Bomba centrífuga asistida en la succión con sistema de vacío

Publicación a texto completo no autorizada por el autorSelecciona el sistema de bombeo más adecuado para alimentar con agua de mar la planta de ósmosis inversa instalada en la unidad minera Cerro Lindo perteneciente a la Compañía Minera Milpo S.A.A., la cual cuenta con un sistema de succión y descarga desarrollado por el área de diseño e ingeniería.Trabajo de suficiencia profesiona

Planeamiento estratégico del sector turismo en la Región Ancash

El presente plan estratégico se ha desarrollado para que en el año 2025 la región Ancash se convierta en el tercer destino turístico del país, luego de Lima y Cusco. Esto se concretará a través del logro de los siguientes objetivos estratégicos: (a) recibir 12.4 millones de turistas, (b) contar con 1,400 establecimientos de hospedaje, (c) tener 15% de personal calificado de la región, trabajando en el sector turismo; y (d) formalizar la situación laboral del 90% de los colaboradores del sector turismo en Ancash. Para lograr estos objetivos a largo plazo, será necesario implementar las siguientes estrategias: (a) desarrollar servicios de internet para llegar a más turistas potenciales con una atención personalizada, (b) atraer turistas nacionales provenientes de Lima, (c) desarrollar el mercado de turistas provenientes de China, (d) penetrar en el mercado de turistas europeos, (e) desarrollar el mercado de turistas estadounidenses, (f) mejorar la infraestructura hotelera existente para que haya una oferta de hospedajes categorizados, y (g) desarrollar servicios de turismo ecológico. La implementación de estas estrategias es tarea de la Dirección Regional de Turismo de Ancash. Por último, se establecerá un control de los resultados mediante el Balanced Scorecard, con indicadores que evalúen las perspectivas de aprendizaje interno, procesos, clientes, y financiera. Estos indicadores se medirán anualmente, comparando los resultados con las metas preestablecidas y, en caso de encontrar desviaciones, se tomarán las medidas pertinentes para corregir el rumbo del sectorThis strategic plan has been developed so that in 2025 the Ancash region becomes the third tourist destination in Peru after Lima and Cusco, having high quality infrastructure and a qualified staff capable of offering unforgettable experiences, promoting in this way a socio-economic development of region. It will be implemented by achieving the following strategic objectives: (a) the Ancash region will receive 12.4 million tourists; (b) having 1,400 lodging places, (c) having 15% of skilled labor force from Ancash region working in tourism industry and (d) 90 % of employees working in tourism industry in Ancash to be recognized as formal employees. These long-term objectives will be achieved by implementing the following strategies: (a) developing internet services to get more potential tourists and offering customized attention; (b) domestic tourism market positioning, particularly tourists from Lima (c) developing Chinese tourists market, (d) developing European tourists market, (e) developing American tourists market, (f) improving existing hotel infrastructure, so that there is an offer of categorized lodging, and (g) developing ecotourism services. In addition to strategies implementation, which the Regional Tourism of Ancash is responsible for, results should be controlled by Balanced Control Board, having the indicators of internal learning, processes, customers and financial. These indicators should be measured yearly, by comparing the results with the stated goals and if deviations are found, corrective actions should be taken to correct themTesi

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