Background: Organizational culture, reflected through institutional values, beliefs, behavioral norms, communication culture, and patterns of collaboration, plays an important role in organizational development. In educational institutions that train health professionals, organizational culture influences not only the internal environment but also the formation of future professionals’ ethics, attitudes, and communication culture. In Mongolia, there is limited research that comprehensively examines organizational culture, institutional values, behavioral norms, and their relationship with satisfaction in higher education institutions. This formed the rationale for the present study. Aim: This study aimed to comparatively assess the perceptions and attitudes of faculty, staff, and students toward organizational culture at the School of Pharmacy, Mongolian National University of Medical Sciences. Materials and Methods: A cross-sectional analytical study design was employed. Data were collected using a structured questionnaire from 194 participants, including faculty, staff, and students of the School of Pharmacy. The data were analyzed using SPSS version 26.0, and a p-value of <0.05 was considered statistically significant. Results: A total of 194 participants were included in the study; 87.6% were students and 12.4% were faculty members. Most participants were female (93.3%), while 6.7% were male. Regarding self-assessed knowledge of organizational culture policy, 47.9% reported having moderate knowledge, 19.6% good knowledge, and 4.6% very good knowledge, whereas 24.2% reported not knowing and 3.6% reported having no knowledge at all. When comparing groups, the mean satisfaction score was 3.73 among faculty and staff, 4.19 among graduate and postgraduate students, and 3.42 among undergraduate students, showing a statistically significant difference (p=0.003). Among undergraduate students, fifth-year students rated organizational culture the highest, with scores of 3.99 for values, 4.14 for behavioral norms, and 3.56 for satisfaction. In contrast, fourth-year students had the lowest scores for behavioral norms (2.88) and satisfaction (2.41), with statistically significant differences (p<0.05). In terms of satisfaction level, 41.2% of participants rated their satisfaction as “Good” and 29.4% as “Very good.” A statistically significant positive association was observed between knowledge of organizational culture policy and satisfaction (p=0.001). Satisfaction was also positively correlated with organizational culture indicators, with the strongest correlations observed for internal environmental culture and comfort (r=0.802), institutional image (r=0.787), and accessibility of information (r=0.760) (p<0.01). Conclusions 1. The perceptions and evaluations of organizational cultural values and behavioral norms among faculty, staff, and students of the School of Pharmacy differed according to their position and level of experience. 2. Participants who demonstrated a higher level of knowledge regarding the institution’s cultural policy reported greater satisfaction, whereas those with limited knowledge showed lower levels of satisfaction.

Background: Studies from other countries have identified multiple contributing factors to renal cell carcinoma (RCC). We conducted this study to investigate the relationship between RCC and certain risk factors among the Mongolian population. Aim: To identify the risk factors for renal cell carcinoma in Mongolian individuals. Material and Methods: This case-control study included 88 patients diagnosed with RCC (confirmed by pathological examination) in the case group. The control group consisted of 88 healthy individuals matched by age and gender. A case-control study design was used. Binary logistic regression analysis was conducted on the questionnaire results from both groups to identify risk factors for RCC through both univariate and multivariate regression analysis. Results: A total of 176 participants were included in the study-88 with RCC and 88 without cancer. Statistically significant associations with RCC were found for hypertension, urinary tract diseases, alcohol consumption, and smoking. Although weight gain appeared to increase the risk for RCC, this was not statistically significant. Conclusion Individuals with hypertension, a history of urinary tract diseases, smokers, and alcohol users are at a higher risk of developing renal cell carcinoma.

