Mexico Institute Research Articles

EE378 Economic Burden of Spinal Muscular Atrophy from the Perspective of Public Health Institutions in Mexico

EE378 Economic Burden of Spinal Muscular Atrophy from the Perspective of Public Health Institutions in Mexico

Not the same, but ¿is it the same? Cycling of biologic agents in rheumatoid arthritis. Experience in the Instituto Mexicano del Seguro Social.

Available data for biocomparable drugs are not enough to make clear decisions with respect to the potential consequences of a change for non-medical reasons in efficacy, security and inmunogenicity in patients. In the near future, options on biological treatments, biocomparable drugs, non biocomparable drugs and new chemical synthesis options will grow. Therefore, it is important to know how patients behave in persistence of treatment after a change for non-medical reasons, which already happens on a regular basis in social security institutions in Mexico. This information will help us to better understand the standard of treatment for patients with chronic immunomediated conditions. The primary objective was to measure the impact of change for non-medical reasons in patients with rheumatoid arthritis (RA) treated with an innovative biological on persistence of treatment after changing to a biocomparable drug or a non-biocomparable drug, compared with those patients staying with the innovative biological. This is an observational study (non-interventionist) of paired cohorts, where an historic cohort obtained by review of clinical records of stable patients in which no modifications to treatment were made for at least six months is compared with two cohorts of patients whose treatments were switched to another treatment with the same therapeutic mechanism for-non-medical reasons (cycling). We included 264 RA patients (ACR/EULAR, 2010); 132 were switched for non-medical reasons, and 132 were not switched. Two-hundred and thirty (87.1%) were female. Average age was 53.9years, ranging from 16 to 84years. Two-hundred and sixty-three patients were Latino (99.6%); one was Caucasian. Persistence of treatment 12months after the change was 84.8% (85.8% in Enbrel/Infinitam, 78.9% for Remicade/Remsima). No statistical difference was found with respect to RA clinical activity measured by DAS28 12months after the switch (P>.05). In the 134 switched patients, 20 discontinued the new treatment due to lack of efficacy of the new drug and were changed to a different drug with a different biologic target. Although no differences were found in the cohorts of switched patients with respect to DAS28 after 12months of use, we did find differences in the frequency of adverse events. Forty-two patients had an adverse event in the drug switch cohorts: 33 in the Enbrel-Infinitam group and 9 in the Remicade-Remsima group. The persistence of treatment after switching from an innovative drug to a biocomparable or a non-biocomparable in RA patients did not show statistically significative differences in our cohorts, but we did find a higher number of adverse events when comparing those who were changed with those who continued on an innovative drug. Twenty patients in the switch groups had to receive a new drug with a different biological target due to lack of efficacy of the switched drug.

Women and industrial hygiene in post-revolutionary Mexico: Juan de Beraza’s report on “La Perfeccionada” (October 25, 1919)

In October 1919, during the construction of post-revolutionary health protection institutions in Mexico, Juan de Beraza, an office assistant to the Secretary of Industry, Commerce, and Labor, wrote a document about the conditions of 479 women workers in a factory in the capital. The report had a summary of hygiene and sexual harassment problems that women experienced in their workplaces. The document offers relevant information about the history of women in the "world of work" in the first decades of the twentieth century. A transcript of the report is published, preceded by a presentation of the report.

Money laundering risk management in multiple-purpose financial institutions in Mexico: a Bayesian network approach

PurposeThis paper aims to develop a money laundering risk management model for multiple-purpose financial institutions (SOFOMES, Spanish acronym for “Sociedades Financieras de Objeto Múltiple”) based on the best international practices.Design/methodology/approachA study of a sample of several SOFOMES is carried out through representative surveys and focus groups to collect information to develop a causal model of risk management under a Bayesian network approach together with a Monte Carlo simulation.FindingsThe probability that SOFOMES has a high incidence to be used as a mean of money laundering is 29.3%, correspondingly with a probability of 33.1% of having medium incidence and 37.4% of low incidence.Research limitations/implicationsOnly nine SOFOMES were willing to provide information for this study.Practical implicationsIn Mexico, there is a large registry in the Ministry of Finance and the Attorney General’s Office of this type of practices in the SOFOMES sector, impacting tax collection and affecting the growth of the real sector. The proposed model serves to establish several preventive policies that reduce the incidence of this type of crime.Originality/valueAs far as the authors know, there is no other study as this one in Mexico or in the rest of the world.

