Universidad Hispanoamerica
  • Heredia, Costa Rica
Recent publications
Adopting sustainable dietary patterns is essential for planetary and human health. As data to address this issue are lacking in Latino populations, this study examined the association between diet-attributable greenhouse gas emissions (GHGEs) and myocardial infarction (MI) in a Costa Rica Heart Study. This analysis included 1817 cases of a first non-fatal acute MI during hospitalization and their matched population-based controls, by age, sex, and area of residence. A validated food frequency questionnaire was used to quantify habitual dietary intake and diet-attributable GHGEs (kg CO2 equivalent (eq.)/year). Due to the matching design, conditional logistic regression was used. Red meat consumption contributed approximately 50% to the total diet-attributable GHGEs among both cases and controls. Higher diet-attributable GHGEs were associated with increased odds of acute MI. The odds of MI were 63% higher (OR = 1.63; 95% CI 1.20–2.21) among participants in the highest quintile (median diet-attributable GHGEs = 6247 kg CO2 eq./year) compared to the lowest quintile (median diet-attributable GHGEs = 2065 kg CO2 eq./year). An increasing linear trend in the odds of acute MI and diet-attributable GHGEs was detected (p-trend 0.0012). These findings highlight the importance of reducing red meat consumption to sustainably mitigate the incidence of MI and improve planetary health.
El gobierno corporativo nace ante la crisis de Wall Street, creando la necesidad de que los tomadores de decisiones respondan a los accionistas por sus prácticas de negocios, siendo así se elaboró un estudio cualitativo al sector cooperativista costarricense por medio de un muestreo de experto sobre los factores predominantes para la implementación de gobierno corporativo y que mediante la alternativa metodológica alcanzable, propuesta por Pablo Cáceres, se detectó que existe una diferenciación potestativa del legislador costarricense para supervisar los controles monetarios de las cooperativas, lo que implica una desventaja en cuanto a la presencia de estructura de regulación y fiscalización robustas y actualizadas.
This qualitative study explores the perception of eight seventh-grade teachers from academic schools in the western region of Costa Rica about implementing the action-oriented approach (AOA). As the main objective, the researchers sought to assess the professors' perception of the execution of this approach in order to explore its precision regarding its principles and the guidelines of the Ministerio de Educación Pública de Costa Rica. The data were collected through a semi-structured interview and then coded considering three primary constructs: the participants’ definition of AOA, its strengths and weaknesses, and the continuities, variations, and innovations that arose with the change from the CLT to the AOA. Regarding the coding, the researchers carried it out under the principles of grounded theory to identify commonalities among participants. The results show a favorable perception of the approach, yet the individuals could not clearly define the AOA for they perceived the materials, the student, and the teacher’s roles as strengths; and tests, materials, and planning as weaknesses. The continuities and variations were not tied to the approach and the most salient innovations were the teacher’s guide and the mini-project. The researchers concluded that there exist discrepancies between the participants’ understanding of the AOA and the actual tenets of the approach.
Systemic glucocorticoid therapy is used worldwide by one to three percent of the general population and 0.5-1.8% on long-term oral glucocorticoid use. It is widely used in conditions such as inflammation, autoimmune diseases, and cancer to inhibit inflammatory responses. One of the possible undesirable side effects of exogenous corticosteroid treatment is adrenal suppression upon discontinuation of the medication and adrenal insufficiency after utilizing the supraphysiologic doses for more than one month. To prevent patients from the unwanted signs and symptoms of adrenal insufficiency, including fatigue, gastrointestinal upset, anorexia/weight loss, etc., better management of the quantity and frequency of exogenous corticosteroid use, as well as better education before starting its use, is needed. For patients actively on exogenous corticosteroids, a close follow-up must be in place to avoid adrenal suppression after the eventual discontinuation of their use. This review article summarizes the important studies to date on this subject, especially oral glucocorticoid use, and analyzes risks such as dose, duration of exposure, and comorbidities of adrenal insufficiency associated with oral glucocorticoid use. We comprehensively include information on those with primary adrenal insufficiency and pediatric patients, hoping to provide better insight and clinical reference.
