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In post-Soviet Kazakhstan, the system of care for children with autism has been transforming over the past three decades. There is little known about the use of complementary and alternative medicine by families raising autistic children in the post-Soviet region. An exploratory qualitative focus group design was employed to study parents' experiences of using complementary and alternative medicine focusing on the perceived factors driving the utilization of complementary and alternative medicine by families of autistic children and the availability of complementary and alternative medicine. Six focus groups were conducted in five cities of diverse geographical locations in Kazakhstan. Data were analyzed using a framework analysis. Two overarching themes and subthemes are developed. The first "unmet needs" relates to predisposing factors that motivate parents to complementary and alternative medicine uptake and the second "chasing hope" relates to enabling factors that facilitate parents' uptake of complementary and alternative medicines. In summary, parents of autism spectrum disorder children in Kazakhstan face multiple challenges when seeking treatment for their children's condition and implement whatever complementary and alternative medicine interventions available. A decision to use, and the choice of intervention, mainly comes from perceptions of having no other choice rather than from rational decisions based on efficacy of complementary and alternative medicines. This study provides the first empirical conceptualization of parents' motives for choosing complementary and alternative medicine in Kazakhstan.

Little is known about the experiences of frontline professionals in Kazakhstan. Although studies of frontline workers have been conducted worldwide, it is imperative that caution should be exercised when extrapolating findings from disparate societies and generalizing them to Central Asian countries. As such, the purpose of this study was to explore and describe the firsthand experiences, perceptions, and knowledge gained from the experience of Kazakh frontline physicians and nurses during the COVID-19 pandemic. An exploratory-descriptive qualitative (EDQ) study was conducted over the course of a year in COVID-19 hospitals in Kazakhstan, with physicians (n = 23) and nurses (n = 7). Each participant was interviewed three times between May 2021 and May 2022. Braun and Clarke's six-step method was used for the thematic analysis. Three overarching themes and subthemes were identified: (1) Longitudinal Journey ("Nobody knew, nobody understood, nobody was ready"; "It's just life"); (2) Facets of Professionalism ("In my lifetime this is something unique"; "Who else if not us"; "We survived the war and the enemy"); and (3) Facets of Resilience ("God's providence"; "A good word heals too"). In light of the lack of research that has previously been conducted in Kazakhstan, the results of this study offer important new insight into the experiences of medical professionals during the COVID-19 epidemic. [ABSTRACT FROM AUTHOR]

This study provides an overview of research findings on long-term effects on healthcare workers mental health and factors associated with positive or negative changes. Medline and PubMed databases were searched for observational longitudinal studies and 18 papers were included in the review (PROSPERO: CRD42021260307). 12 articles indicated negative changes over time and six studies revealed a positive trend in a variety of mental health outcomes (anxiety, depression, insomnia, and others). Female sex, younger age, nursing occupation, frontline work, longer working hours and concerns about contracting COVID-19 were identified to be associated with negative changes. Conversely, a supportive environment, access to psychological resources, provision of sufficient personal protective equipment and availability of COVID-19 tests were linked to positive changes. Therefore, our findings can assist governmental and institutional authorities with effective interventions to improve psychological care for healthcare workers. [ABSTRACT FROM AUTHOR]

Introduction: There is a complex interaction between glucose and insulin homeostasis pathways, diabetes and autism spectrum disorder (ASD). It is known that neuronal migration pathways may be interrupted by intrauterine hyperinsulinemia and hyperglycemia. Moreover, neonatal hypoglycemia which is related to mitochondrial dysfunction has a potential role that influences ASD pathogenesis [6,7]. We present here a preliminary case-control study on children and adolescents (8 - 15 years old) with and without autism spectrum disorder examining the association between genetic polymorphisms impacting glucose and insulin homeostasis and autism spectrum disorder in Kazakhstan. Methods: In this case-control study looking at 211 samples, associations of glucose and insulin homeostasis gene polymorphisms of 10 genes and demographic variables with autism spectrum disorder were examined. Fisher's exact test and multivariate logistic regression models were used to find associations between polymorphisms and other predictors. Results: Preliminary results suggest that there is a complex relation between autism spectrum disorder and genetic variations that are associated with impaired glucose and insulin homeostasis susceptibility. There is a significant association of the T allele of ADIPOQ (rs1501299) (OR=1.75, 95% CI:1.04-2.93, p-value=0.035); the T allele of GCKR (rs1260326) (OR=0.6, 95% CI:0.39-0.93, p-value=0.023); the T allele of SLC30A8 (rs13266634) (OR=1.77, 95% CI:1.12-2.78, p-value=0.014); and the recessive GG genotype of rs10757278 (CDKN2B) (OR=2.58, 95% CI: 1.24-5.36, p-value=0.011) with autism spectrum disorder in the Kazakhstan population. Conclusion: Overall, this preliminary study revealed that there is evidence of significant associations between glucose and insulin homeostasis gene polymorphisms and autism spectrum disorder susceptibility in Kazakhstan and further study in this area to further verify this, is needed. [ABSTRACT FROM AUTHOR]