Effects on and adaptation of the family context during the COVID-19 pandemic. Some remarks from Italy and Mexico

ABSTRACT The first COVID-19 case in Italy was registered on 21 February 2020, thrusting Italy into a state of emergency which quickly produced burdensome economic and social effects. In this contribution we choose to reflect on how social institutions, family and school have been reacting to the pandemic. We will try to analyse the main changes that occurred regarding educational and family institutions in Italy and Mexico, two countries that show numerous similarities with respect to both the inequalities present in families and the school learning process and their reactions to the crisis. In both countries the pandemic has demonstrated the great resilience of families, but there are also social, economic, cultural and educational inequalities that force us to deeply rethink the cultural and social development models of the two countries.

POSB110 Economic Evaluation of Acalabrutinib for Previously-Treated Patients with Mantle Cell Lymphoma in Mexico

To perform an economic evaluation of acalabrutinib use in adult patients with Mantle Cell Lymphoma (MCL) who have received at least one previous therapy from the perspective of public health institutions in Mexico.

Technology Transfer Model between National Health Institutions in Mexico: Case of Pacs-Inr System for Medical Images Management

Technology Transfer Model between National Health Institutions in Mexico: Case of Pacs-Inr System for Medical Images Management

Resistances, results and learning from Organizational Change. The case of the Higher Education Institution in central Mexico

Organizational change processes are constant and inherent not only in organizations, but in life itself. In this particular case, we will refer to a public institution of higher education (IES) in central Mexico which, as of January 2009, began to operate with a new academic-administrative structure, going from a Napoleonic model to one matrix-departmental-multicampus. Although it seems simple, although the legal-normative process involved difficulties, they were not as many as the resistance that has been experienced since then, and the lessons learned to achieve the transformation that, indisputably, represents this proposal in the academic field. In this work, the results of an investigation dedicated to the analysis of this change and its relationships with the organizational culture will be reported. For the development of this project, documentary research, classical methods such as analysis-synthesis and self-observation were used; all this, with the aim of reflecting on the administrative, labor, academic and personal implications of an organizational change of this magnitude. Likewise, a brief description of some gaps, opened and overcome, is presented; of the learning and the indicators that show us that it is possible to advance in the realization of this organizational change.

Sustainability: A Public Policy, a Concept, or a Competence? Efforts on the Implementation of Sustainability as a Transversal Competence throughout Higher Education Programs

The concept of sustainability emerged globally in the 1987 Brundtland Report. Initially, it comprised three dimensions: environmental, social, and economic. Over time, sustainability became a global necessity that led to the establishment in 2015 of the 17 Sustainable Development Goals (SDGs), so that sustainability became a public policy of extreme urgency. Thirty-four years later, there is an imperative need to expand the original concept not in a public policy but in a competence that graduates of higher education develop, regardless of their studied academic program. We propose sustainability as a transversal competence. Our work describes the path that a higher education institution in Mexico, Tecnologico de Monterrey, has followed to accomplish this task. The new educational model Tec21 based on challenge-based learning experiences has a focus on the development of sustainability competences and actions ownership towards solving the problems described in the 17 SDGs. Our proposed definition for the sustainability transversal competence is: “The student possesses the knowledge, skills and attitudes necessary for the successful performance of the task and the resolution of problems related to the challenges and opportunities for sustainability in today’s world”. Thus, education is both an objective and a means to achieve all the other SDGs.