Introducción: La enfermedad por coronavirus (COVID-19) se ha extendido entre la población de todo el país y ha tenido un gran impacto a nivel mundial. Sin embargo, existen diferencias geográficas importantes en la mortalidad de COVID-19 entre las diferentes regiones del mundo y en Costa Rica. Objetivo: Explorar el efecto de algunos de los factores sociodemográficos en la mortalidad de COVID-19 en pequeñas divisiones geográficas o cantones de Costa Rica. Métodos: Usamos registros oficiales y aplicamos un modelo de regresión clásica de Poisson y un modelo de regresión ponderada geográficamente. Resultados: Obtuvimos un criterio de información de Akaike (AIC) más bajo con la regresión ponderada (927.1 en la regresión de Poison versus 358.4 en la regresión ponderada). Los cantones con un mayor riesgo de mortalidad por COVID-19 tuvo una población más densa; bienestar material más alto; menor proporción de cobertura de salud y están ubicadas en el área del Pacífico de Costa Rica. Conclusiones: Una estrategia de intervención de COVID-19 específica debería concentrarse en áreas de la costa pacífica con poblaciones más densas, mayor bienestar material y menor población por unidad de salud.
Introducción: la investigación se realiza en un período en que la Organización Mundial de la Salud determina que pandemia y postpandemia “tiene una amplia afectación en salud mental, a nivel mundial”.1 En estas circunstancias, la enfermería en salud mental busca el significado del propósito de vida, la capacidad de afrontamiento ante el impacto de realidad y promover los derechos humanos, la recuperación física, emocional, espiritual y la capacidad resiliente. En el enfoque metodológico, se complementa la ciencia de enfermería desde la visión de Watson, otras teorías antecesoras y actuales de la disciplina, que hacen referencia a la dinámica interactiva del encuentro enfermería-persona. Objetivo: analizar las experiencias de especialidadde enfermería en salud mental, con la aplicación de terapia complementaria, el sistema de salud costarricense, durante el período 2020-2022. Método: metodología cualitativa, interpretativa, fenomenológica y existencialista del estudio, privilegia el análisis de significados subjetivos e intersubjetivos de la trascendencia del acto profesional de la especialidad. Conclusiones: ante las experiencias vividas, enfermería como un todo construye sentido de vida en el cuidado de la salud mental; reconoce que la prevención es vital ante el vacío y la frustración existencial, una condición anímica progresiva que puede llevar al personal de salud al agotamiento. Para superar estas adversidades, una respuesta es la gestión en el sistema de salud, de la dotación del recurso humano de enfermería especializado en el cuidado de la salud mental, accesible a la población al personal sanitario, a nivel nacional, institucional y comunitario.
Published studies report inconsistent associations of polyunsaturated fatty acid (PUFA) intake with non-Hodgkin lymphoma (NHL) risk. We conducted a nested case-control study in Nurses' Health Study and Health Professionals Follow-Up Study participants to evaluate a hypothesis of inverse association of pre-diagnosis red blood cell (RBC) membrane PUFA levels with risk of NHL endpoints. We confirmed 583 NHL cases and matched 583 controls by cohort/sex, age, race and blood draw date/time. We estimated odds ratios (OR) and 95% confidence intervals (CI) for risk of NHL endpoints using logistic regression. RBC PUFA levels were not associated with all NHL risk; cis 20:2n-6 was associated with follicular lymphoma risk (OR [95% CI] per one standard deviation increase: 1.35 [1.03-1.77]), and the omega-6/omega-3 PUFA ratio was associated with diffuse large B-cell lymphoma risk (2.33 [1.23-4.43]). Overall, PUFA did not demonstrate a role in NHL etiology; the two unexpected positive associations lack clear biologic explanations.
