Patients' compliance with physician's advice in Costa Rica

The penetration of the western-developed pharmaceutical industry in developing nations has had an impact not only on access to medicines but also on the value attached to medicines and the way they are consumed. People in developing countries have more faith in medicines than in doctors. Medicines constitute a large share of government health expenses but little emphasis has been placed on how medicines are being used. This dissertation includes a discussion on the penetration of pharmaceuticals in the Costa Rican society, a thorough literature review on patients' compliance with medical recommendations (including studies conducted in developed and developing countries, factors affecting adherence, issues involved in measuring compliance, treatment compliance models, and strategies to improve patients' recollection and compliance with medical recommendations), results of a compliance survey conducted in Costa Rica, and a presentation of a compliance model for developing societies.^ The Costa Rican survey includes observations on 505 medical encounters involving 13 general practitioners and 1 pediatrician in 1 urban and 2 rural clinics. Home visits yielded information on patients' adherence to medical recommendations on 404 patients and 988 medicines. The level of patients' adherence in Costa Rica is similar to what has been documented in developed societies but the strategies to improve adherence are different. Costa Ricans are prone to follow the behaviors advertised through the media or recommended by persons they consider knowlegeable in health matters and with whom they can have a personal relationship. Programs to improve adherence to medical regimens should include mass media campaigns, a re-organization of the way drugs are being dispensed, and educating health professionals to communicate and establish meaningful relationships with their patients. ^

DOCUMENTARY DIRECTED PRACTICE CONTROL IN CANTON PURISCAL, SAN JOSE, COSTA RICA

The Directed Practice Seminar was developed under the theme Document Control in Canton Puriscal, San Jose Costa Rica. The practice consisted of a process of identification, collection, description, analysis and typing of documents Puriscal of historical, scientific and cultural, to publicize the county's documentary heritage, thus contributing to the Costa Rican national literature, and also promote the rescue culture of the peoples, a task that performs modern librarianship.The search, identification and collection of documents that have been published or not, in and to the Canton Puriscal was thorough and in all possible formats: books, journals, letters, brochures, memos, videos, newspaper articles, manuscripts , periodicals, electronic resources, among others.

Un pájaro azul en Costa Rica: la función de la traducción de L’Oiseau bleu en la Costa Rica de 1912

El estudio procura desvelar la función de El pájaro azul (traducción de Roberto Brenes Mesén) dentro del contexto histórico en que surge. Tras describir y analizar las especificidades ideológicas, sociales y literarias de contexto, individuos y textos involucrados, se concluye que la traducción pudo haber funcionado como un instrumento para promover cambios ideológicos, sociales y estéticos dentro de la sociedad costarricense de principios del siglo veinte.This study seeks to describe the role of El pájaro azul (translated by Roberto Brenes Mesén) when it first appeared in Costa Rica in 1912. A description is provided of the ideological, social and literary features present in the context, and of the agents and texts involved in the production of El pájaro azul. The analysis of these features makes it possible to state that the text is likely to have been an instrument used to promote ideological, social and aesthetic changes within the 20th century Costa Rican society.

Life Cycle Thinking for sustainability assessment and decision-making in selected food supply chains in Costa Rica

The Agenda 2030 contains 17 integrated Sustainable Development Goals (SDGs). SDG 12 for Sustainable Consumption and Production (SCP) promotes the efficient use of resources through a systemic change that decouples economic growth from environmental degradation. The Food Systems (FS) pillar in SDG 12 entails paramount relevance due to its interconnection to many other SDGs, and even when being a crucial world food supplier, the Latin American and Caribbean (LAC) Region struggles with environmental and social externalities, low investment in agriculture, inequity, food insecurity, poverty, and migration. Life Cycle Thinking (LCT) was regarded as a pertinent approach to identify hotspots and trade-offs, and support decision-making process to aid LAC Region countries as Costa Rica to diagnose sustainability and overcome certain challenges. This thesis aimed to ‘evaluate the sustainability of selected products from food supply chains in Costa Rica, to provide inputs for further sustainable decision-making, through the application of Life Cycle Thinking’. To do this, Life Cycle Assessment (LCA), Life Cycle Costing (LCC), and Social Life Cycle Assessment (S-LCA) evaluated the sustainability of food-waste-to-energy alternatives, and the production of green coffee, raw milk and leafy vegetables, and identified environmental, social and cost hotspots. This approach also proved to be a useful component of decision-making and policy-making processes together with other methods. LCT scientific literature led by LAC or Costa Rican researchers is still scarce; therefore, this research contributed to improve capacities in the use of LCT in this context, while offering potential replicability of the developed frameworks in similar cases. Main limitations related to the representativeness and availability of primary data; however, future research and extension activities are foreseen to increase local data availability, capacity building, and the discussion of potential integration through Life Cycle Sustainability Assessment (LCSA).

