BACKGROUND: The Western Australian Family Study of Schizophrenia (WAFSS) has conducted genetic epidemiology studies of schizophrenia in Australia for two decades. Recently the WAFSS practices were adopted at the National Centre for for Mental Health in Mongolia, with a view tocollecting comparable data. Like the cited projects (supra), we are cognizant of the dangers of multi site data collection. We replicate common practices, such as training manuals and common site training and refreshment (CCRN WHO training centre). However in international (possibly multilingual) collection and pooling, identical assessment is difficult, it is impossible to replicate endophenotype instructions verbatim (Calkins 2007), and identical recording equipment may not be available indisparate sites. At the very least the data must be compared separately, with the option of weighting,before the pooling for genetic analysis. The use of endophenotypes (Gottesman& Gould) is well established in schizophrenia research for genetic analysis () as well as in more general neuroscience biomarker approaches. The use of electrophysiological markers, and particularly Event-Related Potentials (ERPs) is a well developedaspect of this approach (BraffDL, 2007, TuretskyBI, 2009). Electrophysiological endophenotypes include (inter alia) the Mismatch Negativity (MMN), P50 suppression ratio (P50), auditory oddball P300 (P300), and Antisaccade (AS) tasks. In this study, we seek to follow the multi centre quality assurance examples for pooled data on a smallerscale. This report details the validation of compatibility between the Western Australian Family Study of Schizophrenia (WAFSS) dataset (Perth, Australia), and a pilot dataset from the National Centre for Mental Health (NCMH) in Ulaanbaatar, Mongolia. The working hypothesis is that the psychiatric and endophenotype profiles in the two datasets are sufficiently similar to allow data ompatibility for genetic analysis.METHODS: The Mongolian version of the DIP was developed as part of a joint genetic investigation of schizophrenia between the Centre for Clinical Research in europsychiatry (CCRN) in Perth Western Australia, and the National Center of Mental Health (NCMH) in Ulaanbaatar, Mongolia.The DIP is a semi-structured interview for psychosis for use in epidemiological and clinical settings (CastleD, 2006). It is designed to provide a diagnosis, as well as to assess symptom profiles (present state, past year and lifetime), social functioning, disablement, and service utilisation. It was developed specifically for the National Mental Health Survey – Low Prevalence (Psychotic) Disorders Study(Jablensky et al, 1999, 2000), and has been translated to Italian (RossiA, 2010), Norwegion (SkorvenCS, 2010), and to Mongolian in 2012. The process started with the translation of the original English language version (Castle et al., 2006) by an experienced bilingual psychiatrist (GE) from the NCMH whose native language was Mongolian. Layout and formatting of the document were preserved. It was then back-translated by a non medical,tertiary educated professional, whose native language is Mongolian, but is now resident in Perth. The back-translation was reviewed by an original author (AJ) and experienced practitioners (GP). Grammatical and syntactical discrepancies were resolved directly with the original translator. Event Related Potentials To replicate the WAFSS ERP approach at NCMH, a new portable ERP recording system was deployed. This decision was based on several considerations: a) the WAFSS system could not be taken out of service; b) an identical system could not be replicated due to the age of the components; c) an equivalent system would be too substantial for easy, cost effective transport; d) the system was expected to be used in multiple sites in Mongolia; e) the same system was expected to be used in other Australian projects.The Portable ERP system uses NuAmps, with a hardware selected reference at the FPz location. While the ear references A1 and A2 were recorded, the mathematically re-referenced data is not the same as directly linking ears. (Citation ****). Instead the data was analysed as recorded, with cognizance traces (instead of 20) could not be used. This marks a variation from the original WAFSS processing. Instead of artifact rejection on any trace, only the relevant trace (Fz, Cz, Pz) was used for each ERP (MMN, P50, P300). Endophenotypes The ERP endophenotypes are clearly continous variables, and analysed with general linear modelling. Two tailed significance testing was used for between cohort comparisons, since there is no a priori indication which cohort would have the higher values. Single tailed testing was used in comparing Proband (Pb) and Control (Ctl) groups within the same cohort, as thedirection of any difference is well established.RESULTS: DIP The structure of the diagnostic module (DIP-DM) follows the Operational Criteria for Psychosis, OPCRIT, version 3.31 (McGuffin et al., 1991; Williams et al., 1996) 90-item checklist. It can be used to generate diagnoses according to the criteria of ICD-10 (World Health Organization, 1993); DSM-IV (American Psychiatric Association, 1994); the Research Diagnostic Criteria (Spitzer et al., 1978), and others. The summary of diagnoses (ICD-10 and DSM-IV) generated for each cohort are shown in Figure 1. Diagnostic distribution (%) of 30 interviewed cases from NCMH and 201 cases from the WAFSS cohorts, according to the DIP diagnostic algorithm, by diagnostic classification system. To facilitate omparisons between different criteria systems, Castle (2006) escribes aggregated diagnostic classification descriptors (with reservations) that