Background Cardiovascular diseases (CVD) occupy leading positions in the mortality of the Republic of Kazakhstan (RK). In RK CVD screening is performed with 40-years of age. Objectives: to evaluate the effectiveness of screening over time. Methods We conducted a survey of 121 patients with CVD, identified on screening. Results The average age patients in survey-54.3 [95% CI: 52.64;55.96], of which 38% are men and 62%-women. Fact smoking mark 64 persons (52±8), alcohol-(37.2±11.6), family history-66 (54.5±8.1) daily physical activity-34 person (28.1±14.3). Middle systolic blood pressure (BP) is 144.3 [95% CI: 141.61;146.99] and diastolic BP 90.2 [95% CI: 89.02;91.38] mm.Hg. Most of the respondents have different degrees of obesity. The average BMI is 31.8 [95% CI: 30.93;32.67]. The average waist size is 89.1 [95% CI: 86.88;91.52], with the waist size of women over 80 cm (91.9 [89.03;94.77] and the waist size of men 86.1 [82.31; 89.89]. Mean values for total cholesterol of 5.9 [95% CI: 5.85;5.95]. To evaluate the effect of various factors on the increase in BP, we calculated the analysis of variance. According to our calculations, gender does not affect BP, however, age, BMI and waist size affect. We interviewed patients for complaints, analyzed outpatient cards, a check-up journal: chest pains or interruptions in the heart during exercise are noted by 25 people (20.7±17.5), improvement of the subjective state-29 (24±15.9), regularly receive basic therapy-59 (48.8±9.1), call the ambulance team-43 (35.5±12), are urgently hospitalized for a year-31 (25.6±15.2) and 7 person participate in the school of CVD. There is a statistically significant relationship between gender and smoking, gender and alcohol, gender and regular intake of basic therapy at a significance level of p < 0.05. Conclusions Identifying the low effectiveness of CVD screening over time requires the revision of a comprehensive training program for doctors-nurses and the public. Key messages Patients in Kazakhstan generally do not change their lifestyle after screening for a disease. The effectiveness of the screening depends on the teamwork of the doctor, nurse and patient.
Issue Constantly emerging new challenges for national health systems (HS) and new technologies require the creation of conditions for the continuous provision of the HS with the necessary number of health workers (HW) with the appropriate level of qualifications. In this regard, the high relevance acquires the formulation of a structured description of levels of qualifications in the HS, the requirements for the future and existing qualifications, taking into account the priorities of the HS development, as well as mapping of occupations by the qualification level. Description of the Problem The main problems in regulating the sectoral qualifications system (SQS) in Kazakhstan is the lack of a sectoral framework of qualifications (SQF) and professional standards governing the requirements for specialists in the HS, and the lack of a clear distinction of competencies by the qualification level. Accordingly, there is a discrepancy between educational programs and practical health care needs, and an imperfection of the HWs certification system. Changes: We have incorporated into the National Code 'On the health of the people and the HS' points that define the SQS basic principles and regulation. As SQS has been defined set of legal and institutional mechanisms to control demand of HWs from the labor market and the qualifications offer from the health education system. SQS includes SQF; professional standards; state compulsory health education standards; system for assessing the professional preparedness and certification of specialists; system of continuing professional development of HWs. For a structured description of the levels of qualifications recognized in the HS we developed SQF. In SQF all HWs were divided into sub-sectors: medicine, pharmacy, public health and intersubsectoral processes. Lessons The presence of an effective SQS will create the conditions for providing the HS with human resources that meet the needs of the state, business and society. Key messages We have analyzed the existing system for regulating the qualifications of health professionals and have proposed legislative mechanisms for regulating the SQS in the field of healthcare. This made it possible to ensure conditions for effective legal regulation of the HWs qualification demands from the labor market and the supply of qualifications from the health education system.
