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A few months ago the Bicentennial of the Independence of Central America was commemorated and, after its celebration, there is a trail of reflections on the path to follow to materialize the "Costa Rica we want", an expression that swarmed in those days and that becomes utopian when it is noticed that the effective processes of dialogue and consensus building, in terms of social consensus to achieve national agreements, have been mostly unproductive. However, in order to transcend in the effort that such phrase points out, the discourses of academics on the local, Central American and Latin American future constitute a valuable resource to face the challenges that emerge when participating in nation building.In order to contribute to this task, the Revista de Historia, then, proceeds to deliver a collection of 14 articles that invite deliberation based on the contributions of authors who, from different theoretical and disciplinary positions, share the findings of their studies. The contents of their manuscripts will not be described in this section, as has been the custom, because it is considered more enriching for the reader to consult the texts without the mediation of a third party in their relationship with the writer; instead, we will briefly allude to the importance of scientific dissemination and its contribution to the processes of discussion that generate inputs for conscientious decision making. ; Hace unos meses se conmemoró el Bicentenario de la Independencia de Centroamérica y, tras su celebración, queda una estela de reflexiones sobre el derrotero por trazar para materializar la «Costa Rica que queremos», expresión que pululó en esos días y que se torna utópica cuando se advierte que los procesos efectivos de diálogo y concertación, en materia de consensos sociales para lograr acuerdos nacionales, en su mayoría han sido improductivos. No obstante, para trascender en el esfuerzo que tal frase señala, las discursividades de académicos sobre el devenir local, centroamericano y latinoamericano ...

La fotografía es un recurso documental importante en la interpretación de la realidad sociocultural; por esta razón, en este artículo se recurre a una parte del acervo del fotógrafo Amando Céspedes Marín para elucidar un planteamiento de identidad costarricense, creado dentro del marco de la conmemoración del primer centenario de la independencia de la República. Los Estudios Culturales conforman la plataforma teórica a partir de la cual se analizan 20 fotos (diez con temas urbanos y diez con temas rurales) elaboradas entre 1905 y 1923. Metodológicamente, las imágenes se escrutan mediante preguntas pertinentes a la narrativa; finalmente, se formula una reflexión en la cual se revela una identidad basada en lo enunciado y lo omitido, labor que involucra al experto en mención.

Los servicios sanitarios, lugares cotidianos e indispensables, son el escenario de una práctica homosexual, denominada cruising, que desafía la política heterosexual materializada en normas que regulan la edificación y legitiman, simultáneamente, la construcción binaria del género asociada a la genitalidad. Como resultado de un seminario doctoral, en el presente ensayo se muestran los resultados de una investigación que recoge las principales directrices nomotéticas costarricenses que tutelan el diseño y levantamiento de los baños. Asimismo, se acopian testimonios de hombres quienes, de cara a la praxis y retórica heteronormativa, se apropian de estos espacios para subvertir su connotación y, así, desmantelar su función como deponente del género.

The water closets, daily and indispensable places, are the scene of a homosexual practice called cruising that challenges the heterosexual policy materialized in rules that regulate the building and legitimize, simultaneously, the binary construction of the genre associated with genitality. As a result of a doctoral seminar, the present essay shows the results of an investigation that includes the main nomothetic Costa Rican guidelines that protect the design and construction of bathrooms. Likewise, testimonies of men are collected, and they, in order to face the heteronormative praxis and rhetoric, proceed to appropriate these spaces to subvert their connotation and, thus, dismantle their function as a deponent of the genre. ; Los servicios sanitarios, lugares cotidianos e indispensables, son el escenario de una práctica homosexual, denominadacruising, que desafía la política heterosexual materializada en normas que regulan la edificación y legitiman, simultáneamente, la construcción binaria del género asociada a la genitalidad. Como resultado de un seminario doctoral, en el presente ensayo se muestran los resultados de una investigación que recoge las principales directrices nomotéticas costarricenses que tutelan el diseño y levantamiento de los baños. Asimismo, se acopian testimonios de hombres quienes, de cara a la praxis y retórica heteronormativa, se apropian de estos espacios para subvertir su connotación y, así, desmantelar su función como deponente del género.

