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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?

On the academy's front page, they have information regarding DRLA in the news and other highlights. It would appear that the program is highly regarded. USAID's Office of US Foreign Disaster Assistance visits Tulane to speak to students about career opportunities, showing that this program produces leaders that would fit the role of a caring and talented worker. Graduate students were also able to collaborate with local volunteer teams in the Louisiana Flood Recovery. Some Tulane professors also have UNICEF grants, which allow them to help lead UNICEF tranings meant to strengthen social service workfoce. They have met with several governmental agencies and FEMA, which provides a framework highlighting how well esteemed this academy and program really is. 

Emily Goldmann, PhD, MPH, is an Assistant Research Professor of Global Public Health at the College of Global Public Health. Her work focuses on social and environmental determinants of mental health conditions such as posttraumatic stress disorder and depression, as well as the mental health consequences of acute health events. She believes that context is important when thinking about mental health conditions and that the causes of mental illnesses are embedded in all aspects of life. She has also worked as an epidemiologist at the NYC Dept of Health and Mental Hygiene in the Bureau of Adult Mental Health following Hurricane Sandy. 

Sandro Galea, MD, MPH, DrPH is a physician and epidemiologist. He is the Robert A. Knox Professor and Dean at the Boston University School of Public Health. He has served as the Anna Cheskis Gelman and Murray Charles Gelman Professor and Chair of the Department of Epidemiology at the Columbia University Mailman School of Public Health. He has also held leadership positions at the University of Michigan and at the New York Academy of Medicine. His interests lie in the social production of health of urban populations, with a focus on the causes of brain disorders such as mood-anxiety disorders and substance abuse. He also works on the consequences of mass trauma worldwide. He has published over 600 scientific journal articles, 50 chapters, and 10 books and has received funding from NIH and CDC. His medical degree is from the University of Toronto, and his graduate degrees are from Harvard and Columbia with an honorary doctorate from the University of Glasgow. He has held several prestigous leadership positions. 

The system relies on its developers, as mentioned, for support and information. They are also responsible with creating updated versions in order to provide better functionality, but also keep the information up-to-date and accurate. 

1. Schmid discusses the aftermath of Fukushima and how the workers at the plant lacked expertise in handling this type of disaster, and as a result, retreated. This is an example of the lack of knowledge among workers and lack of an action plan in case a disaster such as the one that occured happens.

2. Schmid points out how world leaders are recognizing the need for a unified and consice nuclear emergency response plan. One of the leaders include Russian nuclear operator, who suggested that international law should force countries operating nuclear plants to abide by international safety standards. 

3. She also points out how executives in the nuclear industry create many rules in order to control the workers. They don't necessarily analyze when, why, and by whom rules are broken, but instead implement more rules. When rule-beinding or judgement calls are made, executives try to conceal them instead of learn from them, which is part of the issue at hand. Improvisation is very important. Especially when it emphasizes the expertise of the executives. During an emergency, improvisation would show what experts have experienced and how well they can lead and cooperate. 

The main point of this article is that medicine needs human experience through stories and vignettes in order to provide better diagnoses and outcomes for patients. This author highlights the importance for doctors to consider stories and personal anecdotes when deciding what would be best for their patient. 

Not that I could find. 

1. "Part of the great appeal of humanitarianism is that it exemplifies moral certainty: it purports to save lives and alleviate suffering. How can one argue with this kind of moral imperative?"
2. "But more significantly, in addition to revealing the reproduction of inequality, the fissures rendered visible by the entry of gender-based violence into humanitarian missions force an engagement with new forms of the political. Humanitarianism’s mission has expanded so that it now occupies a dominant place in the global political arena – whether humanitarians asked for this or not."
3. "My argument is that while humanitarianism, in conjunction with certain feminist movements, may work to medicalise and depoliticise gender-based violence, the politics of gender actually creep back in undercover, revealing problems at the heart of the humanitarian mission – problems that undermine the very idea of a ‘humanitarian space’ critical to humanitarian action, that is, a space that tries to temporarily hold the political at bay."
4. "That is, if one errs on the side of the duty to bear witness, this is considered ‘political’ and threatens the neutrality which gives access to crisis zones. It is a fine line to tread."