Rican National Research Articles

A surveillance study of cancer incidence and mortality among young adults in Costa Rica

There has been an increase in certain cancers among young adults (YA) aged 20-39, particularly in LatinAmerica. This is the first study to examine cancer incidence and mortality in YA in Costa Rica, focusing on sex-specific patterns. Invasive cancer cases (excluding non-melanoma skin cancer) in YA from 2006 to 2015 were obtained from the Costa Rican National Registry of Tumors. Utilising SEER∗Stat software, age-standardized incidence rates (IRs) and incidence rate ratios (IRRs) were calculated. Trends and annual percent changes (APCs) in IRs were estimated using the Joinpoint regression analysis program. Cancer deaths from 2000 to 2021 were obtained from the Costa Rican National Institute of Statistics and Census. Age-standardised mortality rates were calculated using STATA®17. YA comprised 10.7% of all invasive cancer cases diagnosed from 2006 to 2015. The age-standardized incidence rate (ASIR) of invasive cancer in YA was 50.9/100,000 person-years. The ASIR was twofold higher for females compared to males (IRR=2.03, 95% CI:1.94, 2.13). This difference increased with age, peaking in the 35-39-year age group (IRR=2.84, 95% CI:2.62, 3.10). Thyroid, breast, and cervical cancer were the most common in females. Testicular cancer was the most common in males. Leading causes of cancer-related deaths included cervical and breast cancer in females and stomach and brain/nervous system cancer in males. The study highlights sex-specific patterns in cancer incidence and mortality among YA in Costa Rica to increase understanding and improve cancer outcomes in this age group. This study was funded by the Intramural Research Program of the National Cancer Institute.

The Pilgrim’s Quest: On Solidarity and Justice in the Work of Eugenio María de Hostos

Abstract: Eugenio María de Hostos, arguably the main founding father of Puerto Rican nationalism, recreates Puerto Rican national identity through the sacred symbol of the pilgrim. This article connects Hostos’ first work, a novel titled La peregrinación de Bayoán (1863), to his science of morals, Moral Social , written twenty-five years later. The novel’s main protagonist, a Taíno-pilgrim, is a liminal archetype who embodies an ethics of solidarity from below rooted in Christianity. Hostos’ work provides an alternative view of the human experience from the periphery that can contribute to contemporary literature on service leadership, global awareness, and citizenship education.

Trends in incidence rates of head and neck squamous cell carcinomas overall and by potential relatedness to human papillomavirus, Costa Rica 2006 to 2015.

In Costa Rica (CR), only one report on head and neck cancer (HNC) incidence trends (1985-2007) has been published and no investigations on the epidemiology of potentially human papillomavirus (HPV)-related and HPV-unrelated HNCs have been done. We examined the age-standardized incidence rates (IRs) and trends of head and neck squamous cell carcinomas (HNSCC) and compared incidence trends of potentially HPV-related and HPV-unrelated HNSCCs. We obtained all available HNC cases for the period 2006-2015 from the Costa Rican National Cancer Registry of Tumors and the population estimates from the Costa Rican National Institute of Statistics and Census. The analysis was restricted to invasive HNSCCs (n=1577). IRs and incidence rate ratios were calculated using SEER*Stat software and were age-standardized for the 2010 Costa Rican population. Joinpoint regression analysis program was used to calculate trends and annual percent changes (APCs) in rates. For all HNSCCs, the age-standardized IR was 34.0/million person-years; 95% CI 32.4, 35.8. There was a significant decline in the incidence of nasopharyngeal cancer (APC: -5.9% per year; 95% CI -10.8, -0.7) and laryngeal cancer (APC: -5.4% per year; -9.2, 1.5). The incidence trends for hypopharyngeal, oropharyngeal and oral cavity cancers each remained stable over time. HNSCCs were categorized by their potential relatedness to HPV infection. Though the APCs were not statistically significant, IRs of potentially HPV-related HNSCCs trended upward, while HPV-unrelated HNSCCs trended downward. HNSCCs are uncommon in CR and decreased over time. We observed a divergent pattern of decreasing HPV-unrelated with increasing HPV-related HNSCCs that should be further informed by HPV genotyping tumor samples.

Epidemiological Patterns of Common Cancers in Costa Rica: An Overview up to 2020.

