Marianela Rojas-Garbanzo

Background: Cases for chronic kidney disease of unknown etiology (CKDu) are increasing in specific disease hotspots located in rural agricultural communities over Central America. The goal of the study was to estimate the prevalence and geographic distribution of self-reported work-related CKD and associated risk factors for CKDu by industry sector in Central America. Methods: We calculated the prevalence and distribution of self-reported CKD, work-related CKD, and suspected CKDu risk factors among the 9032 workers in the Second Central American Survey of Working Conditions and Health (II ECCTS, 2018). We mapped the distribution of suspected CKDu risk factors to work-related CKDu and weather conditions using average annual temperatures. Results: The primary and secondary industry sectors showed the highest proportion of males, suspected CKDu risk factors, and work-related CKD. Age (30–49 years: OR = 2.38, 95% CI 1.03–5.51), ethnicity (mestizo: OR, 7.44, 95% CI: 2.14–25.82), and exposure to high physical work demands (OR = 2.45, 95% CI: 1.18–5.09) were associated with work-related CKD. The majority of work-related CKD were reported in the western parts of Honduras and Nicaragua, in hot temperature regions, and overlapped with those areas with a high density of CKDu risk factors. Finally, some areas clustered CKDu risk factors without any work-related CKD points, mainly in the western part of Guatemala. Conclusion: Our findings supplement prior CKDu findings regarding a high prevalence of work-related CKD among 30- to 49-year-old mestizo males in the primary and secondary sectors, in hot temperature areas, in the central and western region, and overlapping with persons reporting two or more CKDu risk factors. Moreover, several geographic areas with CKDu risk factor clusters had no reported work-related CKD. These areas represent new industries and sectors to be monitored for possible future increases of CKDu cases.

Objective: Identify the psychometric properties of a measure of Employment Precariousness (EP) in six Central American Spanish-speaking countries (Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama) through the items of the EPRES scale (Employment Precariousness Scale) included in the II Central American Survey of Working Conditions and Health (II ECCTS) of 2018. Methods: The sample was 3,782 salaried persons, aged 18 and older, formal and informal, who participated in the II ECCTS. An EP measure of 10 items was constructed, grouped in the dimensions of temporality, salary, labor rights, and exercise of these rights. Results: The sample was composed mostly of men, with a permanent contract, with a working age of between 2 to 5 years, a salary between $301 and $500s, who have labor rights and who exercise them. The factorial structure could not be verified. However, nine of the ten articles showed a high factorial load with their dimensions. A high acceptability of the EP measure was observed, and the Cronbach's Alpha coefficients of the dimensions were between 0.59 and 0.72, except for temporality (0.30). The reliability of the total scale was 0.68 and the EP patterns in women, youth, temporary and lower income countries were as expected. Conclusions: The EP measure constructed from the items available from the EPRES scale in the II ECCTS questionnaire shows acceptable psychometric properties to approximate the epidemiological quantification of job insecurity in Central America. Objetivo: Establecer las propiedades psicométricas de una medida de Precariedad Laboral (PL) en seis países centroamericanos de habla española (Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua y Panamá) mediante un conjunto de ítems incluidos en la II Encuesta Centroamericana de Condiciones de Trabajo y Salud (II ECCTS) de 2018 que se correspondían con ítems de la Escala de Precariedad Laboral (EPRES). Método: A partir de una muestra de 3.782 personas asalariadas de 18 años o más, formales e informales, en la II ECCTS, se construyó una medida de PL de 10 ítems representando cuatro dimensiones: temporalidad, salario, derechos y ejercicio de derechos. Resultados: La muestra estuvo compuesta en su mayoría por hombres, con contrato permanente, con antigüedad laboral de entre 2 a 5 años, un salario entre 301 a 500 dólares, que reportaban tener derechos laborales y ejercerlos. La estructura factorial no pudo ser comprobada. Sin embargo, nueve de los diez ítems arrojaron alta carga factorial en sus dimensiones correspondientes. Se observó una alta aceptabilidad de medida de PL y los coeficientes de Alpha de Cronbach de las cuatro dimensiones fueron >0,59 excepto para temporalidad (0,30). La confiabilidad de la escala fue de 0,68 y los patrones de PL en mujeres, jóvenes, temporales y países con menores ingresos fueron los esperados. Conclusiones: La medida de PL construida a partir de ítems disponibles de la escala EPRES en el cuestionario de la II ECCTS evidencia propiedades psicométricas aceptables para aproximarnos a la cuantificación epidemiológica de la precariedad laboral en Centroamérica.

