Trust, Conflict, and Engagement in Occupational Health: North American Epidemiologists Conduct Occupational Study in Communities Affected by Chronic Kidney Disease of Unknown Origin (CKDu).

PURPOSE OF REVIEW: Science has been used as a tool of colonialism, and aspects of science privilege researchers in the global North (USA and Europe). The environmental justice and worker health movements in the USA and globally have influenced aspects of how occupational and environmental health research is conceived and conducted so that it is more equitable. This review provides a case example of research in the area of chronic kidney disease of unknown origin (CKDu). RECENT FINDINGS: In the present work, the author describes aspects of community-based participatory research and anti-colonial research that influence a current occupational epidemiology study of CKDu in Mesoamerica among workers in agriculture and non-agricultural industries. The research includes investigators from numerous countries in the global North and South and funding from the US government and corporations. The role of industry in science and the misuse of science by corporate interests remain substantial threats to research integrity. The ability of researchers to navigate potentially conflicting interests with industry and workers, and establish trust within and outside the scientific community, is essential for sustained engagement in longitudinal studies. Trust is about human relationships. It takes time and effort to build and is essential for creating equitable, empowering research relationships.

The virtuous epidemiologist.

This article addresses the scholarly gap in the ethics of epidemiology by exploring what virtue ethics, one of the oldest ethical traditions in moral philosophy, has to say about 'the virtuous epidemiologist'. It expounds comparatively the content and merits of a virtue ethics approach against more popular contemporary schools of thought such as consequentialism and deontology. Without necessarily dismissing the value of principles and standards, it presents a vision that a virtuous epidemiologist should cultivate wisdom in making prudential judgments in conditions of uncertainty; fortitude in dealing with powerful politicians and administrators which does not sacrifice truth; temperance and self-restraint in keeping one's ideological views from compromising one's scientific credibility; and justice in giving due weight to individual rights and the public interest when doing research and giving advice on public health interventions.

Heterogeneous perception of the ethical legitimacy of unbalanced randomization by institutional review board members: a clinical vignette-based survey.

BACKGROUND: Institutional review boards must guarantee the ethical acceptability of a randomized controlled trial before it is conducted. However, some may regard an unbalanced randomization ratio as reflecting an absence of uncertainty between the groups being compared. The objective was to assess institutional review board members' perceptions of whether unbalanced randomization in randomized controlled trials is justified and ethically acceptable. METHODS: Institutional review board members worldwide completed a survey involving clinical vignettes modeling situations classically advocated to explain the use of unbalanced randomization. Institutional review board members were asked whether unbalanced randomization was justified and ethically sound. Answers were collected by using visual analog scales. Data were analyzed by principal component analysis, and a hierarchical ascending classification was created. Verbatim answers were assessed by qualitative content analysis. RESULTS: We analyzed responses from 148 institutional review board members. Three classes of respondents were identified: class 1 (n = 58; 39.2%), mostly skeptics who disagreed with unbalanced randomization, whatever the justification; class 2 (n = 46; 31.1%), believers who considered that unbalanced randomization was acceptable whatever the justification, except cost; and class 3 (n = 44; 29.7%), circumstantial believers for whom unbalanced randomization may be justified for methodological and safety issues but not cost or ethical issues. When institutional review board members were asked whether unbalanced randomization respected the equipoise principle, the mean quotation was low (4.5 ± 3.3 out of 10), especially for class 1 members. CONCLUSIONS: Institutional review board members perceive unbalanced randomization heterogeneously in terms of its justification and its ethical validity.

[Perceptions about their own old age from the perspective of a group of epidemiologists in training]. / Percepciones de un grupo de epidemiólogos en formación acerca de su propia vejez.

OBJECTIVE: Exploring, from the perspective of a group of epidemiologists in training, the perceptions about their own old age. MATERIAL AND METHODS: Exploratory, qualitative-descriptive study, in which ethnographic tools were applied: observation, field diary and group interview (GF). RESULTADOS: Explored from the perspective of a group of epidemiologists in training. The group agreed that to plan to reach a functional and decent old is important, despite the current unfavorable and adverse conditions, recognizing that not all will reach there, and it is less common for young people to think and plan their own old age, and even less work with and for the elderly. The meaning of aging most often mentioned by the group contain the word "phase", in which concept and care reflect the high standards desired individually. It became clear, that nursing homes for old age people are necessary, but the services provided are differentiated since "the economy determines the care for the elderly". CONCLUSION: Reflecting on the perception of old age itself, for the group of epidemiologists in training, helped visualize their concerns, fears, expectations, and to reflect on their responsibilities and possibilities in providing scientific evidence to plan and make sound decisions for a dignified old age and aging of the population from Nariño.

OBJETIVO: Explorar desde la mirada de un grupo de epidemiólogos en formación, las percepciones sobre su propia vejez. MATERIAL Y MÉTODOS: Estudio exploratorio, cualitativo - descriptivo, en el cual se hizo aplicación de herramientas etnográficas: observación, diario de campo y entrevista grupal (GF). RESULTADOS: El grupo consensuo que programarse para llegar a una vejez funcional y digna es importante, a pesar de las desfavorables y adversas condiciones actuales, reconociendo que no todos lograrán llegar a ella, y que es menos común en los jóvenes pensar y planear su propia vejez, y menos trabajar con y para los viejos. Los significados sobre vejez más frecuentemente referidos por el grupo contienen la palabra "etapa", en cuyo concepto y cuidados se reflejan los altos estándares deseados a nivel individual. Se puso de manifiesto que los hogares para ancianos son necesarios, pero que los servicios prestados son diferenciados pues "la economía determina la atención para el anciano". CONCLUSIÓN: La reflexión acerca de la percepción de la propia vejez, para el grupo de epidemiólogos en formación, ayudó a visualizar sus inquietudes, miedos, expectativas y a reflexionar acerca de su responsabilidad y posibilidades en el aporte de evidencia científica que permita planear y tomar decisiones acertadas para un envejecimiento y vejez dignas de la población nariñense.