The increasing cancer incidence and mortality rates in Costa Rica have become a public health concern, with prostate, breast, and colorectal cancers being the most prevalent. This study aimed to analyze the trends in cancer incidence and mortality rates by tumor type, sex, age group, and geographic region using data from the Costa Rican National Cancer Registry. In this retrospective study, we analyzed cancer incidence and mortality anonymized data from the Costa Rican National Cancer Registry between 2010 and 2020. The study included data on cancer cases diagnosed and deaths attributable to cancer within the population. Our findings revealed variations in cancer incidence and mortality rates based on geographic region, age group, and tumor type. Cancer was most predominant in the province of San Jose, followed by Alajuela, Heredia, Cartago, Guanacaste, and Puntarenas. Breast cancer, colorectal cancer, and prostate cancer were the leading causes of cancer in both sexes. Mortality rates due to gastric cancer and prostate cancer were highest among men, while breast cancer was the leading cause of cancer mortality among women. The results of this study underscore the need for targeted prevention and screening programs, improved access to treatment for patients living in rural areas, and a comprehensive cancer control program in Costa Rica. By implementing evidence-based interventions, such as tobacco control programs, cancer screening initiatives, and equitable access to cancer treatment, the cancer burden in Costa Rica can be mitigated, ultimately improving the overall health of the population.

Carmen Kordick, The Saints of Progress: A History of Coffee, Migration, and Costa Rican National Identity (Tuscaloosa, AL: University of Alabama Press, 2019), pp. xx + 268, $49.95 hb.

Carmen Kordick, The Saints of Progress: A History of Coffee, Migration, and Costa Rican National Identity (Tuscaloosa, AL: University of Alabama Press, 2019), pp. xx + 268, $49.95 hb. - Volume 54 Issue 4

The Saints of Progress: A History of Coffee, Migration, and Costa Rican National Identity

The Saints of Progress: A History of Coffee, Migration, and Costa Rican National Identity

Transforming REDD+ for Indigenous rights in Costa Rica

ABSTRACT : Financing the conservation of critical global carbon sinks in developing countries has been an ongoing focus in global climate change mitigation talks, with the development of the Reducing Emissions from Deforestation and Forest Degradation (REDD+) strategy through the United Nations Framework Convention on Climate Change. The importance of returning land tenure of these forests to Indigenous People is also recognised as a crucial component of forest conservation as well as fulfilment of Indigenous Rights, as outlined in the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). However, denunciations of REDD+ by Indigenous rights activists justify concern over transparency and accountability for governments claiming to effectively uphold Indigenous rights throughout the negotiation of their national REDD+ strategies. This case study of the KéköLdi Indigenous Territory of Costa Rica yields essential decolonial transformations for the Costa Rican National REDD+ strategy in order to support ten specific articles of the UNDRIP. These decolonial Indigenous proposals hold the Costa Rican government accountable to its legal commitments to its Indigenous People as well as recognise and respect the robustness of Indigenous environmental knowledge and cultural conservation practices. These decolonial approaches could be applied in other countries that are developing their own national REDD+ strategies while fulfilling their commitment to Indigenous rights.

CARMEN KORDICK, The Saints of Progress: A History of Coffee, Migration, and Costa Rican National Identity. Tuscaloosa: University of Alabama Press, 2019.

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Costa Rica - The Saints of Progress: A History of Coffee, Migration, and Costa Rican National Identity. By Carmen Kordick. Tuscaloosa: University of Alabama Press, 2019. Pp. xv, 268. Abbreviations. Illustrations. Notes. Bibliography. Index. $49.95 cloth.

Costa Rica - The Saints of Progress: A History of Coffee, Migration, and Costa Rican National Identity. By Carmen Kordick. Tuscaloosa: University of Alabama Press, 2019. Pp. xv, 268. Abbreviations. Illustrations. Notes. Bibliography. Index. $49.95 cloth. - Volume 78 Issue 1

MON-101 Costa Rican National Primary Congenital Hypothyroidism Screening Program Evaluation. Retrospective Cohort Trial Between 2015 and 2017