Progressing to the new normal: Teaching in radiology during COVID-19 at a major institution in Mexico

Progressing to the new normal: Teaching in radiology during COVID-19 at a major institution in Mexico

915. Hepatitis A Burden of Disease and Associated Complications in Children and Adults in Mexico: A Retrospective Database Study from 2000-2019

BackgroundIn Mexico, Hepatitis A virus (HAV) infection is the leading cause of viral hepatitis in children, yet the pediatric HAV vaccine is not included in the national immunization program (NIP). Since 2013, 1-dose HAV vaccine is only given to infants of agricultural workers and in day-care centers. Mexico has intermediate HAV endemicity, yet the real burden of symptomatic HAV is unknown. The objective of this study is to describe the burden of HAV infection and severe complications in children and adults in Mexico.MethodsA retrospective database study was performed using the national surveillance system from all public health institutions in Mexico. Data on laboratory/clinically confirmed HAV cases, hospitalizations, and deaths, including for severe complications (Fulminant Hepatic Failure, Acute Liver Failure, Liver transplant), from 2000 to 2019 were analyzed (Table 1). Descriptive analyses were performed to estimate the disease burden and direct medical costs due to HAV per year for all ages, sex, and region. Table 1. Definition HAV-associated disease based on ICD-10 codes HAV, Hepatitis A Virus; ICD-10, International Classification of Diseases 10 Classification SystemResultsDuring the analysis period, the average annual incidence was 29.4 per 100,000 population (range: 43.0–10.9); the average hospitalization rate/year was 5.8% (range: 2.9%– 9.6%); and the average fatality rate/year was 0.44% (range: 0.23%–0.83%) (Figures 1a-b). Overall, there was a decreasing trend in HAV incidence over 2000–2017, with a recent increase in 2017–2019. As the incidence risk of HAV infection decreased, the mean age of infection increased. The biggest burden of HAV continued to be in children (1–9 years-old), yet there was an increase in incidence and hospitalizations (with complications) in older age groups (≥ 10–64 years-old) (Figures 2-3). The total direct medical costs (2019) due to HAV and related complications was estimated at &3.8 million Mexican pesos, which represented about 0.063% of total 2019 expenditure of the federal public budget for the health function. Figure 1. (a) Hospitalization rate (%) due to HAV infection by year in Mexico. (b) Fatality rate (%) due to HAV infection by year in Mexico. HAV, Hepatitis A Virus Figure 2. Incidence of HAV cases by age group and year in Mexico. HAV, Hepatitis A Virus; YoA, Years of Age Figure 3. Hospitalizations due to HAV infection and complications by age group and year in Mexico. HAV, Hepatitis A Virus; YoA, Years of Age ConclusionIn addition to Mexico’s intermediate HAV endemicity and improved sanitary conditions, these results describe an increase of HAV infection from children to adolescents/adults, which increases the risk for more severe and complicated disease and greater demand on healthcare resources. Our findings support the evidence for HAV vaccine inclusion in the NIP in Mexico.Disclosures Gerardo Luna-Casas, MD, The GSK Group of Companies (Scientific Research Study Investigator, Other Financial or Material Support, Company Owner (Estimatio SC)) Gilberto Sanchez-Gonzalez, PhD, The GSK Group of Companies (Scientific Research Study Investigator, Other Financial or Material Support, Company Owner (Estimatio SC)) Maria Yolanda Cervantes Apolinar, MD, The GSK Group of Companies (Employee, Shareholder) Gloria Huerta, MD, The GSK Group of Companies (Employee, Shareholder) Adriana Guzman Holst, MPH, The GSK Group of Companies (Employee)

Prognostic Factors for Survival in Patients with Gastric Cancer Treated at Two Public Health Institutions in Mexico

