Perspectivas del gobierno electrónico local en México

Este libro se realiza en momentos en los cuales el gobierno electrónico aún es una novedad para muchos de los gobiernos de México. Pretende ser una de las publicaciones iniciales de un proceso editorial de otros muchos libros referidos a nuestro país que hacen buena falta para un buen desarrollo de gobierno electrónico, que ya debe contemplarse como una nueva etapa del desarrollo de la administración y gestión gubernamental en México.. Así mismo con este libro se espera impulsar la investigación del tema en México con la finalidad de que el desarrollo del gobierno electrónico en nuestro medio considere las particularidades de nuestras condiciones políticas y administrativas en municipios como en Estados, ya que estas particularidades suelen representar salvedades que condicionan seriamente las versiones mexicanas de gobierno electrónico

Precios unitarios y elaboración de las propuestas técnica y económica para licitación de obra pública, con aplicación de software, en un estudio de caso.

A través de la historia el ser humano se ha preocupado por satisfacer sus necesidades básicas, además de extender sus dominios consiguiendo poder obtener una forma de lograrlo, sin lugar a dudas es el de contar con bienes materiales y económicos, los cuales están estrechamente relacionados con la moneda como forma de pago, aunque al principio de los tiempos esto se realizaba por medio de trueques de mercancías o productos, luego, con la aparición del dinero, los cambios se facilitaron ya que se pagaba realmente por el valor de un bien. De manera que el tiempo ha ido transcurriendo se han generado nuevas formas de pago desde la moneda hecha de metal, hasta la aparición de dinero electrónico. Además de que todas las áreas de estudio están influenciadas por este factor (dinero). Y cuando hablamos del dinero a cambio de alguna mercancía o producto es inevitable caer en el término “Precio” y la rama de la ingeniería civil no está exenta de esta problemática ya que el creciente desarrollo de los países ha generado mayor demanda de construcciones en cada uno de ellos. La presente investigación de tesis, corresponde a: “Precios unitarios y elaboración de las propuestas técnica y económica para licitación de obra pública”. Es indispensable para un Ingeniero Civil comprender que La licitación Públicaes un procedimiento administrativo de preparación de la voluntad contractual, por el que un ente público en ejercicio de la función administrativa invita a los interesados para que, sujetándose al pliego de condiciones (Bases de la licitación), formulen propuestas (Técnica y Económica) de entre las cuales seleccionará la más conveniente (Adjudicación). Cuando es necesario contratar obra pública, existen leyes que obligan a los entes gubernamentales a seguir un proceso legalmente definido por el derecho administrativo. En México, el Artículo 134 Constitucional determina como el gobierno debe realizar las adquisiciones y contratación de obra pública; de esa Ley se deriva la Ley de Adquisiciones, Arrendamiento y Servicios del Sector Público y Ley de Obras Públicas y Servicios relacionados con las mismas

Administración pública y gobernanza en la segunda década del siglo XXI

La administración pública constituye una de las ciencias sociales que están en constante transformación y una de las que se encuentran íntimamente vinculadas al contexto regional, nacional y mundial, así lo constatan los cambios que ha manifestado en las tres últimas décadas, tanto en el plano nacional como en el continental. En ese lapso hemos sido testigos de la irrupción y el desarrollo de conceptos, enfoques y campos e conocimiento, tales cómo las políticas públicas o ciencias de políticas, la nueva gestión pública, el neoinstitucionalismo y recientemente el de la gobernanza, para citar a los más visibles; todos, sin embargo, indisolublemente asociados a la Administración Pública, ya sea desde una perspectiva disciplinaria o desde su acción como brazo ejecutor del Estado

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease

Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: A subgroup analysis of the ARISTOTLE trial