Congenital hypothyroidism (CH) is one of the leading causes of intellectual impairment worldwide in infancy. The newborn screening has been able to prevent this mental disability, by a prompt initiation of therapy. Over the last years the incidence of HC has been increasing, mainly by lowering the screening cut-off level that leads to detection of milder cases. There is conflicting evidence if children with mild CH without treatment may develop neurological impairment in the future.Costa Rican newborn screening program in divided in three stages, measuring serum TSH concentrations from a heel prick aliquot of capillary blood dried onto a filter paper. Each test has different TSH cut-off values to determine if the newborn needs a clinical evaluation by an endocrinologist, needs another screening test or rules out hypothyroidism.We developed an observational, descriptive, retrospective study, based on medical records, to evaluate our newborn screening program performance. The study included the total national population of screened newborns from 2015 to 2017. Descriptive analysis and analytical analysis of variables were done, and test’s sensitivity and specificity were determined.The study analyzed 204.241 screened newborns, and 145 children referred to the Endocrinology Department of the National Children Hospital. This population represents 97% of births in these 3 years. The recall rate for a first positive test was 0.3%. Congenital hypothyroidism was confirmed in 73% of children referred to the Endocrinology Department because of a positive screening. Incidence was 1/1926 births. Detection rate was independent of birth weight nor gestational age. 45.3% of children diagnosed with CH were detected after the first screening test, 52.8% after the second screening test and 1.9% after the third screening test. Screening test analysis showed high sensitivity and specificity, with diagnostic accuracy above 90%, except for the third screening test. Free thyroxine measurements alone weren’t useful to predict CH diagnosis.The coverage of the national neonatal screening program extends almost to the entire population. Our test specificity is within international standards. Incidence of CH in Costa Rica is similar to that reported in medical literature. With current detection cut-off level, there is no need of performing a second mandatory evaluation to preterm and low weight newborns. The third screening test has a low performance rate, does not improve detection of children with CH significantly, and delays clinical evaluation by the endocrinologist. Prognosis of treated children with CH is excellent, with no evidence of severe cognitive deficit.

Vehicle Lateral Wander Measures Using Ultrasonic Sensors

This paper evaluates the measurement of vehicle lateral wander using ultrasonic sensors. Measurements were made on different sections of the Costa Rican National Road Network. The recorded data allowed to determine the cumulative frequency distribution, lateral wander data and a confidence interval for the measurements. In some routes, where the sample size is greater than 70 vehicles, the distribution of the lateral wander data adjusted to a normal distribution. However, in several cases the data does not resemble a normal distribution curve, or other distributions reported in the literature. Finally, an Android app was developed to automate the data collection process using the ultrasonic sensor setup, simplifying the measurement process. From the cumulative frequency results, obtained with the ultrasonic sensors, it was determined that most vehicles travel between 50 and 150 cm from the edge of the road. In order to validate the data, the results obtained with the ultrasonic sensor setup were compared with the results obtained by image analysis of video recordings. These image analysis is possible due to pavement markings every five centimeters on the pavement from the lane edge. The results from video recordings and ultrasonic sensors show a high coefficient of correlation.

Carmen Kordick. The Saints of Progress. A History of Coffee, Migration, and Costa Rican National Identity. Tuscaloosa: University Alabama Press, 2019

El libro The Saints of Progress. A History of Coffee, Migration, and Costa Rican National Identity fue publicado en el año 2019 por la University of Alabama Press, y corresponde a los resultados de la investigación que Carmen Kordick realizó como proyecto de graduación doctoral en Yale University (Kordick).

Investigaciones científicas en el Parque Nacional Isla del Coco y aguas adyacentes del Pacífico de Costa Rica

<p>This Special Issue of the Revista de Biología Tropical, “Scientific Research at Isla del Coco National Park and Adjacent Waters, Pacific Costa Rica” (Volume 64, Supplement 1, 2016) contains 20 papers, with topics ranging from atmospheric sciences to an analysis of conservation public policies, including also papers on physical oceanography, chemistry, botany and marine biodiversity of Isla del Coco National Park, its adjacent waters and regions between the continent and the island. The 20 papers were written by 54 authors, including 15 students, from 13 national and international institutions. The manuscripts were reviewed by more than 75 researchers to whom I am greatly thankful. (The list of reviewers is presented at the end; several requested to remain anonymous.) Their corrections, suggestions and comments greatly contributed to improve the papers. Most of the publications are the product of research projects funded by the Vice-rectory for Research of the University of Costa Rica, the French Fund for the World Environment, the National Council of Rectors of the Public Universities of Costa Rica (CONARE), Conservation International, the Undersea Hunter Group, and other funding agencies. I acknowledge the unconditional support, once more, of the Revista de Biología Tropical. The publication of this Special Issue was possible thanks to the financial contributions by the Costa Rican National Academy of Science, the Undersea Hunter Group, the Pristine Seas Project (National Geographic Society, thanks to Enric Sala), and Conservation International (CI). Finally, I want to thank each and every one of the authors for contributing with their manuscripts for this new Special Issue on scientific research at Isla del Coco National Park and its surrounding waters. I hope that this Special Issue, as well as the previous ones, contributes to increase awareness of the importance of Isla del Coco for Costa Rica and the entire world.</p><div> </div>

Prevalence of diabetes and impaired fasting glucose in Costa Rica: Costa Rican National Cardiovascular Risk Factors Survey, 2010.

