Actions for adaptation to tourism: the creation of a new spirit of capitalism in the Coca Valley (Arequipa, Peru)

The article uses an interdisciplinary perspective to analyze the creation of a new spirit of capitalism. This is put in evidence trough institutional documents analysis, historic contextualization and the characterization of the adaptive dynamics of actors, under the frame of national policies, programs and projects for tourism development. The main findings, at the exploratory level, show the responses of the actors and the logics to which their actions correspond, taking into account what happened in Colca Valley (Arequipa, Peru) around tourism and their desires of entering in the market, diversify their economies as well as to participate in development projects.El artículo emplea una perspectiva interdisciplinaria para analizar la creación de un nuevo espíritu del capitalismo. Esto se evidencia a través del análisis de documentos institucionales, la contextualización histórica y la caracterización de dinámicas de adaptación de los actores, en el marco de políticas nacionales, programas y proyectos de desarrollo turístico. Los hallazgos a nivel exploratorio señalan respuestas de los actores y las lógicas a las que corresponden sus acciones, tomando en cuenta lo ocurrido en el Valle del Colca (Arequipa, Perú) en torno al turismo y sus deseos de ingresar al mercado, diversificar sus economías así como participar en proyectos de desarrollo

The development trough tourism agenda in Peru and its relationship with international interests

Este ensayo evidencia la relación entre la agenda para el desarrollo a través del turismo en Perú y los intereses internacionales en torno al desarrollo en este campo. Para ello, se emplea elementos teóricos desde la perspectiva constructivista acerca del desarrollo, de las políticas públicas y las relaciones internacionales, partiendo de una descripción de antecedentes históricos en la construcción política y económica del estado Peruano. Se señala rasgos principales en la configuración de la política exterior del Perú en el s.XXI y se identifica la agenda nacional para el desarrollo a través del turismo, conformada por normas, estrategias, aparatos técnicos y programas que muestran intersubjetividades y vínculos con intereses internacionales. La información se obtuvo mediante entrevistas en profundidad y consultando documentos oficiales y publicaciones. Se espera aportar al mejor conocimiento de ideas a vinculadas a paradigmas del desarrollo, compartidas por actores globales y locales, así como elementos para el análisis crítico del turismo.This essay puts in evidence the relationship between development through tourism agenda in Peru and international interests related to development in this field. With that aim, we use theoric elements on development, public policies and international relationships, starting from the description of historic information of politic and economic construction of Peruvian state. We point out main features in international policies of Peru in the XXI century and identify the national agenda of development through tourism, formed by norms, strategies, technical apparatus and programmes that show intersubjectivities and links with international interests. The information was obtained using in -depth interviews and reviewing official documents and publications. We hope to contribute to achieve a better knowledge of ideas linked to development paradigms that are shared by both local and global actors, as well as in the critical analysis of tourism

Acciones de adaptación al turismo: la creación de un nuevo espíritu de capitalismo en el Valle del Colca (Arequipa, Perú)

The article uses an interdisciplinary perspective to analyze the creation of a new spirit of capitalism. This is put in evidence trough institutional documents analysis, historic contextualization and the characterization of the adaptive dynamics of actors, under the frame of national policies, programs and projects for tourism development. The main findings, at the exploratory level, show the responses of the actors and the logics to which their actions correspond, taking into account what happened in Colca Valley (Arequipa, Peru) around tourism and their desires of entering in the market, diversify their economies as well as to participate in development projects.El artículo emplea una perspectiva interdisciplinaria para analizar la creación de un nuevo espíritu del capitalismo. Esto se evidencia a través del análisis de documentos institucionales, la contextualización histórica y la caracterización de dinámicas de adaptación de los actores, en el marco de políticas nacionales, programas y proyectos de desarrollo turístico. Los hallazgos a nivel exploratorio señalan respuestas de los actores y las lógicas a las que corresponden sus acciones, tomando en cuenta lo ocurrido en el Valle del Colca (Arequipa, Perú) en torno al turismo y sus deseos de ingresar al mercado, diversificar sus economías así como participar en proyectos de desarrollo

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)