Incidencia del alto porcentaje de agua no contabilizada en la rentabilidad financiera de la empresa Prestadora de Servicios de Saneamiento Lambayeque S.A. - 2009

El sector hídrico a nivel nacional atraviesa por una grave crisis que dificulta el desarrollo económico. El marco institucional del sector de agua potable y saneamiento ha sufrido de muchos cambios sucesivos durante las últimas décadas, con ciclos de centralización y de descentralización, sin lograr una mejora calidad de servicios. Los problemas más graves se encuentran en el ámbito legal e institucional, adicionalmente, la EMPRESA PRESTADORA DE SERVICIOS DE SANEAMIENTO LAMBAYEQUE S.A. cuenta con ciertas limitaciones para invertir en el mantenimiento y renovación de redes. La capacidad pública para regular y hacer cumplir las normas es muy débil, y los recursos captados y asignados a los temas de gestión del agua son muy pocos. Objetivo general: determinar la incidencia del alto porcentaje de agua no contabilizada que afecta la rentabilidad de la empresa prestadora de servicios de saneamiento Lambayeque S.A. Técnicas que emplearemos son la encuesta y el análisis documental.Tesi

Knowledge of HIV transmission and condom use among HIV-positive heterosexual men and women in Guatemala

<p>Abstract</p> <p>Background</p> <p>The prevalence of HIV/AIDS in Guatemala among the general population is 0.79%, and 94% of transmission is directly related to sexual contact. Studies have been conducted on high- prevalence HIV-positive populations (men who have sex with men, commercial sex workers and prisoners). Heterosexual transmission has gained importance in the epidemic in Central America. To our knowledge, no study addressing knowledge of mechanisms of HIV transmission and condom use has been done on HIV-positive heterosexual men and women.</p> <p>Methods</p> <p>A closed-ended structured interview that addressed knowledge of mechanisms of HIV transmission and condom use was conducted on 283 heterosexual HIV-positive men (54.8%) and women (45.2%) outpatients who attend the Roosevelt Hospital's Clinic of Infectious Diseases in Guatemala City. Differences between selected characteristics were examined for significance using the Chi-square test. A multiple logistic regression was done to determine socio-demographic variables associated with inconsistent condom use.</p> <p>Results</p> <p>Of the interviewed persons, 68.5% were either living with a partner or married, and 94.3% were currently using antiretroviral therapy. Most respondents knew the mechanisms of transmission of HIV. 81.7% and 87.3% reported always using a condom with their regular and casual sexual partner in the past year, respectively. There was no statistically difference in condom use according to the patient's formal education, gender, type of partner (regular or casual)or number of sexual partners. According to the interviewees, 72% of sexual partners in the past year were either HIV negative or of an unknown serostatus. Potentially, these HIV-negative persons are at risk of contracting the virus. Among the main reasons given for not using a condom were: "my partner did not want to use a condom"; and "the condom irritates or makes my partner uncomfortable".</p> <p>Conclusions</p> <p>Since no socio-demographic or sexual behavior variable was associated with inconsistent condom use, we recommend intensive and regular condom counselling for every heterosexual HIV-positive outpatient who attends the clinic. Further studies should be done to determine condom use negotiation between partners; and to determine social, interpersonal and psychological factors that might affect the decision to use a condom or not.</p

Percepción de discriminación en inmigrantes comparados a nacidos en Chile y su relación con acceso a servicios y resultados de salud

