Derecho Administrativo: Nuevo Procedimiento Sancionador De LA MUNICIPALIDAD DE LIMA METROPOLITANA – 2018

El título de esta investigación es derecho administrativo: nuevo procedimiento sancionador de la Municipalidad de Lima Metropolitana, 2018. El objetivo es determinar si la Municipalidad de Lima Metropolitana puede crear las multas o infracciones a los ciudadanos. La unidad de analizar es revisar la Constitución Política y el Derecho Administrativo. El método de este estudio es Jurídico, cualitativo, no interactivo, inductivo, deductivo, alcance exploratorio, descriptivo. Las conclusiones a que se arribó en este estudio son las siguientes Primera: El rol de las municipalidades se encuentra legislada en la Constitución y leyes especiales de la materia Segunda: Nuestra Carta Magna en su artículo 196, inc. 3 dice “las contribuciones, tasas, arbitrios, licencias y derechos son creados por Ordenanzas Municipales conforme a Ley Tercera: Según la Ley de Leyes en su art. 198 destaca que la capital de la Republica no integra ninguna región. Tiene régimen especial en las leyes de descentralización y en la LOM. La Municipalidad Metropolitana de Lima ejerce su competencia dentro del ámbito de la provincia de Lima.The title of this investigation is administrative law: new sanctioning procedure of the municipality of Metropolitan Lima, 2018. The objective is to determine if the Municipality of Metropolitan Lima can create fines or infractions to citizens. The unit to analyze is to revise the Political Constitution and Administrative Law. The method of this study is legal, qualitative, non-interactive, inductive, deductive, exploratory,descriptive. The conclusions reached in this study are the following First: The Constitution of 1993, in force since January 1, 1994, in its article 194, determines "The provincial and district municipalities are the organs of Local Government. They have political, economic and administrative autonomy in the matters of their competence. The municipalities of the populated centers are created according. Second: Our Magna Carta in its article 196, Inc. 3 says Contributions, fees, excise taxes, licenses and rights are created by Municipal Ordinances according to Law Third: According to the Law of Laws in its art. 198 highlights that the capital of the Republic does not integrate any region. It has a special regime in the decentralization laws and in the LOM. The Metropolitan Municipality of Lima exercises its competence within the scope of the province of Lima.Tesi

Derecho Administrativo: Nuevo Procedimiento Sancionador De LA MUNICIPALIDAD DE LIMA METROPOLITANA – 2018

El título de esta investigación es derecho administrativo: nuevo procedimiento sancionador de la Municipalidad de Lima Metropolitana, 2018. El objetivo es determinar si la Municipalidad de Lima Metropolitana puede crear las multas o infracciones a los ciudadanos. La unidad de analizar es revisar la Constitución Política y el Derecho Administrativo. El método de este estudio es Jurídico, cualitativo, no interactivo, inductivo, deductivo, alcance exploratorio, descriptivo. Las conclusiones a que se arribó en este estudio son las siguientes Primera: El rol de las municipalidades se encuentra legislada en la Constitución y leyes especiales de la materia Segunda: Nuestra Carta Magna en su artículo 196, inc. 3 dice “las contribuciones, tasas, arbitrios, licencias y derechos son creados por Ordenanzas Municipales conforme a Ley Tercera: Según la Ley de Leyes en su art. 198 destaca que la capital de la Republica no integra ninguna región. Tiene régimen especial en las leyes de descentralización y en la LOM. La Municipalidad Metropolitana de Lima ejerce su competencia dentro del ámbito de la provincia de Lima.The title of this investigation is administrative law: new sanctioning procedure of the municipality of Metropolitan Lima, 2018. The objective is to determine if the Municipality of Metropolitan Lima can create fines or infractions to citizens. The unit to analyze is to revise the Political Constitution and Administrative Law. The method of this study is legal, qualitative, non-interactive, inductive, deductive, exploratory,descriptive. The conclusions reached in this study are the following First: The Constitution of 1993, in force since January 1, 1994, in its article 194, determines "The provincial and district municipalities are the organs of Local Government. They have political, economic and administrative autonomy in the matters of their competence. The municipalities of the populated centers are created according. Second: Our Magna Carta in its article 196, Inc. 3 says Contributions, fees, excise taxes, licenses and rights are created by Municipal Ordinances according to Law Third: According to the Law of Laws in its art. 198 highlights that the capital of the Republic does not integrate any region. It has a special regime in the decentralization laws and in the LOM. The Metropolitan Municipality of Lima exercises its competence within the scope of the province of Lima.Tesi

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030