Post-exercise rehydration has been widely studied, with particular emphasis on retention of ingested fluid; comparatively little research has been conducted on why we drink more or less. To identify physiological values corresponding to voluntary drinking cessation (VDC), nine males exercised intermittently at 70–80% HRmax in the heat (WBGT = 28.1 ± 0.7 °C) to achieve a dehydration of approximately 4.0% body mass (BM). After exercise, participants were instructed to drink water as long and as much as they needed. Urine color (Ucolor), specific gravity (USG), osmolality (Uosm), plasma osmolality (Posm), fullness, BM, and thirst perception (TP) were measured pre- and post-exercise and at VDC. Each variable was compared for the three points in time with a one-way ANOVA. Participants reached dehydration of −3.6 ± 0.3% BM. Pre-exercise USG (1.022 ± 0.004) was lower than at VDC (1.029 ± 0.004, p = 0.022), Uosm did not change over time (p = 0.217), and Ucolor was lower pre-exercise (3.4 ± 0.7) vs. post-exercise (5.5 ± 1.23, p = 0.0008) and vs. VDC (6.3 ± 1.1, p < 0.0001). Posm showed a difference between pre-exercise (289.5 ± 2.3) and post-exercise (297.8 ± 3.9, p = 0.0006) and between post-exercise and VDC (287.3 ± 5.4, p < 0.0001). TP post-exercise (96.4 ± 4.34) was significantly higher than pre-exercise (36.2 ± 19.1) and VDC (25.0 ± 18.2, p < 0.0001). At VDC, participants had recovered 58.7 ± 12.1% of BM loss. At the point of voluntary drinking cessation, Posm and thirst perception had returned to their pre-exercise values, while rehydration relative to initial BM was still incomplete.
The project is developed for Industrial Engineering Schools in the Latin American context, developing two critical aspects of higher education centers: the employability of students after their training and the role of the University in establishing the facilities to achieve it. The main objective of this study is to characterize the current situation of the employability of Industrial Engineering graduates through the measurement of the current working conditions for the improvement of services and processes that this study demands. Although the study is carried out on high school and undergraduate graduates of industrial engineering, the improvements of services and processes, established as a result of the study, will influence all students of the participating universities and the employability study itself will serve as a basis for future studies extended to the other careers of the institutions. The research proceeds through a quantitative approach, descriptive correlational scope, and a non-experimental transectional correlational design; in which the program curriculum and employability are evaluated by means of a content analysis and questionnaires to graduates. The solutions refer to the establishment of strategic activities towards the integral strengthening of the career, which show the interest of the career with the commitment to academic excellence, through the process of continuous improvement applied in an institution of higher education.
El presente artículo se enmarca en el contexto de la educación a distancia, la cual se implementó en Costa Rica en el 2020, para frenar el contagio por Covid-19. El objetivo es problematizar la desigualdad educativa que enfrentan aquellos estudiantes sin acceso a internet y a la tecnolo- gía, lo que limita su derecho a la formación. Además, se presenta la importancia de establecer estrategias que permitan incluir, a futuro, los recursos tecnológicos en los procesos educativos, de forma que se pueda brindar una educación de mayor calidad y adecuada al panorama actual. Aunado, se concluye que el acceso a internet y a los recursos tecnológicos es el primer paso para garantizar el derecho a la educación, en la modalidad a distancia.
To test the diagnostic ability of two combined practical markers for elevated urine osmolality (underhydration) in free-living adults and children. One hundred and one healthy adults (females n = 52, 40 ± 14 y, 1.70 ± 0.95 m, 76.7 ± 17.4 kg, 26.5 ± 5.5 kg/m²) and 210 children (females = 105, 1.49 ± 0.13 m, 43.4 ± 12.6 kg, 19.2 ± 3.2 kg m⁻²) collected urine for 24-h. Urine was analyzed for urine osmolality (UOsm), color (UC), while the number of voids (void) was also recorded. Receiver Operating Characteristic (ROC) analysis was performed for UC, void, and combination of UC and void, to determine markers’ diagnostic ability for detecting underhydration based on elevated UOsm (UOsm ≥ 800 mmol kg⁻¹). Linear regression analysis revealed that UC was significantly associated with UOsm in both adults (R² = 0.38; P < 0.001) and children (R² = 0.45; P < 0.001). Void was significantly associated with UOsm in both adults (R² = 0.13; P < 0.001) and children (R² = 0.15; P < 0.001). In adults, when UC > 3 and void <7 were combined, the overall diagnostic ability for underhydration was 97% with sensitivity and specificity of 100% and 88%, respectively. In children, UC > 3 and void <5 had an overall diagnostic ability for underhydration of 89% with sensitivity and specificity of 100% and 62%, respectively. Urine color alone and the combination of urine color with void number can a valid and simple field-measure to detect underhydration based on elevated urine osmolality.
