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I situate my research at the crossroads of history, philosophy, sociology and anthropology of science. In the past, I have focused on epigenetics, environmental research, empirical bioethics and environmental justice, within and outside the academia, as you can read here, or here. Now I am focusing on antibiotic resistance, and I use it as a lens to interpret the contradictions of the last century derived by industrial production, environmental degradation and biomedical cultures.

What interests me is the (at that time) new epistemic discourse that since the Forties has been produced to explain morphological changes of organisms produce when they experience new environmental conditions or perturbations. Through an important experiment at the base of the so-called concept of genetic assimilation, Conrad H. Waddington showed that a thermic shock can produce changes in wings’ veins of fruit flies, changes that can eventually be inherited across generations, without the environmental trigger that caused them.

This focus on production and (genetic) storage of biological differences elicited by the environment is nowadays coupled with the knowledge produced through microbiome research that explains the phenotypic patterns that recur across generations.

In a thought-provoking twist, with microbiome research, the focus shifts from production and inheritance of biological differences to production and inheritance of biological similarities. Microbiome research shows that some phenotypic patterns are allowed by ecological communities of microorganisms composing all animals. Bacteria allow the development and functioning of our bodies within an epistemic framework that is now key to understand biology. The network of vessels composing mammals’ stomach is formed through cellular differentiation and expression of genes coordinated by bacteria. The same is true for our immune system that is coordinated by gut bacteria. Food, which is an important aspect of our lives also impacts on this microecology and mediates between our biological functions and functioning of means of production whose parts dedicated to food production have immense importance for our biology and our internal and external ecologies. Antibiotic resistance is one of the crossroads where culture, biology, history and the Anthropocene meet. Indeed, Antibiotic resistance shows that means of production of our societies have an even more widespread, deep and allegedly unexpected impact on the biology of animals and plants. The microorganism can indeed adapt to resist the selective toxicity of antibiotics. Moreover, bacteria can transfer their genetic code horizontally, by touch, so that we can acquire antibiotic resistance by eating food that functions as a vector, by hosting lice on our heads and many other contacts. Bacteria that are resistant to antibiotics that have been used as growth factors in animal husbandry and to prevent diseases in livestock and aquaculture, spread in natural ecosystems and can be found in wild species. Rivers and estuarine waters are places hosting antibiotic resistance.

Searching on PubMed (the search engine for biomedical literature) titles of articles containing the terms ‘antimicrobial’ and ‘Louisiana’ I retrieved just one twelve-years-old article. No results with terms such as 'Mississippi' or 'New Orleans'. The authors collected and analysed Oysters from both waters of Louisiana Gulf and in restaurants and food retailers in Baton Rouge. In most of the samples gathered, scientists recognised the presence of bacteria (Vibrio parahaemolyticus and Vibrio vulnificus) resistant to specific antimicrobials. Food production is indeed the first factor in terms of the quantity of antibiotics used. This use and related antibiotic resistance impact all the living beings present in a specific area, and can easily travel around the globe through many channels. As Littman & Viens have highlighted, a sustainable future is a future without antibiotics as “there may be no truly sustainable way of using antibiotics in the long-run, as microorganisms have shown to be almost infinitely adaptable since the first introduction of antibiotics” (Littman & Viens 2015). But in the meanwhile, we need to use them and antibiotic resistance is a phenomenon that can be better studied through environmental research, by analysing wild species and emissions nearby livestock, for instance.

The study that I retrieved focuses on Oysters. But what about antibiotic resistance conveyed through food that is consumed by the most?

What about exposures of communities that are living in highly polluted areas?

And what is the additive value on antibiotic resistance for individuals who experience the presence of industrial pollutants and that live in areas where cancer epidemics are registered?

In this respect, there is a strategy to cope with the issue of antibiotic resistance promoted by the Center for Disease Control and Prevention. The document doesn’t mention any action to monitor and regulate the production and usage of antibiotics in livestock. Nevertheless, the CDC wants to scrutinise, through genome sequencing, “Listeria, Salmonella, Campylobacter, and E. coli and uploads sequence data into PulseNet for nationwide monitoring of outbreaks and trends.” Moreover, the document reports that “In Fiscal Year 2019, Louisiana will begin simultaneously monitoring these isolates for resistance genes. When outbreaks are detected, local CDC-supported epidemiologists investigate the cases to stop spread.”

The questions that I would like to ask (to local ppl, activists, researchers, practitioners..) are:

What could be the epidemiologic characteristics (socioeconomic status, gender, residence..) of the populations more vulnerable to antibiotic resistance?

What is the additive role of antibiotic resistance for people living in highly polluted areas?

What is the impact of antibiotic resistance for people and patients living in areas where cancer incidence is high?

And on the long run I am interested in imagining possible strategies to not only living with the problem but also to tackle the problem itself, which means to develop strategies to answer the questions:

Why antibiotic resistance, which is known since a century, it’s a problem on the rise?

What is the role and interest of capitalism, in terms of profit-making of corporations, knowledge production and environmental degradation, in not being able to resolve antibiotic resistance?

What can be strategies of local communities to tackle the problem and to promote environmental justice in terms of alliances with ecologists, doctors, epidemiologists and other activists?

"In the interest of sustainable and socially legitimate solutions, arguably decisions to even the technical responses to disasters should not be left to scientists and engineers alone"

This statement is very thought-provoking and is not exactly expected in a research article - that a scientist's or engineer's decision should be influenced or editied by those without such specific education or expertise.

-balancing point between safety and profitability

-disaster did not happen as a chain of events that made it bound to occur at some point, it happened on a system that was in good shape

-over regulation of the industry and workers results in a lack of flexibility and therefore an inability to be creative in emergency situations

-need emergency response team to be skilled professionally and socially, but on a low budget - and very importantly - cooperation from nuclear corporations

The film goes through the lives of those in the emrgency room of a hospital: the doctors, nurses, patients, families. It looked at how some families don't have any choice other than to go to the ER, which makes the wait times longer. It shows how the field is different than the doctors thought when going into it, but it is still rewarding and they can change lives. It shows holes in the system and how easy it is for people to fall through the cracks, especially if they do not have insurance or a PCP. There is stress on everyone involved to keep people moving but making sure nobody is forgotten. Traumas also bump those waiting farther down the list.

They are partnered with some of the largest and most prestigious health care companies and institutes in the world, so that helps them to have cutting edge technology and as many resources as possible, given their budget. Those partners may encourage them to use their resources in particular ways, but overall, healthcare is the basis of each partner's goals, so they shouldn't be swayed in unethical ways.

Users can search by topic, by category, or by the type of post: field notes, briefing, etc. Rapid Questions can also be asked, which are typically answered within 72 hours.

I looked into some of the big fires in America's history as well as the emergency response for them. It is very saddening to see how poor the response was back then and how many lives were lost unnecessarily, but at least we have improved.

Emergency response is not addressed, but it could lead to more patients if illegal immigrants are more encouraged to seek advanced medical attention, and billing could be complicated, since it may be funded by the government.

The policy deals with Institutions for Mental Diseases (IMD), which are defined as facilities with at least 16 beds, and focuses on diagnosing, treating, and caring for those with mental diseases. There are additional ways to determine whether a facility is an IMD. Once this determination is made, this policy aims to set limits on IMDs, as well as specify which services they should provide.

This program aims to aid the member states in preparing, testing, and improving emergency response for nuclear emergencies and radiological accidents.

I looked up how other countries and areas of the world fund emergency response, like ambulance agencies. I also looked to see in which countries these services are most developed. The last point I researched was the size of the area affected by Chernobyl and the population density of that area.