Background: Among the total healthcare waste generated from health-related activities, 10–20% is considered haz ardous, posing significant threats to both the environment and human health. Approximately 3% of healthcare waste is pharmaceutical waste. In Ulaanbaatar city, an estimated 2.65 tons of healthcare waste is generated daily (0.78 tons of medical waste and 1.87 tons of general waste). With the continuous increase in pharmaceutical consumption, the improper disposal of pharmaceutical waste has emerged as a major environmental concern, adversely affecting nature, animals, and the food chain. Contamination from pharmaceutical waste, such as the development of antibiotic resistance, is closely linked to inadequate public awareness of waste management. Aim: This study aimed to assess the knowledge, skills, and attitudes of pharmacy technicians in community pharmacies regarding pharmaceutical waste management. Materials and Methods: A cross-sectional survey was conducted among pharmacy technicians across Mongolia. As of 2023, there are 4,959 licensed pharmacy professionals in the country. Using a representative sampling method, data were collected from 360 pharmacist and pharmacy technicians. Data were analyzed using MS Excel and SPSS version 26. Results: A total of 360 pharmacists from both urban and rural areas participated in the study. The assessment was based on a 5-point Likert scale, with scores of 1-2 considered negative and 3–5 considered positive. The average scores for knowledge, skills, and attitudes were 3.3, 3.06, and 3.25 respectively. While individual scores were satisfactory, the results of questions targeting social awareness were relatively low. Conclusion The knowledge, skills, and attitudes of pharmacy technicians regarding pharmaceutical waste management were found to be satisfactory. However, to further improve knowledge levels, it is recommended to implement additional training programs related to pharmaceutical waste management among pharmacy technicians.

Background: Community pharmacies are accessible healthcare institutions that offer services without the need for appointments or prepayment. In recent years, the scope of pharmacist responsibilities has expanded from merely dispensing medications and medical devices to providing patient-centered pharmaceutical care, health promotion, and disease prevention. As a result, pharmacists are increasingly confronted with ethical challenges in their daily practice. Aim: To identify the ethical issues faced by pharmacists working in community pharmacies in Ulaanbaatar, Mongolia. Materials and Methods: A cross-sectional survey was conducted between March and September 2024 among pharmacists working in community pharmacies in Ulaanbaatar. Participants included 374 pharmacists who had been working for at least three months, held valid professional licenses, and voluntarily agreed to participate. A structured questionnaire was used to collect data. Descriptive statistics were analyzed using SPSS version 25.0. Results: Among the respondents, 339 (90.4%) were female, 301 (80.48%) were pharmacists, and 230 (61.5%) were under 30 years old. Additionally, 214 (57.2%) had worked in a community pharmacy for less than five years. Open-ended responses were coded into three major categories and 15 subcategories: (1) pharmacy management and organization, (2) compliance with laws and regulations, and (3) professional communication with clients. The most frequently reported ethical issues were: Customers demanding prescription-only medications without a valid prescription (56.6%), Negative or inappropriate client behavior (27.5%), Attempts to use expired or invalid prescriptions (14%) Conclusion 1. A total of 56.1% of pharmacists demonstrated insufficient knowledge of the Code of Ethics for healthcare professionals, which is essential for their professional practice. 2. Among pharmacists, 54.5% showed a negative attitude, and 48.9% exhibited inappropriate practices when faced with certain ethical situations. 3. The most common ethical challenges faced by pharmacists include: Requests from clients to dispense prescription-only medicines without a valid prescription (56.6%), Unethical or inappropriate behavior from clients (27.5%), Attempts to obtain medicines using invalid prescriptions (14%).

