Survey of safety climate in public hospitals in Costa Rica in 1997

In response to growing concern for occupational health and safety in the public hospital system in Costa Rica, a research program was initiated in 1995 to evaluate and improve the safety climate in the national healthcare system through regional training programs, and to develop the capacity of the occupational health commissions in these settings to improve the identification and mitigation of workplace risks. A cross-sectional survey of 1000 hospital-based healthcare workers was conducted in 1997 to collect baseline data that will be used to develop appropriate worker training programs in occupational health. The objectives of this survey were to: (1) describe the safety climate within the national hospital system, (2) identify factors associated with safety climate focusing on individual and organizational variables, and (3) to evaluate the relationship between safety climate and workplace injuries and safety practices of employees. Individual factors evaluated included the demographic variables of age, gender, education and profession. Organizational factors evaluated included training, psychosocial work environment, job-task demands, availability of protective equipment and administrative controls. Work-related injuries and safety practices of employees included the type and frequency of injuries experienced and reported, and compliance with established safety practices. Multivariate regression analyses demonstrated that training and administrative controls were the two most significant predictors of safety climate. None of the demographic variables were significant predictors of safety climate. Safety climate was inversely and significantly associated with workplace injuries and positively and significantly associated with safety practices. These results suggest that training and administrative controls should be included in future training efforts and that improving safety climate will decrease workplace injuries and increase safety practices. ^

Adolescent Pregnancy Prevention in San Jose, Costa Rica : Assessment of an Educational Intervention

This thesis explores adolescent pregnancy in San Jose, Costa Rica and examines a school-based pregnancy prevention intervention. The relationships between school, gender and risk of adolescent pregnancy are also analyzed, and recommendations are made for effective pregnancy prevention programming. The Purral region of Guadalupe on the outskirts of San Jose, Costa Rica, suffers a higher rate of adolescent pregnancy compared to the rest of the country. In response to this problem, the International Health Central American Institute (IHCAI) implemented a sexual health education program in two local secondary schools in 2006. Very little information about the program is available. It is known that the program was initially evaluated through assessments of the participants’ knowledge before and after the educational sessions. There was no evaluation of the youth attitudes or behaviors, adolescent pregnancies, or long-term impact. The author worked with IHCAI in San Jose, Costa Rica to perform an assessment of the longer term effects of this sexual health education program. They developed a questionnaire to evaluate the knowledge, attitudes, and behaviors surrounding sexual health of youth in the Purral community. Researchers at IHCAI later used this survey to collect data from adolescents who had participated in the educational intervention and those who had not. This thesis analyzes the data collected by IHCAI to assess the effectiveness of the - 2 - educational intervention and the influence of other factors on the knowledge, attitudes, and behaviors of adolescents in the Purral region. The thesis begins with an overview of adolescent pregnancy, Costa Rica and the Purral region, and a description of the education intervention implemented by IHCAI. The research goal, logic model, and methods are then described. The results are reported, and the thesis then concludes with discussion of the results as well as study limitations and recommendations for future research and intervention. This thesis will be used to guide IHCAI’s continuation and expansion of adolescent pregnancy prevention programming.

Plantae Lehmannianae in Guatemala, Costa-Rica, Columbia, Ecuador etc. collectae: Leguminosae

Auctore Mare Micheli

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. ^

Fornet Betancourt, Raúl. Hacia una filosofía intercultural latinoamericana. Costa Rica, DEI., 1994.

Fil: Jalif de Bertranou, Clara Alicia. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras. Instituto de Filosofía Argentina y Americana

Alejandra Ciriza; Estela Fernández; Daniel Prieto y Francisco Gutiérrez. El discurso pedagógico. San José, Costa Rica, Radio Nederland; Universidades de San Carlos de Guatemala y Rafael Landívar, 1992, 157 p.

Fil: Follari, Roberto. Universidad Nacional de Cuyo. Facultad de Ciencias Políticas y Sociales

Burbujas racionales en el mercado de valores argentino

Desde el surgimiento de los mercados de valores, han existido periodos con importante aumento en los precios de sus activos, que luego se han atribuido a la presencia de burbujas especulativas. Entre los más conocidos se encuentran la manía de los tulipanes en Holanda a principios del siglo XVII, donde un bulbo de tulipán llegó a valer 24 toneladas de trigo, la ola especulativa en Wall Street que terminó en el “crash" de 1929, la burbuja tecnológica en el Nasdaq que estalló a principios de siglo. Estos acontecimientos motivan a deliberar sobre la racionalidad de los precios de los títulos que se negocian en los mercados. Bajo la hipótesis de mercados eficientes, los precios de las acciones varían solamente si los inversores reaccionan a la nueva información relacionada con los fundamentos. Esto significa que los precios siguen una martingala y que cualquier desvió sistemático en relación al valor fundamental debe ser considerado una burbuja. Si existe una burbuja especulativa, el precio de mercado tendrá dos componentes: el precio racional o valor fundamental y la burbuja especulativa. Las razones por las cuales se paga un precio mayor al racional van desde la creencia que existirá un “tonto más grande" que comprará ese activo en el futuro, excesos de confianza o simplemente por un comportamiento de manada de los agentes involucrados. Las burbujas en los precios de los activos pueden ser relevantes en economías emergentes porque pueden acarrear efectos colaterales (como apreciación de su moneda) y potencial reversibilidad. Una burbuja puntual en los precios de las acciones puede terminar acarreando excesiva inversión en capital y euforia seguida de “crash" y recesión. Muchos de los comienzos de crisis económicas o financieras estuvieron históricamente asociados a la formación de burbujas en los precios de los activos, como bien enseña la reciente burbuja en las propiedades inmobiliarias de Estados Unidos. El objetivo de este trabajo consiste en recopilar los diferentes modelos y pruebas utilizadas en la literatura para la detección de burbujas especulativas en los precios de mercado, para luego, siguiendo la metodología propuesta por Diba y Grossman (1988), realizar contrastes de raíces unitarias y cointegración para encontrar dichas burbujas en el Merval. Se destacan en este trabajo dos aportes de interés. En primer lugar, se trata del primer estudio empírico para el mercado bursátil argentino sobre la existencia de burbujas especulativas utilizando las variables de precios y dividendos con la metodología anteriormente descrita. En segundo lugar, el periodo muestral considerado es uno de los más interesantes a la hora de abordar un estudio sobre burbujas especulativas al estar este caracterizado por un importante crecimiento.

Introduciendo el uso obstétrico del misoprostol en Costa Rica

El presente informe describe las actividades realizadas con los objetivos de: Desarrollar procesos de información preparatorios para incluir el uso obstétrico del misoprostol en las normas de la Caja Costarricense del Seguro Social (CCSS), relacionado con la Guía de procedimientos para la Interrupción Terapéutica del Embarazo. Desarrollar procesos de capacitación sobre el uso obstétrico del misoprostol, tales como la interrupción terapéutica del embarazo, la inducción de parto y la atención al aborto incompleto.

Situación del aborto en Costa Rica

Describe la situación del aborto en Costa Rica, desde su marco legal, estadísticas nacionales. La disponibilidad y uso del misoprostol.

Al amparo de la noche. La ruta crítica de las mujeres que se realizan abortos clandestinos en Costa Rica

Para la Colectiva por el Derecho a Decidir, conocer el número de abortos inducidos que se realizan en Costa Rica o el número de denuncias interpuestas ante las autoridades respectivas es importante, mas no suficiente para comprender la verdadera dimensión que tiene esta situación en la vida de las mujeres