El crecimiento urbano en la Gran Área Metropolitana (GAM) de Costa Rica se incrementó, sustancialmente, en las últimas tres décadas, manifestándose claramente en su forma espacial. Sin embargo, esta permuta es la expresión de otra más profunda: una procedente del cambio en su forma social; por eso, para comprender e interpretar la transformación en este ámbito, es preponderante establecer una posición epistemológica. Así, partiendo del supuesto de la ciudad como una construcción social, en este escrito se exponen los criterios teóricos de algunos científicos cuyos aportes, desde una perspectiva crítica, permiten el análisis de la urbe como una red y una representación. El objetivo del acopio y la concatenación de tales abonos es formular un itinerario teórico con el cual elucidar en los poblados urbanos, los procesos velados que los transfiguran y que presentan una dualidad: son causados por la acción humana y su efecto recae en ella; dialéctica constante que amerita un abordaje cognitivo que considere la ciudad como un ente vivo, en tensión e inacabado

El presente artículo tiene como objetivo proponer acciones de mejora para generar desarrollo sostenible en las veredas Chicaque y Cascajal por medio de las actividades turísticas realizadas en el parque natural Chicaque, teniendo en cuenta que estas dos veredas se encuentran en el área de influencia del territorio delimitado por este parque. Es así como se analizan los diferentes factores en torno a tres problemáticas: el recurso hídrico, la lucha constante del territorio y la desarticulación con los grupos de interés. Para darle cumplimiento a los objetivos de la investigación, se parte de un análisis teórico-conceptual desde la teoría general de los sistemas, se realiza un diagnóstico de las actividades turísticas en el parque, se caracterizan sus grupos de interés y se determinan acciones de mejora en torno a delimitación del territorio, impactos ambientales, socioculturales y económicos.

La transparencia de realizar y ejecutar procesos dentro de la Administración Pública es una herramienta cuya aplicación, por parte de las instituciones públicas de El Salvador, sufre de carencia y notoriedad, los procesos de selección y contratación de servicio público que presentan las instituciones de este estudio gozan de un nivel de transparencia medio, bajo el cual se identifican las deficiencias que poseen dichas entidades públicas durante la ejecución de las actividades que conforman el proceso.Por otro lado, con base en el análisis de resultados obtenidos se destacan los esfuerzos que llevan a cabo las diferentes entidades para alcanzar un nivel de transparencia significativo, tomando en cuenta modelos de otros países como es el caso del Estado de Chile cuyo sistema de selección y contratación fue tomado como comparativo, cuenta con un orden sistemático de las fases en las cuales se divide un proceso de selección y contratación.

SIMPLE SUMMARY: Despite political efforts across the world and Europe, social inequalities in cancer incidence are persistent. We studied the association between socioeconomic status (SES) and cancer incidence in nine Spanish provinces. Lower SES was associated with an increased risk of lung cancer among males. Higher SES was associated with an increased risk of breast cancer among females in Spain. Understanding the reasons behind the association between cancer incidence and SES could help develop appropriate public health programs to promote health and reduce socioeconomic inequalities in cancer incidence in Spain. ABSTRACT: Socioeconomic inequalities in cancer incidence are not well documented in southern Europe. We aim to study the association between socioeconomic status (SES) and colorectal, lung, and breast cancer incidence in Spain. We conducted a multilevel study using data from Spanish population-based cancer registries, including incident cases diagnosed for the period 2010–2013 in nine Spanish provinces. We used Poisson mixed-effects models, including the census tract as a random intercept, to derive cancer incidence rate ratios by SES, adjusted for age and calendar year. Male adults with the lowest SES, compared to those with the highest SES, showed weak evidence of being at increased risk of lung cancer (risk ratio (RR): 1.18, 95% CI: 0.94–1.46) but showed moderate evidence of being at reduced risk of colorectal cancer (RR: 0.84, 95% CI: 0.74–0.97). Female adults with the lowest SES, compared to those with the highest SES, showed strong evidence of lower breast cancer incidence with 24% decreased risk (RR: 0.76, 95% CI: 0.68–0.85). Among females, we did not find evidence of an association between SES and lung or colorectal cancer. The associations found between SES and cancer incidence in Spain are consistent with those obtained in other European countries.