Background: In the ARISTOTLE trial, the rate of stroke or systemic embolism was reduced by apixaban compared with warfarin in patients with atrial fibrillation (AF). Patients with AF and previous stroke or transient ischaemic attack (TIA) have a high risk of stroke. We therefore aimed to assess the efficacy and safety of apixaban compared with warfarin in prespecified subgroups of patients with and without previous stroke or TIA. Methods: Between Dec 19, 2006, and April 2, 2010, patients were enrolled in the ARISTOTLE trial at 1034 clinical sites in 39 countries. 18 201 patients with AF or atrial flutter were randomly assigned to receive apixaban 5 mg twice daily or warfarin (target international normalised ratio 2·0-3·0). The median duration of follow-up was 1·8 years (IQR 1·4-2·3). The primary efficacy outcome was stroke or systemic embolism, analysed by intention to treat. The primary safety outcome was major bleeding in the on-treatment population. All participants, investigators, and sponsors were masked to treatment assignments. In this subgroup analysis, we estimated event rates and used Cox models to compare outcomes in patients with and without previous stroke or TIA. The ARISTOTLE trial is registered with ClinicalTrials.gov, number NTC00412984. Findings: Of the trial population, 3436 (19%) had a previous stroke or TIA. In the subgroup of patients with previous stroke or TIA, the rate of stroke or systemic embolism was 2·46 per 100 patient-years of follow-up in the apixaban group and 3·24 in the warfarin group (hazard ratio [HR] 0·76, 95% CI 0·56 to 1·03); in the subgroup of patients without previous stroke or TIA, the rate of stroke or systemic embolism was 1·01 per 100 patient-years of follow-up with apixaban and 1·23 with warfarin (HR 0·82, 95% CI 0·65 to 1·03; p for interaction=0·71). The absolute reduction in the rate of stroke and systemic embolism with apixaban versus warfarin was 0·77 per 100 patient-years of follow-up (95% CI -0·08 to 1·63) in patients with and 0·22 (-0·03 to 0·47) in those without previous stroke or TIA. The difference in major bleeding with apixaban compared with warfarin was 1·07 per 100 patient-years (95% CI 0·09-2·04) in patients with and 0·93 (0·54-1·32) in those without previous stroke or TIA. Interpretation: The effects of apixaban versus warfarin were consistent in patients with AF with and without previous stroke or TIA. Owing to the higher risk of these outcomes in patients with previous stroke or TIA, the absolute benefits of apixaban might be greater in this population. Funding: Bristol-Myers Squibb and Pfizer. © 2012 Elsevier Ltd

Apixaban versus warfarin in patients with atrial fibrillation

BACKGROUND: Vitamin K antagonists are highly effective in preventing stroke in patients with atrial fibrillation but have several limitations. Apixaban is a novel oral direct factor Xa inhibitor that has been shown to reduce the risk of stroke in a similar population in comparison with aspirin. METHODS: In this randomized, double-blind trial, we compared apixaban (at a dose of 5 mg twice daily) with warfarin (target international normalized ratio, 2.0 to 3.0) in 18,201 patients with atrial fibrillation and at least one additional risk factor for stroke. The primary outcome was ischemic or hemorrhagic stroke or systemic embolism. The trial was designed to test for noninferiority, with key secondary objectives of testing for superiority with respect to the primary outcome and to the rates of major bleeding and death from any cause. RESULTS: The median duration of follow-up was 1.8 years. The rate of the primary outcome was 1.27% per year in the apixaban group, as compared with 1.60% per year in the warfarin group (hazard ratio with apixaban, 0.79; 95% confidence interval [CI], 0.66 to 0.95; P<0.001 for noninferiority; P = 0.01 for superiority). The rate of major bleeding was 2.13% per year in the apixaban group, as compared with 3.09% per year in the warfarin group (hazard ratio, 0.69; 95% CI, 0.60 to 0.80; P<0.001), and the rates of death from any cause were 3.52% and 3.94%, respectively (hazard ratio, 0.89; 95% CI, 0.80 to 0.99; P = 0.047). The rate of hemorrhagic stroke was 0.24% per year in the apixaban group, as compared with 0.47% per year in the warfarin group (hazard ratio, 0.51; 95% CI, 0.35 to 0.75; P<0.001), and the rate of ischemic or uncertain type of stroke was 0.97% per year in the apixaban group and 1.05% per year in the warfarin group (hazard ratio, 0.92; 95% CI, 0.74 to 1.13; P = 0.42). CONCLUSIONS: In patients with atrial fibrillation, apixaban was superior to warfarin in preventing stroke or systemic embolism, caused less bleeding, and resulted in lower mortality. Copyright © 2011 Massachusetts Medical Society. All rights reserved