Introduction: Studying the prevalence of anxiety, depression, and insomnia among medical workers in emergency medical services is a relevant task that will improve our understanding of scope of the problem and develop effective strategies to support and prevent psychological problems among medical staff. Insomnia is closely linked to anxiety and depression, as sleep disturbances can exacerbate emotional distress, while persistent anxiety and depressive symptoms contribute to sleep disruptions. Individuals suffering from insomnia are at a higher risk of developing anxiety and depression, creating a bidirectional relationship that negatively impacts overall mental well-being. This raises a crucial question: “What specific measures and intervention strategies can be implemented to reduce the levels of anxiety, depression, and insomnia among EMS personnel?” Methods: A cross-sectional study was conducted with the participation of 592 medical workers employed in emergency medical services in the East Kazakhstan and Abay regions of the Republic of Kazakhstan. This study included questions regarding the socio-demographic data of the respondents, questions assessing the severity of insomnia using the Insomnia Severity Index (ISI), and questions from the Hospital Anxiety and Depression Scale (HADS) scale assessing the level of anxiety and depression among the participants. Results: Nearly a third of the EMS personnel reported symptoms of insomnia (28.2% subthreshold, 16.2% insomnia, and 3.0% severe), anxiety (22.1% subclinical, and 13.0% clinical), or depression (20.4% subclinical, and 9.8% clinical). Feldshers (nursing staff) and those with higher education had elevated levels of these conditions. The insomnia was strongly correlated with anxiety (r = 0.539, p < 0.001) and depression (r = 0.415, p < 0.001), emphasizing the need for targeted mental health interventions. Conclusions: This study found elevated levels of insomnia, anxiety, and depression among emergency medical service (EMS) personnel—especially nursing staff and those with higher education. We recommend comprehensive mental health support, routine screenings, stress management training, and integrating sleep hygiene into wellness programs.

Intrduction. Studying the prevalence of anxiety, depression and insomnia among medical workers of Emergency medical service is a relevant task that will allow us to better understand the scope of the problem and develop effective strategies to support and prevent psychological problems among medical staff. Methods. A cross-sectional study was conducted with the participation of 592 medical workers employed at emergency medical service in the East Kazakhstan and the Abay regions of the Republic of Kazakhstan. The study included questions regarding socio-demographic data of the respondents, questions aimed at assessing the severity of insomnia using the Insomnia Severity Index (ISI) and questions from the HADS scale to assess the level of anxiety and depression among the participants. Results. Nearly half of healthcare workers reported symptoms of insomnia (28.2% subthreshold, 16.2% insomnia, 3.0% severe), anxiety (22.1% subclinical, 13.0% clinical), or depression (20.4% subclinical, 9.8% clinical). Feldshers (nursing staff) and those with higher education had elevated levels of these conditions. Insomnia severity strongly correlated with anxiety (r=0.539, p<0.001) and depression (r=0.415, p<0.001), emphasizing the need for targeted mental health interventions. Conclusion. The study revealed high rates of insomnia, anxiety, and depression among healthcare workers, with nursing staff and highly educated individuals most affected. Insomnia correlated strongly with anxiety and depression, highlighting the need for mental health support.

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

Введение:На сегодняшний день, вопрос о влиянии микропластика на организм человека является актуальной проблемой, ввиду того, что микропластик представляет собой дробные частицы пластикового мусора размером менее 5 мм, которые могут быть обнаружены в различных окружающих нас средах, включая воду, почву и пищевые продукты. Согласно статистике, в организм человека ежедневно попадает около 330 частиц микропластика. С каждым годом уровень применения пластика в разных сферах растет. Например, службы доставки еды, которые пользуются большим спросом среди населения, и студентов в частности. Цель исследования: Оценить информированность студентов НАО «Медицинского университета Семей» о вреде микропластика на организм человека. Материалы и методы. Одномоментное поперечное исследование студентов 1-5 курсов НАО «Медицинского университета Семей» (г.Семей, Республика Казахстан). Генеральная совокупность = 2343, выборочная совокупность = 330. Нами было проанкетировано 659 респондентов. Статистическая обработка данных была произведена в программном обеспечении IBM SPSS Statistic (Version 22) с использованием методов описательной статистики. Доверительный интервал = 95%. Результаты исследования.Результаты анкетирования свидетельствуют о том, что 578 (87,7%) опрошенных в повседневной жизни используют изделия из пластика, при этом, только 308 (46,7%) студентов знают о том, что такое микропластик. О влиянии микропластика на организм осведомлены лишь 245 (37,2%) студентов. Всего 116 (17,6%) – указали верную категорию тар для напитков; 58 (8,8%) – для «желтков» из-под киндеров; 50 (7,6%) – для пищевой пленки; 58 (8,8%) – для многоразовой пластиковой посуды; 182 (27,6%) выбрали верный вариант ответа в вопросе о категориях ланч-боксов. 594 (90,1%) исследуемых обеспокоены проблемой загрязнения природы, связанной с неправильной утилизацией пластиковых отходов. Выводы: Подавляющее большинство студентов НАО «Медицинского университета Семей», пользуясь в повседневной жизни пластиковыми изделиями, не осведомлены о понятии микропластика и его классификации, путях проникновения в организм человека и потенциальных последствиях его воздействия. Introduction: Today, the question of the impact of microplastics on the human body is an urgent problem, due to the fact that microplastics are fractional particles of plastic debris less than 5 mm in size, which can be found in various environments around us, including water, soil and food products. According to statistics, about 330 microplastic particles enter the human body every day. The level of plastic consumption is growing every year, and this is also due to food delivery services, which are in great demand among students. The aim of the work: To assess the awareness of students of Semey Medical University about the dangers of microplastics on the human body. Materials and research methods. A single-stage cross-sectional study of 1–5-year students of the Semey Medical University (Semey, Republic of Kazakhstan). General population = 2343, sample population = 330. We surveyed 659 respondents. Statistical data processing was performed using IBM SPSS Statistic software (Version 22) using descriptive statistics methods. Confidence interval = 95%. Research results. The survey results indicate that 578 (87,7%) respondents use plastic products in everyday life, while only 308 (46,7%) students know what microplastics are. Only 245 (37,2%) students are aware of the impact of microplastics on the body. A total of 116 (17,6%) indicated the correct category of beverage containers; 58 (8,8%) – for «yolks» from under kinders; 50 (7,6%) – for cling film; 58 (8,8%) – for reusable plastic tableware; 182 (27,6%) chose the correct answer when asked about the categories of lunch boxes. 594 (90,1%) of the respondents are concerned about the problem of environmental pollution associated with improper disposal of plastic waste. Conclusions: The vast majority of students at Semey Medical University, using plastic products in everyday life, are not aware of the concept of microplastic and its classification, routes of penetration into the human body and the potential consequences of its exposure. Кіріспе: Бүгінгі таңда микропластиктің адам ағзасына әсері...

