Criterios de implementación norma ISO 14001:2015, Caso de estudio, empresa TREFIALAMBRES S.A.S

El presente trabajo describe la planificación de un sistema de gestión ambiental basado en la norma internacional ISO 14001:2015, para la empresa TREFIALAMBRES S.A.S, compañía dedicada a la fabricación de alambre de acero. Para la planificación del Sistema de Gestión Ambiental SGA, se llevan a consideración los diferentes procesos que se llevan a cabo en el sistema de producción, desde el ingreso de la materia prima hasta el producto terminado. El análisis realizado en la compañía de metalmecánica, se ha elaborado de acuerdo con los requisitos establecidos en la Norma Técnica Colombiana ISO 14001:2015, iniciando con una Revisión Ambiental Inicial (RAI); la cual incluye: contexto de la organización y descripción de la problemática actual del sector; se contemplan las etapas del proceso productivo, la identificación de los aspectos e impactos ambientales significativos; se define el alcance del Sistema de Gestión Ambiental SGA y la legislación ambiental aplicable, entre otros requisitos legales. A partir de la revisión inicial, se logro identificar las necesidades y expectativas que tiene la empresa TREFIALAMBRES S.A.S y con base en ello se emitió el informe de evaluación de la gestión ambiental de la empresa. En la actualidad las empresas tienen un reto que es la competitividad y la productividad, debido a esto deben mejorar continuamente sus productos, procesos y servicios para poder estar en el mercado, esto se logra mediante nuevas estrategias que ayuden a minimizar el impacto ambiental generado en sus actividades.This paper describes the planning of an environmental management system based on the international standard ISO 14001: 2015, for the company TREFIALAMBRES S.A.S, a company dedicated to the manufacture of steel wire. For the planning of the EMS Environmental Management System, the different processes that are carried out in the production system are taken into consideration, from the entry of the raw material to the finished product. The analysis carried out in the metalworking company has been prepared in accordance with the requirements established in the Colombian Technical Standard ISO 14001: 2015, starting with an Initial Environmental Review (RAI); which includes: context of the organization and description of the current problems of the sector; The stages of the production process are contemplated, as well as the identification of significant environmental aspects and impacts; the scope of the EMS Environmental Management System and the applicable environmental legislation are defined, among other legal requirements. From the initial review, it was possible to identify the needs and expectations of the company TREFIALAMBRES S.A.S and based on this, the company's environmental management evaluation report was issued. Currently companies have a challenge that is competitiveness and productivity, due to this they must continuously improve their products, processes and services to be in the market, this is achieved through new strategies that help minimize the environmental impact generated in Your activities

The Caldera. No. 23

La pandemia, sin lugar a dudas, nos ha cambiado la vida a todos; un viernes nos fuimos para nuestros hogares, en el marco de una educación presencial; al lunes siguiente, después de dos días, estábamos iniciando el camino hacia una educación remota, una educación virtual, que se ha convertido en una gran alternativa para seguir contribuyendo con la formación de nuestros niños y jóvenes caldistas y al mejoramiento de nuestra calidad de vida que halla, en la educación, nuevamente la respuesta; han sido meses de cambios drásticos, inimaginables pero, cambios positivos que nos han permitido crecer como individuos, como familia, como escuela y como sociedad.Especial pandemia. Una generación Resiliente por promoción DINASTIA…06 VII Concurso Intercolegiado departamental de Oratoria. Ulibro 2020…51 Deporte en el Caldas…64 Expresiones Caldistas…71 Celebremos la palabra…93 Nuestros Maestros…102 Galería de Imágenes…107The pandemic, without a doubt, has changed the lives of all of us; One Friday we went to our homes, as part of a face-to-face education; The following Monday, after two days, we were starting the path towards a remote education, a virtual education, which has become a great alternative to continue contributing to the training of our children and young Caldistas and to the improvement of our quality of life. that finds, in education, the answer again; They have been months of drastic changes, unimaginable but positive changes that have allowed us to grow as individuals, as a family, as a school and as a society

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine