No disponible a texto completo / El presente documento es un breve de política, que describe la problemática referente a la responsabilidad fiscal del estado costarricense con el seguro público de salud (SEM). Respecto de lo anterior, el síntoma más evidente de la actual política fiscal, radica en el hecho de que el Estado es el principal deudor que tiene el seguro de salud, con una deuda equivalente al 1,7% del PIB1, situación que pone en riesgo la sostenibilidad financiera de dicho seguro. Así, en este trabajo se inicia una exploración de lo que representa la responsabilidad fiscal, y su importancia, en particular en su relación con su contribución a la estabilidad del financiamiento de la protección social. Se definen los elementos básicos que modelan el concepto, y se relevan la importancia de la transparencia y de una administración prospectiva de las obligaciones fiscales. Adicionalmente, se hace una descripción del funcionamiento del seguro público de salud, que pone énfasis en sus características: solidaridad, y la pretensión de atender de forma integral a la personas. También, se hace una revisión del marco normativo, en busca de las obligaciones reglamentarias del Estado con el SEM y la comprensión de la intencionalidad de los legisladores. Por otra parte, utilizando la tipología de (Polackova, 1998), se determinan las obligaciones del Estado. Igualmente el trabajo aporta una proyección de la responsabilidad fiscal explícita del Estado con el seguro de salud, para el decenio: 2012-2021. Los resultados se presentan en dos perspectivas, una que incorporó al grupo de los “No asegurados”, y otro que no los consideró, en la primera la responsabilidad fiscal del Estado es del 1% del PIB, en tanto que en la segunda es del orden del 0,5% del PIB. Por todo lo anterior, se espera que el presente trabajo sea de utilidad para diferentes actores en el ámbito de las políticas públicas.

The conflicts of the past decade in Central America have produced substantial refugee movements into neighboring nations. Costa Rica has had to cope with an influx of refugees and migrants as large as 10 percent of its population. This work presents a case study of the situation in Costa Rica, focusing on the issue of refugee integration into the host society. It draws on qualitative field research conducted in that country during 1986. The study discusses the evolution of the Costa Rican state's response to the refugee crisis and analyzes the characteristics and impact of policies undertaken by various state bureaucracies. It also describes the assistance efforts of the United Nations High Commissioner for Refugees and private voluntary organizations, along with their interaction with the Costa Rican state. The study concludes that the government's need to maintain firm control of refugee programs has overshadowed its commitment to refugee integration. In so doing, the humanitarian purpose of refugee assistance has been compromised.

This research is an ethnographic case study of the emerging ecotourism economies in the agricultural village of San Gerardo de Rivas, Pérez Zeledón, Costa Rica. Due to the village’s location as the main entry point to climb the country’s tallest mountain within Chirripó National Park, the majority of households in San Gerardo now derive some income from tourism. I conducted twenty household surveys, followed by twenty-one semi-structured interviews with male and female heads of households and representatives of local organizations and tourism businesses. Drawing on local perspectives, I found that ecotourism was a complementary income source to agriculture and that men and women were engaging differently in ecotourism employment. Local organizations were involved in the participatory management of ecotourism activities within Chirripó National Park. Ecotourism has affected environmental practices and local people are strategically negotiating the direction of tourism development, including through using environmental discourses, to optimize the benefits to their community.

