International Expansion: A Case Study Of Mongolias Dairy Market

A businessman teaches himself the fundamentals of business and marketing in order to expand beyond the region of his Mongolian home.He must work through the meaning of supply and demand and customer-orientation which are foreign concepts to him.Letting go of the fundamental principles taught to him by a socialist system and competing in the 21st century may bring success, but first he must identify the challenges and begin to understand which ones are significant to overcome for success

A Study of Job Burnout, Job Satisfaction, and Intention to Leave Their Present Job Among Healthcare Workers Using Structural Equation Modelling

Maintaining and improving the quality of nursing care is a critical issue in the healthcare system, and the shortage of healthcare workers is a significant challenge faced by many countries worldwide. The shortage of healthcare workers can have a severe impact on the healthcare system, leading to decreased quality of care, increased patient wait times, and lower patient satisfaction. It can also lead to higher rates of burnout and stress, low job satisfaction, and intention to leave their job among healthcare workers who are overworked and have limited resources.The current study aims to explore the correlations between job burnout, job satisfaction, and intention to leave. The survey employed random sampling to gather data from employees of a private hospital in Ulaanbaatar. A total of 217 employees participated in the study, and for verification and testing the proposed hypothesis in the study, we conducted various statistical analyses inclusive of factor analysis, reliability analysis, correlation analysis, and structural equation models (SEMs).The study's findings revealed a significant negative effect of job burnout on healthcare workers' job satisfaction, as well as a positive effect on their intention to leave their current position. Furthermore, the study findings indicate that there is a negative relationship between job satisfaction and employee's intention to leave their jobs. In other words, a decrease in job satisfaction correlates with an increase in the likelihood of employees seeking alternative employment opportunities. Additionally, the results revealed that job satisfaction plays a mediating role in the connection between job burnout and the intention to leave.Our study highlights the negative impact of job burnout on job satisfaction and its positive impact on the intention to leave. Additionally, it emphasizes the important mediating role of job satisfaction in this relationship.  These findings provide empirical evidence for the importance of addressing job burnout and promoting job satisfaction to reduce the intention to leave among employees in clinics. Keywords: Job burnout, job satisfaction, intention to leave, healthcare workers DOI: 10.7176/EJBM/15-11-01 Publication date:June 30th 202

Aboveground biomass of mongolian larch (Larix sibiricledeb.) forests in the eurasian region

We used our database of tree biomass with a number of 433 sample trees of Larix from different ecoregions of Eurasia, involving 61 trees from Mongolia for developing an additive model of biomass tree components. Our approach solved the combined problem of additivity and regionality of the model. Our additive model of tree aboveground biomass was harmonized in two ways: first, it eliminated the internal contradictions of the component and of the total biomass equations, secondly, it took into account regional (and correspondingly species-specific) differences of trees in its component structure. A significant excess of larch biomass in the forest-tundra is found that may be explained by permafrost conditions, by tree growth in low-yielding stands with a high basic density of stem wood and relatively high developed tree crown in open stands. The aboveground biomass of larch trees in Mongolia does not stand out against the background of the most ecoregions of Eurasia. Based on our results, we conclude that the growing conditions of larch in Mongolia are not as tough as it was suggested earlier by other scientists. Biomass relations between regions may be explained by unknown and unaccounted factors and errors of measurements in all their phases (assessment of age, diameter, height of a tree, the selection of supposedly representative samples of component biomass, their drying, weighing, etc.). The question what explains the regional differences in the structure of biomass of trees with the same linear dimensions of their stems, remains open. Undoubtedly, the differences in tree age here play an important role. Also, important factor is the variation in the morphological structure of stands, which, in turn, is determined by both climatic and edaphic factors. The obtained models allow the determination of larch forest biomass in different ecoregions of Eurasia with the help of height and diameter data. © 2019, Lomonosov Moscow State University. All rights reserved

Nonorganic sleep disorders and sleep quality among the general population of Mongolia

The aim of this study was to determine the prevalence of non-organic sleep disorders and sleep quality, using a structured psychiatric interview following screening through the Pittsburgh Sleep Quality Index (PSQI) among the general population. This nationwide population-based cross-sectional study was carried out between August and October 2020 and involved 964 participants (74% women, mean age: 40.72±14.34) who were randomly selected from 64 clusters in 10 sites of Mongolia. 27.9% of the study participants were evaluated as having non-organic sleep disorders based on the diagnostic guidelines of the International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10). The prevalence of non-organic sleep disorders differed in age (p<0.001). Non-organic sleep disorders were related to age, employment, diastolic blood pressure, sleep quality, and quality of life. The prevalence of non-organic sleep disorders in the general population of Mongolia was calculated as 27.9%, while the prevalence rate of the poor sleep quality was 42.2%

