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Impact of a bioethics and humanities program on the educational training of nephrology residents
(Oxford University Press (OUP), 2025-09-24)
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Gómez Guerrero, Irma
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Garcia-Villalobos, Gloria
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Martin Alemañy, Geovana
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Aguiñaga-Chiñas, Nuria
Background: Modern medical training must integrate not only clinical skills but also ethical and humanistic competencies. In 2013, a structured program in bioethics and humanism was implemented as part of a nephrology residency curriculum. The objective of this study was to evaluate the impact of a 3-year humanism and bioethics program for nephrology residents that focused on improving clinical communication, reducing complaint and lawsuit numbers, increasing patient satisfaction, and supporting decision-making centered on quality of life. Methods: A longitudinal, ambispective cohort (2010–19), our 3-year curriculum delivered weekly 1-h sessions for 6 months/year to 45 residents and was facilitated by three faculty instructors across six core themes. To relate outcomes to the intervention, analyses were anchored to the 2013 launch and compared pre-program (2010–13) versus post-program (2014–19) rates of formal complaints, legal claims, patient satisfaction and maximum benefit discharges. Results: Formal complaints decreased from 47.8 to 26.0 per year [incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.44–0.67; P < .001; Holm <0.001]. Legal claims were reduced from 4.25 to 0.17 per year (IRR 0.039, 95% CI 0.005–0.295; P = .0016; Holm = 0.0016). Maximum benefit discharges increased from 4.25 to 76.5 per year (IRR 18.0, 95% CI 11.09–29.21; P < .001; Holm <0.001). For satisfaction, the ordinal logistic model showed an odds ratio (OR) of 3.53 (95% CI 1.96–6.38; P < .001; Holm = 0.0001), consistent with the dichotomous sensitivity analysis (≥4 vs ≤3) (OR 4.08, 95% CI 2.16–7.71; P < .000). Conclusions: The humanism and bioethics program was proven to be an effective and transformative educational tool that promoted ethical, empathetic and patient-centered nephrology practices. The positive impact of this program was evident in both clinical indicators and strengthened medical professionalism. ©The authors ©Oxford University Press (OUP) © Clinical Kidney Journal.
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Who Holds the Reins of Power in Chaos? Military Involvement and the Emergence of a De Facto State of Exception in Mexico
(Universidad Panamericana, 2025-03-04)
Torres-Checa, Daniel E.
Mexico’s public security has been progressively moving towards militarization for at least eighteen years. The army’s participation, previously reserved for war and exceptional junctures, has normalized. This article critically reviews the military’s role in Mexico’s bloodshed and human rights crisis during the 2006-2024 period. I argue that the ongoing phenomenon has perpetuated the cycle of violence, threatened democratic standards, and severely impacted human rights. In this framework, I question whether the policy of militarization can be placed in the context of a de facto state of exception. My aim, in short, is to assess the ways in which militarization reinforces exceptionality and how they both signal a counter-phenomena to human rights.
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Management of scientific and ancestral knowledge: a decision-making model in mezcal industry in Mexico
(Frontiers Media SA, 2025)
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Leyva-Hernández, Sandra Nelly
Introduction: Knowledge management is essential to ensure the sustainability of rural communities and small producers since it generates value for innovation, productivity, and competitiveness. The aim of this study is to identify relevant factors for adequate decision-making in managing knowledge in the Mexican mezcal industry and its impact on developing rural communities and small producers - mezcaleros. For this purpose, a decision-making model for managing scientific and ancestral knowledge is created to support links with universities, research centers, and rural communities to accelerate innovation and competitiveness in this sector. Methods: The analysis methods were carried out through decision-making, machine-learning techniques, and fuzzy logic. Results: The Bayesian Network model suggests that the preceding variables to optimize the Mezcaleros Knowledge Management are the Mezcaleros Indigenous community, the Denomination of Origin, Scientific and Ancestral Knowledge, Waste Management and Use, and Jima. Discussion: This knowledge management model aims to guide small producers to be more productive and competitive through the support of a facilitator. ©The authors ©Frontiers in Artificial Intelligence ©Frontiers Media SA.
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Knowledge and innovation management model in the mezcal industry in Mexico
(Elsevier, 2025)
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Leyva-Hernández, Sandra Nelly
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This research aims to study and analyze knowledge management in the mezcal sector in Mexico and its impact on the development of rural communities through Bayesian-networks with machine learning techniques. A model is made in which the critical factors that impact is identified and quantified to optimally manage the knowledge that generates value and translates into innovation and competitive advantages. The results show that the most relevant factors to adequate knowledge and innovation management are commercialization and marketing capacity, value system model, ancient knowledge, strategic business model, process management, competencies, Business structure model, Facilitators governments, universities, mezcaleros, and indigenous communities. ©The authors ©Elsevier Ltd.
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Sustainability and Quality of Life in Marginalized Areas: An Impact Evaluation of a Community Center in Santa Fe, Mexico
(MDPI, 2024)
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The aim of this paper is to present the results of an impact evaluation of a community center in health, capacity building, and digital access, which form an approximation of quality of life, in the population of Santa Fe town in Mexico City, from 2022 to 2024. The methodology is quantitative, using an impact index and the differences in differences (DD) technique. The data were obtained from primary sources with surveys undertaken via questionnaires. The center is operated by a private university and funded by private firms. The results show a positive impact of 0.287127 out of 1 on the weighted impact index, which allows us to consider this program successful in improving the quality of life of the target population. Through impact evaluation, the effectiveness of interventions and opportunities for improvement are identified, fostering collaboration among local actors, including community members, state-run public programs, and community centers. This collaborative effort improves the quality of life, creating a sustainable community wherein each actor addresses specific needs. Impact evaluation plays a crucial role in measuring sustainability because it is a continuous improvement process that, when combined with other actions, enhances the community’s overall well-being. ©2024 MDPI, The authors.