Este estudio cumple como propósito obtener la percepción del estudiantado de grado y posgrado de las carreras en ciencias del movimiento humano, acerca de la enseñanza, aprendizaje y la evaluación durante la pandemia COVID-19 relacionada con el virus SARS-CoV-2. En este estudio participan de manera voluntaria un total de 23 estudiantes (12 grado y 11 estudiantes de posgrado) con edades entre los 19 años y los 45 años. Con el fin de obtener el consentimiento informado de participación, se contacta al estudiantado por diferentes medios virtuales como redes sociales. Una vez se obtuvo la muestra a participar en la investigación, se procede enviar por correo electrónico el debido consentimiento y la entrevista semi estructurada para que sean completadas por las personas participantes. Esta entrevista fue diseñada por el investigador principal y analizada por criterio de expertos en pedagogía. Una vez que se obtuvo las respuestas se procede a sistematizarlas utilizando conglomerados según similitud temática para su análisis. Los resultados muestran que los estudiantes perciben un aprendizaje más significativo cuando están presentes en el aula. Adicionalmente, rescatan que la presencialidad remota facilita un mayor aprovechamiento del tiempo y recurso y rescatan su pertinencia en cursos con un alto componente teórico. Además, consideran que las evaluaciones deben enfocarse en la asignación de prácticas investigativas y no en la realización pruebas memorísticas. Con base en los resultados, se concluye que ante la eventualidad de la pandemia COVID-19, el estudiantado considera que la metodología de presencialidad remota puede ser una opción potencial para el desarrollo de componente teórico y utilizar las horas contacto presencial para el desarrollo de prácticas que le permitan vivenciar y poner en práctica su aprendizaje.

The aim of this study was to evaluate heat exposure, dehydration, and kidney function in rice workers over the course of three months, in Guanacaste, Costa Rica. We collected biological and questionnaire data across a three-month-period in male field (n = 27) and other (n = 45) workers from a rice company where chronic kidney disease of unknown origin (CKDu) is endemic. We used stepwise forward regression to determine variables associated with estimated glomerular filtration rate eGFR at enrollment and/or change in eGFR, and Poisson regression to assess associations with incident kidney injury (IKI) over the course of three months. Participants were 20–62 years old (median = 40 in both groups). Dehydration was common (≥37%) in both groups, particularly among other workers at enrollment, but field workers were more exposed to heat and had higher workloads. Low eGFR (2) was more prevalent in field workers at enrollment (19% vs. 4%) and follow-up (26% vs. 7%). Field workers experienced incident kidney injury (IKI) more frequently than other workers: 26% versus 2%, respectively. Age (β = −0.71, 95%CI: −1.1, −0.4), current position as a field worker (β = −2.75, 95%CI: −6.49, 0.99) and past work in construction (β = 3.8, 95%CI: −0.1, 7.6) were included in the multivariate regression model to explain eGFR at enrollment. The multivariate regression model for decreased in eGFR over three month included current field worker (β = −3.9, 95%CI: −8.2, 0.4), current smoking (β= −6.2, 95%CI: −13.7–1.3), dehydration (USG ≥ 1.025) at both visits (β= −3.19, 95%CI: −7.6, 1.2) and pain medication at follow-up (β= −3.2, 95%CI: −8.2, 1.95). Current fieldwork [IR (incidence rate) = 2.2, 95%CI 1.1, 5.8) and being diabetic (IR = 1.8, 95%CI 0.9, 3.6) were associated with IKI. Low eGFR was common in field workers from a rice company in Guanacaste, and being a field worker was a risk factor for IKI, consistent with the hypothesis that occupational heat exposure is a critical risk factor for CKDu in Mesoamerica.