Background: Medical experts in pharmacies are the most accessible health professionals and play a key role in primary health care. They must strike a balance between their autonomy, the objectives of the company, and professional standards, while facing a lot of ethical dilemmas. This phenomenon can impact the quality of pharmaceutical care, as highlighted in several studies. Numerous studies have been carried out internationally to explore the medical ethics knowledge of pharmacists working in community pharmacies, their attitudes towards emerging ethical issues, and identification of their common problems. However, research in this area is scarce in Mongolia, which serves as the basis for conducting this study. Aim: Assessing the knowledge, attitudes, and practices of pharmacists regarding professional ethics in community pharmacies in Ulaanbaatar city. Materials and Methods: This study was conducted using an analytical cross-sectional study design and included 374 pharmacists who had been working in community pharmacies in Ulaanbaatar for more than three months, had a valid professional license, and consented to participate in the study between March and September 2024 (ethical approval number 2024/3-01). To determine the degree of knowledge, attitude, and practice, a questionnaire including 39 closed questions and 4 groups was used to gather survey data. For statistical analysis, SPSS-25 software was utilized. Results: Of those who took part, 301 (80.48%) were pharmacists, 73 (19.52%) were pharmacy technicians, and 339 (90.4%) were women. Additionally, 259 (69.3%) work in secondary pharmacies, and 305 (81.6%) have received ethics training. The study shows that 56.1% of pharmacists had insufficient knowledge of professional ethics, 54.5% had poor attitudes towards ethical issues, and 48.9% had inappropriate practices. When analyzed in relation to their profession, the ethical knowledge of pharmacists did not differ by profession, age, years of experience in community pharmacies, professional degree, and university graduated, but it was statistically significantly correlated with the participants’ self-assessed ethical knowledge (CL 95%, p=0.0001). Conclusions 1. The knowledge of professional ethical principles and standards is insufficient among pharmacists. 2. While handling emerging ethical issues, they have a negative attitudes and inappropriate practices. Consequently, it is compulsory to intensify training on the ethical code of conduct for medical experts s based on the needs of pharmaceutical professionals.

Background: Hospitalization consumes a large proportion of healthcare financing, and reducing avoidable admissions is critical for optimizing resource use. Objective: To determine the level of hospital admissions due to Ambulatory Care Sensitive Conditions (ACSCs) in Mongolia. Methods: Using the list of 19 ACSC groups defined by Purde et al., a quantitative analysis was conducted on 8.1 million hospital admissions recorded in the National Health Management Information System between 2014 and 2023. The main indicators included admission rates per 1,000 population, average length of stay, and average cost per admission. Results: During the study period, 759,500 avoidable admissions were identified, accounting for 13.2% of non-maternity hospitalizations. The rate of avoidable admissions was 2,375.6 per 10,000 population, with an average length of stay of 7.7 days and an average cost of 116,457.5 MNT per admission. Hypertension (42.8%) and pyelonephritis (25.4%) were the leading causes. Higher risks of avoidable admission were observed among women, the elderly, and those with lower educational attainment. Conclusion Avoidable hospitalizations impose a substantial burden on healthcare resources in Mongolia. Developing a nationally tailored ACSC list with expert consensus and implementing policies to monitor and reduce avoidable admissions are essential steps to support ongoing health sector reforms

Background: Patient safety is a core dimension of healthcare quality and has become a global priority. According to the report by the U.S. Institute of Medicine, between 44,000 and 98,000 deaths occur annually due to medical errors in hospitals. One of the key indicators of patient safety is the Adverse Events (AE), defined as unintended harm to a patient that results from medical care rather than from the underlying disease. The assessment of adverse events is not only a tool for detecting errors but also an active strategy for improving system reliability and safety. Accurate identification of adverse events is therefore essential for enhancing patient safety and serves as a critical performance indicator with financial implications for hospitals. Aim: To determine the incidence of adverse events in referral hospitals and to analyze the relationship between triggers and adverse events. Material and Methods: Data were collected during 2023–2024 from three referral hospitals, the First, Second, and Third State Central Hospitals after obtaining institutional approval. The study was conducted within the framework of the Whole System Measures methodology developed by the Institute for Healthcare Improvement (IHI), which is internationally used for system-wide performance assessment. Data extraction was performed from electronic health records and inpatient departments, and statistical analyses were conducted using SPSS version 25. Results: The study identified 8.3% adverse events per 1,000 patient-days, which is 1.66 times higher than the international reference rate. A statistically significant association was observed between the number of triggers and the occurrence of adverse events, indicating that the use of triggers facilitates the active detection of adverse events. Conclusion The incidence of adverse events in tertiary specialized hospitals was found to be higher than international benchmarks. The application of trigger-based active surveillance proved to be an effective method for identifying adverse events and enhancing patient safety monitoring systems.