Most partial value functions displayed non-linearities and were similar in shape, indicating that the scoring scale of the EVIDEM should not automatically be used as interval scales. Scores need to be adjusted by their partial value functions before calculating the aggregate score.
particular: independent visits to patients with chronic diseases at home 60% (95% CI:51;69.4)respondents; independent primary admission of patients seeking medical care 48.9% (95%CI:38.5;59.3); independent daily bypass of inpatients 60.8% (95% CI:50.4;71.2); conduct training of patients with chronic diseases of the skills of a healthy lifestyle, dieting 73% (95%CI:61.8;84.2). Conclusions: In general, the population is aware of the reforms carried out on the reorganization of the nursing, which indicates their effectiveness. Nevertheless, among the population, there is not enough explanatory work on reforms and on the new status of a nurse, which should lead to the formation of a positive image of the new profession of a nurse.
The aim of this study is to assess whether risk factors for cardiovascular disease (CVD) are similar by sex. Methods: We conducted a pooled analysis using National Health Interview Survey (NHIS)-National Cardiovascular Disease Surveillance Data (2000-2015) to determine period prevalence of major CVD, acute myocardial infarction (AMI), coronary heart disease (CHD), and stroke along with the commonly known risk factors stratified by sex among the adults in the United States. Descriptive statistics were used to summarise the results. Analyses were conducted using SAS. Results: Between 2000 and 2015, age-standardised prevalence (ASP) for major CVD, AMI, CHD, and stroke were 7.56%, 3.14%, 4.10%, and 2.47%, respectively. ASP of all the CVD categories were higher among males compared to females (major CVD: 9.07% vs. 6.29%; AMI: 4.34% vs. 2.11%; CHD: 5.54% vs. 2.90%; Stroke: 2.50% vs. 2.43%). Interestingly, ASP of some of the known risk factors such as smoking, physical inactivity and hypertension were higher in females as compared to males (smoking: 80.59% vs. 78.81%; physical inactivity: 36.04% vs. 31.73%; hypertension: 94.00% vs. 89.20%). Conclusions: Prevalence of CVD was higher among males whereas, females had a more diverse profile of CVD risk factors. This suggests substantial scope for risk factors such as sex, in probably being able to predict CVD more accurately and improve management of the disease.
Issue/problem Nurses play a key role in the system of public health. The total number of nurses in Kazakhstan is 105,441 people (January 1, 2019), which is over 40% of all health workers in the health system of Kazakhstan. The continuing problem of insufficiently effective nursing service (NS) in the country prompted us to develop policy options to increase the NS effectiveness. Description of the problem Key problems of the NS in Kazakhstan include the ineffective management of NS in health organizations, which is associated with an underestimation of the role of nurses in the therapeutic and diagnostic process. There is also a discrepancy in the functioning of the system of nursing education, research and practice with European directives. There are inadequate regulatory acts governing the activities of nurses (including the lack of national guidelines, nursing standards, etc.). Results As a result of analyzing the current situation in the country and summarizing the data from systematic reviews, we were developed the Policy Brief on the issues of implementation of a new model of the NS management. As the key policy options, we proposed: 1. Improving the NS management in health organizations based on a revision of the role of nursing staff in the treatment and diagnostic process; 2. Improving the sectoral qualifications system of nursing specialists in accordance with European directives; 3. Ensuring the development of evidence-based nursing practices with the implementation of generally accepted international standards and models, the development of national guidelines and standards for NS. Lessons The proposed measures found support from the Ministry of Health and were included in the action plans. Each of these policy options contributes to increasing the effectiveness of NS in the health system of Kazakhstan, but these options provide more substantial achievement of the goal of enhancing the role and status of a nurse with their combined implementation. Key messages Implementation of a new model of the NS management in which nurses and physicions work on an equal footing and independently can significantly improve the efficiency of NS. Implementation of evidence-based approaches to the formation of a policy in the field of the NS development gives possibility to increase the effectiveness of the reforms in this field.
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