Objective: To analyze the clinical records of patients with gastric adenocarcinoma, treated at two different public health institutions in Mexico to determine survival rates. Methods: Cox proportional-hazards model was fitted to identify the factors involved in survival of patients. Result: The results show that subjects aged 41 to 50 years of age had a 56% lower risk of death from gastric cancer compared to those <40 years of age. Asthenia and/or adynamia, weight loss and leukocytosis increased the risk of dying. The incidence of melena was found to be a protective factor for mortality. Conclusion: At age <40 years, symptoms such as asthenia, adynamia and weight loss and leukocytosis are poor prognosis predictors in patients with gastric cancer. Melena seems to be a protective sign of gastric cancer mortality in Mexico. Given the low 5-year survival rate in patients with gastric cancer, further studies are necessary to explore the factors associated with survival to contribute to effective intervention.

User-Centered Virtual Reality Environments to Support the Educational Needs of Children With ADHD in the COVID-19 Pandemic

The use of technology to face the challenges in daily life is something that is increasingly needed and in complicated times like the one we live in today where there is a health contingency (COVID-19) that prevents people from exposing themselves to each other and restricts physical contact, virtual reality can be an alternative that allows the transmission of knowledge in an immersive and interactive way in various fields. This work proposes the use of virtual reality environments as an alternative to support the learning process in children with special educational needs such as Attention Deficit and Hyperactivity Disorder (ADHD) and other associated disorders that occur in basic education. These proposed virtual reality environments are designed under a user-centered approach and their contents are in accordance with expert therapeutic guidelines. As a result of this proposal, a case study is presented in which the user experience is evaluated through the use of an interactive environment to support the special educational needs of elementary school children attending an educational institution in Mexico.

A Local Health Situation Room for COVID-19: Recommendations for Decision-Making From a Higher Education Institution in Mexico

Introduction: The Situation Room is a physical or virtual space where experts systematically analyze information to characterize a health situation, especially during emergencies. Decision-making processes are made toward solving health needs and promoting collaboration among institutions and social sectors. This paper presents the context and circumstances that led the University of Guadalajara (UdeG) to install a local health situation room (HSR) to address the COVID-19 pandemic at this institution based in the state of Jalisco, Mexico, a narrative is also made of its working processes and some of its results.Methods: The design of this situation room for COVID-19 was based on the methodology established by the Pan American Health Organization (PAHO)/WHO. This local-type situation room was installed on February 12, 2020. The health problem was characterized, and strategic lines, objectives, and goals were established; the first analysis was derived from an action plan deployed at the UdeG. The strategic lines were situational diagnosis, preventive actions, and containment strategies.Results: The situation room influenced the activities of the UdeG before the epidemic cases started in the state. One of the actions with the greatest impact was developing a mathematical model for predicting COVID-19 cases. Subsequently, new models have been developed according to the epidemiological evolution of the disease, helping manage the epidemic in the state. Another important result was the early closing of face-to-face university activities, reducing contagion risks and the mobility of more than 310,000 students, faculty, and administrative personnel throughout Jalisco.Conclusions: A consequence of the closure was that the confinement generated by the pandemic was the change to virtual meetings from April 2020 to date; but at the same time, this working format was a strength, since it influenced the decision of the university board to change all the academic activities to virtual format before other educational, economic, and social activities in the state did. By April 2020, the situation room transcended its institutional boundaries and was invited to participate at the Jalisco State's Health Committee. Its recommendations have helped to maintain the state with one of Mexico's lowest COVID-19 incidence and mortality rates.

Sharing Research Data: An Analysis of the Interest of Social Scientists in the Context of a Mexican University

Open Science and open research data have the potential to speed up the processes of science and to generate benefits to society. However, the openness of research data and science cannot be taken for granted since there is a trend toward the capitalization of knowledge. In addition, each area of knowledge differs in terms of the data used and the rules that govern each scientific community. The aim of this article is to analyze social researchers’ interest in sharing research data within the context of a Mexican university. Based on the constructivist grounded theory approach, 12 interviews were conducted with social scientists from a higher education institution in Mexico. From the analysis, four categories associated with the researchers’ attitudes of sharing their data emerged. The findings exhibit that researchers’ interest in sharing their scientific data is prone to (1) selectively sharing, (2) perpetuating the system, (3) protecting privacy and (4) considering resources. These results show that the scientists interviewed show an opposite inclination to Open Science, since they are not willing to share their data openly, including the fact that within the Mexican context, the practice of sharing data openly is not encouraged.

