Background: Following its independence, Kazakhstan implemented several reforms, including the adoption of the Entrepreneurial Code in 2008. This study aims to evaluate the impact of these reforms on the number and per capita rates of epidemiologists, nurse epidemiologists, epidemiological surveillance centers, and infectious morbidity from 1998 to 2022. Such an evaluation is critical for informing policy decisions regarding the future of epidemiological services in Kazakhstan. Methods: An interrupted time series analysis using a best-fit epidemiological model was conducted to assess the impact of key interventions—specifically, the adoption of the Entrepreneurial Code of the Republic of Kazakhstan and subsequent legislation—on the number and per capita rates of epidemiologists, nurse epidemiologists, and epidemiological surveillance facilities with infectious morbidity across the country. Results: Infectious morbidity per million individuals ranged from 4698.14 to 2263.79, with a consistent downward trend observed throughout the study period. Over the study period, the per capita rates of urban epidemiologists exhibited a downward trend, whereas the rates of rural epidemiologists showed an upward trajectory. The per capita rate of epidemiological surveillance centers declined from 26.89 to 15.24 over the study period. Substantial disparities were observed between urban and rural areas, with the epidemiology workforce in urban settings being 3–4 times larger than that in rural areas. Conclusions: This evaluation is important for informing policy decisions regarding the future of epidemiological surveillance services in Kazakhstan.

The molecular mechanisms and signal transduction cascades evoked by the activation of aryl hydrocarbon receptor (AhR) are becoming increasingly understandable. AhR is a ligand-activated transcriptional factor that integrates environmental, dietary and metabolic cues for the pleiotropic regulation of a wide variety of mechanisms. AhR mediates transcriptional programming in a ligand-specific, context-specific and cell-type-specific manner. Pioneering cutting-edge research works have provided fascinating new insights into the mechanistic role of AhR-driven downstream signaling in a wide variety of cancers. AhR ligands derived from food, environmental contaminants and intestinal microbiota strategically activated AhR signaling and regulated multiple stages of cancer. Although AhR has classically been viewed and characterized as a ligand-regulated transcriptional factor, its role as a ubiquitin ligase is fascinating. Accordingly, recent evidence has paradigmatically shifted our understanding and urged researchers to drill down deep into these novel and clinically valuable facets of AhR biology. Our rapidly increasing realization related to AhR-mediated regulation of the ubiquitination and proteasomal degradation of different proteins has started to scratch the surface of intriguing mechanisms. Furthermore, AhR and epigenome dynamics have shown previously unprecedented complexity during multiple stages of cancer progression. AhR not only transcriptionally regulated epigenetic-associated molecules, but also worked with epigenetic-modifying enzymes during cancer progression. In this review, we have summarized the findings obtained not only from cell-culture studies, but also from animal models. Different clinical trials are currently being conducted using AhR inhibitors and PD-1 inhibitors (Pembrolizumab and nivolumab), which confirm the linchpin role of AhR-related mechanistic details in cancer progression. Therefore, further studies are required to develop a better comprehension of the many-sided and “diametrically opposed” roles of AhR in the regulation of carcinogenesis and metastatic spread of cancer cells to the secondary organs.

BACKGROUND: The problem of unemployment among young people worries the world for many generations, since young people are the stratum of the population on which the future in each country depends (Brydsten et al. 2016). The socioeconomic situation of young people, especially the unemployed, is alarming, which is not always emphasized in the priorities of social policy. The study of incidence among unemployed youth is carried out in many countries, where it is noted that the unemployed people have worse mental and physical health compared to employed one (Grzegorczyk and Wolff, 2020). AIM: Our study aims to assess the difference between the incidence of working and unemployed youth. METHODS: The study involved 536 people, from 18 to 29-years-old, among whom women - 69.2%, men - 30.8%, from all regions of Kazakhstan. RESULTS: The results of the work showed that the level of youth unemployment increased during the pandemic by an average of 1% in the world and in Kazakhstan, young people had limitations in receiving medical and social assistance due to financial constraints, deficiency of health insurance and personal reluctance. It was also found that social status is a significant predictor of vaccination (beta = −0.225, R2 = 0.0507, p < 0.001) and a predictor of alcohol consumption (beta = −0.0908, R2 = 0.00824, p = 0.037). More often unemployed youth noted health problems over the past year (42.3%) than in other social groups (35.6–37.8%), a similar situation was observed when assessing the frequency of chronic diseases (p = 0.365). CONCLUSION: In our study, we show that the decline in health by virtue of unemployment is likely to be significant, since our estimated effect implies that the health of young people is almost 10% worse (in absolute terms) due to unemployment compared to the employed population. This further underscores that unemployment is a public health problem that needs more attention. Furthermore, the results obtained show that unemployment has the most negative consequences for vulnerable people, including young people.