OBJECTIVES: Compare self-perceived discrimination between immigrants and locals in Chile and analyze the relationship between immigration and perceived discrimination and immigration, discrimination and health outcomes, adjusting for sociodemographic characteristics and social capital. METHODS: Cross-sectional study, using population-based survey (CASEN2017). We selected 2,409 immigrants (representative of N = 291,270) and 67,857 locals (representative of N = 5,438,036) over 18 years of age surveyed. We estimated logistic regression models, considering the complex sample, with discrimination, self-assessed health, medical treatment, healthcare system membership, complementary health insurance, medical consultation and problems when consulting as dependent variables, immigration and discrimination as main exposure variables, and social capital and sociodemographic variables as covariates of the models. RESULTS: Immigrants were more likely to perceive discrimination in general compared to locals (OR = 2.31; 95%CI: 1.9-2.9). However, this does not occur for all specific reasons for discrimination; skin color and physical appearance were the most frequent causes of discrimination in immigrants. The interaction between immigration and discrimination was significantly related to worse self-assessed health outcomes and treatment for pathologies, disfavoring discrimination against immigrants. In both locals and immigrants, discrimination was not associated with health care access outcomes, except for problems during consultation in locals (OR = 1.61; 95%CI 1.4-1.8). CONCLUSIONS: In Chile, experiences of discrimination are intertwined with other forms of rejection and social exclusion, so it is urgent to raise awareness among the population to prevent these discriminatory practices, especially in health care and daily use places. It is essential to address discrimination in order to have an impact on intermediate variables and health outcomes. The extension of the results to the entire immigrant population could be very useful to deepen the problem and improve the estimates made.OBJETIVOS: Comparar la autopercepción de discriminación entre inmigrantes y locales en Chile y analizar la relación entre inmigración y discriminación percibida e inmigración, discriminación y resultados de salud, ajustando por características sociodemográficas y capital social. MÉTODOS: Estudio transversal, utilizando encuesta poblacional (CASEN2017). Se seleccionaron 2.409 inmigrantes (representativos de N = 291.270) y 67.857 locales (representativos de N = 5.438.036) mayores de 18 años encuestados. Se estimaron modelos de regresión logística, considerando la muestra compleja, con discriminación, salud autoevaluada, tratamiento médico, pertenencia al sistema de salud, seguros complementarios de salud, consulta médica y problemas al consultar como variables dependientes, inmigración y discriminación como variables de exposición principal, y capital social y variables sociodemográficas como covariables de los modelos. RESULTADOS: Inmigrantes tuvieron mayor posibilidad de percibir discriminación en general comparado con locales (OR = 2,31; IC95%:1,9–2,9). Sin embargo, esto no ocurre para todos los motivos específicos de discriminación; color de piel y apariencia física fueron las causas de discriminación más frecuentes en inmigrantes. La interacción entre inmigración y discriminación se relacionó significativamente con peores resultados de salud autoevaluada y tratamiento por patologías, en desfavor de los inmigrantes discriminados. Tanto en locales como en inmigrantes la discriminación no se asoció con resultados de acceso a atención en salud, excepto problemas durante la consulta en locales (OR = 1,61; IC95% 1,4–1,8). CONCLUSIONES: En Chile, las experiencias de discriminación se entrelazan con otras formas de rechazo y exclusión social, por lo cual es urgente concientizar a la población para prevenir estas prácticas discriminatorias, sobre todo en la atención en salud y lugares de uso cotidiano. Abordar la discriminación es indispensable para lograr impactar en variables intermedias y resultados de salud. La extensión de los resultados a toda la población inmigrante podría ser de amplia utilidad para profundizar la problemática y mejorar las estimaciones realizadas

El conciliador como tercero en la relación contractual : La innovación social en la práctica restaurativa de solución de conflictos

El comportamiento entre las partes, basada en su razón jurídica, impone límites al desequilibrio contractual, que en principio se hace previsible en determinadas circunstancias perceptibles, a partir de una comunicación clara influenciada por valores como herramienta para solucionar conflictos con la participación de un tercero, sobre la base de la conciliación entre las partes, centrada en sus necesidades mediante un proceso colaborativo, innovador, y amistoso, con técnicas asertivas, que constituye una nueva forma de entender la defensa jurídica y la justicia, bajo un código deontológico.The behavior between the parties, based on their legal reason, imposes limits to the contractual imbalance, which in principle is made foreseeable in certain perceivable circumstances, based on a clear communication influenced by values as a tool to resolve conflicts with the participation of a third party, on the basis of reconciliation between the parties, focused on their needs through a collaborative, innovative, and friendly process, with assertive techniques, which constitutes a new way of understanding legal defense and justice, under a code of ethics.Facultad de Ciencias Jurídicas y Sociale

A autonomia da vontade como princípio anterior à autoconfiguração das cláusulas do contrato