ДОСВІД ВИКОРИСТАННЯ СИСТЕМ ДИСТАНЦІЙНОГО НАВЧАННЯ В УНІВЕРСИТЕТАХ УКРАЇНИ ТА МЕКСИКИ

The basic didactic principles of distance and traditional forms of education are considered. The use of learning management systems (Learning Management System) is relevant in the context of the COVID-19 pandemic. In the process of transition of educational institutions to distance work and learning during quarantine, there was an expansion of the range of tools used and the expansion of the functionality of existing new tools. The main functional modules of modern learning management systems like Moodle, Google Classroom, Microsoft Office 365 and their implementation in distance learning are analyzed. The main functional modules of modern distance learning management systems are identified, they include such modules as system administration, access to educational materials, means to ensure communication between participants in the distance learning process, etc. Distance education is based on the principles and features of traditional forms of learning, in addition, new features are added, which are the use of Internet technologies for access to educational materials, online interaction between students and more. The peculiarities of implementation of the principles of distance and traditional forms of education on the example of higher education institutions of Ukraine (Berdiansk State Pedagogical University, National University of Life and Environmental Sciences of Ukraine) and Mexico (Autonomous Honored University of Puebla) are considered in the article. Based on the results of the study, general recommendations were developed for the simultaneous use of several platforms, which allows you to work from any device; under modern pandemic conditions, you can also use the mobile Internet, which increases the convenience and productivity; at any time you can view the necessary documents, perform tasks, responds to changes in the workflow, which allows you to learn quickly about innovations and change ways to solve problems. Thanks to the obtained results, teachers will be able to develop more effectively online learning environment. Keywords: distance learning, didactic principles, distance learning management system.

School Culture and Digital Technologies: Educational Practices at Universities within the Context of the COVID-19 Pandemic

The pandemic caused by COVID-19 led schools to continue their work by relying on digital technologies. Changes in this matter are observed within three dimensions in the theoretical and conceptual background: (a) the influence of ITC in education, (b) the macrosocial changes in the educational systems and public policy derived from the COVID-19 pandemic, and (c) the impact of the COVID-19 pandemic in higher education and its role for the future. The general objective of this research was to characterize the educational practices executed by the university community (students, professors, and managers) during the emerging remote classes derived from the pandemic at the Universidad Autonoma Metropolitana, Cuajimalpa Campus, a public educational institution in Mexico (through an explanation for each educational actor profile). As specific research objectives, this paper: (a) examines whether the professors and students had enough digital technology to continue with the classes, (b) defines the obstacles they had in the use of said digital technology, and (c) recognizes the existence of innovative educational practices and determines whether stated learning was achieved in educational programs. For this purpose, a mixed methodology was chosen, comprising the application of surveys to students and professors and semi-structured interviews with managers, professors, and students. It was found that there was innovation in the area of resources (material–economic dimension) and in the area of relationships (socio-political dimension), while the discursive dimension (cultural-discursive dimension) was negatively impacted. Based on the above, we conclude that the school culture of the UAM-C is solid and that it has the necessary technological resources to continue with the teaching–learning process. The educational practice was transformed, which resulted in advantages and disadvantages, but despite these situations, most students developed their learning.