Over the last two decades, the use of empowerment approaches to help reduce health-related vulnerabilities and violence among female sex workers has increasingly informed global health efforts directed at HIV/STD prevention. The empowerment approach to sex worker health rejects both abolitionist and narrowly conceived clinical approaches in favor of strategies that promote commercial sex as valid work, strengthen sex workers’ agency, reinforce female sexual autonomy, and support rights-based framing. A significant outcome of the empowerment approach to integrating health, social, and legal strategies has been the creation of numerous sex worker associations and NGOs, which advocate for collective mobilization and community-based HIV/STD prevention programs among sex workers. Despite numerous studies examining the efficacy of community empowerment approaches to sex worker health and the creation of civil society organizations to implement such approaches, there has been little theorization about how participation in sex worker NGO-based programming and activism shapes the personal, embodied experiences and subjectivities of sex workers. Similarly, questions of how sex worker associations and NGOs are shaped by the experiences, realities, feelings, and personal opinions of sex workers have received limited attention. Given the morally charged and highly stigmatized environments in which sex workers typically operate, studying how and which sex workers come into contact with these NGOs helps to illuminate how community and kinship relations, and individual and collective aspirations, shape sex work activism and contribute to the making (and unmaking) of related associations and NGOs. Drawing on long-term ethnographic research with female sex workers and sex work activists, this work combines medical anthropological and feminist perspectives to interpret sex worker associations and NGOs as “local moral worlds” that highlight how subjectivities, body, moral experience, kinship, care, and women’s agency relate. From the subjective experiences of older female sex worker/activist informants, I argue that sex worker associations and NGOs are best comprehended not simply as the outcomes of global health efforts to curb the spread of HIV and other STDs, but also as complex social arenas that need to be reconsidered in light of existing relationships between and among sex workers and their families and the state. This argument is informed by my yearlong engagement with Women’s Solidarity House (WSH), a pseudonym for an organized association of active and retired female sex workers in the red-light district of San José, which recently received NGO status from the Costa Rican state. One important dimension of WSH that requires careful consideration is the fact that most of the women who participate in its development and programming are over the age of 40, with an average age of about 52. This fact makes WSH an interesting and important case study, since it caters most especially to female sex workers who are generally outside of the purview of most sex worker empowerment and health-related prevention programs, which are designed and implemented by public health researchers and development specialists. While theories of gender, stigma, and social inequality have increasingly informed medical anthropological efforts to understand how structural factors shape the personal, embodied experiences of sex workers and the distribution of HIV/STDs, there has been very little effort to understand how aging and ageism factor into the making and unmaking of sex worker embodiment and subjectivity and older women sex workers’ risk of contracting sexually transmitted diseases and infections. Given that sex work is a profession or income-generating strategy that adult women in various stages of their lives perform, the lack of research and theorization about these aspects of female sex workers’ lives, I suggest, has prevented a broader research and programmatic response both to common risks such as HIV/STDs and violence, and to work-related health problems and occupational conditions that older sex workers may consider more important in their day-to-day lives. My research shows that a “structural approach” to sex work, which highlights the underlying social, historical, political, and economic forces that encourage and foster the economic exploitation, stigmatization, and negative health outcomes of women (and men) who sell sex, would benefit from adding a feminist anthropological perspective on aging. In this view, aging is a critical social structural inequality that society uses to devalue women’s status and which women often experience as stigmatizing and/or shameful. In Costa Rica, where recent reporting has suggested an increase in the number of older women in the local sex industry, studying women’s experiences of and responses to growing old in the sex trade reveals not only the long-term impacts of neoliberal reform polices, but also how gendered discourses about aging, increasing familial caregiving responsibilities, and growing inequality and economic pressure, together, conspire to limit older women sex workers’ employment opportunities and put them at greater risk of violence, discrimination, psychological distress, sexual assault, substance abuse, poverty, and HIV/STDs.

The genera of Tingidae of the neotropics are herein diagnosed and a key for their identification is also provided. Five new genera are described from Central America, two from Panama, two from Costa Rica, and one new genus is described from Mexico. This brings the total of neotropical genera to 74. One new species, Mexibyrsa woolleyi is described from Mexico. The Tingidae of southern Central America (Nicaragua, Costa Rica, and Panama) are reviewed in detail. There are now 153 described species spread among 43 genera. Thirty-two new species from southern Central America are described. Identification keys are provided for all species found in the study region. / NDSU Entomology Scholarship Committee / Oswald, John D. (TAMU)