The purpose of this investigation was to assess the validity and reliability of a seven-day water frequency questionnaire (TWI-FQ) to estimate daily total water intake (TWI) in comparison to a water turnover objective reference value via deuterium oxide (D 2 O). Data collection occurred over 3 weeks, with a wash-out period during week two. Healthy adults ( n = 98; 52% female; 41 ± 14 y; BMI, 26.4 ± 5.5 kg·m ⁻² ) retrospectively self-reported consumption frequencies of 17 liquids and 35 foods with specified volumes/amounts for weeks one and three via TWI-FQ. Standard water content values were utilized to determine the volume of water consumed from each liquid and food for calculation of mean daily TWI for each week. Diet records were completed daily during week two to estimate metabolic water production. To assess validity of the TWI-FQ, participants consumed D 2 O at the start of each week and provided urine samples immediately before ingestion, the following day, and at the end of the week to calculate water turnover. Metabolic water was subtracted from water turnover to estimate TWI. TWI-FQ validity was assessed via Bland-Altman plot for multiple observations. Reliability was assessed via intraclass correlation and Pearson's correlation between weeks. TWI-FQ significantly underestimated D 2 O TWI by −350 ± 1,431 mL·d ⁻¹ (95% confidence interval (CI): −551, −149 mL·d ⁻¹ ). TWI-FQ TWI was significantly correlated ( r = 0.707, P <0.01) and not different (198 ± 1,180 mL·d ⁻¹ , 95% CI: −38, 435 mL·d ⁻¹ ) between weeks. TWI-FQ intraclass correlation = 0.706 was significant [95% CI: 0.591, 0.793; F (97, 98) = 5.799], indicating moderate test-retest reliability. While this tool would not be suitable for individual TWI assessment, the magnitude of bias may be acceptable for assessment at the sample-level.
Background: The gap between the nutrition education provided to medical students and the nutritional competencies and attitudes needed for physicians to provide adequate nutritional care is a global concern. There is no universally accepted benchmark on nutrition competencies for doctors. The objective of this study was to establish, by expert consensus, the objectives of undergraduate nutrition medial education, the nutrition core competencies, and strategies for curriculum development in medical nutrition education. Methods: We administered a Delphi survey to systematically gather the opinion of a panel of Latin-American experts in nutrition. The survey questionnaire was constructed considering scientific literature using a five-point Linkert scale. Consensus was defined as a higher than 70% agreement on the importance of an item (Likert scale 4 and 5). Results: A four-round Delphi survey was conducted for this research. In the second, third and fourth rounds, we validated by consensus a total of 130 competences, which were distributed into four different thematic areas: 1) Basic nutrition concepts, 2) Public nutrition and nutritional prevention throughout the life cycle, 3) Nutritional status and disease, and 4) Nutritional care process. Conclusion: The curricula for general physician education in medical school must include health promotion, prevention, and treatment of diseases related to nutrition. This goal can be reached by integrating at least 130 competencies into four different fundamental areas. This article is protected by copyright. All rights reserved.