Diet may influence the development of inflammatory bowel disease through the modulation of inflammation. We investigated whether the inflammatory potential of the diet is associated with the risk of Crohn's disease (CD) and ulcerative colitis (UC) in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The study included 32,633 participants aged 29–69 years. The inflammatory potential of the diet was measured by using an inflammatory score of the diet (ISD) based on a baseline dietary history questionnaire. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 21 years (674,547 person-years) of follow-up, 32 and 57 participants developed CD and UC, respectively. In multivariable analysis, a one-standard deviation (SD) increment in the ISD (two-unit increase) was associated with a higher risk of CD (HR of 1.71; 95% CI: 1.05–2.80; p = 0.031). By contrast, ISD was not associated with UC (HR for one-SD increment of 0.89; 95% CI: 0.66–1.19; p = 0.436). Our results suggest that consuming a more pro-inflammatory diet may contribute to the risk of CD, supporting that a healthy diet might be beneficial in its prevention. Further, larger studies are needed to verify these findings. ; Instituto de Salud Carlos III (PIE14/00045) ; Crohn's and Colitis UK (M2017-2) ; e Intra-CIBERESP mobility program (ESPF60/2017) ; International Agency for Research on Cancer (IARC) ; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London ; NIHR Imperial Biomedical Research Centre (BRC) ; Health Research Fund (FIS)-Instituto de Salud Carlos III (ISCIII) ; e Regional Governments of Andalusia, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology-ICO (Spain)

The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as "high intakes" those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5–25 kg/m2) a high intake of carbohydrates (≥809 Kcal/day), specifically monosaccharides (≥468 Kcal/day), worsened prognostic compared to lowest (≤352 Kcal/day). Haz-ard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95%CI (1.04 to 4.72) and HR:2.59 95%CI (1.04 to 6.48), respectively (p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (≥135Kcal/day) improved global survival (HR: 0.39 95%CI (0.15 to 1.02) p-trend = 0.05) compared to the lowest (≤92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (≥811Kcal/day) showed a protective effect (HR:0.20 95%CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (≥238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of dif-ferent nutrients ; This research was funded by the 'Acción Transversal del Cancer', approved by the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III, co-founded by FEDER funds –'a way to build Europe' (grants PI08/1770, PI08/0533, PI08/1359, PI09/00773, PI09/01286, PI09/01903, PI09/02078, PI09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150, PI14/01219, PI14/00613, and PI15/00069). Support was also provided by the Fundación Marqués de Valdecilla (grant API 10/09); the Junta de Castilla y León (grant LE22A10-2); the Consejería de Salud of the Junta de Andalucía (2009-S0143); the Conselleria de Sanitat of the Generalitat Valenciana (grant AP 061/10); the Recercaixa (grant 2010ACUP 00310); the Regional Government of the Basque Country; the Consejería de Sanidad de la Región de Murcia; European Commission grants FOOD-CT-2006-036224-HIWATE;the Spanish Association Against Cancer (AECC) Scientific Foundation; the Catalan Government DURSI (grant 2014SGR647); the Fundación Caja de Ahorros de Asturias; the University of Oviedo and COST action BM1206 Eucolongene