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Optimization of public resources through an ensemble-learning model to measure quality perception in the social protection system in health of Mexico
(Springer, 2018)
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Rivera-Peña, Gustavo
In order to optimize the use of public resources, a model of ensemble learning was proposed to measure the perception of quality in the medical care granted to the people affiliated to the social protection in health system of Mexico. Which allows a more efficient allocation of resources based on the main areas of opportunity identified in the measurement of service quality. Identify the effect of the main factors that are directly related to the satisfaction level and perception of quality of health services. A satisfaction index was built using an ensemble model using principal component analysis, logistic model and bagging meta-estimator, to identify the effect of a group of factors in the perception of quality of health services and monitor the perceived quality of users in real time. The survey data collected for the “Social Protection System in Health-SPSS 2014” was used, considering a sample of 28,290 users. The proposed index shows, in general, the positive perception of quality of health services, the national average index was of 0.0756, 95% CI [− 9.714 to 2.027]. There are factors statistically significant (P < 0.05) that influence these results, among the most important that can be highlighted is the good perception of infrastructure OR 2.12; CI [95% 1.9–2.36]; the gratuity of the service provided OR 1.98; CI [95% 1.42–2.76]; and full medicines supply OR 1.81; CI [95% 1.91–2.36]. The key factors identified that determine the perception of quality allow to define focused strategies and lines of action to improve service quality as well as better allocation of resources. ©Springer, The Authors.
Scopus© Citations 1 21
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Benefit-Cost Analysis of Nonprofit Cataract Surgery Services: A Social Return on Investment Approach at the Mexican Institute of Ophthalmology
(International Society for Third-Sector Research, 2024)
Aleman-Castilla, Benjamin
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Ochoa-Ramírez, Paola
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López-Star, Ellery
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Dahik Loor, Ana Cristina
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Espinosa-Vega, Daniela
Cataract is the primary cause of treatable blindness in low- and middle-income countries. Due to limited resources, the public sector often fails to provide adequate services, resulting in long waiting times, low quality or significant quantity gaps. Nonprofits are crucial in providing supplementary or complementary funding and resources for affordable eye care and other public goods and services. This study evaluates costs and benefits of cataract surgery at the nonprofit Mexican Institute of Ophthalmology (IMO) using data from interviews conducted in 2022 to estimate its social return. For every peso invested, the average stakeholder receives a 12:1 return in improved autonomy, self-confidence, and reduced stress levels. Sensitivity analysis suggests a SROI ratio of at least 2:1 in the most restrictive scenario, increasing to 33:1 under more lenient assumptions. Measuring and communicating the social value of nonprofit activities is critical for optimizing resource allocation, enhancing accountability, and generating valuable insights into their effectiveness. © International Society for Third-Sector Research
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Cross-Cultural Effects in Adoption Patterns of a Mobile Coaching Service for Studies
(IGI Global, 2021)
Shahidi, Niousha
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Cacho-Elizondo, Silvia
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Tossan, Vessélina
This study applied an adoption model, inspired by the Technology Acceptance Model (TAM) and Multipurpose Information Appliances Adoption Model (MIAAM), to compare key variables explaining adoption patterns of a mobile coaching app that guides and encourages students via a technology-based platform. This article constitutes a pioneer effort to compare adoption behaviors across a developed country and an emerging country (France and Mexico) with differences in level of use of mobile apps. A multi-group structural equation modelling approach was used to test the causal structure of the conceptual model. Results confirmed significant differences and similarities across samples and identified critical factors. Perceived usefulness was found to be the most important driver with mediating effects. Organizations implementing coaching services with an improved perceived usefulness could boost their adoption rates.
Scopus© Citations 3 47 2
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When Space and Time Matter in Environmental Injustice: A Bayesian Analysis of the Association between Socio-economic Disadvantage and Air Pollution in Greater Mexico City
(Springer, 2023)
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Touza, Julia
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White, Piran C. L.
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McClean, Colin J.
Environmental injustice refers to the unequal burden of pollutants on groups with lower socioeconomic status. An increasing number of studies have identified associations between high levels of pollution and socioeconomic disadvantage. However, few studies have controlled adequately for spatio-temporal variations in pollution. This study uses a Bayesian approach to explore the association between socioeconomic disadvantage and pollution in Mexico City Metropolitan Area. We quantify the association of socioeconomic disadvantage with PM10 and ozone and evaluate the impact of accounting for spatio-temporal structure of the pollution data. We find a significant positive association between socio-economic disadvantage and pollution for levels of PM10, but not ozone. The inclusion of the spatio-temporal element in the modeling results in improved weaker estimates of this association but this does not alter results substantially. These findings confirm the robustness of previous studies that found signs of environmental injustice where spatio-temporal variations have not been explicitly considered, confirming that targeted policies to reduce pollution in socio-economically disadvantaged areas are required. © 2024 Springer Nature
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Salesperson resistance to change: an empirical investigation of antecedents and outcomes
(Emerald Group Publishing Limited, 2012)
Jaramillo, Fernando
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Prakash Mulki, Jay
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Onyemah, Vincent
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Rivera-Pesquera, Martha
Purpose: The purpose of this paper is to investigate why salespeople resist change and the impact of resistance to change on customer responsiveness and performance outcomes. Design/methodology/approach: Survey responses derived from 233 salespeople from three large financial institutions in Mexico are used to test relationships involving salespersons’ resistance to change. Publisher: Emerald Group Publishing Limited Copyright © 2012, Emerald Group Publishing Limited
Scopus© Citations 14 17 2

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