BackgroundThe aim of this study was to ascertain the prevalence of burnout in Kazakhstan firefighters with regard to position and to identify predictors of faster burnout in order to plan future preventive strategies.MethodsData on demographics, lifestyle, fatigue (Fatigue Severity Scale (FSS)), SF-8 health-related quality of life (HRQL) and Maslach Burnout Inventory (MBI) emotional exhaustion (EX), cynicism (CY) and professional efficacy (PE) were obtained from 604 (94% men, median age 27 (interquartile range (IQR) 12) years) firefighters from all 18 fire departments of the city of Almaty. Associations between predictors and burnout EX, CY and PE dimensions were tested using multivariate logistic regression analyses.ResultsBurnout scores were low in this sample, including EX (0.6; IQR 1.55), CY (1.2; IQR 1.8) and PE (4.8; IQR 2.4). The highest median EX score (1.5 (IQR 2.0)) was in managers as opposed to the lowest in drivers (0.4 (IQR 1.4)), (p < 0.01). The greatest CY difference was between managers (2.1 (IQR 2.2)) and trainees (0.4 (IQR 1.1)) (p < 0.001). Age, work duration, education or fatigue were not associated with EX or CY in adjusted models. Better HRQL predicted lower EX and CY burnout, whereas alcohol never-use and language barrier predicted high CY. Male sex and no university degree predicted high PE burnout.ConclusionsFirefighting managers are at risk for higher burnout, irrespective of age and work duration, and the targeted intervention to combat burnout should include better uniform, mitigation of language barrier, general health improvement and less alcohol.

Background: Breast cancer in Kazakhstan and its Kyzylorda oblast is the most prevalent cancer in women and features increasing trends of incidence. The aim of study was to reveal risk factors for breast cancer among women of Kyzylorda oblast of Kazakhstan. Materials and Methods: A hospital-based case-control study was conducted at Kyzylorda oblast Oncology Center, including 114 cases of breast cancer and 196 controls. Binary logistic regression analysis was performed. Results: Social and behavioral risk factors for breast cancer were evaluated, among which unfavorable living conditions, chronic stress, unilateral breastfeeding, breastfeeding less than 3 months and over 2 years, abortions, and hereditary predisposition were found to be related with increased breast cancer risk. Breastfeeding for 6-24 months was found to be protective. Conclusions: The findings may have significant impact on activity planning aimed towards breast cancer reduction among women in Kazakhstan.

Background: The study’s aim is to examine adolescent girls’ attitudes toward the continuation or discontinuation of female genital mutilation (FGM) in association with their demographics in seven different countries in Africa. Methods: Data from the women’s survey of the Demographic and Health Surveys (DHS) conducted by the respective ministries (of Health and Family Welfare) in Egypt, Guinea, Kenya, Mali, Niger, Senegal and Sierra Leone were used. Adolescent girls (15–19 years) were included in the current analysis: Egypt (N=636), Guinea (N=1994), Kenya (N= 1767), Mali (N=2791), Niger (N=1835), Senegal (N=3604), Sierra Leone (N=1237). Results: Prevalence of supporting the continuation of FGM among adolescent girls was in Egypt 58%, Guinea 63%, Kenya 16%, Mali 72%, Niger 3%, Senegal 23%, and Sierra Leone 52%. Being Muslim and having low economic status were significantly associated with supporting the continuation of FGM in five of the participating countries. Girls having no education or only primary education in Guinea, Kenya, Mali and Sierra Leone exhibited a higher likelihood of supporting FGM than girls with secondary or higher education. In Egypt, Niger and Senegal there was no association between education and supporting FGM. The girls who stated that they had no exposure to media showed the higher likelihood of supporting FGM in Guinea, Kenya, and Senegal than those with exposure to media. Conclusions: The current study argues that increasing media coverage and education, and reducing poverty are of importance for shifting adolescent girls’ attitudes in favor of discontinuation of FGM.

In Kazakhstan, the regime and habits of consuming liquids by athletes in various sports have not been suffi ciently explored yet. The purpose of the study is to determine the amount, schedule and characteristics of consumption of drinks by sportsmen after the example of diff erent sports. In 2017 15 volleyball players of the Burevestnik team in Almaty, 15 judo wrestlers of the national team of Kazakhstan, 15 wrestlers of the club team and 15 triathletes of the national team of Kazakhstan took part in the estimation of the regime of water and other liquids consumption. A valid questionnaire was used to study the data on the volume and water consumption schedule and other liquids. The amount of water and other drinks consumed was studied by reproducing drinking during 24 hours. The questionnaire put questions about the amount of water and beverages consumed prior to training, during and after it, and furthermore certain types of beverages were determined. Our research showed that 63.34% of the Kazakhstan athletes under examination drink the recommended norm (2-3 liters per day), another 6.69% of the investigated consume from 3 to 6 liters of liquid. The researched athletes do not consume enough liquid 2 hours before training. Only 20% of volleyball players, judoists and triathletes of national teams consume the recommended norm of liquid (400-600 ml). Most of the investigated athletes consume necessary amount of water and other beverages during training. 70.0% of respondents drink water and juices during training, and only 16.7% of them drink sport drinks.

Relevance: The 5-year overall survival rate(s) in NSCLC p-stage IA is 73%, and the recurrence rate in radically treated patients is almost 10%. The study aimed to evaluate the prognostic significance of several clinical and morphological factors and apply machine learning algorithms to predict the results of overall survival of patients with lung cancer. Methods: The forms 030-6/y C34 – lung cancer (n=19,379) from the EROB database for 2014-2018 were analyzed, and the impact of risk factors on overall survival was assessed using the Kaplan-Meier method. Accordingly, the training data set for constructing forecasting models included 19,379 observations and 15 factors. The machine learning algorithms such as Random Forest Classifier, Gradient Boosting Classifier, Logistic Regression Model, Decision Tree Classifier, and K Nearest Neighbors (KNN) Classifier were implemented in the Python programming lan- guage. The results were evaluated by constructing an error matrix, calculating classification metrics: the proportion of correctly classified objects (accuracy) during training and validation (validation), accuracy (precision), completeness (recall), Kappa-Cohen. Results: In our study, 19,379 patients were analyzed, including 15,494 men (79.95%) and 3,885 women (20.04%). At the time of the study, 6,171 men (39.8%) and 1,962 women (49.5%) were alive. Median survival was 8.3 months (SE – 0.154 months, 95% CI – 7.96-8.56) in men and 15.43 months (SE – 1.0 months, 95% CI – 13.497-17.363) in women. At diagnosis, 1,037 patients (5.35%) had stage I disease, other 4,145 (21.38%) had stage II. Most patients (61.4%) had advanced stage NSCLC: 9,189 people (47.4%) were diagnosed with stage III, and 4,655 (24%) – with stage IV. The reliability of differences in median survival (χ2=3991.6, p=0.00) indicated the prognostic significance of the tumor process stage and its influence on the patient’s survival. Also, the revealed significant difference in the median survival of patients with various morphological forms of lung cancer sug- gests the prognostic significance of the morphological factor (the difference between those indicators was statistically significant, χ2=623.4 p=0.000). Conclusion: Machine learning models can predict the risk of fatal outcomes for patients after surgical treatment and registration in the EROB database. The creation of patient-oriented systems to support medical decision-making makes it possible to choose the optimal strategies for adju- vant therapy, dispensary observation, and frequency of diagnostic studies