The projected rising prevalence of diabetes and impaired fasting glucose (IFG) in developing countries warrants careful monitoring. The aim of this study was to present the results of the Costa Rican National Cardiovascular Risk Factors Surveillance System, which provides the first national estimates of diabetes and IFG prevalence among adults in Costa Rica. A cross-sectional survey of 3653 non-institutionalized adults aged ≥20 years (87.8% response rate) following the World Health Organization STEPwise approach was built on a probabilistic sample of the non-institutionalized population during 2010. Known diabetes was defined as self-reported diagnosis, the use of insulin, or hypoglycemic oral treatment as consequence of diabetes during at least the previous 2 weeks before the survey. Unknown diabetes was defined no self-reported diabetes but with venous blood concentrations of fasting glucose >125 mg/dL determined by laboratory testing. Impaired fasting glucose was defined as fasting glucose between 100 and 125 mg/dL among those without diabetes. The prevalence of diabetes and IFG prevalence was estimated according gender, body mass index (BMI), waist circumference (WC), educational level, and physical activity level. Overall diabetes prevalence was 10.8% (9.5% known and 1.3% unknown diabetes) and IFG prevalence was 16.5%. The prevalence of known diabetes was higher among women >65 years compared with men of the same age group. Both known and unknown diabetes were significantly associated with higher BMI, increased WC, and low education level (P = 0.01). The prevalence of diabetes and IFG in Costa Rica is comparable to that in developed countries and indicates an urgent need for effective preventive interventions.

Applying the Situational Theory of Publics to the first external voting process for Costa Ricans abroad: Lessons for international public relations and public diplomacy / Aplicación de la Teoría Situacional de los Públicos al primer proceso de voto en el

Using information gathered from 40 interviews with Costa Ricans who live abroad (some who decided to vote in the newly granted external voting right and others who did not vote in the Costa Rican National Elections of 2014), the variables that impacted the voting intention and/or behavior of these Costa Rican diaspora members were categorized using the independent variables presented by the Situational Theory of Publics: problem recognition, constraint recognition (internal and external constraints), and level of involvement. This theory was used to better understand what is moving these potential external voters to vote or not, in order to suggest what kinds of efforts should the Costa Rican government undertake to increase the number of external voters. The implications for public diplomacy and international public relations are explored

Family Matters: Puerto Rican Women Authors on the Island and the Mainland by Marisel C. Moreno (review)

Reviewed by: Family Matters: Puerto Rican Women Authors on the Island and the Mainland by Marisel C. Moreno Carmen Rivera Marisel C. Moreno. Family Matters: Puerto Rican Women Authors on the Island and the Mainland. Charlottesville: U of Virginia P, 2012. xii + 232. On September 23, 2009, Puerto Ricans in Hartford, Connecticut unveiled a monument to la familia puertorriqueña. Thus starts Marisel C. Moreno’s book, Family Matters, using this event and the monument as a concrete and symbolic icon of the central theme of her study, the “foundational myth of la gran familia puertorriqueña” (8) and the subversion of it in the writings of Puerto Rican women de aquí y de allá (from here and there). It is this juxtaposition of Puerto Rican writers separated by more than an ocean that makes Moreno’s book a groundbreaking landmark of what she calls “a new dawn for Puerto Rican island-diaspora studies” (4). Up until now, writers and scholars have engaged in exclusionary practices in Puerto Rican literature and the literary canon. Most anthologies and critical studies tend to focus on either the island’s literary corpus or that of the mainland. To this day, Puerto Ricans writing in the US are almost unknown in [End Page 559] the island and seldom studied in its academic institutions. Moreno proposes the term “transinsular literature” (26), which “signals the importance of recognizing works produced ‘beyond the island,’ or outside its borders.” So, why then focus on the theme of la gran familia puertorriqueña in this first approximation to “transinsular literature”? With the American colonization of the island, and the election of the first Puerto Rican governor, Luis Muñoz Marín, there was a concerted effort to define puertorriqueñidad. Muñoz Marín with the help of government agencies engaged in an island-wide promotion of Puerto Rican culture by delving into the past of Spanish hacendados, who were the heads not only of the big plantations but also of their families and of all their servants and workers. Hence, the emergence of the myth of la gran familia puertorriqueña, which, according to Moreno, operates on three important principles: “social harmony and racial democracy, the glorification of the past, and the cult of patriarchy” (13). Moreno argues that the Puerto Rican women writers in this study were growing up at the time of Muñoz Marín’s industrialization and acculturation projects that also brought about the Great Migration (1946–64), which explains why even those writing in the mainland were influenced by this myth. While others insist on defining the differences between Puerto Rican writers on either side of the Atlantic, Moreno wants to establish “literary contact zones” (4), a term she borrows from Mary Louise Pratt, to emphasize the axis of commonalities between two groups of colonized people. Family Matters is organized in four chapters and an epilogue. The first chapter, “The Literary Canon and Puerto Rican National Culture,” provides one of the best articulated and eloquent discussions of the intersection between canon and nation formation and the implications for Puerto Rican letters. The chapter focuses on the classical texts produced by the “Generation of the 1930s” (12), which Moreno identifies as the architects of the canon. Many of the intellectuals in this group are the second generation of the hacendado bourgeoisie, who saw the transformation of their feudal economy into a capitalist industrialist one. The patriarchal figure of the hacendado at the head of la gran familia puertorriqueña becomes “a strategy of resistance against US colonialism” (19). In order to fight policies that made English the official language not only of the government but of the schools as well, the writers from the Generation of the 1930s resorted to “Hispanophilia, or the cult of all things Spanish” (12). Spanish then becomes a “border” or “frontera intranacional” to demarcate the boundaries of what is and is not Puerto Rican literature (47). However, Moreno concludes this chapter with the observation that “nations are fluid, and so are the canons that mirror them” (50), [End Page 560] and the writers studied in the following chapters not only debunk the myth of la gran familia puertorriqueña...