are used in Figure 1. Greater detail of the DIP responses that support these descriptors is shown for similiarly aggregated questions in Figure 2. aMicrovolts for MMNAmp and P300Amp, numeric forothers.bFor MMN, P50, and AS, but not P300, the raw mean (notabsolute value) for the Pb and Fm groups are higher thanthat of the Ctl group. cEqual variances not assumed.Endophenotype values were each significantly “worse” inthe proband group of the NCMH cohort, for MMN (t=1.65;p=0.05), P300 (t=-2.02; p=0.02) and AS (t=2.12; p=0.02).The comparable values from the WAFSS cohort showed thesame behaviour for MMN (t=4.52; p<0.01), P300 (t=-3.35;p<0.01) and AS (t=3.93; p<0.01). The P50 endophenotypedid not show a significant difference between clinical groups in either NCMH (t=0.20) or WAFSS (t=1.12) cohort. DISCUSSION: This comparison has shown that there is not a significant difference (α= 0.05) between the NCMH and WAFSSpopulations (patient and control). This outcome is deemed sufficient to allow pooled analysis of genetic and electrophysiological data in future studies. It is acknowledged that the outcome does not show that the two populations are the same. Questions of international comparison (McGrathJJ, 2006) in incidence and prevalence, of mental illness and particularly of schizophrenia are eschewed. These were not the purpose of the study. Our experience from this study, as distinct from analysis, is that situational variation in equipment, protocol and recruitment likely outweigh any cultural differencesin epidemiology. The absolute value of the lectrophysiologicalendophenotypes was different between the two sites, butthe relative values were the same. The control group showed“better” responses than the patient group, with similareffect size. Moreover, the patient clinical profile was also slightly different. The incidence of neuroleptic medication was a substantial uncontrolled factor. The question becomes how to deal with these differences.In combining population groups, the data can be discarded,equalized, or transformed. Describe each. We seek to standardize comparisons between populations by transforming data by scaling prior to genetic analysis.Absolute value The raw amplitude data for both ERP eatures (MMN, P300) is significantly lower from the Mongolian cohort in both Patient and Control groups. Endophenotype characteristics.ScalingWhile the difference in absolute values precludes directlycombining data from different cohorts, the consistentendophenotype characteristics allows one possiblemethod to further genetic investigation of continuousendophenotype variables. The results are expected toderive from a combination of technical, situational, clinicaland endophenotype factors. Each of these factors could befurther investigated individually. However, if a combinedendophenotype analysis is even theoretically acceptable,then the endophenotypebehaviour in different cohorts hasto be defined as identical, and the standardized measuresfrom equivalent Control groups must be equal. If the WAFSScontrol group is considered as the standard in this study, then the scaling factors for the NCMH cohort are 13.5 (MMN), 1.0 (P50), 2.5 (P300) and 0.6 (AS).SUMMARY: The consistency in endophenotypebehaviour betweencohorts legitimizes the application of the genetic approachin Mongolia. DNA extraction and analysis for this cohort iscontinuing and, although for smaller numbers, preliminaryresults can be compared with the Australian cohort.

Background: The average of cesarean has increased over the last 30 years in developed as well as in developing countries. During the last decade, cesarean surgery rates increased by 1 to 2 times. As of 2015, there were 80434 mothers gave birth nationwide. In Ulaanbaatar city, 267106 births were recorded, from which 14,327 (30.7%) was born with cesarean section. In 2015, 32.2% of all births born in Ulaanbaatar delivered by cesarean surgery, which is 2.5% higher than the previous year. The rate of cesarean surgery has increased dramatically, however, causes and complications are unclear and these subjects are rarely investigated, thus, we decided to study this important issue. Material and methods: The study was carried out through a retrospective design of descriptive statistics. Using cross-sectional study, we randomly collected data from the history of total of 5125 births recorded in the Urguu Maternity Hospital, in 2015 and 408 were selected. Data was collected by using 48 questions in 5 sections. We used the Statistical Package for the Social Sciences (SPSS) 20 for data processing and estimation of survey findings. Results: From the total of 408 women, who given birth by cesarean delivery, 50.2% done under cesarean surgery for the first time, 33.3% for the second time and 16.5% of them experienced with cesarean surgery 3 or more times. The impact of cesarean section on abortions was studied by comparing the rates of cesarean section compared to rates of abortion and we had revealed that 25.3% of cesarean surgery had an abortion once and 11.2% of them twice and 7.4% had 3 or more abortions. Conclusion Number of chances getting pregnant is age-related (p=0.001). Cases of first cesarean delivery have increased to 50.2%. The frequency of cesarean section and the number of pregnancies was statistically significant (p=0.001). According to the retrospective study of maternity history, 43.9% had abortions. There is an inverse correlation between the rates of cesarean section and rates of abortion (p=0.004). Combination of disorders of the organ systems do not affect the rate of the cesarean section (p= 0.941). Vaginal inflammation does not affect the frequency of cesarean section (p=0.237).