Im tropischen Trockenwald im Nordwesten Costa Ricas wurde der Verlauf der Regeneration von Sekundärwäldern untersucht. Neun Sukzessionsstufen, die seit unterschiedlichen Zeiträumen ohne erkennbare anthropogene Störungen wuchsen, waren Bestandteil dieser Untersuchungen. Analysiert wurden folgende Aspekte der natürlichen Sylvigenesis degradierter Trockenwaldareale. 1. Die aktuellen Vegetationsbestände der Untersuchungsflächen umfassten 328 Gefäßpflanzenarten aus 79 Familien und 247 Gattungen. Die höchste Artenvielfalt zeigte sich nach 15 Jahren mit 140 Arten. Die Diversität der Gehölzspezies war nach 20 Jahren am Höchsten. 2. Die potentielle Vegetation wurde anhand der Diasporen- und Keimlingsbanken untersucht. Insgesamt wurden 14567 Ausbreitungseinheiten in allen Flächen angetroffen. 122 Diasporenarten waren insgesamt vertreten. Wurden die jüngeren sekundären Flächen durch Nichtgehölze geprägt, beherrschten Gehölze die älteren Waldflächen. Die Artenvielfalt der Keimlingsbanken zeigt nach 10 Jahren einen sprunghaften Anstieg, wobei die Diversität sich in den drei ältesten Flächen auf etwa 50 Gehölzspezies einstellte. 3. Vorhandene Standortfaktoren, die Einfluss auf die natürliche Sylvigenesis nehmen, wurden analysiert. Die Pflanzenbedeckung zeigte während des Sukzessionsverlaufs ein prozentuales Absinken im Bodenbereich bei gleichzeitiger Zunahme des Anteils der Baumschichten. Die Temperaturdifferenzen in der Tag- und Nachtrhythmik senkte sich von etwa 24°C in den jüngsten Flächen auf 11°C im ältesten Waldstück. Die vorliegende Arbeit stellt umfassende Erkenntnisse über den komplexen Verlauf der Sylvigenesis innerhalb der Trockenwaldareale Costa Ricas zur Verfügung. Die gelieferten Ergebnisse sind ein Beitrag, die einer effektiveren Gestaltung der Renaturierungsmaßnahmen auch in anderen tropischen Waldformationen dienen können.

Background Pressure ulcers are localized injuries to the skin and underlying tissue caused by pressure, shear or a combination of these. The consequences of pressure ulcers are contributing to higher risk of morbidity and mortality. It also increases costs to society and causing suffering affecting the quality of life for individuals. Research shows that patients often do not get access to those interventions with the highest evidence-based utility. Many times, there can be great differences within countries regarding interventions that reaches the patients. Aim The aim of the study was to describe pressure ulcers prevention by registered nurses in San José, Costa Rica. Method A qualitative design with semi-structured interviews was used. The study consisted of interviews with six registered nurses whereof one was an included pilot interview. The data process consisted of recording the interviews, transcription and a qualitative content analysis. Findings The main findings show that there is insufficient knowledge regarding pressure ulcer prevention and that there is a lacking ability to implement the existing knowledge into daily practice. Conclusion Strategies are needed to implement routines regarding pressure ulcer prevention and broader knowledge is needed to enable the registered nurses to follow these routines and to perform accurate and evidence based care. The lack of resources and time influence the ability to fulfil professional responsibilities regarding pressure ulcer prevention. The management have the important task to make sure that the needed knowledge and resources exists so that the staff can fulfil their work duties.