Periodization Model for Costa Rican Taekwondo Athletes

THE PURPOSE OF THIS ARTICLE IS TO DESCRIBE THE CONDITIONING OF ELITE TAEKWONDO COMPETITORS BASED ON THE BLOCK-PERIODIZED TRAINING MODEL. THIS MODEL OF PERIODIZATION HAS BEEN USED BY THE COSTA RICAN NATIONAL TAEKWONDO TEAM AND GUIDED THEIR PHYSICAL PREPARATION FOR INTERNATIONAL COMPETITIONS INCLUDING THE BEIJING 2008 AND LONDON 2012 OLYMPIC GAMES. EXAMPLES OF DRILLS PERFORMED ARE PRESENTED FOR A MACROCYCLE OF PREPARATION AIMED TO DEVELOP PHYSICAL AND TECHNICAL QUALITIES REQUIRED FOR SUCCESSFUL PREPARATION IN THIS COMBAT SPORT.

Anthropometric and Muscle Power Profile, Costa Rican National Team Soccer, in World Cup Brazil 2014

Anthropometric and Muscle Power Profile, Costa Rican National Team Soccer, in World Cup Brazil 2014

Undeserving mothers? Shifting rationalities in the maternal healthcare of undocumented Nicaraguan migrants in Costa Rica

The case of Nicaraguan migrants in Costa Rica is emblematic of the issues that immigration generates in host countries. Undocumented Nicaraguan women seeking maternal care constitute a key challenge to the universal coverage of Costa Rica's health system. Can the long-standing commitment to universality, solidarity and equality expressed in the legislation be translated into practice? Discourses of health professionals in Costa Rica reveal a contradiction between merit and prejudice in prenatal and delivery care. Here, I present qualitative research based on semi-structured interviews with physicians and nurses at a Costa Rican National Hospital. The data show that migrant women, rejected from primary care, do find help in emergency services, but not without difficulties, as they must engage in individual negotiations centred on their bodies. The discourses of health providers reflect an ambivalence between the perceived undeservingness of undocumented migrant women and the medical realisation that two lives are at risk. While the foetus often evokes compassion, the mother commonly provokes repression, as specific and shifting rationalities reflect new moral regimes that are applied to this population. Women are perceived as being ‘illegal’, ‘immoral’ and ‘irrational’, and the baby, although legally Costa Rican due to jus solis policy, embodies ‘the other’. Ultimately, otherness frames perceptions of deservingness of maternal care for undocumented migrant women in Costa Rica.

La ética del cuidado en la Pedagogía Saludable

In the scope of the Healthy Pedagogy Investigation Project, currently under development at the Elementary Education Division of the Costa Rican National University’s (UNA) Center for Investigation and Teaching in Education (CIDE), this essay suggests a relationship between pedagogy and health, based on an ethical vision of caring. The authors propose the understanding of Healthy Pedagogy as a new node, which includes the concept of cohabitation and considers that all living creatures are fundamental for the fabric of life. The paradigm of caring is approached as a love relationship with ourselves, with others, and with all existence, facing the critical situation that both humanity and Mother Earth currently have, as an alternative to the aggression and destruction that threatens not only the planet and all living creatures, but the most basic interrelationships. From this perspective, the authors conclude that the ethics of caring represent a commitment towards the urgent construction of a world held together by affection, populated by people with the highest principles and which may guarantee the continuity and wellbeing of all living forms.