NEED FOR STUDY AND GOAL: There is no data available on pupil’s health with relation to the school environmental condition and organization of educational activities in Mongolia. Therefore, the goal of the study was to assess organization of the educational activities and conduct hygienic assessment of chemical and bacteriological contamination in the school environment.MATERIALS AND METHODS: A total of 1440 children were surveyed in this cross sectional study from the 6 secondary schools of UB city, Uvurhangai and Dornod aimags.Hygiene conditions of school was assessed and organization of educational activities evaluated by class timetable and pupil’s notes of daily regime.RESULT: Timetable of lessons: It was observed that in some cases teachers’ taught to primary pupils Mathematics and Mongolian language for 2 sequential hours, depending on some indexes such as lesson content, capacity and student’s activity. According to timetable of lessons of the secondary schools, pupils have lessons for 32-34 hours in a week. It was revealed that most schools have 2-3 hours more than standard timetable and heavy lessons were taught for 2-3 sequential hours. For the secondary classes, average length of classes was 32-34 hours in a week which indicates 2-3 hours longer timetable. There was no special place for physical training and movement games etc where pupil can do physical exercise, relax and enjoy school life. DAILY REGIME: pupils have been spending most of their time watching TV and listening music and spending few hours to help housework, to read a book and to prepare meal. Urban pupils spent total of 0.5-1 hour for coming to school and going to home but rural pupils spent 20-30 minutes approximately. RESULT OF THE LABORATORY ANALYSIS: The bacteriological analysis of 36 classes in schools showed that before lesson, 94.4% of classes were clean while 5.6% was contaminated in first season of school year. After the lesson, percentage of classes without contamination had been dropped to 88.8% and classes with contamination had been increased to 11.2%. In the 4th season of school year, before lesson 61.6% of classes was clean and 16.6% was contaminated and 22.3% was highly contaminated. Moreover, after the lesson, classes without contamination had been dropped to 27.7% while 72.3% was at high level contamination.CONCLUSION: 1. Time table of lessons and break time management is inadequate in the schools and 32-39.1% of pupils do not follow the daily regime. 2. In the end of day, chemical and bacteriological contamination increased in the classes.

INTRODUSTION: There have been limited research studies done in Mongolia on health status of children in relation to density of children in school classrooms.GOAL: This study aims to evaluate learning ability of children in Mongolia and develop recommendations for next intervention measures.MATERIALS AN METHODS: A total of 1440 children were surveyed in a cross sectional study that included 6 classes from 6 secondary schools of UB city, Uvurhangai and Dornod aimags. The test of letter drawing created by of V.Ya.Anfi mova was used to evaluate the pupil’s learning skills. This test was performed at the fi rst and last classes in each day of which was tested at the beginning (I quarter or September) and end (IV quarter or May) of the academic year.For each tests we accounted the mean of drawing letter, mean of mistake for 500 letter and standard deviation.RESULTS: The results of pupil’s letter drawing tests were compared by quarter for fi rst and last classes in each day. Pupil’s learning ability of class 4 was enough while other classes were not enough (P index 1) on the fi rst and last tests.CONCLUSION: Pupil’s learning ability has been changed by the same way of physiological adaptation process of child.Pupil’s learning ability had been decreased in last tests of each day and on Friday which was revealed by letter drawing test.Pupil’s learning ability of classes between 4 to 9 were not enough on the fi rst term while 4th class was good enough on the forth term (P index 1).

