La necesidad de problematizar el trabajo infantil: participación y preparación comunitaria en una localidad socialmente vulnerable de Lima, Perú / The need of problematize child labor. Community readiness and participation in a socially vulnerable locality of Lima, Peru

El objetivo de estudio fue analizar la relación entre la participación y la preparación comunitaria frente al trabajo infantil, tomando como eje principal el contexto comunitario en una muestra intencionada de 76 mujeres y hombres miembros de una comunidad y 4 informantes clave de la localidad. Se aplicaron encuestas a los miembros de la comunidad, y se realizaron entrevistas semiestructuradas a los informantes clave. Se evaluó la estructura factorial y consistencia interna de las escalas, obteniéndose dimensiones específicas. Se analizó las variables a través de correlaciones y regresión lineal múltiple, encontrando modelos que explican la varianza de participación y preparación comunitaria entre el 15% al 46%. Las entrevistas situaron a la comunidad en un nivel de "negación/resistencia" al cambio frente al trabajo infantil. Así, los resultados sugieren la necesidad de problematizar esta temática desde la comunidad y las propuestas de intervención, pues si bien existe una participación activa en general, se mantiene una visión ambigua acerca del trabajo infantil, así como una baja disposición a actuar colectivamente frente a esta problemática.

The aim of the study was to analyze the relationship between community readiness and participation concerning child labor taking as the main axis the community context of a purposive sample of 76 men and women community members and 4 local key informants. Surveys were applied on community members and semi-structured interviews were conducted to local key informants. The factorial structure and internal consistency of the scales were evaluated, obtaining specific dimensions. The variables were analyzed by multiple linear regression and correlations, evidencing models that explain the variance of community readiness and participation between 15% and 46%. The interviews placed the community in a level of "deny/resistance" to change when facing child labor. Thus, the results suggest the need to problematize this subject from the community and intervention proposals, because although there is an active participation in general, an ambiguous view remains on child labor, as well as a low willingness to act collectively on this issue.

"But We Want to Work": The Movement of Child Workers in Peru and the Actions for Reducing Child Labor.

The program Edúcame Primero (Educate Me First) is an evidence-based practice for eradicating child labor that has been applied with positive results in Colombia, Peru, and several Central American countries. In this article, we describe the difficulties of implementing the program in two poor areas of Lima (Peru) between 2014 and 2016. Specifically, we discuss three ethical challenges faced during the implementation of the program: (a) the existence of a movement of working children that defends the right of children to work; (b) the polarization of some community-based associations and government institutions on how to deal with the problems of working children; and (c) the use of network indicators in the evaluation of the community's level of cohesion. Taking the Code of Ethics of the General Council of Associations of Psychologists in Spain as a guide, we adopted a consensus approach in planning and research design, combining different criteria of value with the participation of different stakeholders. The implementation of the program in Peru gave preference to developing skills in children over changing attitudes in relation to child protection, although the intervention openly declared its aims when engaging institutions and families. Finally, we address how social network research places special ethical demands on conventional ethical standards. Our experience with this project shows the importance of acting as a bridge between different stakeholders and assessing how all of them benefit from the intervention.

Survey on Ethical Conduct Thresholds in Cardiologal Medical Practice in Argentina.

The purpose of this study was to analyze the attitude of a group of cardiologists on the ethical conducts they would accept or adopt when encountered with different hypothetical situations of medical practice. Between August and September of 2011, 700 Argentine cardiologists were surveyed in situations which posed ethical dilemmas in the patient-physician relationship, among colleagues or involving financial agreements with employers or the pharmaceutical industry. Ethical conflicts were evidenced in a series of inappropriate conducts such as differential fees, trips and meals sponsored by laboratories, splitting fees, overbilling, self-referral, charging for patient referral, financial compensation for ordering medical procedures, and various situations derived from the relationship with employers. In general, financial compensation from the pharmaceutical industry was more accepted than the conflictive situations which directly involved patients, colleagues or employers. The rejection of these conducts, the physicians' deontological education and the improvement of financial and organizational conditions in medical practice will help to encourage better medical professionalism and avoid unseemly behaviors.

Cooperativas médicas / Medical cooperative system

A relação atual entre emprego e salário, aliada à dificuldade cada vez maior de uma justa adequação do mercado de trabalho ao cardiologista brasileiro, vem provocando, no seio da sociedade de especialidade, um clamor cada vez maior dos associados na busca de uma solução que tenha alternativas mais justas e uma premissa mais técnica para o desenvolvimento da especialidade em nosso país. A criação de cooperativas cardiológicas, fomentadas pela Sociedade Brasileira de Cardiologia, constitui, assim, um caminho ético, racional e viável para o desenvolvimento da prática cardiológica em nosso meio.

[Evaluation of the obligations of the health sector in the public policy for eradication of child labor and protection for young working people]. / Pertinencia de los compromisos del sector salud en la política nacional para la erradicación del trabajo infantil y la protección del joven trabajador.

OBJECTIVE: As part of the evaluation of the obligations which the health sector acquired within the national policy for eradication of child labor, it is necessary to analyze their pertinence in relation to the context, the goals of the system and, overall, the needs felt by children of both sexes, young workers and their families. METHODS: For this evaluation the systemic approach is used where one side the commitments are compared with the social, political and economic context in which they were formulated and, on the other side, all those involved in the subject are called. From this a comparative strategy or triangulation is generated in order to obtain the coincident aspects as well as the conflicting ones, analyzing the different positions. RESULTS: Difficulties become evident in the sector regarding decision taking, as well as the ignorance of children and youths as social subjects of rights. CONCLUSIONS: In the health sector limitations are present for the understanding of the phenomenon of child labor, as well as of the role of the health sector in the solution of the problem ad the structural barriers created by the Law 100 of 1993.

Equity and working time: a challenge to achieve.

Equity is a humanitarian issue that gained strength during the transition from the 20th to the 21st century due to the mounting global discussion and social crisis involving human rights, health, and work. This article aims at (1) introducing the concept of equity as it applies to work environments, particularly to situations involving demanding work schedules, (2) discussing the role of science in equity issues related to work, (3) introducing a new scientific society dedicated to working-time issues, and (4) presenting an overview of new research on working time and health as addressed by the series of manuscripts published in this special issue of Chronobiology International devoted to the XVIth International Symposium on Night and Shiftwork, held in Santos, Brazil, November 2003. The concept of equity has a political as a well as a scientific dimension. Many worldwide organizations, e.g., civil society, academia, and occupational health research institutions, advocate prompt actions toward equity as a strategy to attain sustainable development and to reduce poverty. The analyses of current tendencies in work settings reveal a general situation of disrespect for equity principles, which is expressed by heavy workloads, long work hours, poor work conditions, and deregulation of established labor laws, mainly in (but not restricted to) developing countries. In spite of the great contribution of science in the past five decades, obstacles stand in the way of effectively improving good working conditions, particularly in times of precarious employment. The Working Time Society is a new scientific society that aims at promoting research into working time and health and offers practical advice on how to minimize adverse effects of working hours on workers' health and well-being. An updated view of the research on working times and health includes studies on the relationship between work schedules, worker health, and well-being; effects of night and shiftwork on the internal synchronization of circadian rhythms and laboratory and field interventions; new methods of investigation or new approaches in shift-work studies; and prediction of risks in night and shift work. Current tendencies of work organization contribute to the amplification of inequality across groups and populations, revealing that equity remains a challenge to achieve.