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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?

" we aim to provide an overall picture of what we have learned from decades of research on the presentation, burden, correlates, and treatment of mental disorder following disasters. We also describe challenges to studyingdisaster-relatedpsychopathologyandlimitationsinourcurrentmethodologiesandoffer directions for future research."

"Childrenexposedtodisastersareparticularlyvulnerabletopsychologicalproblems,mostcommonly symptoms of anxiety (e.g., PTSD, panic, phobias) and depression but also acute stress reactionsandadjustmentdisorder(27).Elevatedvulnerabilityamongchildrenmaybeafunctionof their being less equipped to cope with what they have experienced (49)."

"Psychological first aid (PFA) has become the preferred post-disaster intervention, with three goals: Secure survivors’ safety and basic necessities (e.g., food, medical supplies, shelter), which promotes adaptive coping and problem solving; reduce acute stress by addressing post-disaster stressors and providing strategies that may limit stress reactions; and help victims obtain additional resources that may help them cope and regain feelings of control"

The argument is supported through research into political trends - the survivors gave up their own values to support anyone that could help them. There were interviews with the survivors and those living in the area - they dicussed how their lives changed, their inability to find work and their health issues that started immediately or soon after the disaster. The authors also did research of programs to help the survivors - looking at the compensation they could recieve, options for working, how to get healthcare, etc.

**Linda not Laura as I previously stated

"Two FDNY EMTs who had to intervene to stop four police officers beating a handcuffed patient on a stretcher have turned the cops in to authorities"

""Three cops began to punch the patient in the face, EMS (had) to get in the middle of it to intervene. Pt's. wounds and injuries cleaned in the (ambulance)," the report said."

I further researched the reliability of some of the funds that were donated to in the months after the disaster. The FBI issued warnings to those donating to be sure they were giving money to a reliable fund, as there was a lot of fraud taking place. With so much money being donated internationally in a short period of time, it was likely easy for such to occur, and that also took away from the amount of aid Haiti received.

I also looked into the improvements in the country over the first few years since the earthquake. The people of Haiti were cited as having a strong desire to help rebuild, they just needed to be shown how. http://www.nbc29.com/story/20596283/haiti-sees-improvements-since-earth…

I looked up the rates of hospital bankruptcy/closing, the results looked to be interesting. The article (http://www.healthcarefinancenews.com/news/hospital-bankruptcies-result-…) makes it seem avoidable, if the warnings are taken seriously in the years leading up to the crisis. "What they found was that filing hospitals tended to be smaller, not part of a health system and were more likely to be in the Northeast or West Coast. Many factors were involved, including poor financial management, changes in payer mix, reimbursement reductions, overzealous construction and purchasing of physician practices, decrease in volume and demographic shifts that were the impetus for filing."

I also looked up ER wait time statistics, by state, over the course of several years, etc. (https://projects.propublica.org/emergency/) Very interesting!

"History shows that, with time, a given community of engineers and scientists has generally proven able to explain the technical particulars of a structural collapse. Yet, the demands placed in an investigation have as much, or more, to do with defining the dominant investigator and quickly addressing the fears and anger of the press, government, and an outraged public than they do with discovering the defiinintive technical truths of a catastrophic event."

"Steam power...utterly transformed American economic and social life in the 19th century. With this promising technology, though, arrived a whole series of risks, catastrophic boiler explosions being the most dramatic, and the deadliest."