Patients’ priorities around drug-resistant tuberculosis treatment: A multi-national qualitative study from Mongolia, South Africa and Georgia

We conducted qualitative research exploring the treatment experience of people with DR-TB. We held nine focus group discussions with 57 adults undergoing/recently completed treatment for DR-TB in Georgia, Mongolia and South Africa. Translated transcripts were analysed using thematic analysis. We identified three higher order themes: (1) Treatment experience and the role of good relationships with healthcare providers: Treatment duration, pill burden and side-effects were challenging aspects of treatment. Side-effects/symptoms that were visible signs of illness were particularly troubling. Good relations with clinical staff helped combat fear and uncertainty regarding treatment. (2) Mental distress and opportunities for wellbeing: The shame, stigma and isolation people experienced as a result of their DR-TB diagnosis was an important cause of mental distress. No longer being infectious enabled people to resume work and socialising. Positive emotions emerged with good treatment outcomes. (3) Fear and worry along the treatment journey: Participants expressed fears about TB: infecting others; whether they would be able to endure treatment; side-effects; health consequences of treatment. Worries mostly disappeared with successful treatment. Alongside measuring side-effects, time to culture conversion and cure rates, future trials of DR-TB treatments should capture how quickly visible symptoms resolve, quality of life measures, and mental health outcomes

Emerging Infectious Diseases in Mongolia

Since 1990, Mongolia’s health system has been in transition. Impressive gains have been accomplished through a national immunization program, which was instituted in 1991. Nevertheless, the country continues to confront four major chronic infections: hepatitis B and C, brucellosis, tuberculosis, and sexually transmitted diseases (STDs). As of 2001, only two cases of HIV infections had been detected in Mongolia, but concern grows that the rate will increase along with the rising rates of STDs and increase in tourism. Other infectious diseases of importance in Mongolia include echinococcus, plague, tularemia, anthrax, foot-and-mouth, and rabies

Thermoregulatory effects of swaddling in Mongolia: A randomised controlled study

Objective To investigate thermal balance of infants in a Mongolian winter, and compare the effects of traditional swaddling with an infant sleeping-bag in apartments or traditional tents (Gers).Design A substudy within a randomised controlled trial.Setting Community in Ulaanbaatar, Mongolia.Subjects A stratified randomly selected sample of 40 swaddled and 40 non-swaddled infants recruited within 48 h of birth.Intervention Sleeping-bags and baby outfits of total thermal resistance equivalent to that of swaddled babies.Outcome measure Digital recordings of infants’ core, peripheral, environmental and microenvironmental temperatures at 30-s intervals over 24 h at ages 1 month and 3 months.Results In Gers, indoor temperatures varied greatly ( 25°C), but remained between 20°C and 22°C, in apartments. Despite this, heavy wrapping, bed sharing and partial head covering, infant core and peripheral temperatures were similar and no infants showed evidence of significant heat or cold stress whether they were swaddled or in sleeping-bags. At 3 months, infants in sleeping-bags showed the ‘mature’ diurnal pattern of a fall in core temperature after sleep onset, accompanied by a rise in peripheral temperature, with a reverse pattern later in the night, just before awakening. This pattern was not related to room temperature, and was absent in the swaddled infants, suggesting that the mature diurnal pattern may develop later in them.Conclusions No evidence of cold stress was found. Swaddling had no identifiable thermal advantages over sleeping-bags during the coldest times, and in centrally heated apartments could contribute to the risk of overheating during the daytime.Trial registration number ISRTN01992617

