Modelo de valoración financiera por suma de partes para empresas de capital abierto en Costa Rica

Proyecto de graduación (Licenciatura en Administración de Empresas. Enfasis en Finanzas) Instituto Tecnológico de Costa Rica, Escuela de Administración de Empresas, 2015En el medio nacional actual no se dispone de un instrumento que le permita a las empresas realizar valoración financiera mediante el uso de información de compañías comparables. Con el fin de satisfacer este vacío, se procede a diseñar un Modelo de Valoración Financiera por suma de partes que permita conocer el valor actual y futuro de la acción de una empresa de capital abierto. Para ello, se analiza el caso de Florida Ice and Farm Company, empresa objetivo del presente Estudio, cuya información financiera permita la aplicación y análisis del Modelo diseñado. Asimismo, se realiza la selección de compañías comparables para cada una de las unidades de negocio que posee la empresa objetivo, con el fin de elegir a los referentes comerciales óptimos que posibiliten la ejecución de un análisis de naturaleza comparativa y que den a conocer la posición financiera de la compañía en correspondencia a otras del sector. Finalmente se plantea una propuesta a futuro, mediante la cual se pretende llevar a cabo la colocación y divulgación de la herramienta diseñada y asegurar su disponibilidad para el público nacional. El presente Estudio busca servir de aporte al medio empresarial nacional, a través del diseño de un Modelo de valoración financiera por suma de partes para empresas de capital abierto en Costa Rica.Instituto Tecnológico de Costa Rica. Escuela de Administración de Empresa

Program Development and Implementation for South Carolina Youth through Expanded Food and Nutrition Education Program (EFNEP)

The Expanded Food Nutrition and Education Program (EFNEP) is a federally-funded program that aims at informing and educating limited-resource children, youth, and families in developing and maintaining a nutritionally sound diet, and a physically active lifestyle. Many of the intervention programs implemented through Youth EFNEP are created to be part of an existing school curriculum or as an after-school program. Currently, few programs exist that allow for easy transferability of these already existing curriculums to a summer camp setting.Therefore, the purpose of our Creative Inquiry was to develop the students\u27 abilities to design and implement a Nutrition Education program for youth audiences in a community setting. Students\u27 responsibilities comprised the analysis of lesson structure for grades K-12, development of lesson materials, implementation of the nutrition education lessons with youth audiences from surrounding community areas, and the application of Youth EFNEP evaluation tools.The 8-lesson curriculum is being pilot-tested during the fall of 2014 and spring of 2015 at Littlejohn Community Center in Clemson. The students have taken a leading role in the implementation of the nutrition education activities at the center, acquired the skills to work with low income audiences and have been actively providing the necessary feedback to improve the quality and content of the curriculum, so that one day it becomes a tool that can be used nationwide in summer camps by Youth EFNEP educators

Importance of the Quality Control of Herbal Teas: Evaluation of Two Senna Leaf Tisanes Brands Commercialized in Costa Rica through Physicochemical and Microbiological Assays Stipulated in the Central American Technical Regulation 11.03.56.09

The senna leaf contains a powerful natural laxative called anthraquinone. Despite this indication, the quality control of this raw material is not strict, compared to other substances with pharmacological properties, which is unacceptable. Therefore, the present investigation sought to evaluate physicochemical and microbiological quality aspects of the senna leaf tisanes from two brands commercialized in Costa Rica, through various assays established in the current Central American Technical Regulation (RTCA) 11.03.56.09. The aforementioned was made in order to identify and compare whether these aspects are constant or not for the different batches of the same product for each of the brands. For that reason, the following assays were done for three batches of two different brands: Labeling, minimum fill, organoleptic, foreign organic matter, identification, loss on drying, total ash, acid-insoluble ash, microbial enumerations and determination of specific microorganisms. The results show that the batches of both brands are in compliance for all the assays, except for the labeling assay (six of the 23 items required for primary and secondary packaging labeling were not found). For all of the above, the raw material commercialized in Costa Rica meet the quality standards according with the requirements of the RTCA. Also, there is reproducibility for the characteristics of the senna leaf between the different batches in each one of the two commercialized brands. This is an indication that the raw material used maintains the quality characteristics required to favor its efficiency and safety.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones Farmacéuticas (INIFAR

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Genome-Based Characterization of Listeria monocytogenes, Costa Rica

International audienceGenomic data on the foodborne pathogen Listeria monocytogenes from Central America are scarce. Here, we analysed 92 isolates collected in Costa Rica over a decade from different regions, compared them to publicly available genomes and identified unrecognized outbreaks. This study calls for mandatory reporting of listeriosis to improve pathogen surveillance

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research