patient and his loved ones. Conclusion The results of this study can serve as a basis for strengthening the work of nurses, who are an integral element in the medical care system, playing a key role in supporting palliative patients at a difficult life stage. Bangladesh Journal of Medical Science Vol. 24 No. 01 January’25 Page : 136-144

Introduction. Patient safety is widely recognized as a priority in modern healthcare systems. Reporting adverse events is an important mechanism for identifying weaknesses in healthcare processes and improving the quality of care. Nevertheless, underreporting remains a common problem in many healthcare organizations. Nurses are closely involved in clinical care and therefore play a key role in patient safety. Their willingness to report adverse events may depend on several factors, including organizational culture, peer expectations, perceived blame, and the clarity of reporting procedures. The Reporting of Clinical Adverse Events Scale (RoCAES ) is frequently used to examine healthcare professionals’ attitudes toward reporting practices. Aim. To assess nurses’ attitudes toward adverse event reporting using the RoCAES scale. Materials and Methods. A cross-sectional study was carried out from September to November 2025 in primary healthcare organizations located in six cities of Kazakhstan. The study involved 468 practicing nurses who met the inclusion criteria and agreed to participate. Attitudes toward adverse event reporting were assessed using the 25-item RoCAES instrument, which includes five subscales: perceived blame, perceived criteria for reporting, perceptions of colleagues’ expectations, perceived benefits of reporting, and perceived clarity of reporting procedures. Data were collected anonymously using an online questionnaire. Statistical analysis was performed in IBM SPSS Statistics (version 29.0). Descriptive statistics were calculated and the internal consistency of the instrument was evaluated using Cronbach’s alpha. Results. The findings indicate differences in attitudes across the RoCAES dimensions. The highest mean score was observed for the subscale Perceptions of Colleagues’ Expectations (M = 2.43, mean score), suggesting that peer-related norms may influence reporting attitudes. Moderate values were found for Perceived Criteria for Reporting (M = 2.41) and Perceived Blame (M = 2.36). Lower mean scores were observed for Perceived Benefits of Reporting (M = 1.97) and Perceived Clarity of Reporting Procedures (M = 1.92), reflecting generally positive evaluations of these aspects. Overall, structural aspects of reporting were evaluated more positively than socio-cultural factors. Conclusion. The results suggest that nurses’ attitudes toward adverse event reporting are shaped by both structural and socio-cultural factors. While reporting procedures and perceived benefits appear to be relatively well understood, peer expectations, uncertainty regarding reporting criteria, and concerns about blame may still influence reporting behavior. Strengthening supportive professional norms and maintaining a non-punitive reporting environment may contribute to improving reporting practices in healthcare organizations.