La autoconfiguración de las cláusulas del contrato sobreviene en obligaciones entre las partes y, de conformidad con la autonomía de la voluntad, responden al interés general, como principio previo al ordenamiento jurídico. La sistematización de su fundamento jurídico permite -mediante un análisis lógico- la concreción de conocimientos sobre la estructura teórica del contrato como instrumento jurídico regulador de la economía. Dicho análisis se basa en la buena fe que irrumpe como un principio general del Derecho, que construye actuaciones condicionadas y derivan consecuencias jurídicas a interpretarse de la forma que más favorezca su aplicación. Esa interpretación es la vía para alcanzar la progresividad de los derechos del individuo en la sociedad a partir del desarrollo de las políticas públicas.The autoconfiguration of the clauses of the contract ensues in obligations between the parties and in accordance with the autonomy of the will respond to the general interest, as a prior principle to the legal system, the systematization of its legal basis allows through a logical analysis the concretion of knowledge about the theoretical structure of the contract as a regulatory legal instrument of the economy, based on good faith that breaks down as a general principle of law, which constructs conditioned actions and derives legal consequences to be interpreted in the way that favors its application, as a way to achieve the progressiveness of the rights of the individual in society based on the development of public policies.Facultad de Ciencias Jurídicas y Sociale

O conciliador como terceiro na relação contratual: inovação social na prática de resolução de conflitos restaurativos

El comportamiento entre las partes, basada en su razón jurídica, impone límites al desequilibrio contractual, que en principio se hace previsible en determinadas circunstancias perceptibles, a partir de una comunicación clara&nbsp; influenciada por valores como herramienta para solucionar conflictos con la participación de un tercero, sobre la base de la&nbsp; conciliación entre las partes, centrada en sus necesidades&nbsp; mediante un proceso colaborativo, innovador, y amistoso, con técnicas asertivas, que constituye una nueva forma de entender la defensa jurídica y la justicia, bajo&nbsp; un&nbsp; código deontológico.The behavior between the parties, based on their legal reason, imposes limits to the contractual imbalance, which in principle is made foreseeable in certain perceivable circumstances, based on a clear communication influenced by values as a tool to resolve conflicts with the participation of a third party, on the basis of reconciliation between the parties, focused on their needs through a collaborative, innovative, and friendly process, with assertive techniques, which constitutes a new way of understanding legal defense and justice, under a code of ethicsLe comportement entre les parties, sur la base de leur raison juridique, impose des limites au déséquilibre contractuel, qui est en principe rendu prévisible dans certaines circonstances perceptibles, sur la base d'une communication claire influencée par les valeurs comme outil pour résoudre les conflits avec la participation d'un tiers, sur la base de la réconciliation entre les parties, centrée sur leurs besoins à travers un processus collaboratif, innovant et convivial, avec des techniques d'affirmation, qui constitue une nouvelle façon d'appréhender la défense juridique et la justice, selon un code d'éthiqueO comportamento entre as partes, com base em sua razão legal, impõe limites ao desequilíbrio contratual, que em princípio é previsível em determinadas circunstâncias perceptíveis, com base em uma comunicação clara, influenciada por valores como ferramenta para solucionar conflitos com a participação de terceiros, com base na reconciliação entre as partes, focada em suas necessidades por meio de um processo colaborativo, inovador e amigável, com técnicas assertivas, que constitui uma nova maneira de entender a defesa legal e a justiça, sob um código de étic

A autonomia da vontade como princípio anterior à autoconfiguração das cláusulas do contrato

La autoconfiguración de las cláusulas del contrato sobreviene en obligaciones entre las partes y, de conformidad con la autonomía de la voluntad, responden al interés general, como principio previo al ordenamiento jurídico. La sistematización de su fundamento jurídico permite -mediante un análisis lógico- la concreción de conocimientos sobre la estructura teórica del contrato como instrumento jurídico regulador de la economía. Dicho análisis se basa en la buena fe que irrumpe como un principio general del Derecho, que construye actuaciones condicionadas y derivan consecuencias jurídicas a interpretarse de la forma que más favorezca su aplicación. Esa interpretación es la vía para alcanzar la progresividad de los derechos del individuo en la sociedad a partir del desarrollo de las políticas públicas.The autoconfiguration of the clauses of the contract ensues in obligations between the parties and in accordance with the autonomy of the will respond to the general interest, as a prior principle to the legal system, the systematization of its legal basis allows through a logical analysis the concretion of knowledge about the theoretical structure of the contract as a regulatory legal instrument of the economy, based on good faith that breaks down as a general principle of law, which constructs conditioned actions and derives legal consequences to be interpreted in the way that favors its application, as a way to achieve the progressiveness of the rights of the individual in society based on the development of public policies.Facultad de Ciencias Jurídicas y Sociale

A autonomia da vontade como princípio anterior à autoconfiguração das cláusulas do contrato