Efecto de la temperatura de la piel en la leishmaniasis cutanea experimental

The literature on the thermosensitive properties of strains or species of Leishmania and of other miercorganisms is revised. Cutaneous or mucocutaneous strains that infect animais in the coldest areas of the skin or mucosa in general can not grow in tissue culture at 37°C or higher temperatures and their respiratory metabolism decreases at these temperatures. These facts suggest a thermosensitive event in some important metabolism phase of the organisme. The strains or species that are able to produce visceral leishmaniasis were probably originated from cutaneous strains after genetioally determined physiological adaptation, to warmer temperatures. These strains can not only visceralize in animais and man but will also grow in tissue culture at 36-37°C and the respiratory metabolism will be higher at such temperatures. There are reasons to believe that intermediate strains, i. e., with properties of both groupsí do exist. A thermosensitive physiological event is a more general phenomenon and examples of it can also be found in the fields of virology, bacteriology and mycology. It has practical applications since some of the diseases produced by these agents can be cured by treatments with heat or artificial fever. Experiments along these line were performed on hamsters with a Costa Rican strain of L. braziliensis as an experimental model. Even after intraperitoneal inoculation lesions appear in the nose, ears, paws and tail with a subcutaneous temperature bellow 33°C at 22-24°C. Healing of the lesión is accomplished by increasing room temperature. A good lesión is produced in the rump of the animal if the area is depilated (comercial cream depilatory) previously and the naked skin cooled artificially. Elevated temperature, or the growing back of the hair will tend to diminish or cure the lesion.

Entomological and ecological aspects of six sylvatic species of triatomines (Hemiptera, Reduviidae) from the collection of the National Biodiversity Institute of Costa Rica, Central America

A total of 797 specimens of wild adult triatomines, belonging to six species from the entomological collections of the Costa Rican National Biodiversity Institute, was studied from the standpoint of their relative abundance, as reflected by light traps, distribution in the country, seasonal variations and climatic and altitudinal preferences. Triatoma dimidiata was the most abundant species (32.9% of the total specimens), with a very extensive distribution in different ecological zones, being more common between 100 to 400 m above sea level mainly at the end of the dry season. T. dispar was the third in frequency (21.5%), with narrower distribution, more abundant between 600 to 800 m and scarce during the dry season. Panstrongylus geniculatus and P. rufotuberculatus, second and fourth in frequency (22.1% and 15.1%, respectively), were widely distributed on both the Pacific and Caribbean basins, the former being more common between 80 to 270 m all year round and the latter below 800 m mainly during the first semester. Eratyrus cuspidatus which represented only 4.9% of the insects, was also present on both basins mainly below 200 m with a tendency to be scarce during certain months of the year, and was found in all types of ecological zones. Finally, Rhodnius pallescens, the least abundant species (3.6%) was restricted to very humid areas below 20 m, on the north side and Caribbean basin. With the exception of R. pallescens, males were more commonly found than females. Some epidemiological implications related to the six species are discussed.

Distribution and ecological aspects of Rhodnius pallescens in Costa Rica and Nicaragua and their epidemiological implications

In light of the Central American Initiative for the control of Chagas disease, efforts were made on the part of Costa Rican and Nicaraguan teams, working separately, to determine the present status of Rhodnius pallescens in areas close to the common border of the two countries, where the insect has appeared within the last few years. The opportunity was also used to establish whether R. prolixus, a vector present in some areas of Nicaragua, has been introduced in recent years into Costa Rica with Nicaraguan immigrants. It became evident that wild adults of R. pallescens are common visitors to houses in different towns of a wide area characterized as a humid, warm lowland, on both sides of the frontier. Up to the present, this bug has been able to colonize a small proportion of human dwellings only on the Nicaraguan side. There was strong evidence that the visitation of the adult bug to houses is related to the attraction of this species to electric lights. There were no indications of the presence of R. prolixus either in Nicaragua or in Costa Rica in this area of the Caribbean basin. Triatoma dimidiata, a widespread domestic species in both countries, was totally absent in the explored areas of Costa Rica but occasionally occurs on the Nicaraguan side. Serological surveys in children of both areas showed that transmission of Chagas disease takes place in a rather small degree in Costa Rica and more commonly in Nicaragua, indicating that R. pallescens could be a potential threat as a vector in this particular region.