BACKGROUND: The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology. METHODS: MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns-derived in another Spanish case-control study-with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models. RESULTS: A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratiofourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratiosecond_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratiofourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors. CONCLUSION: Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma. ; The study was supported by the "Acción Transversal del Cáncer," approved by the Spanish Ministry Council on 11 October 2007, by the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), by the Instituto de Salud Carlos III grants, co-funded by FEDER funds: a way to build Europe-PI08/1770 (to M. Kogevinas), PI09/0773 (to J. Llorca), PI09/1286 (to V. Martín), PI09/1903 (to R. Peiró), PI09/2078 (to F.J. Caballero), PI09/1662 (to J.J. Jiménez-Moleón), PI11/01403 (to N. Aragonés), and PI12/00150 (to B. Pérez-Gómez), by the Fundación Marqués de Valdecilla grant API 10/09 (to J. Llorca), by Catalan Government DURSI grant 2014SGR647 (to V. Moreno) and 2014SGR756 (to S. de Sanjose), by the Junta de Castilla y León Grant LE22A10-2 (to V. Martín), by the Consejería de Salud of the Junta de Andalucía Grant 2009-S0143 (to J. Alguacil), by the Conselleria de Sanitat of the Generalitat Valenciana grant AP061/10 (to R. Peiró), by the Regional Government of the Basque Country, by the Consejería de Sanidad de la Región de Murcia, by the Fundación Caja de Ahorros de Asturias, by the University of Oviedo, by the Spanish Association Against Cancer (AECC) Scientific Foundation, and by the Spanish Ministry of Economy and Competitiveness Juan de la Cierva de Incorporación Grant IJCI-2014-20900 (to A. Castelló). None of the sponsors intervened in any stage of the research. ; Sí

Samples: Biological samples were stored at the biobanks supported by Instituto de Salud Carlos III- FEDER: Parc de Salut MAR Biobank (MARBiobanc) (RD09/0076/00036), "Biobanco La Fe" (RD 09 0076/00021) and FISABIO Biobank (RD09 0076/00058), and also at the Public Health Laboratory from Gipuzkoa, the Basque Biobank, the ICOBIOBANC (sponsored by the Catalan Institute of Oncology), the IUOPA Biobank from the University of Oviedo and the ISCIII Biobank. Genotyping: SNP genotyping services were provided by the Spanish "Centro Nacional de Genotipado" (CEGEN-ISCIII)". ; Background: Reproductive factors are well known risk factors for breast cancer; however, little is known about how genetic variants in hormonal pathways interact with that relationship. Methods: One thousand one hundred thirty nine cases of breast cancer in women and 1322 frequency-matched controls were compared. Genetic variants in hormonal pathways (identified in the Kyoto Encyclopedia of Genes and Genomes) were screened according to their relationship with breast cancer using the Cochran-Armitage statistic. Information on reproductive factors was obtained using a face-to-face questionnaire. The interaction among the selected genetic variants and reproductive factors was tested with logistic regression. Results: Concerning C allele in rs2229712, compared to nulliparity in non-carriers the ORs for 1–2 and > 2 deliveries were 0.48 (0.28–0.81) and 0.34 (0.19–0.59), and in C carriers they were 0.92 (0.42–1.98) and 0.71 (0.31–1.61). Similar results were found in women carrying the C allele in rs1269851. Carriers of Allele T in rs35652107 and allele C in rs6018027 had the delivery number effect more pronounced. Conclusions: The number of deliveries had a dose-response protective effect on breast cancer; women carrying C allele in rs2229712 did not benefit from this protective effect. ; This work was partially funded by the "Accion Transversal del Cancer", approved by the Spanish Ministry Council on the 11th October 2007; The Instituto de Salud Carlos III-FEDER [PI08/1770, PI08/0533, PI08/1359, PI09/ 00773-Cantabria, PI09/01286-León, PI09/01903-Valencia, PI09/02078-Huelva, PI09/01662-Granada, PI11/01403, PI11/01889-FEDER, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150, PI14/01219, PI14/0613, PI15/00069, PI15/00914, PI15/01032]; The Fundación Marqués de Valdecilla [API 10/09]; The ICGC International Cancer Genome Consortium CLL (The ICGC CLL-Genome Project is funded by Spanish Ministerio de Economía y Competitividad (MINECO) through the Instituto de Salud Carlos III (ISCIII) and Red Temática de Investigación del Cáncer (RTICC) del ISCIII (RD12/0036/0036)); The Junta de Castilla y León [LE22A10–2]; The Consejería de Salud of the Junta de Andalucía [2009-S0143]; The Conselleria de Sanitat of the Generalitat Valenciana [AP_061/10]; The Recercaixa [2010ACUP 00310]; The Regional Government of the Basque Country; The Consejería de Sanidad de la Región de Murcia; The European Commission [grants FOOD-CT-2006-036224-HIWATE]; The Spanish Association Against Cancer (AECC) Scientific Foundation; The Catalan Government DURSI [grant 2014SGR647]; The Fundación Caja de Ahorros de Asturias; and the University of Oviedo.

