A disponibilidade por água direcionou e motivou o desenvolvimento das atividades e das ocupações territoriais na Bacia Hidrográfica do Alto Tietê (BAT). Nessa trajetória, a água subterrânea passou a ser uma das grandes reservas disponíveis para suprir a essa crescente demanda onde atualmente existem aproximadamente 12 mil poços fornecendo cerca de 10m³/s. Na BAT este cenário de dependência ao recurso hídrico subterrâneo se acentua, na medida em que a disponibilidade de água superficial diminui. Dessa forma, a intensa extração de água, concentrada na área urbana da bacia, tem causado rebaixamentos nos níveis dos aquíferos. A situação é agravada, pois parte da água fisicamente disponível torna-se qualitativamente indisponível por contaminações provenientes das atividades antrópicas mal operadas. Hoje na BAT são reconhecidas 2.018 áreas onde os aquíferos e os solos são contaminadas, ademais de existirem outras 53 mil atividades com potencial para gerar contaminação aos aquíferos. Nessa pesquisa foi realizado um mapeamento das áreas críticas integradas de qualidade e quantidade, onde a área da BAT foi dividida em células de 500x500m. De um total de 23.867 áreas em toda a BAT, foi possível identificar, 943 áreas de alta, 1876 áreas de média e 3120 áreas de baixa criticidade. Entretanto, essa situação é desconhecida pelos usuários dos recursos hídricos. Apesar desse cenário, a gestão das águas subterrâneas ainda é bastante incipiente na bacia. A limitação é ainda maior, pois a identificação dos poços é difícil e os problemas, quando detectados, não são de responsabilidade de apenas um, mas de um conjunto de usuários. Assim, como em outras regiões metropolitanas do Brasil, a BAT possui uma alta densidade de poços ilegais, onde a sua explotação acarreta em um rebaixamento excessivo nos níveis dos aquíferos, reduzindo a oferta de água, diminuindo assim, a segurança hídrica da bacia. Experiências recentes na gestão das águas subterrâneas têm indicado que o gerenciamento desse recurso terá mais sucesso quanto maior for a participação do usuário, portanto a gestão da água, aplicada nesse trabalho através da integração de informações relativas ao meio físico, uso e ocupação do solo, aspectos sócios econômicos, do balanço hídrico, e os aspectos hidrogeológicos torna-se fundamental para prover o conhecimento e as ferramentas gerenciais para a tomada de decisões e conscientização dos usuários, que levarão à proteção e ao uso controlado dos recursos hídricos subterrâneos. / The availability of water directed and motivated the development of activities and land occupations along the Alto Tiete Basin (BAT). In this way, groundwater has become one of the major reserves available to supply the growing demand, where there are currently approximately 12 thousand wells supplying almost 10m³/s. In the BAT, the scenery of groundwater resource dependence increases whereas the availability of surface water decreases. In this way, the intense water extraction, concentrated in the urban area of the basin, has led downgrades in the levels of aquifers. The situation is exacerbated because the water physically available becomes qualitatively unavailable due to chemical contamination from chemicals used in productive activities and services. The BAT has serious quality problems in part of the aquifers, having 2.018 contaminated areas recognized by CETESB, furthermore there are other 53.000 activities with the potential to generate contamination to aquifers. In the BAT, 23.867 areas of 500x500m, it was identified by mapping of the integrated critical areas, 943 high critical areas, 1876 medium critical areas, and 3120 low critical areas. However, this scenario is unknown to users. . Despite this scenario, the management of groundwater is still incipient in the basin. The limitation is even greater, since identification of the wells is difficult and problems, when detected, are not the responsibility of just one, but a number of users. As well as in other metropolitan areas of Brazil, BAT has a high density of illegal wells, where the illegal exploitation may result in an excessive drawdown of groundwater levels, reducing the supply of water, thus reducing water security of the basin. Recent experiments in management of groundwater have indicated that the management of this resource will be more successful with greater user participation. Therefore, water management applied in this work through the integration of information relating to the environment, use and occupation of land, socio economics aspects, of the water balance and hydrogeological aspects becomes essential to provide the knowledge and managerial tools for making decisions and user awareness, which will lead to the protection and controlled use of groundwater resources.