Cordiluroides Albuquerque from Costa Rica: first records, descriptions and taxonomic changes (Diptera, Muscidae, Coenosiinae)

Cordiluroides Albuquerque is a genus of Neotropical Coenosiinae (Muscidae), known from six species. The genus is here recorded for the first time from Costa Rica, on the basis of three species: C. listrata Albuquerque, 1954, C. insularis (Willliston, 1896) and C. bistriata (Wulp, 1896) sp. rev.. We provide a key for the identification of these Costa Rican species, redescribe and illustrate their external morphological characters and terminalia. C. bistriata and C. vittifera (Stein, 1904) are both considered to be good species and are re-instated from the synonymy of C. insularis. The type material of C. listrata (Museu Nacional, Rio de Janeiro), of C. insularis and C. bistriata (The Natural History Museum, London) and of C. vittifera (Museum für Naturkunde, Humboldt-Universität zu Berlin) has been examined.

Molecular Basis for Resistance to Fluazifop-P-Butyl in Itchgrass (Rottboellia cochinchinensis) from Costa Rica

Rottboellia cochinchinensis is an annual grass weed species known as itchgrass, or "caminadora" in America´s Spanish speaking countries, and has become a major and troublesome weed in several crops. The application of fluazifop-P-butyl at recommended rates (125 g a.i. ha-1) was observed to be failing to control itchgrass in a field in San José, Upala county, Alajuela province, Costa Rica. Plants from the putative resistant R. cochinchinensis population survived fluazifop-P-butyl when treated with 250 g a.i. ha-1 (2X label rate) at the three- to four-leaf stage under greenhouse conditions. PCR amplification and sequencing of partial carboxyl transferase domain (CT) of the acetyl-CoA carboxylase (ACCase) gene were used to determine the molecular mechanism of resistance. A single non-synonymous point mutation from TGG (susceptible plants) to TGC (putative resistant plants) that leads to a Trp-2027-Cys substitution was found. This Trp-2027-Cys mutation is known to confer resistance to all aryloxyphenoxyproprionate (APP) herbicides to which fluazifop-P-butyl belongs. To the best of our knowledge, this is the first report of fluazifop-P-butyl resistance and a mutation at position 2027 for a Costa Rican R. cochinchinensis population.

Estudio de caso- lanzamiento de la marca Davivienda en Costa Rica, el Salvador y Honduras

Este documento tiene como propósito reunir y analizar el universo de información disponible al respecto del proceso de Lanzamiento de la Marca Davivienda en tres mercados Centroamericanos: Costa Rica, El Salvador y Honduras y así, lograr aprovechar al máximo las experiencias y lecciones aprendidas por la entidad durante este período. Para este propósito, la estructura del trabajo consta de un marco teórico que contempla las teorías sobre el posicionamiento de marca, procediendo a un estudio de caso formal. Este estudio se compone inicialmente de la descripción del Banco Davivienda y los países en los que la entidad ingresó tras la adquisición de la operación de HSBC. Posteriormente, se analiza el proceso del Lanzamiento de Marca desde la formulación e implementación de la estrategia hasta la evaluación y análisis de los resultados obtenidos. Por último, se presentan las conclusiones y recomendaciones con base en la teoría, resultados y aprendizajes.

Ventajas y limitaciones de la experiencia de Costa Rica en materia de políticas de competencia: un punto de referencia para la región centroamericana

Incluye Bibliografía

Health management contracts in Costa Rica from a comparative perspective

Includes bibliography

Isotopic composition of water in fog, rain, throughfall and stemflow in the Monte Verde, Costa Rica

Fog deposition, precipitation, throughfall and stemflow were measured in a windward tropical montane cloud forest near Monteverde, Costa Rica, for a 65-day period during the dry season of 2003. Net fog deposition was measured directly using the eddy covariance (EC) method and it amounted to 1.2 ± 0.1 mm/day (mean ± standard error). Fog water deposition was 5-9% of incident rainfall for the entire period, which is at the low end of previously reported values. Stable isotope concentrations (d18O and d2H) were determined in a large number of samples of each water component. Mass balance-based estimates of fog deposition were 1.0 ± 0.3 and 5.0 ± 2.7 mm/day (mean ± SE) when d18O and d2H were used as tracer, respectively. Comparisons between direct fog deposition measurements and the results of the mass balance model using d18O as a tracer indicated that the latter might be a good tool to estimate fog deposition in the absence of direct measurement under many (but not all) conditions. At 506 mm, measured water inputs over the 65 days (fog plus rain) fell short by 46 mm compared to the canopy output of 552 mm (throughfall, stemflow and interception evaporation). This discrepancy is attributed to the underestimation of rainfall during conditions of high wind.