Only a few studies primarily examined the associations between starchy vegetables (other than potatoes) and metabolic syndrome (MetS). We aimed to evaluate the association between starchy vegetables consumption and MetS in a population-based sample of Costa Rican adults. We hypothesized that a higher overall intake of starchy vegetables would not be associated with higher MetS prevalence. In this cross-sectional study, log-binomial regression models were used to estimate prevalence ratios (PRs) of MetS across quintiles of total, unhealthy, healthy starchy vegetables, and individual starchy vegetables (potatoes, purple sweet potatoes, etc.), among 1881 Costa Rican adults. Least square means and 95% confidence intervals (CIs) from linear regression models were estimated for each MetS component by categories of starchy vegetable variables. Higher intakes of starchy vegetables were associated with a higher prevalence of MetS in crude models, but no significant trends were observed after adjusting for confounders. A significant inverse association was observed between total starchy and healthy starchy vegetables consumption and fasting blood glucose. In this population, starchy vegetables might be part of a healthy dietary pattern.
Rationale: The gap between the nutrition education provided to medical students and the nutrition competences and attitudes needed for doctors to provide effective and efficient nutrition care is a global concern. The goal of this study was to investigate the curricular content on nutrition education in Latin American medical schools, and to evaluate the self-perceived knowledge, attitudes, and barriers to nutrition practice of final year medical students. Methods: Eighty-five public and private medical schools from 17 Latin American and Caribbean countries were invited to participate in the study. Two close-ended online questionnaires consisting of 25 and 43 questions were sent to medical school directors. Quantitative variables were expressed as frequencies, percentages, mean ± standard deviation, medians, and ranges. Results: A total of 22 (26%) medical school directors responded, of which 11 schools (50%) offered stand-alone mandatory nutrition courses in preclinical and 8 (36%) in clinical years. The mean hours dedicated to nutrition education was 47 (range: 0-150). 1,530 of 1,630 (94%) students from 12 countries responded. Students´ average age was 25±3 years, and 59% were female. Most students agreed that improving patients' health through nutrition (91%) is important and that nutritional counseling and assessment should be part of routine care provided by all physicians (89%), but they lack the level of education and training required to address nutrition-related issues. Conclusions: Positive attitude and interest in nutrition among final year medical students is high, but nutrition education is not perceived as sufficient to adequately prepare doctors in the field of nutrition. This article is protected by copyright. All rights reserved.
Background Food timing affects circadian rhythms involved in weight control. Regular consumption of breakfast may affect body weight. Objective We examined the relation between breakfast frequency with weight change in middle-age women over a 3-y period. Methods We used data from 65,099 nonpregnant women aged >20 y participating in the Mexican Teachers’ Cohort (MTC) who at baseline (2006–2008) were cancer free and for whom self-reported breakfast frequency at baseline was available. We analyzed body weight change between baseline and the first follow-up (2011) according to breakfast frequency. Participants were classified according to baseline breakfast frequency 0, 1–3, 4–6, or 7 d/wk and meal frequency 1–2, 3–4, or ≥5 meals/d. We used linear and modified Poisson regression to analyze body weight change as a continuous variable and for weight gain ≥5 kg (yes/no), respectively. Models were adjusted for sociodemographic and lifestyle confounders. Results At baseline, 25% of participants were daily breakfast consumers and 18.4% of women increased ≥5 kg between 2008 and 2011. The prevalence of weight gain ≥5 kg among daily breakfast consumers was 7% lower than among those who skipped breakfast (prevalence ratio: 0.93; 95% CI: 0.89, 0.97; P-trend = 0.02). The association was stronger among normal-weight women at baseline with a corresponding estimate of 0.87 (95% CI: 0.79, 0.97; P-trend = 0.02). Conclusion Daily breakfast consumption was inversely associated with weight gain ≥5 kg over 3 y in middle-aged Mexican women. Regular breakfast may be an important dietary factor for body weight change.
Institution pages aggregate content on ResearchGate related to an institution. The members listed on this page have self-identified as being affiliated with this institution. Publications listed on this page were identified by our algorithms as relating to this institution. This page was not created or approved by the institution. If you represent an institution and have questions about these pages or wish to report inaccurate content, you can contact us here.
560 members
Catalina Capitán
  • Department of Nutrition
Ronald Evans-Meza
  • Escuela de Medicina
Edén Galán-Rodas
  • Unidad de Investigación e Innovación en Salud
Roberto Chacón
  • Departamento de Psicología
Information
Address
Heredia, Costa Rica