A disponibilidade por água direcionou e motivou o desenvolvimento das atividades e das ocupações territoriais na Bacia Hidrográfica do Alto Tietê (BAT). Nessa trajetória, a água subterrânea passou a ser uma das grandes reservas disponíveis para suprir a essa crescente demanda onde atualmente existem aproximadamente 12 mil poços fornecendo cerca de 10m³/s. Na BAT este cenário de dependência ao recurso hídrico subterrâneo se acentua, na medida em que a disponibilidade de água superficial diminui. Dessa forma, a intensa extração de água, concentrada na área urbana da bacia, tem causado rebaixamentos nos níveis dos aquíferos. A situação é agravada, pois parte da água fisicamente disponível torna-se qualitativamente indisponível por contaminações provenientes das atividades antrópicas mal operadas. Hoje na BAT são reconhecidas 2.018 áreas onde os aquíferos e os solos são contaminadas, ademais de existirem outras 53 mil atividades com potencial para gerar contaminação aos aquíferos. Nessa pesquisa foi realizado um mapeamento das áreas críticas integradas de qualidade e quantidade, onde a área da BAT foi dividida em células de 500x500m. De um total de 23.867 áreas em toda a BAT, foi possível identificar, 943 áreas de alta, 1876 áreas de média e 3120 áreas de baixa criticidade. Entretanto, essa situação é desconhecida pelos usuários dos recursos hídricos. Apesar desse cenário, a gestão das águas subterrâneas ainda é bastante incipiente na bacia. A limitação é ainda maior, pois a identificação dos poços é difícil e os problemas, quando detectados, não são de responsabilidade de apenas um, mas de um conjunto de usuários. Assim, como em outras regiões metropolitanas do Brasil, a BAT possui uma alta densidade de poços ilegais, onde a sua explotação acarreta em um rebaixamento excessivo nos níveis dos aquíferos, reduzindo a oferta de água, diminuindo assim, a segurança hídrica da bacia. Experiências recentes na gestão das águas subterrâneas têm indicado que o gerenciamento desse recurso terá mais sucesso quanto maior for a participação do usuário, portanto a gestão da água, aplicada nesse trabalho através da integração de informações relativas ao meio físico, uso e ocupação do solo, aspectos sócios econômicos, do balanço hídrico, e os aspectos hidrogeológicos torna-se fundamental para prover o conhecimento e as ferramentas gerenciais para a tomada de decisões e conscientização dos usuários, que levarão à proteção e ao uso controlado dos recursos hídricos subterrâneos. / The availability of water directed and motivated the development of activities and land occupations along the Alto Tiete Basin (BAT). In this way, groundwater has become one of the major reserves available to supply the growing demand, where there are currently approximately 12 thousand wells supplying almost 10m³/s. In the BAT, the scenery of groundwater resource dependence increases whereas the availability of surface water decreases. In this way, the intense water extraction, concentrated in the urban area of the basin, has led downgrades in the levels of aquifers. The situation is exacerbated because the water physically available becomes qualitatively unavailable due to chemical contamination from chemicals used in productive activities and services. The BAT has serious quality problems in part of the aquifers, having 2.018 contaminated areas recognized by CETESB, furthermore there are other 53.000 activities with the potential to generate contamination to aquifers. In the BAT, 23.867 areas of 500x500m, it was identified by mapping of the integrated critical areas, 943 high critical areas, 1876 medium critical areas, and 3120 low critical areas. However, this scenario is unknown to users. . Despite this scenario, the management of groundwater is still incipient in the basin. The limitation is even greater, since identification of the wells is difficult and problems, when detected, are not the responsibility of just one, but a number of users. As well as in other metropolitan areas of Brazil, BAT has a high density of illegal wells, where the illegal exploitation may result in an excessive drawdown of groundwater levels, reducing the supply of water, thus reducing water security of the basin. Recent experiments in management of groundwater have indicated that the management of this resource will be more successful with greater user participation. Therefore, water management applied in this work through the integration of information relating to the environment, use and occupation of land, socio economics aspects, of the water balance and hydrogeological aspects becomes essential to provide the knowledge and managerial tools for making decisions and user awareness, which will lead to the protection and controlled use of groundwater resources.