Geochemistry of oceanic crust beneath Costa Rica

Resolving flow geometry in the mantle wedge is central to understanding the thermal and chemical structure of subduction zones, subducting plate dehydration, and melting that leads to arc volcanism, which can threaten large populations and alter climate through gas and particle emission. Here we show that isotope geochemistry and seismic velocity anisotropy provide strong evidence for trench-parallel flow in the mantle wedge beneath Costa Rica and Nicaragua. This finding contradicts classical models, which predict trench-normal flow owing to the overlying wedge mantle being dragged downwards by the subducting plate. The isotopic signature of central Costa Rican volcanic rocks is not consistent with its derivation from the mantle wedge (Feigenson et al., 2004, doi:10.1029/2003GC000621; Herrstom et al., 1995, doi:10.1130/0091-7613(1995)023<0617:VILCAW>2.3.CO;2; Abratis and Woerner, 2001) or eroded fore-arc complexes (Goss and Kay, 2006, doi:10.1029/2005GC001163) but instead from seamounts of the Galapagos hotspot track on the subducting Cocos plate. This isotopic signature decreases continuously from central Costa Rica to northwestern Nicaragua. As the age of the isotopic signature beneath Costa Rica can be constrained and its transport distance is known, minimum northwestward flow rates can be estimated (~63-190 mm/yr) and are comparable to the magnitude of subducting Cocos plate motion (approx85 mm/yr). Trench-parallel flow needs to be taken into account in models evaluating thermal and chemical structure and melt generation in subduction zones.

Análise da possível expansão internacional de empresas brasileiras de real estate residencial para o mercado costarriquenho, uma abordagem SWOT.

Devido ao crescimento e à experiência adquirida pelas empresas brasileiras de real estate residencial nos últimos anos, e às características próprias desse setor, os mercados internacionais poderiam ser considerados como possíveis alvos para essas empresas. Por exemplo, no mercado residencial costarriquenho, incentivos para projetos residenciais de alta densidade populacional, reformas nos processos para a obtenção dos alvarás de construção e mudanças demográficas e culturais, parecem propiciar um ambiente favorável para empresas dessa indústria. Portanto, o objetivo do presente trabalho é estudar uma possível expansão geográfica de empresas brasileiras de real estate no mercado residencial costarriquenho, a partir da estruturação de uma análise de abordagem SWOT dos elementos necessários para tal incursão. Para isso, realizou-se uma revisão bibliográfica na busca dos elementos estratégicos do ambiente interno de empresas de real estate residencial que devem ser considerados para processos de internacionalização, identificando-se 12 forças e 10 fraquezas desta revisão. Ademais, analisou-se: o mercado residencial; a macroeconomia, e as conjunturas político-legais e socioculturais da Costa Rica, na procura de fatores que devem ser tomados em conta por parte de empresas de real estate ao ingressar nesse país, distinguindo-se 24 oportunidades e 20 ameaças dessa análise. Para complementar o estudo, foi avaliada a atratividade do mercado residencial costarriquenho para receber investimentos por onze importantes empresas do setor de real estate residencial brasileiro, por meio de um questionário estruturado com os elementos identificados na primeira parte do trabalho. Os resultados mostraram que, no momento da avaliação, as empresas entrevistadas deram maior atenção ao tamanho do mercado e às características do sistema financeiro para o setor residencial, e identificaram a carência do conhecimento local e sua cultura empresarial, como os elementos que dificultariam sua internacionalização. Conclui-se sobre a possível internacionalização de empresas brasileiras de real estate residencial para o mercado da Costa Rica, que elementos desde uma perspectiva econômica racional e principalmente contingencial definem essa estratégia, não sendo viável nem vantajoso idealizar um processo de internacionalização nesse mercado, devido às atuais condições de seus mercados locais e aos elementos do ambiente interno que várias dessas empresas apresentam.