<p> The beach at Manzanillo, Costa Rica, is composed of a mixture of terrigenous siliciclastic and marine calcareous sediment. The most abundant siliclastic grains are magnetite and diopside. The most abundant calcareous grains are red algae and molluscan fragments. These grains are found in much greater abundance in the beach sediment then in their source areas as a result of their resistance to breakdown.</p> <p> The distribution of the siliclastic minerals on the beach shows longshore drift to be from east to west. The main source of siliclastic sediment is the Rio Sixaola. Local rivers provide small inputs of sediment.</p> <p> The trace element chemistry of the beach indicates the possibility that some elements may be absorbed on the surfaces of grains as opposed to being substituted for other elements in mineral lattices.</p> / Thesis / Bachelor of Science (BSc)

This thesis is missing page 123, no other copy of the thesis has this page. -Digitization Centre / This research provides the first detailed study of the coastal geomorphology of Playa Guiones, Guanacaste Province Costa Rica. Playa Guiones is located within a tropical wet/dry climate necessitating that field work is completed in both seasons to ensure a broad understanding of the coastal characteristics. The research commenced February 2005 with site selection and preliminary field work. During June 2005 a detailed real-time kinematic GPS survey and beach inventory (sediment, rock and vegetation) was conducted. During a third field session a comparison was made between the current observed coastal characteristics and those observed during the two other field seasons. Playa Guiones is composed of primarily fine grained sand and carbonate shell material. Rock samples collected adjacent to the southern headland on the rocky shore platform consisted of limestone and finely grained, interbedded sandstone and siltstone. Adjacent to the northern headland on the rocky shore platform the rock consisted of sandstone. Playa Guiones displays some temporal variability which may be linked to the wet and dry seasons. On initial inspection Playa Guiones appears to have the characteristics of an embayed beach but more detailed inspection illustrates that Playa Guiones has many characteristics that are contradictory to a typical embayed beach. Although Playa Guiones lies on a convergent margin it has many characteristics of a divergent margin coast. This study is significant because it provides important baseline information for future work. Playa Guiones is located on the Nicoya Peninsula where a large seismic gap, which last fully ruptured in 1950, is known to exist. The baseline data will be very useful subsequent to any future earthquake event for measuring change that occurs along this rapidly developing coastline. The methodologies employed in this study provide much more detail information than is typically collected in gee-indicator studies which often only measure several profiles along a beach to create a digital elevation model rather than the 3 m gridding distance used in this study. / Thesis / Master of Science (MS)

Aedes mosquitoes are responsible for the transmission of several arboviruses throughout tropical and subtropical regions of the world. In the Americas, Aedes aegypti is the most competent vector of dengue, chikungunya, Zika, and yellow fever. With up to 400 million cases globally each year, dengue fever is the fastest growing vector-borne disease in the world, and it has become an increasingly significant risk to global health. In the Western Hemisphere, dengue, and more recently chikungunya and Zika, exists throughout much of Latin America and the Caribbean. Both diseases are spread via Aedes mosquitoes and both constitute major health risks in Costa Rica. A dengue outbreak in Costa Rica in 2013 was the largest epidemic in the country since the return of the disease in 1993. Moreover, between 2014 and 2015 there was a 54.9% increase in dengue cases in Costa Rica, further demonstrating the relevancy of research on mosquito-borne diseases. Given this context, this study employs qualitative methods to critically investigate measures to combat Aedes mosquito-borne diseases in Costa Rica. Data were collected using household interviews (n = 80); semi-structured key informant interviews with public health officials, researchers, nonprofit organizations, and community leaders (n = 22); and a focus group discussion in each of two study areas. The results provide broad and place-specific information about mosquito control efforts and other actions deployed in Costa Rica to mitigate mosquito-borne diseases. The data reveal differences in perceptions and disease incidence among household interviewees as well as where households source information about mosquitoes and mosquito-borne diseases. Varying degrees of knowledge on mosquitoes and mosquito-borne diseases were uncovered across the study sites, as were differing attitudes among the general population regarding mosquito control techniques (e.g., fumigation, education campaigns, and household visits by public health officials). Additionally, data indicated a gap in knowledge regarding the ability of the public to report mosquito-related problems to health authorities. Households also exhibited discrepancies in knowledge pertaining to chikungunya transmission and details about the vector. / Master of Science