Background: Spine diseases, back pain, curvature, and intervertebral disorders are increasing among the population of Mongolia. According to a study of diseases covering 195 countries of the world in 1990-2016, spine disease ranked third among non-communicable diseases. However, at present, very little research has been done on the prevalence of spinal diseases among the population of Mongolia. Research goal: Detecting the location of spinal pain in patients with back pain, curvature and other pains who visited “Altanmed” hospital. Research methods: The study was conducted in a hospital setting using a snapshot survey method. From January 1, 2021, to January 1, 2022, a total of 2,210 patients were examined and treated at “Altanmed” hospital, of which 560 therapists were randomly selected from patients over 18 years old and participated in the study. Subjects were asked to complete a questionnaire and rate their pain on a 0-10 scale. Conclusion
1. 69.8% (n=391) of 560 patients who came to “Altanmed” hospital with back pain were lumbar and lower back pain.
2. 74.4% (n=291) or the majority has lumbar and lower back pain among patients aged 31-50. Of the 391 clients with lower back pain, 11.5% or 45 had mild (pain score 1-3), 52.9% (n=207) moderate (pain score 4-6), and 35.5% (n=139) severe pain (pain score 7-10), and the groups differ with statistical probability (p<0.01).
3. Regarding the duration of pain, 8.4% (n=33) had acute pain up to the last 3 months, and the remaining 91.6% had chronic back pain. The average pain scale was 5.76 (SD±1.8).

Background: Traditional Mongolian medicine (TMM), which is the main knowledge of medicine of ancient nomads, has produced hundreds of healers, practitioners, doctors, and scientists in the course of 5,000 years of historical development. The methods developed to diagnose, treat, and prevent diseases are used to protect the health of the population even today. Based on the study of medical records and artifacts, it is possible to determine which diseases were prevalent and use archeological finds and records related to the diseases to determine what treatment methods were used. Research goal: To clarify reports, facts, and evidence on spinal disorders and their treatment methods from ancient books written in Tibetan, Manchu, and Mongolian languages on Traditional Mongolian medicine. Methods: The source study method, hermeneutic method, and a method of comparison were used in studying traditional medical books, research literature, and other related materials. Conclusion Research has shown that the structure, function, pathological changes, diagnosis, and treatment methods of the spine have been recorded in many ancient records written in Tibetan, Manchu, and Mongolian languages on Traditional Mongolian medicine. At the same time, since ancient times, Mongolians have been adapting to the transformation of natural phenomena, and drastic changes in climate and developed methods of treating injuries and diseases caused by the characteristics of life, habits, and war, as well as established an independent system of methods for studying and treating the structure of the human body and living a healthy life by accumulating experience passed down from generation to generation. This system was not only based on the knowledge of Mongolian dhom treatment, and Indian and Tibetan medicine, but it was also a complex of knowledge that incorporated the ancient scriptures of Western medicine.

Background: Throughout history, Mongolians experienced struggles of ups and downs, creating a comprehensive teaching, knowledge, and system on the art and science of living and healthy living and passing it on to the next generation. Since the middle of the last century, the use and study of traditional knowledge have decreased, and with it, the use has decreased, and some knowledge has almost been forgotten. In particular, many branches of traditional medicine, including manual techniques, surgical methods, techniques related to surgery, the use of tools, and the skills of pressing, bone setting, and massage have declined in value, and some methods have almost been forgotten. Therefore, we have chosen the topic due to the need of exploring the possibility of solving this issue and enriching the history of traditional medicine by elucidating the ancient historical development of Mongolian bone-setting therapy, of which reports and historical documents in Mongolian medicine are rare. Research goal: To clarify the ancient history of Mongolian bone-setting therapy, establishing its features, usage, and types of methods based on historical evidence.
The following methods were used in the research
Herein: the method of researching original documents and reports, the method of comparison, and the method of probabilistic listing. Conclusion
1. Evidence related to ancient Mongolian bone-setting therapy dates back to the Iron Age and can be traced back to 2000 years ago from the traces of illness and injuries, bone ossification, and signs of healing of the ancient nomads living in Chandman mountain of present day Uvs province, the tribe known as Chandman people.
2. The research shows that it is possible to determine which diseases were prevalent based on the study of related artifacts and scriptures related to Traditional Mongolian medicine, and which methods of treatment were used using archaeological finds and scriptures related to the diseases.