膀胱癌進展、浸潤におけるHGF-MET-MMP1 signalingの関与とMET阻害薬、カボザンチニブの有効性

OBJECTIVES To clarify the invasive mechanisms of muscle-invasive bladder cancer (BCa) would be useful for the determination of appropriate treatment strategies.We previously showed that hepatocyte growth factor (HGF)-MET signaling is correlated with invasiveness of BCa cells. Here, we investigated the effects of the MET inhibitor, cabozantinib (XL184), on BCa cells. METHODS We first conducted Western blot analysis to investigate MET expression in BCa cell lines. Next, we examined the effect of cabozantinib on their proliferation and invasive abilities using MTT and Matrigel invasion assays, respectively. Invasion assays were performed using the xCELLigence system. Additionally, to investigate the biological function of HGF-MET signaling, we analyzed gene expression profiles and performed real-time polymerase chain reaction analyses of 5637 cells that were cultivated with or without HGF stimulation, with or without cabozantinib. RESULTS MET was highly expressed in 4 of 5 BCa cell lines, and 5637 and T24 cells showed especially high protein expression of MET. Cabozantinib suppressed cell proliferation and invasion (cell index; mock, 1.49 vs HGF, 2.26 vs HGF + XL184, 1.47, P < .05). Gene expression profile analysis indicated that matrix metalloproteinase 1 (MMP1) was significantly elevated at the mRNA level with addition of HGF. Moreover, cabozantinib suppressed HGF-induced MMP1 expression in 5637 T24 cells. CONCLUSIONS These data indicate that cabozantinib suppressed MMP1 expression by blocking HGF-MET signaling and that HGF-MET-MMP1 signaling is involved in the invasiveness and proliferation of BCa cells. These results suggest that cabozantinib might prove useful for future treatment of muscleinvasive BCa

Effectiveness of GenoType MTBDRsl in excluding TB drug resistance in a clinical trial

OBJECTIVES: To assess the performance of the GenoType MTBDRsl v1, a line-probe assay (LPA), to exclude baseline resistance to fluoroquinolones (FQs) and second-line injectables (SLIs) in the Standard Treatment Regimen of Anti-tuberculosis Drugs for Patients With MDR-TB 1 (STREAM 1) trial. METHODS: Direct sputum MTBDRsl results in the site laboratories were compared to indirect phenotypic drug susceptibility testing (pDST) results in the central laboratory, with DNA sequencing as a reference standard. RESULTS: Of 413 multidrug-resistant TB (MDR-TB) patients tested using MTBDRsl and pDST, 389 (94.2%) were FQ-susceptible and 7 (1.7%) FQ-resistant, while 17 (4.1%) had an inconclusive MTBDRsl result. For SLI, 372 (90.1%) were susceptible, 5 (1.2%) resistant and 36 (8.7%) inconclusive. There were 9 (2.3%) FQ discordant pDST/MTBDRsl results, of which 3 revealed a mutation and 5 (1.3%) SLI discordant pDST/MTBDRsl results, none of which were mutants on sequencing. Among the 17 FQ- and SLI MTBDRsl-inconclusive samples, sequencing showed 1 FQ- and zero SLI-resistant results, similar to frequencies among the conclusive MTBDRsl. The majority of inconclusive MTBDRsl results were associated with low bacillary load samples (acid-fast bacilli smear-negative or scantily positive) compared to conclusive results (P < 0.001). CONCLUSION: MTBDRsl can facilitate the rapid exclusion of FQ and SLI resistances for enrolment in clinical trials

Initial Trials With Susceptibility-Based and Empiric Anti-H. pylori Therapies in Mongolia

Background: Mongolia has a high prevalence of Helicobacter pylori infection and gastric cancer. We conducted a prospective, randomized, single-blind study to evaluate the efficacy of common regimens in Mongolia and to obtain specimens for susceptibility testing.Methods: Empiric treatments: 270 patients with confirmed H. pylori infection were randomized to receive 10 days clarithromycin-triple therapy (Clari-TT) (n = 90), modified bismuth quadruple therapy (M-BQT) (n = 90), or sequential therapy (ST) (n = 90). A second group of 46 patients received susceptibility-based Clari-TT. H. pylori was cultured from 131 patients and susceptibility testing was performed. H. pylori eradication was confirmed by stool antigen 4 weeks after the therapy.Results: Intention-to-treat (ITT) analysis cure rates were 71.1% (95% CI = 61.7–80.5%) for Clari-TT, 87.8% (95% CI = 81–94.6%) for M-BQT, 67.8% (95% CI = 58.1–77.5%) for ST vs. 89.1% (95% CI = 86–98.2%) for susceptibility-based Clari-TT. Per-protocol (PP) analysis results for these therapies were 72.7% (63.4–82%), 89.8% (83.5–96.1%), 68.5% (58.8–78.2%), and 97.6% (89.5–99.8%), respectively. Among 131 cultured H. pylori, resistance rates to amoxicillin, clarithromycin, and metronidazole were 8.4, 37.4, and 74%, respectively.Conclusion: In Mongolia, the prevalence of H. pylori resistance is high requiring bismuth quadruple therapy or susceptibility-based therapy to obtain acceptable cure rates