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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?

Data for this report was collected from other sources and forms of documentation as early as the day of the event. Information and details such as population sizes, weather conditions that day, human population distribution and more were all information collected from that day of the event. Other forms of data collected, ranging over the time of the event occurring to the publication time, include factors such as the quality of the air, water, animals and living conditions surrounding the plant. Human radiation levels and infection were also gathered, radiation levels of crops and much, much more were all statistics and data collected over roughly twenty year timespan that this report covers. This is actually one of the main driving points of the report, listed in the title "twenty years of experience." It compiles 20 years of research and findings into one large report.

After the Fukushima disaster, thyroid examinations were performed on residents less than 18 years of age. The first three years post disaster are noted as the "Initial phase" and act as a control. Of those tested, 113 cases were suspected of or found to have thyroid malignancies, 99 of those underwent surgery. After this, the goal became to compare and observe prevalence of thyroid cancer in this initial screen program with historical controls based off if there was a nuclear disaster or not.

For this study, the observed/expected ratio was calculated for residents less than 20 years old. Observed prevalence of cancer was calculated using numbers found in the initial thyroid screening program mentioned above. Expected prevalence was then calculated by using a life-table method utilizing national estimates of thyroid cancer incidences before the disaster. The population of Fukushima was taken into account.  A 5 year cumulative risk of thyroid cancer incidences was calculated for the year of 2010.  This 5 year risk was then converted to a 1 year cumulative risk using a method called spline smoothing. Then the age-specific prevalence of thyroid cancer was estimated by multiplying the 0 year old population by the age specific risk in 2010. 

I have done research involving cancer rates and their correlation with power plants (in my case Indian Point.) Doing that research caused me to read hundreds of studies similar to this one where estimates are made using calculations based off cancer rates before the incident and then taking them and putting them into context of a post disaster area. I wouldn't quite say that this method is new or inventive but it follows similar methodology to other studies of this same caliber, yet there are aspects that make it more unique such as converting the 5 year to 1 year cumulative risk using a spline smoothing method. 

"Data from this study provide the opportunity for addressing not only problems of medical care and public health, but for reflecting on theoretical and methodological questions central to this book as well."

"As the interviews went on, it became evident that "fainting" is a cultural category often used to describe classical tonic--clonic seizures. However, the term is associated with a more general semantic domain that includes fainting occurring in times of acute distress or in the context of a life of suffering, and is less stigmatizing than the term "epilepsy."

"Narrative theory describes two aspects of plot: plot as the underlying structure of a story, and "emplotment'' as the activity of a reader or hearer of a story who engages imaginatively in making sense of the story. Both are relevant to the analysis of illness narratives."

The American Red Cross has volunteers in different sectors, some are blood drive volunteers, while others are disaster volunteers or digital advocates. Disaster volunteers form action teams and respond to single-family fires, or provide food and shelter, comfort, etc to areas of major disaster, a recent example would be the fires in California. Yet they also aid areas that recently have succumbed to hurricanes and tornados. They also act as disaster preparedness presenters and educate people on how to be prepared for disaster. The American Red Cross is always hosting blood drives, yet when there is a national disaster, they hold emergency drives and increase the amount of drives they have in order to get blood for those devastated by the disaster. American Red Cross doesn't just respond to disaster and act as an emergency response force but they actively hold seminars to educate people on being both prepared and preventative. 

EMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.

http://www.pitt.edu/~kconover/ftp/emtala-draft.pdf

I would say that the perspectives of the government as well as first responders were not included in this film. They were not able to communicate the stresses as well as the lack of resources and man power. There were no viewpoints from first responders or volunteers, having that testimony would have more accurately depicted the hardships that first responders and aid were facing. 

The purpose of this study is to look at the effect of social and economic factors, status and health comunication behaviors on people's knowledge about the flu pandemic and prevention efforts. In the past it has been reflected in studies that people in different social groups have a far different access to information form each other about health and specific threats of diseases, which in effect may alter their behavior and knowledge on the topic. This study looks to see if these inequalities lead to a compromised  adversity in these vulnerable populations when it comes to responses to the flu outbreak. 

The author supports his arguments by discussing other events such as the US capitol building burning, the Hague Street boiler explosion, and Iroquois Theater Fire. The Capital Building section of the paper focused on the investigation that followed and what it revealed in terms of the people's concern of the meaning behind the burning of the building, rather than the building actually falling down. This section follows the investigation as well as the ultimate rebuilding of the Capitol. The Hague Street Explosion was similar in that there was an investigation. This investigation was focused on figuring out a party to blame. It was ultimate decided everyone involved with the boiler at all was responsible. The Iroquois theater fire section discussed mechanisms that caused and could have accounted for what occurred. Building codes were questioned as well and proved to be a unique disaster investigation. This was due to the factor of public responsibility at play in this disaster. 

This website itself doesn't translate the data into information. Researchers collect the data, run analyses and tests, and then post them on the site for the public as well as other researchers. The website doesn't translate or post any data, registry staff does. Participants also do not enter the information into the website. Any information participants need to update or provide must be given directly to the registry staff.