La autoconfiguración de las cláusulas del contrato sobreviene en obligaciones entre las partes y, de conformidad con la autonomía de la voluntad, responden al interés general, como principio previo al ordenamiento jurídico. La sistematización de su fundamento jurídico permite -mediante un análisis lógico- la concreción de conocimientos sobre la estructura teórica del contrato como instrumento jurídico regulador de la economía. Dicho análisis se basa en la buena fe que irrumpe como un principio general del Derecho, que construye actuaciones condicionadas y derivan consecuencias jurídicas a interpretarse de la forma que más favorezca su aplicación. Esa interpretación es la vía para alcanzar la progresividad de los derechos del individuo en la sociedad a partir del desarrollo de las políticas públicas.The autoconfiguration of the clauses of the contract ensues in obligations between the parties and in accordance with the autonomy of the will respond to the general interest, as a prior principle to the legal system, the systematization of its legal basis allows through a logical analysis the concretion of knowledge about the theoretical structure of the contract as a regulatory legal instrument of the economy, based on good faith that breaks down as a general principle of law, which constructs conditioned actions and derives legal consequences to be interpreted in the way that favors its application, as a way to achieve the progressiveness of the rights of the individual in society based on the development of public policies.Facultad de Ciencias Jurídicas y Sociale

"Just" accuracy? Procedural fairness demands explainability in AI-based medical resource allocations

Altres ajuts: Universidad de Granada/CBUA. This research is funded by the project "Detección y eliminación de sesgos en algoritmos de triaje y localización para la COVID-19" of the call Ayudas Fundación BBVA a Equipos de Investigación Científica SARS-CoV-2 y COVID-19, en el área de Humanidades. DR-A thanks the funding of the Spanish Research Agency (codes FFI2017-88913-P and PID2020-118729RB-I00). IPJ also thanks the funding of the Spanish Research Agency (code PID2019-105422GB-I00).The increasing application of artificial intelligence (AI) to healthcare raises both hope and ethical concerns. Some advanced machine learning methods provide accurate clinical predictions at the expense of a significant lack of explainability. Alex John London has defended that accuracy is a more important value than explainability in AI medicine. In this article, we locate the trade-off between accurate performance and explainable algorithms in the context of distributive justice. We acknowledge that accuracy is cardinal from outcome-oriented justice because it helps to maximize patients' benefits and optimizes limited resources. However, we claim that the opaqueness of the algorithmic black box and its absence of explainability threatens core commitments of procedural fairness such as accountability, avoidance of bias, and transparency. To illustrate this, we discuss liver transplantation as a case of critical medical resources in which the lack of explainability in AI-based allocation algorithms is procedurally unfair. Finally, we provide a number of ethical recommendations for when considering the use of unexplainable algorithms in the distribution of health-related resources

Negative Physical Self-Concept Is Associated to Low Cardiorespiratory Fitness, Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren

[EN] Background: Evidence suggests that physical self-concept (PSC) is linked to well-being in children and adolescents. Objective: The objective was to investigate the association of PSC with mental health (i.e., depression and body image), physical status (i.e., fitness and weight status) and lifestyle (physical activity (PA) patterns and nutritional level) in Chilean schoolchildren. Methods: A total of 617 schoolchildren (n = 271 girls and n = 346 boys) aged 10–14 years participated in this study. Self-concept, depression and body image dissatisfaction were determined by questionnaires. Physical fitness, PA, screen time (ST), Mediterranean diet (MD) adherence and anthropometric parameters were also included. Results: Poor PSC was linked to bad cardiorespiratory fitness (CRF) (<42 VO2max) (OR 1.64; 95%CI 1.12–2.34; p = 0.01), severe body image dissatisfaction (OR 2.51, 95%CI 0.99–6.35; p = 0.05), ST of more than two hours a day (OR 2.1; 95%CI 1.41–3.12; p < 0.001), PA after school of no more than two hours per week (OR 1.52; 95%CI 1.08–2.13; p = 0.015) and depression (OR 1.80; 95%CI 1.1–2.92; p = 0.017). High nutritional level showed an association with general PSC and general self-concept (p < 0.05). Absence of body image dissatisfaction was related to general self-concept (p < 0.01) and physical condition dimensions (p < 0.05). Conclusions: PSC is associated with CRF, PA after school, ST and nutritional level. According to mental health variables, poor PSC is related to depression in Chilean schoolchildren. Therefore, promoting a healthy lifestyle among children should be a target of community- and school-based interventions to promote PSC.S