Transitional points in constructing the preimage concept in linear algebra

From an APOS (Action–Process–Object–Schema) theory perspective, learning mathematics involves construction of knowledge through mental mechanisms, which evolves between different mental structures or stages. The focus of this study is to explore how transition occurs from an Action to a Process conception, in the context of a task related to the learning of the concept of linear transformation in general, and the notion of preimage in particular. A questionnaire was designed and applied to 31 students from three different higher education institutions in Mexico, who were enrolled in an introductory linear algebra course. For the first time, transitional points known as levels are explicitly identified in the aforementioned context and empirical evidence is presented. Some difficulties resulting from the intervention of constructions related to the function concept are also pointed out. Discussion about the characteristics of levels in the APOS framework provides a theoretical contribution to the field.

Not the same, but is it the same? Cycling of biologic agents in rheumatoid arthritis. Experience in the Instituto Mexicano del Seguro Social

IntroductionAvailable data for biocomparable drugs are not enough to make clear decisions with respect to the potential consequences of a change for non-medical reasons in efficacy, security and inmunogenicity in patients. In the near future, options on biological treatments, biocomparable drugs, non biocomparable drugs and new chemical synthesis options will grow. Therefore, it is important to know how patients behave in persistence of treatment after a change for non- medical reasons, which already happens on a regular basis in social security institutions in Mexico. This information will help us to better understand the standard of treatment for patients with chronic immunomediated conditions. ObjectiveThe primary objective was to measure the impact of change for non-medical reasons in patients with rheumatoid arthritis (RA) treated with an innovative biological on persistence of treatment after changing to a biocomparable drug or a non-biocomparable drug, compared with those patients staying with the innovative biological. Study designThis is an observational study (non-interventionist) of paired cohorts, where an historic cohort obtained by review of clinical records of stable patients in which no modifications to treatment were made for at least six months is compared with two cohorts of patients whose treatments were switched to another treatment with the same therapeutic mechanism for-non-medical reasons (cycling). ResultsWe included 264 RA patients (ACR/EULAR, 2010); 132 were switched for non-medical reasons, and 132 were not switched. Two-hundred and thirty (87.1%) were female. Average age was 53.9 years, ranging from 16 to 84 years. Two-hundred and sixty-three patients were Latino (99.6%); one was Caucasian. Persistence of treatment 12 months after the change was 84.8% (85.8% in Enbrel/Infinitam, 78.9% for Remicade/Remsima). No statistical difference was found with respect to RA clinical activity measured by DAS28 12 months after the switch (P > .05). In the 134 switched patients, 20 discontinued the new treatment due to lack of efficacy of the new drug and were changed to a different drug with a different biologic target. Although no differences were found in the cohorts of switched patients with respect to DAS 28 after 12 months of use, we did find differences in the frequency of adverse events. Forty-two patients had an adverse event in the drug switch cohorts: 33 in the Enbrel-Infinitam group and 9 in the Remicade-Remsima group. ConclusionsThe persistence of treatment after switching from an innovative drug to a biocomparable or a non- biocomparable in RA patients did not show statistically significative differences in our cohorts, but we did find a higher number of adverse events when comparing those who were changed with those who continued on an innovative drug. Twenty patients in the switch groups had to receive a new drug with a different biological target due to lack of efficacy of the switched drug.

Социальная ролевая игра на онлайн-сессиях для дошкольников

Educational isolation, as a consequence of the global pandemic, has become an obstacle for guiding activity of pre-school age for a period of over one year. Online education did not include collective playing activity; actually, simultaneous modality of sessions was not at all applied in many public and private pre-school institutions in Latin America. The goal of the article is to show a unique experience of organizing collective sessions of playing with social roles by a preschool institution in Mexico. The results show the necessity of modification of some of the elements of the structure of playing activity, such as the means and the orientation of the activity. A broad variety of means at concrete, perceptive and verbal level were used for online playing. The part of orientation of action was separated from the part of realization of playing to guarantee the process of collective playing. The favorable and negative aspects of organization of online playing activity with social roles are discussed. The conclusions claim for the necessity of profound analysis of online modality of education for psychological development together with urgent re-conceptualization of the content of pre-school period as a period of affective communication and preparation for studying at school.