Background and Objectives. Lung cancer remains one of the leading causes of mortality, while the issues of patient rehabilitation, especially at advanced stages, remain insufficiently studied. The opinion of medical professionals plays a key role in the organization and implementation of rehabilitation measures. The purpose of this study was to assess the views of physicians from different specialties on the need for rehabilitation of patients with lung cancer, and to identify key barriers to oncology and rehabilitation care. Materials and Methods. The study was conducted among practicing physicians directly involved in the process of medical rehabilitation at various levels of medical care in the Republic of Kazakhstan. Data were collected from April to December 2024. The inclusion criteria were: oncologists, general practitioner, pulmonologists, therapists, and surgeons of outpatient clinics involved in the implementation of rehabilitation measures for lung cancer. The study included 306 physicians who met the inclusion criteria and fully completed the questionnaire. Results. In terms of gender, the majority of respondents were female 75.2% (N=230). The mean age was 38.7±10.7 years. The main barriers to effective cancer care: the most frequently cited barriers among general practitioner were patients’ indifference to their health 53.5% (N=38), insufficient funding 43.8% (N=32) and insufficient oncology knowledge 46.3% (N=19). Conclusions. The data obtained indicate the need for a multidisciplinary approach to the organization of rehabilitation care for patients with lung cancer. Differences in the opinions of physicians, as well as the identified barriers - informational, organizational and personnel - emphasize the importance of improving the qualifications of medical staff and informing patients to increase the availability and effectiveness of rehabilitation measures.

Background: Postpartum depression (PPD) is a common mental health condition, and women with elevated prenatal anxiety are at increased risk. Evidence from Kazakhstan remains limited. This study aimed to describe postpartum depressive symptoms and associated factors among women with elevated prenatal anxiety who received routine perinatal care and participated in the PRISM prenatal psychoeducational program. Methods: This prospective single-arm cohort study with postpartum follow-up was conducted in Astana, Kazakhstan. Of 1232 pregnant women screened, 234 women with elevated prenatal anxiety participated in the PRISM program, and 226 completed the postpartum assessment. Because no control group was included, the study was not designed to evaluate the effectiveness of PRISM or establish causal effects. Postpartum depressive symptoms were assessed using the Postpartum Depression Screening Scale–Short Form (PDSS-SF). Descriptive statistics were calculated, and associations with age, parity, and postpartum assessment period were examined using Spearman’s rank correlation and non-parametric tests. Results: The mean PDSS-SF score was 20.65 ± 6.00. Using a cut-off score of ≥17, 158 of 226 participants screened positive for clinically significant depressive symptoms, corresponding to 69.9% (95% confidence interval (CI): 63.6–75.5%). Scores were highest among women assessed between 6 weeks and 6 months postpartum (p < 0.001). Age showed a weak negative correlation with depressive symptoms, whereas parity was not significantly associated. The most frequently reported symptoms were sleep disturbance, loneliness, and depressed mood. Conclusions: A substantial burden of postpartum depressive symptoms was observed in this high-risk cohort. The findings support early identification of prenatal anxiety, continued postpartum screening, and access to appropriate psychological and psychiatric care. Controlled studies are needed to evaluate PRISM and similar preventive programs.

Background and Objectives. Lung cancer is the leading cause of cancer-related mortality worldwide. Due to late-stage diagnosis, the five-year survival rate remains as low as 15%. Disease progression, symptom severity, and treatment-related adverse effects significantly diminish the quality of life (QoL) in these patients. The objective of this study was to assess the quality of life in patients with lung cancer. Materials and Methods. This prospective study was conducted from May to October 2024 in the Abay region of the Republic of Kazakhstan and included 123 patients diagnosed with lung cancer. Patient-reported quality of life and symptom burden were evaluated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), with scores ranging from 0 to 100. Results.Overall quality of life (mean score > 50) and functional scales (mean score > 50) were moderate to good. The highest mean score was observed for social functioning (94±11.3), followed by physical functioning (79.73±13.3), cognitive functioning (76.15±19.5), emotional functioning (74.08±22.6), and role functioning (67±15.4). Conclusions.This study highlights the necessity of conducting multicenter research to assess quality of life in larger populations of lung cancer patients. It underscores that patient-reported outcomes regarding quality of life should be considered essential in developing new healthcare strategies aimed at improving medical care, including treatment, rehabilitation, and palliative support for oncology patients. Введение и цель. Рак легких является основной причиной смерти от онкологических заболеваний во всем мире. Из-за поздней диагностики 5-летняя выживаемость составляет всего 15%. Прогрессирование заболевания, тяжесть его симптомов и побочные эффекты значительно снижают качество жизни (КЖ) у этих пациентов. Целью данного исследования была оценка качества у пациентов с раком легких. Материалы и методы. Проспективное исследование, проводившееся в период с мая по октябрь 2024 года области Абай Республики Казахстан, включало 123 пациента с раком легкого. Качество жизни пациентов и бремя симптомов оценивались с использованием опросника качества жизни Европейской организации по исследованиям и лечению рака (EORTC QLQ C-30) (диапазон значений 0–100). Результаты. Качество жизни (средний балл> 50) и функциональные измерения (средний балл> 50) были умеренными или хорошими. Самый высокий средний балл был зафиксирован по социальному функционированию 94±11.3 балла, за которым следовали физическое функционирование 79.73±13.3 балла, когнитивное 76.15 ±19.5, эмоциональное 74,08±22.6 и ролевое 67±15.4 функционирование. Выводы. Исследование подчеркивается необходимость проведения многоцентровых исследований, которые позволят оценить качество жизни в более крупных популяциях пациентов с раком легкого, подчеркивая, что отчеты пациентов о качестве жизни следует считать необходимыми для разработки новых стратегий здравоохранения, которые могли бы повысить уровень предоставляемой медицинской помощи с точки зрения лечения, реабилитации или паллиативной помощи онкологическим больным.