Particulate black carbon mass concentrations and the episodic source identification driven by atmospheric blocking effects in Astana, Kazakhstan.

Black carbon (BC) is a component of fine particulate matter (PM2.5) that is a key contributor to adverse human health effects and climate forcing. To date, BC mass concentrations and possible sources in Kazakhstan have not been studied. Thus, understanding the temporal variations of BC for a large developing region with a complex climate is useful. In this study, measurements of fine particulate BC mass concentrations in Astana were made from June 2020 to October 2021 by measuring light absorption of PM2.5 on filters. The mean BC concentration was 2.56 ± 1.29 µg m-3 with maximum and minimum monthly mean BC concentrations being 4.56 ± 2.03 µg m-3 and 1.12 ± 0.42 µg m-3 in January 2021 and June 2020, respectively. Temporal analyses of BC, SO2, PM10, NOx, CO, meteorological and atmospheric stability parameters were performed. Aggregated pollutant 'episodic loadings' during the heating and non-heating periods were identified. Their relationships with blocking anticyclones and cyclones were investigated by examining the reversal of meridional gradients at 500 hPa geopotential height (GPH) maps and identifying Omega (Ω) and Rex blocking types. Astana has some of the highest BC concentrations of cities worldwide. Seasonal BC source location identification using Conditional Bivariate Probability Function (CBPF) analysis implicated combined heat and power (CHP) plant emissions as the major BC source in Astana. Significant increases in BC concentrations were observed during the cold season due to numerous sources, generally poorer atmospheric dispersion and blocking events. The Concentration Weighted Trajectory (CWT) analysis results showed that the distribution of the 75th percentile of BC during episodic periods actively controlled by blockings exceeding than the entire measurement period, which may reflect cross-border transport and adjacent countries.

Heterogeneous (gas-solid) chemistry of atmospheric Cr: A case study of Astana, Kazakhstan.

Hexavalent chromium (Cr(VI)) is a known carcinogen derived from both anthropogenic and natural sources. This work reports the size-segregated concentrations of total Cr(VI) in particulate matter (PM) in Astana, the capital of Kazakhstan, and provides new insights into the gas-solid reactions of atmospheric Cr. A study of total Cr(VI) in the particulate matter, via a microwave-assisted digestion technique, was conducted using a 5-stage Sioutas Cascade impactor that captures airborne particles in size ranges: >2.5 µm, 1.0-2.5 µm, 0.50-1.0 µm, 0.25-0.50 µm, and <0.25 µm. The total Cr(VI) concentration in the size fraction <0.25 µm was the highest with a maximum value of 9.7 ng/m3. This high concentration may pose a greater risk because smaller airborne particles can penetrate deeper into the lower respiratory tract of the lungs. Total suspended particles Cr(VI) exceeded the 8.0 ng/m3 Reference Concentration (RfC) by 22 times. The overall total Cr(VI) concentration in summer was significantly higher than in fall (p < 0.05), which could be due to factors, including higher temperatures, ozone, and NO2 concentrations in summer and a higher VOC concentration in fall. The results indicate that the interaction between Cr(III) and Cr(VI) through gas-solid reaction can control the speciation of atmospheric Cr.

Una mirada a la atención primaria desde Alma-Ata hasta Astaná / Um olhar sobre cuidados primários de Alma-Ata a Astaná / A look at primary care from Alma-Ata to Astaná

The history of Primary Care does not begin in 1978 with the Declaration of Alma-Ata, but mustbe contextualized in the history of Social Medicine, as the first is a strategy of the second. The advancesthat have been made in the area of Primary Care are undeniable, but they have not been enough toovercome inequities with regard to addressing vulnerable groups with low economic resources. Theobjective of the article is to analyze the evolution of Primary Health Care from the declaration of AlmaAta to that of Astana. To do this, a bibliographic review of articles published in the last five years wascarried out in journals indexed in Google Scholar, Lilacs and Scopus. Scientific recognition of thepractices of Traditional Chinese Medicine is evident, extending its use to various regions of the westernworld; the enactment of health promotion and disease prevention as a necessity of the first order.Strengthening the primary level of care constitutes the most inclusive, efficient and effective approach toimproving people's physical and mental health, as well as their social well-being.

La historia de la Atención Primaria no comienza en 1978 con la Declaración de Alma-Ata;aunque la primera es una estrategia derivada de la segunda, hay que contextualizarla en la historia dela Medicina Social. Son innegables los avances que se han dado en materia de Atención Primaria,sin embargo no han sido suficientes para superar las inequidades en lo que respecta al abordaje delos grupos vulnerables y de bajos recursos económicos. El objetivo del artículo es analizar el devenirde la Atención Primaria en Salud desde la declaración de Alma-Ata hasta la de Astaná. Para ello, serealizó una revisión bibliográfica, de artículos publicados en los últimos cinco años, en revistasindexadas en Google Scholar, Lilacs y Scopus. Resulta evidente el reconocimiento científico a lasprácticas de la Medicina Tradicional China, extendiéndose su uso por diversas regiones del mundooccidental; la promulgación de la promoción de la salud y la prevención de las enfermedades comouna necesidad de primer orden. El fortalecimiento del nivel primario de atención constituye elenfoque más inclusivo, eficaz y efectivo para la mejora de la salud física y mental de las personas,así como su bienestar social.

