Health system adaptation to climate change: a Peruvian case study.

Despite mitigation attempts, the trajectory of climate change remains on an accelerated path, with devastating health impacts. As a response to the United Nations Framework Convention on Climate Change call for National Adaptation Plans, Peru has developed a national and decentralized regional adaptation plans. The purpose of this article is to understand the role and priority status of health within the adaptation planning and process. Peru was used as a case study to analyse the policy process in the creation of adaptation plans, encompassing the need to address climate change impacts on health with a particular focus on marginalized people. An actor, content and context policy analyses were conducted to analyse 17 out of 25 regional adaptation plans, which are available. The national adaptation plans (2002, 2015) do not include health as a priority or health adaptation strategies. In a decentralized health care system, regional plans demonstrate an increased improvement of complexity, systematization and structure over time (2009-17). In general, health has not been identified as a priority but as another area of impact. There is no cohesiveness between plans in format, content, planning and execution and only a limited consideration for marginalized populations. In conclusion, the regional departments of Peru stand on unequal footing regarding adapting the health sector to climate change. Findings in the strategies call into question how mitigation and adaption to climate change may be achieved. The lack of local research on health impacts due to climate change and a particular focus on marginalized people creates a policy vacuum. The Peruvian case study resembles global challenges to put health in the centre of national and regional adaptation plans. In-depth cross-country analysis is still missing but urgently needed to learn from other experiences.

[Towards a national commission on health research ethics in Peru: reflections on the routes and processes comparing viewpoints]. / Hacia una comisión nacional de ética de la investigación en salud en Perú: apuntes acerca de rutas y procesos en perspectiva comparada.

We performed a review of the constitution processes and functions of national commissions on health research ethics in Latin America and Europe countries, which are characterized by its relation with the legislation and governmental structures in health sector, but, especially, in almost totality of cases for being linked by the functioning of the Research Ethics Committees. On the basis of this review there are realized an initial balance sheet and perspectives of the conformation of a National Commission on Health Research Ethics in Peru.

Proceso de fortalecimiento de Comités de Ética en Investigación en el Perú / Research ethics committees strenghtening process in Peru

El Ministerio de Salud de Perú tiene la misión de regular, promover y proteger la salud. El Instituto Nacional de Salud (INS) , como institución encargada de la gestión de la investigación, tiene como uno de sus desafíos regular a los Comités Institucionales de Ética en Investigación . Por tanto debe evaluar la competencia y capacidad de dichos comités. El Destacamento del Centro Médico Naval de los EEUU (con base en el Perú), la universidad de Washington y el Departamento de Bioética Clínica del NIH se han convertido en el centro de formación en ética de la investigación en el Perú y Latinoamérica. Con las evidencias encontradas en las inspecciones realizadas por el INS podemos inferir que la formación brindada por las citadas instituciones no contribuyen a mejorar la revisión ética de la investigación, por tanto el Estado peruano tiene la responsabilidad de asumir estos procesos formativos desde los espacios regulatorios bajo la perspectiva de respetar, proteger y cumplir los derechos de los sujetos de investigación.(AU)

The Ministry of Health of Peru’s mission is to regulate, promote and protect health. The National Institute of Health (NIH), as the institution responsible for managing research, has as one of its regular challenges to the Research Ethics Committees. Therefore should assess the competence and capacity of these committees. The Naval Medical Center Detachment of the U.S. (based in Peru), University of Washington and the Department of Clinical Bioethics at NIH have become the training center on ethics of research in Peru and Latin America. With the evidence found during inspections conducted by the INS can infer that the training offered by these institutions do not contribute to improving the ethical review of research, therefore, the Peruvian State has the responsibility to take these formative processes from the spaces under regulatory the perspective of respect, protect and fulfill the rights of research subjects.(AU)

Hacia una comisión nacional de ética de la investigación en salud en Perú: apuntes acerca de rutas y procesos en perspectiva comparada / Towards a national commission on health research ethics in Peru: reflections on the routes and processes comparing viewpoints

Se realizó una revisión de los procesos de constitución y funciones de instancias nacionales de la ética de la investigación en salud en países de Latinoamérica y Europa, que se caracterizan por su relación con la legislación y estructuras gubernamentales del ámbito de la salud, pero, sobre todo, por estar vinculados en casi la totalidad de casos con el funcionamiento de los Comités de Ética en Investigación. Sobre la base de dicha revisión se efectúa un balance primicial y perspectivas de la conformación de una Comisión Nacional de Ética de la Investigación en Salud en el Perú.

We performed a review of the constitution processes and functions of national commissions on health research ethics in Latin America and Europe countries, which are characterized by its relation with the legislation and governmental structures in health sector, but, especially, in almost totality of cases for being linked by the functioning of the Research Ethics Committees. On the basis of this review there are realized an initial balance sheet and perspectives of the conformation of a National Commission on Health Research Ethics in Peru.

El contexto en la epistemología personal: consideraciones teóricas y exploraciones empíricas / Context in personal epistemology: teoretical considerations and empirical explorations

En la investigación sobre epistemología personal, se ha tenido escasamente en cuenta el contexto. En este artículo, exponemos razones teóricas que muestran la importancia de considerar el contexto al que la epistemología personal hace referencia, así como el contexto en el que las creencias son declaradas. Proponemos que la comprensión epistemológica referida a y declarada en contextos especializados, podría ser diferente que la referida a y declarada en contextos no especializados. Presentamos dos estudios exploratorios cuyo objetivo fue determinar si la comprensión epistemológica es distinta en contextos referencial y declarativo distintos. Los resultados mostraron que la comprensión epistemológica referida a y declarada en el contexto pedagógico -especializado- es mayor que cuando es referida a y declarada en un contexto social informal - no especializado. Sugerimos que es importante incorporar los contextos declarativo y referencial, así como la distinción entre contexto especializado y no especializado, en la investigación en epistemología personal.(AU)

In personal epistemology research, context has been scarcely kept in mind. In this paper, theoretical reasons are presented that show the importance of considering the context to which the personal epistemology makes reference, as well as the context in which the beliefs are declared. We propose that epistemological understanding referred to and declared in specialized contexts, could be different that the one referred to and declared in non specialized contexts. Two exploratory studies were carried out in order to answer the research question: Are epistemological understanding different in different reference and declarative contexts? In both studies, epistemological understanding referred to and declared in the specialized pedagogic context was bigger than when it is referred to and declared in a non-specialized, an informal social context. It is suggested that it is important to incorporate declarative and referential contexts, as well as the distinction among specialized and non-specialized context, in personal epistemology research.(AU)

Evidencias de estruturacao da agua em solucoes diluidas de cloreto de magnesio / Evidencies of water structuration in dilute solutions of magnesium chloride

Estudo da absorcao de luz ultravioleta em solucoes dinamizadas e diluidas de cloreto de magnesio. Observa-se que as dinamizações apresentam um aumento de absorção de UV a medida que a concentração... (AU)