BackgroundThe target group of the project, working age population, is more vulnerably exposed to the risk factors of NCDs due to deficiency of physical activities, stress, unhealthy eating, etc. The current study was carried out to assess the knowledge and attitude on health promoting workplaces among the employees of public and non-governmental organizations and businesses operating in Kherlen soum of Khentii aimag, identify their needs and make conclusions.Materials and MethodsThe cross-sectional study used questionnaires for 195 employees of 10 public agencies and 3 business entities of Kherlen soum of Khentii aimag, focus group discussions among 32 employees and individual interviews with 13 managing officials.ResultsWomen composed 38% (74 persons) and men composed 62% (121 persons) of the participants of the study. As for the duration of the service, 115 people or 58.7% have served for 1-10 years, 49 people or 25% have served for 11-20 years, 21 persons or 10.7% have served for 21-30 years and 6 persons or 3.1% have worked for 30 years. As for the knowledge of health promoting workplaces, the absolute majority of the participants demonstrated medium or low level of knowledge with statistical significance (p<0.01) among ages, with women demonstrating higher level of knowledge and increasing trend with the years of work. Absolute majority of the participants of the qualitative survey answered that possess insufficient information of health promoting workplaces. Majority or 54.2% (105) of the participants understand health promoting workplaces as provision of working conditions and organization of preventive health check ups. Creating healthy workplaces will have no negativeimpact but increased productivity, higher morale, better wellness, according to the respondents. Job satisfaction as an impact of health promotion at workplace was supported by 48.4% of the employees at 20-30 years age and 54.2% of the employees who have served for 11-20 years. 57.7% (112) of the respondents disagree that their workplaces created health promoting conditions. The knowledge of the majority of the participants in insufficient as 89.3% answer that WHP is provision of healthy environment for working. Health promotion is not implemented sufficiently at the policy level and is limited merely to improvement of physical environment and solution of social problems, with insufficient behavior targeting actions and participation of employees in health promoting activities.Conclusions:1. The knowledge on health promoting workplaces is insufficient.2. The answers of the respondents that lack of health promotion at workplaces will reduce productivity (69.2%) and adversely affect the health of the employees (44.7%) demonstrate the need in WHP.3. The further activities necessary for further development of health promoting workplaces were identified as provision of comprehensive knowledge, cooperation with professional organizations and learn from experiences of health promoting workplace models, mutual learning and solution of the financial issues.

Introduction: The Government of Mongolia has defined a comprehensive national development policy based on the State population policy document and the Millennium Development Goals, and approved the fourth national program on “Reproductive Health’’ by Resolution No. 61 of February 29, 2012 [1]. Goal: To study some risk factors affecting the pregnancy, fetal development and prevention Objectives:
- Evaluation of the pregnancy process, medical care and support
- To study the status of the pregnant woman’s family and society, as well as the health and psychological state of her reproductive health.
- Prevention Materials and Methods:
Study design
A cohort study design was used for the study. Pregnant mothers who are admitted to the study will be screened for maternity leave and a 28-day follow-up period.
The questionnaire was completed and checked for completeness at the end of the day during the data collection process. Before entering the data, they were encoded, entered into Excel 2007, and analyzed using PASW Statistic 18.0. The independent relationship between the variables was determined by an adjusted odd ratio and a 95% confidence interval. Obtained permission to do research in accordance with the Ethics Guidelines for Inclusion and to be discussed at a meeting of the Ethics Committee of the Ministry of Health. The question was asked in a way that does not hurt the dignity. The respondents’ answers will remain confidential and anonymous. Result: Multivariate regression analysis showed that the first visit to the doctor, total number of visits, mineral supplements, and high blood pressure were important parameters for fetal growth. 25% of all births are by caesarean section. Births by age group are 3.0% births under 20, 19% births between 20-24 years old, 31% births between 25-29 years old, 21% births between 30-34 years old, 24% births between 35-39 years old, and 40-44 years old births. 2%, 45-49 year olds accounted for 1%, first births accounted for 24% and 6 or more births accounted for 26%. 100% of all births were delivered by an obstetrician or gynecologist. 95% of monitored mothers are actively monitored within 40-45 days after delivery. The mothers interviewed were 100% consulted only by a doctor, whether the pregnancy was conducted with the participation of a doctor, a psychologist or a social worker. Syphilis was registered in Bayanzurkh-8, Songinokhairkhan-6, Chingeltei-4, Bagakhangai-2, Bayangol, Khan-Uul, Sukhbaatar and Baganuur districts. Of the women surveyed, 35% had bacterial vaginitis, 60% had normal, 3% had fungal infections, and 2% had trichomoniasis. Conclusion The following factors are important in the course of pregnancy and fetal development:
1. The quality of hospital care has a significant impact on the course of pregnancy and fetal development.
2. The family and social status of the pregnant woman, her reproductive health, and his or her psychological state are important factors in the pregnancy process and in the normal development of the fetus.
3. Prevention: Everyone who is planning to become pregnant should be aware of the factors that can affect the progression of pregnancy and the development of the fetus.

A minerals and vitamins are essential in intracellular biological activity. Insufficiency of mineral and vitamin in human body cause risk to functional deficiency of organs. Specially, pregnant, breast feeding, infants, younger, adolescents, vegetarians, elders and patients with chronic disease are having insufficiency of vitamins and minerals.Due to insufficiency and overdose of minerals and vitamins are both negative effect to human body, so balanced food is recommended. However, a right feeding should not be confused with following other locals’ habit blindly. If you are pregnant or planning to get have baby, first thing you need to measure minerals and vitamins. Then identify to need of vitamins and minerals, usage is crucial for pregnancy period and normal growth of future infants.