Search

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?

This policy ensures that EMTs and Paramedics who transport patients to hospitals are not refused admittance or directed to other facilities due to their patients' inability to pay or other factors. While emergency departments still may declare a divert status, whereby incoming EMS units are advised that the ER is either full or unable to accept patients due to other factors, this act, and other relevant state statutes, require that hospitals still accept, treat, and stabilize any patients that are brought to their facilities.

1) “The logic of state soverignty in the control of migration clearly prevailed over the universality of the principle of the right to life.”

2) “By analogy with the therapeutic mesasures applied at the end of life for patients suffering from illness deemed incurable, we can describe the measures and procedures devised to allow foreign patients without residence rights to stay in France, receive treatment, and have their living costs paid, as a compassion protocol.”

3) “Precisely because he or she is illegally resident, the sick immigrant may undertake medical tests or seek treatment under a different name, so that the cost of treatment is coverd, or simply to avoid being denounced and deported.”

Emergency response, specifically the recovery response in the aftermath of a disaster such as Hurricane Katrina, is the principal focus of this report.

1)            Personal trauma: this includes not only the direct, immediate effects of the disaster but also the long-term mental and physical effects from the disaster.

2)            Way of life disrupted “disaster capitalism”: the next part of the syndrome includes business taking advantage of the situation for profits; the main case being private companies profiting off of federal funding to rebuild the homes and lives of the citizens who were affected.

3)            Displacement: the well-off are able to relocated after the disaster has ended but for those less fortunate, there permanent effects are worse, and there is little they can do to relocated to their homes and communities after the superficial aspect of the disaster have ended.

The author argues that a patient's narrative regarding his or her medical history can vary significantly and be affected by his or her culture. Cultural norms can determine how a patient presents or describes signs and symptoms or can determine the extent to which a patient is willing to share information with medical professionals.

The assessments that patients take are not visible to the public so I can not elaborate on it. This is what is quoted from the company’s website about the “Easy Clinical Screenings”:

“Patients take digital, gamified mental health assessments conveniently on their mobile device to learn their actual diagnosis and become more self aware. Providers can deploy customized assessment questions specific to each patient. Patients can see their charted progress over time. Assessments are reimbursable by insurers.”

• "Despite the urgency and impact of violence affecting health service delivery, there is an overall lack of research that is of health-specific, publically accessible and comparable, as well as a lack of gender-disaggregated data and data on perpetrator motives."
• "Although violence directly affecting health service delivery in complex security environments has received a great deal of media attention, there is very little publically available research, particularly peer-reviewed, original research."
• "Key challenges in addressing violence affecting health service delivery in complex security environments include a lack of health-specific, accessible and comparable, gender-disaggregated data and sufficient data on perpetrator motives."

1) The effects from the initial accident are recounted from the past history.

2) The healthcare system that deals with treating these patients are investigated.

3) The politics revolving around the first and second arguments form the third way that the author supports their argument.

1)  “Mismanagement was not the only charge mounted against the Japanese Utility that operated the reactors at Fukushima Diichi, Tokyo Electric Power Company (TEPCO). In the aftermath of the disaster, international media charged workers at the plant, alternatingly, with a lack of expertise to handle the situation adequately, and with a lack of courage, when they retreated temporarily under the threat of dangerously high radiation levels.”

                2) “But emergency preparedness is hardly ever considered ‘good enough’ in retrospect, especially after a disaster in which so many lives were lost or shattered.”

                3) “Within the nuclear industry, an almost exclusive emphasis on accident avoidance has given way to a new strategy of accident preparedness and response.”