Background Clinical decision-making in palliative care is crucial for providing quality care to individuals with life-limiting illnesses. Nurses, as key members of the palliative care team, make critical decisions regarding symptom management, patient comfort, and end-of-life care. In Kazakhstan, where palliative care is still evolving, understanding how nurses make these decisions is essential to improving care quality and informing healthcare policies. Aim This study aimed to explore the clinical decision-making experiences of palliative care nurses in Kazakhstan, focusing on the factors influencing their decisions, the challenges they encounter, the strategies they employ, and how decision-making processes can be improved. Methods A qualitative research design was employed, using semi-structured interviews with 12 palliative care nurses from various healthcare settings across Kazakhstan. Participants were selected through purposive sampling to ensure a diverse representation of experiences from both urban and rural areas. The interviews were transcribed verbatim and analyzed using thematic analysis to identify key patterns and themes related to clinical decision-making. Results The analysis revealed several factors influencing decision-making, including clinical knowledge and experience, patient and family preferences, and systemic factors such as resource constraints. Nurses reported challenges such as cultural reluctance to discuss death, lack of formal palliative care training, and limited access to medications and equipment, particularly in rural areas. To address these challenges, nurses employed strategies like interdisciplinary collaboration, patientcentered care, and a strong desire for ongoing education. Conclusion Clinical decision-making in palliative care nursing in Kazakhstan is shaped by a combination of clinical expertise, cultural dynamics, and systemic limitations. The findings highlight the need for formal education, improved resource availability, and better interdisciplinary collaboration to support nurses in making informed and effective decisions. Enhancing these aspects can significantly improve the quality of palliative care in Kazakhstan, ensuring that decisions align with the values and wishes of patients and their families. BJMS, Vol. 24 No. 03 July’25 Page : 967-974

Tuberculosis (TB) remains a significant global health issue, particularly in countries like Kazakhstan, which is among the 30 high TB burden nations. Tobacco smoking is a major risk factor that increases susceptibility to TB infection and worsens treatment outcomes by impairing immune defenses. Aim: This study aimed to assess the prevalence of active tobacco smoking among TB patients in Kazakhstan and to evaluate how smoking affects TB treatment outcomes. Additionally, it sought to understand patients’ perceptions regarding smoking during treatment. Method: A cross-sectional observational study was conducted in several hospitals in Almaty involving 105 adult TB patients in 2025. Data on smoking status, demographics, and treatment outcomes were collected using structured questionnaires and medical records, with statistical analysis performed to examine associations. Results: Among the patients, 31.5% were active smokers who showed significantly worse treatment outcomes than non-smokers, including higher rates of treatment failure and abandonment. Logistic regression revealed that smokers had nearly three times higher odds of unsuccessful treatment (OR=2.82, p=0.015). Discussion: The findings align with global evidence linking smoking to poor TB outcomes and highlight that psychological factors, such as stress relief from smoking, contribute to continued tobacco use among TB patients. These results underscore the need for integrated smoking cessation and mental health support within TB care programs. Conclusion: Tobacco smoking is common among TB patients in Kazakhstan and is associated with poorer treatment success. Implementing routine tobacco use screening and cessation interventions alongside psychological support is essential to improve TB treatment outcomes