Background: Although burnout levels in oncologists are likely high, its predictors remain poorly understood. Aims: This study was aimed to verify the prevalence of occupational burnout in oncology doctors and nurses in the major cancer centre in Kazakhstan and to elucidate its predictors to plan future prevention activities. Methods: In the leading tertiary-level cancer centre in Kazakhstan, we recruited 256 subjects (67% doctors and 33% nurses, 62% women, median age 37.5 [interquartile range 15] years) and offered them Maslach Burnout Inventory to quantify emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). Demographics, fatigue, health-related quality of life with SF-8 and lifestyle were tested as predictors of burnout in multivariate logistic regression models. Results: Number of subjects with high EE was 121 (47%), high DP was 161 (63%) and high PA was 152 (59%). Fatigue, worse mental component score (MCS), being single and not exercising regularly predicted more burnout in EE. Fatigue, worse physical component score (PCS) and worse MCS predicted more burnout in DP. Finally, more burnout in PA was independently associated with fatigue, worse PCS, being married or divorced and having a university or academic degree. Conclusions: The prevalence of occupational burnout in oncologists was high, necessitating early burnout prevention programmes, addressing, among other, fatigue reduction and regular exercise.

BACKGROUND: To implement effective measures to reduce smoking and the use of novel nicotine-containing products among medical students and physicians, objective national-level data on smoking behavior are required. AIM: This work aimed to assess the prevalence of smoking and use of nicotine-containing products among medical students and primary care physicians in the CIS. METHODS: A cross-sectional consent-based survey was conducted. An online questionnaire administered via an electronic platform was used to assess the type of products consumed, frequency and duration of use, age of initiation, attempts to quit smoking, exposure to passive smoking, awareness of nicotine-related health risks, and availability of smoking cessation programs. RESULTS: The study included 9222 students and 1599 physicians from five countries. The prevalence of smoking among students and physicians, respectively, was: Russia 20.3% and 17.1%; Belarus 17.0% and 18.3%; Kyrgyzstan 15.4% and 6.8%; Kazakhstan 8.2% and 12.8%; Uzbekistan 3.2% and 5.9%. Smoking prevalence among women was lower than among men in all countries (p 0.05), except among students in Belarus (p 0.05). The prevalence of nicotine-containing product use (including combined use with conventional cigarettes) did not differ between men and women among students in most countries, except in Kyrgyzstan (p 0.05). The primary risk factors for smoking among students, regardless of country, were smoking by friends and smoking by classmates or dormitory roommates. Among physicians, 3.7%–12.5% of men and 10%–50% of women who reported quitting tobacco continued to use electronic cigarettes. Male physicians were more frequently exposed to passive smoking at work, whereas female physicians were more frequently exposed at home. Attitudes of healthcare professionals toward tobacco products and electronic cigarettes remarkably influenced the likelihood of using specific forms of smoking. CONCLUSION: This study expands current data on the prevalence of smoking, including passive smoking, as well as on cross-country similarities and differences in smoking behavior and smoking-related risk factors among healthcare professionals.

Objective: to ascertain respiratory symptoms, lung function and selected respiratory disease risk factors in firefighters of the city of Almaty. Materials and methods: N=1379, 91% males, firefighters working in Almaty were recruited at the annual screening, where CAT (COPD Assessment Test) and mMRC (Modified Medical Research Council) questionnaires were offered to quantify the severity of respiratory symptoms. We also assessed respiratory risk factors, including cigarette smoking, exposure to environmental tobacco smoke, fossil fuel use for heating and cooking, and regular physical activity, followed by spirometry. Vital capacity (VC), forced VC (FVC) and forced expiratory volume in one second (FEV1) were measured. Results: Median age was 28 (interquartile range (IQR) 25-35) years, years in service median 5 (IQR 3-13) years. 41% of employees were daily cigarette smokers (significantly more among males, 43 vs. 16%), whereas 93% were exposed to environmental tobacco smoke and only 57% were engaged in regular leisure physical activity. With the overall low score of respiratory symptoms, the prevalence of postbronchodilator FEV1/FVC reduction below lower limit of normality in males was 2%, whereas the diagnosis of chronic bronchitis in the past was found in 2% of participants. Conclusions: healthy worker effect in firefighters of Almaty can explain very low prevalence of bronchoobstructive syndrome among those enrolled in this analysis, even despite high smoking prevalence.

Background/Objectives: The aim of this study was to test the association of poorer spirometry and more respiratory symptoms with being an ex-smoker in a cohort of ever-smokers in a population-based study in Kazakhstan. Methods: We first enrolled 5058 subjects, of whom 1769 were classified as ever-smokers (63% current and 37% former smokers) from the general population in five cities in Kazakhstan and analyzed them hereinafter. They filled in a questionnaire and underwent spirometry with bronchodilation, in which z-scores of post-bronchodilation forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC) were analyzed. Respiratory symptoms and spirometry were compared between continuing smokers and those who stopped in multivariate logistic regression models. Results: Current smokers smoked a median of 10 (interquartile range (IQR) 7;20) cigarettes a day. In the fully adjusted models, neither lung function (FEV₁, FVC and FEV₁/FVC z-scores and even FEV₁/FVC below the lower limit of normality (LLN)) nor symptoms could predict being an ex-smoker at present. Age (odds ratio (OR) 1.02; 95% confidence interval (CI) 1.01; 1.03), body mass index (BMI) over 25 kg/m² (OR 1.36; 95% CI 1.10; 1.68), lifetime exposure to vapor, gas, dust and fume (OR 0.77; 95% CI 0.62; 0.97), exposure to SHS (OR 0.34; 95% CI 0.27; 0.42) and electronic cigarette use (OR 0.58; 95% CI 0.34;0.99) were significantly associated with being a former smoker vs. a current smoker at the time of examination. Conclusions: Spirometry and early respiratory symptoms did not predict being a former smoker, but co-exposure to secondhand smoke, occupational exposures, and electronic cigarette use sustain continuing smoking.

Introduction. Ischemic heart disease is one of the leading causes of mortality worldwide, highlighting the importance of implementing accessible and non-invasive screening tools at the population level. This study aimed to assess the feasibility of using heart rate variability parameters obtained from a wearable photoplethysmography-based device to evaluate the risk of ischemic heart disease. Materials and methods. A finger-worn IoT device called «Zhurek» was developed, based on photoplethysmography technology and capable of calculating real-time heart rate variability indices. The measurements obtained from «Zhurek» were compared with data from three lead Holter electrocardiographic monitoring, and machine learning algorithms were applied to datasets collected from angiographically confirmed patients and healthy volunteers. Results. The deviations between the new device measurements and Holter electrocardiography remained within clinically acceptable limits; heart rate variability parameters, particularly low-frequency power, and patient age were identified as key diagnostic indicators for detecting ischemic heart disease. Conclusion. The «Zhurek» device is suitable for large-scale ischemic heart disease risk stratification and may facilitate a shift in healthcare from a reactive, symptom-driven approach to a proactive, prevention-oriented model.