Costa Rica has intensified vegetable production by implementing monocultures managed with technological packages (synthetic fertilizers and pesticides). This model has sustained production in Zarcero, a municipality that supplies fresh vegetables to Costa Rica’s capital and surroundings. However, investigations developed by the Regional Institute for Studies on Toxic Substances (IRET) have revealed concerning information on pesticide use regime in the area and associated adverse effects on the environment and health of inhabitants. In response to this problem, IRET, the School of Agricultural Sciences, and the Division of Rural Education launched a project in 2018. The project’s primary aim was “to promote an alternative model for agricultural production through collaborative work, social sharing and construction of knowledge, in order to reduce the use of agrochemicals in Zarcero, Alajuela.” The project included activities developed by academic groups, farmers and their families, and school children. The academic groups worked to carry out the following activities: a) a theoretical-political framework of common reference; b) an interdisciplinary perspective to design work strategies based on analysis to transform actual situations; and c) good collaborative relationships, and from there to pool goals. Achieving these activities needed executing other ones: a) study circles; b) fieldwork; c) knowledge exchange processes at the national and international level; d) the production of educational written materials for farmers; and e) articulation of the previous activities with teaching, research, and production activities. In addition, agroecology has been positioned in the institutional, local, regional, and national political agendas and in some international territories. From the academic work produced in the project, we have learned to be and do “Necessary University” since public universities need to legitimize themselves in the country. Therefore, we proposed to regain the trust of farmers and their families by creating spaces for rapprochement to contextualize and reflect on agricultural problems jointly, revitalize local knowledge, obtain inputs for the writing of educational documents with a socio-critical approach from popular education. As a result, it has been possible to “sow” the idea of change in some farmers; spaces for exchange between local farmers and farmers from other municipalities have been created. Small children are a driving force for change in homes; so, we have actively worked with them guided by critical pedagogy and carrying out collaborative school-family-community work. Moreover, it has been possible to politicize the national events, re-signifying the farmer’s knowledge and diversifying the learning scenarios. In conclusion, we consider that academic work linked to real situations enables improvement processes in the productive agricultural life of the communities and enriches teaching, research, extension, and writing in the public university. All these activities stimulate the social sharing of knowledge that links local knowledge to the academic one generated in universities, promotes unlearning of the traditional manner of “building university,” and contributes to reflection anchored to the biocentric approach. The present work provides ideas for the construction of a university extension policy. It contributes to developing a work process to understand better the link that university life should have with the daily needs of communities and the processes of improving farming-socio-community life.

Examine the prevalence of musculoskeletal pain (MSP) in the six Spanish-speaking countries of Central America using a single standardized instrument, the First Survey on Working Conditions and Health in Central America in workers from all manual and non-manual labor sectors, using social security coverage as an indicator of formal versus informal employment. The workers (n = 12 024) were surveyed in their homes. The age-adjusted prevalence of MSP during the previous month was calculated for pain in the back (upper, or cervical; middle, or thoracic; and lower, or lumbar) and arm joints (shoulder, elbow, and wrist). Prevalence was estimated by sex, occupation (manual or non-manual), economic sector (agriculture, industry, or services), and social security coverage. Poisson regression models were used to calculate the prevalence rates and 95% confidence intervals, with stratification by country and anatomical site. By sites, the age-adjusted prevalence of cervical-dorsal MSP was the highest, especially in El Salvador (47.8%) and Nicaragua (45.9%), and lumbar MSP was less prevalent, especially in Panama (12.8%) and Guatemala (14.8%). After additional adjustments, the prevalence of MSP was higher in women and manual workers for all the sites and in all the countries. There were no differences in MSP in terms of social security coverage or sector of economic activity. The high prevalence of MSP in Central America, regardless of sector of activity or social security coverage, indicates that the prevention of MSP should be a priority in occupational health programs in low- and middle-income countries, especially for women and manual workers.