Objetivo: Determinar los factores asociados al Síndrome de Burnout (SB) en el personal de áreas críticas en hospitales ESSALUD de la Región Lambayeque 2022. Metodología: Estudio de diseño no experimental, descriptivo y correlacional, con muestreo no probabilístico tipo bola de nieve. Se aplicó el "Maslach Burnout Inventory" (MBI) y una ficha sociodemográfica mediante Google Forms a 398 trabajadores, seleccionando una muestra final de 196 empleados en diciembre 2022. Resultados: La frecuencia de SB fue de 5.6%, mientras que el 70.9% y el 23.5% mostró tendencia a padecerlo y ausencia del síndrome respectivamente. El promedio de edad fue de 41,8 (± 10.9) años, predominando el sexo femenino con 71.9%, el 50% fue personal de enfermería, 37.8% médicos y 12.2% técnicos, el 48% tuvo entre 2-3 hijos y el 36.2% contaba con más de 15 años de experiencia laboral. El análisis de Chi cuadrado determinó que las variables sexo, especialidad, horas de sueño y trabajo externo, se encontraron asociadas a SB (p-value < 0.05), y en el análisis multivariado solo se encontró asociación significativa con años de experiencia laboral (OR 0,491; IC 95% 0,274-0,880) y horas de sueño (OR 0,316; IC 95% 0,121-0,827). Sobre las dimensiones del SB, la dimensión Agotamiento Emocional (AE) bajo tuvo 65.3%, Despersonalización (DP) baja 54.6% y Realización Personal (RP) baja con 45.9%. Conclusiones: La tendencia de padecer SB fue alta, además se encontró asociación significativa entre SB y las variables sexo, especialidad, horas de sueño, experiencia laboral y trabajo externo. / Objective: To determine the factors associated with Burnout Syndrome (SB) in critical area staff at ESSALUD hospitals in the Lambayeque Region 2022. Methodology: Nonexperimental, descriptive, and correlational study design, with snowball non-probabilistic sampling. The "Maslach Burnout Inventory" (MBI) and a sociodemographic form were applied through Google Forms to 398 workers, selecting a final sample of 196 employees in December 2022. Results: The frequency of SB was 5.6%, while 70.9% and 23.5% showed a tendency towards suffering from it and absence of the syndrome, respectively. The average age was 41.8 (± 10.9) years, with females predominating at 71.9%, 50% were nursing staff, 37.8% doctors, and 12.2% technicians, 48% had between 2-3 children, and 36.2% had more than 15 years of work experience. Chi-square analysis determined that the variables of gender, specialty, hours of sleep, and external work were associated with SB (p-value < 0.05), and in the multivariate analysis, only years of work experience (OR 0.491; 95% CI 0.274-0.880) and hours of sleep (OR 0.316; 95% CI 0.121-0.827) were found to have a significant association. Regarding the dimensions of SB, the low Emotional Exhaustion (AE) dimension was 65.3%, low Depersonalization (DP) 54.6%, and low Personal Accomplishment (RP) 45.9%. Conclusions: The tendency to suffer from SB was high, and a significant association was found between SB and variables such as gender, specialty, hours of sleep, work experience, and external work.

Study of the critical factors for TQM implementation throughout the years, and longitudinal analysis of secondary quality winners of prestigious awards such as the Malcolm Baldrige National Quality Award (MBNQA), is important. The longitudinal analysis in this research will enable verification that there are generic critical factors (CFs) for TQM implementation and generic critical areas of measurement (CAM) that if implemented fully and successfully will deliver excellence. Also, it will enable verification that these generic CFs help to ensure sustainable performance and this could help in answering how excellent organisations sustain their performance constantly. By studying what excellent organisations measure and what they place emphasis on throughout the year, the study will document measurements that have been used to sustain excellence and will consider empirically how these have led to tangible results over a period of twenty years; the study will examine MBNQA winners from 1988 until 2008. Finally, an excellence maturity assessment tool 'assessment software' was developed as result of examining winning case studies over a long period of time, lists of critical factors of implementation (CFI) and critical areas of measurement (CAM) were extracted and used accompanied by the EFQM Excellence Model, and Zairi's two model 'Index of Excellence' and 'Ladder of Excellence'. This formed the basis of the assessment tool developed; companies through this will be able to understand their level of excellence implementation and their position compared to world class organisations.

Study of the critical factors for TQM implementation throughout the years, and longitudinal analysis of secondary quality winners of prestigious awards such as the Malcolm Baldrige National Quality Award (MBNQA), is important. The longitudinal analysis in this research will enable verification that there are generic critical factors (CFs) for TQM implementation and generic critical areas of measurement (CAM) that if implemented fully and successfully will deliver excellence. Also, it will enable verification that these generic CFs help to ensure sustainable performance and this could help in answering how excellent organisations sustain their performance constantly. By studying what excellent organisations measure and what they place emphasis on throughout the year, the study will document measurements that have been used to sustain excellence and will consider empirically how these have led to tangible results over a period of twenty years; the study will examine MBNQA winners from 1988 until 2008. Finally, an excellence maturity assessment tool ¿assessment software¿ was developed as result of examining winning case studies over a long period of time, lists of critical factors of implementation (CFI) and critical areas of measurement (CAM) were extracted and used accompanied by the EFQM Excellence Model, and Zairi¿s two model ¿Index of Excellence¿ and ¿Ladder of Excellence¿. This formed the basis of the assessment tool developed; companies through this will be able to understand their level of excellence implementation and their position compared to world class organisations. / Government of Saudi Arabia represented by the Ministry of Higher Education