A história da Atenção Básica não se inicia em 1978 com a Declaração de Alma-Ata, mas deve sercontextualizada na história da Medicina Social, visto que a primeira é estratégia desta. Os avanços obtidosna Atenção Básica são inegáveis, mas não têm sido suficientes para superar as iniquidades na abordagemde grupos vulneráveis com poucos recursos econômicos. O objetivo do artigo é analisar a evolução daAtenção Primária à Saúde desde a declaração de Alma-Ata até a de Astana. Para tanto, foi realizada umarevisão bibliográfica de artigos publicados nos últimos cinco anos em periódicos indexados no GoogleScholar, Lilacs e Scopus. O reconhecimento científico das práticas da Medicina Tradicional Chinesa éevidente, estendendo seu uso a várias regiões do mundo ocidental; a efetivação da promoção da saúde eprevenção de doenças como uma necessidade de primeira ordem. O fortalecimento do nível primário deatenção constitui a abordagem mais inclusiva, eficiente e eficaz para melhorar a saúde física e mental daspessoas, bem como seu bem-estar social.

Ageing in Asia: Beyond the Astana Declaration Towards Financing Long-term Care for All Comment on "Financing Long-term Care: Lessons From Japan".

The Astana Declaration on primary healthcare in 2018 was the attempt to revive the ideals of the World Health Organization (WHO) Alma-Ata Declaration 40 years later, together with a call for the political will to provide adequate financing at acceptable quality of care. This approach is taken to achieve the past ideals of Health for All, given the new challenges of universal health coverage. The economic case for primary healthcare is justified against the growing demand due in part to the growing costs of chronic conditions and the rise of ageing population, other than the supply-side factors of the healthcare industry. Past healthcare systems have evolved greater roles of the state versus the market, but few have involved the Third Sector or civil society in more integrated ways to provide and finance long-term care (LTC) with population ageing. From the extremes of the communist state to capitalist free markets, an optimal public-private system has to reach a balance in access, cost and quality for health and LTC. Recent studies of health and LTC have distilled newer developments in public-private mixes of provision, financing and regulation, in response to the needs of fast-ageing Asian societies. While Japan was the oldest country in the world, other countries in Asia have caught up and are now acknowledged where innovative models of integrated eldercare under economic limits, hold great promise of their transferability to the rest of ageing societies. Besides other forms of integrated LTC delivery with traditional systems, newer forms of financing like savings funds and superannuation have been developed, with participation from government, industry and civil society. There is much to learn from the new Asian models of financing, using appropriate technology and social innovations, and integrating health and social systems for LTC.

FIP's Commitment to Action on the WHO Astana Declaration: Transforming pharmacy for better health for all.

The attainment of better health for all cannot be achieved without effective primary health care. The WHO Declaration of Astana renewed global commitment to primary health care by all countries and states around the world. With pharmacy and the pharmacy workforce being integral to the delivery of quality primary health care, the International Pharmaceutical Federation (FIP) is leading pharmacy's commitment to the Astana Declaration. Through a series of regional conferences, starting with the Eastern Mediterranean region, FIP is working with its regional partners and members across the world to progress this imperative and consolidate the role of pharmacy in delivering the primary health care agenda. The first pharmacy Commitment to Primary Health Care was made in Amman, Jordan in April 2019, paving the way for transforming pharmacy for better primary health care everywhere. Now, it is time to move from commitment to action.

[Inspiration of the Astana Declaration to the prevention and control of non-communicable diseases in China].

2018 witnessed the 40(th) anniversary of the Alma-Ata Declaration. On October 25, 2018, the World Health Organization issued a new Astana Declaration, which reiterates and further develops the concept and core elements of primary health care. It is also proposes that the implementation of the primary health care concept will facilitate to cope with the increasing burden of non-communicable diseases in different countries. Based on the analysis on the policies and practices of the prevention and control of non-communicable diseases in China, this paper points out that the "government-leading, multi-sectoral collaboration, social mobilization and participation by all people" which we have always emphasized is just the application of this primary health care concept, and the Astana Declaration also brings a new and important inspiration to the prevention and control of non-communicable diseases in China.

A declaration for all?

No abstract available.

[Declaration of Astana and preventive medicine in China].

At the time of the 40th anniversary of the Alma-Ata Declaration, the World Health Organization member states signed the Declaration of Astana. From Health For All to Universal Health Coverage, primary health care is consistantly identified as the key to achieving human health, and preventive services are critical and central component of primary health care. China has provided valuable experience for primary health care to countries around the world. However, with significant socioeconomic changes and rapid population aging, the contexts of primary health care and prevention services in China has undergone tremendous changes. Chronic diseases have become major burden of disease. System development and institution building, health service delivery system development, and the entire society of the country with large population are encountering new and serious challenges. On the basis of reviewing the development of preventive medical services in China for 40 years, Authors analyzes strengths and weaknesses of preventive services in China and looks forward to the challenges and opportunities in the coming decades, from perspective of primary, secondary and tertiary prevention strategies, and proposes suggestions for future development.

Declaration of Astana and preventive medicine in China / 中华预防医学杂志

At the time of the 40th anniversary of the Alma-Ata Declaration, the World Health Organization member states signed the Declaration of Astana. From Health For All to Universal Health Coverage, primary health care is consistantly identified as the key to achieving human health, and preventive services are critical and central component of primary health care. China has provided valuable experience for primary health care to countries around the world. However, with significant socioeconomic changes and rapid population aging, the contexts of primary health care and prevention services in China has undergone tremendous changes. Chronic diseases have become major burden of disease. System development and institution building, health service delivery system development, and the entire society of the country with large population are encountering new and serious challenges. On the basis of reviewing the development of preventive medical services in China for 40 years, Authors analyzes strengths and weaknesses of preventive services in China and looks forward to the challenges and opportunities in the coming decades, from perspective of primary, secondary and tertiary prevention strategies, and proposes suggestions for future development.

Inspiration of the Astana Declaration to the prevention and control of non-communicable diseases in China / 中华流行病学杂志

2018 witnessed the 40th anniversary of the Alma-Ata Declaration. On October 25, 2018, the World Health Organization issued a new Astana Declaration, which reiterates and further develops the concept and core elements of primary health care. It is also proposes that the implementation of the primary health care concept will facilitate to cope with the increasing burden of non-communicable diseases in different countries. Based on the analysis on the policies and practices of the prevention and control of non-communicable diseases in China, this paper points out that the "government-leading, multi-sectoral collaboration, social mobilization and participation by all people" which we have always emphasized is just the application of this primary health care concept, and the Astana Declaration also brings a new and important inspiration to the prevention and control of non-communicable diseases in China.

The incidence and body site of skin cancers in the population groups of Astana, Kazakhstan.

BACKGROUND AND AIMS: Data on cutaneous malignant melanoma (CMM), squamous cell carcinoma of the skin (SCC), and basal cell carcinoma (BCC) in populations consisting of multi-racial groups in the Commonwealth of Independent States are limited. Here, the main aim was to analyse the incidence and body site of these cancers in the population groups of Astana, Kazakhstan (2007-2016). METHODS: Annual age standardised incidences and body sites of BCC, SCC, and CMM in Astana's population, divided into "Kazakhs and other Turkic/Asian" and "Russian and other European/Caucasian" groups, were calculated from histologically confirmed cases reported to Astana Oncology Centre. RESULTS: During the period January 2007 to October 2016, 647 skin cancers were diagnosed. The age and sex standardised incidence of BCC, SCC, and CMM increased significantly between 2007 to 2011 and 2012 to 2016. Higher incidences occurred in the Russian and other European/Caucasian group compared with the Kazakh and other Turkic/Asian group for the 3 skin cancers. BCC was the most common type of skin tumour, followed by SCC, and then CMM, in both population groups and sexes. The head/neck was the commonest site for BCC and SCC in all groups. For CMM, the most frequent site was the trunk in the Russian group and the head/neck in the Kazakh group. CONCLUSION: The incidence of skin tumours in Astana rose over the past 10 years. Differences in skin phototypes and sun exposure/ protection behaviours may account for the more frequent occurrence of skin tumours in the Russian population group compared with the Kazakh population group.

Comparison between landfill gas and waste incineration for power generation in Astana, Kazakhstan.

The city of Astana, the capital of Kazakhstan, which has a population of 804,474, and has been experiencing rapid growth over the last 15 years, generates approximately 1.39 kg capita(-1) day(-1) of municipal solid waste (MSW). Nearly 700 tonnes of MSW are collected daily, of which 97% is disposed of at landfills. The newest landfill was built using modern technologies, including a landfill gas (LFG) collection system.The rapid growth of Astana demands more energy on its path to development, and the viability analysis of MSW to generate electricity is imperative. This paper presents a technical-economic pre-feasibility study comparing landfill including LFG utilization and waste incineration (WI) to produce electricity. The performance of LFG with a reciprocating engine and WI with steam turbine power technologies were compared through corresponding greenhouse gases (GHG) reduction, cost of energy production (CEP), benefit-cost ratio (BCR), net present value (NPV) and internal rate of return (IRR) from the analyses. Results demonstrate that in the city of Astana, WI has the potential to reduce more than 200,000 tonnes of GHG per year, while LFG could reduce slightly less than 40,000 tonnes. LFG offers a CEP 5.7% larger than WI, while the latter presents a BCR two times higher than LFG. WI technology analysis depicts a NPV exceeding 280% of the equity, while for LFG, the NPV is less than the equity, which indicates an expected remarkable financial return for the WI technology and a marginal and risky scenario for the LFG technology. Only existing landfill facilities with a LFG collection system in place may turn LFG into a viable project.