ABSTRACT: Purpose: The objective of this study is to analyse the relative survival with breast cancer in women diagnosed after new treatments were generalised and to ascertain the current effect that tumour characteristics such as grade, stage or subtype have on survival as well as the new AJCC-pathological prognostic score. Methods: The breast cancer MCC-Spain follow-up study is a prospective cohort study of 1685 incident breast cancer cases. Women between 20 and 85 years old were recruited between the years 2008 and 2013 in 18 hospitals located in 10 Spanish provinces and they have been followed until 2017/2018. Relative survival was estimated after 3, 5 and 8 years of follow-up using Ederer II method. In addition, Weibull regression adjusted by age, hospital, grade and stage was used to investigate prognosis factors. Results: Among components of TNM staging system, tumour size greater than 50 mm (i.e. T3 or T4) more than doubled the risk of dying, while N3 nodal involvement and presence of metastasis had a huge effect on mortality. The AJCC pathological prognostic score strongly correlated with survival; thus, hazard ratios increased as the score rose, being 2.31, 4.00, 4.94, 7.92, 2.26, 14.9 and 58.9 for scores IB, IIA, IIB, IIIA, IIIB, IIIC and IV, respectively. Conclusion: Both TNM staging and histological/molecular biomarkers are associated with overall survival in Spanish women with breast cancer; when both are combined in the AJCC pathological prognosis score, the prognostic value improved with risk indices that increased rapidly as the pathological prognosis score increased. ; Funding Biological samples were stored at the biobanks supported by Instituto de Salud Carlos III- FEDER: Parc de Salut MAR Biobank (MARBiobanc) (RD09/0076/00036), 'Biobanco La Fe' (RD 09 0076/00021) and FISABIO Biobank (RD09 0076/00058), as well as at the Public Health Laboratory of Gipuzkoa, the Basque Biobank, the ICOBIOBANC (sponsored by the Catalan Institute of Oncology), the IUOPA Biobank of the University of Oviedo and the ISCIII Biobank. SNP genotyping services were provided by the Spanish 'Centro Nacional de Genotipado' (CEGEN-ISCIII). We thank all the subjects who participated in the study and all MCC-Spain collaborators. This work was supported by the 'Acción Transversal del Cancer', approved by the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III, co-founded by FEDER funds – 'a way to build Europe' (grants PI08/1770, PI08/0533, PI08/1359, PI09/00773, PI09/01286, PI09/01903, PI09/02078, PI09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150, PI14/01219, PI14/00613 and PI15/00069). Support was also provided by the Fundación Marqués de Valdecilla (grant API 10/09); the Junta de Castilla y León (grant LE22A10-2); the Consejería de Salud of the Junta de Andalucía (2009-S0143); the Conselleria de Sanitat of the Generalitat Valenciana (grant AP 061/10); the Recercaixa (grant 2010ACUP 00310); the Regional Government of the Basque Country; the Consejería de Sanidad de la Región de Murcia; European Commission grants FOOD-CT-2006–036224-HIWATE; the Spanish Association Against Cancer (AECC) Scientifc Foundation; the Catalan Government DURSI (grant 2014SGR647); the Fundación Caja de Ahorros de Asturias; the University of Oviedo; Societat Catalana de Digestologia; and COST action BM1206 Eucolongene.