Fast But Right: Outbreak Surveillance And Foodborne Knowledge Infrastructure

This dissertation examines knowledge infrastructures for detecting and investigating national outbreaks of foodborne disease. Drawing on archival and ethnographic material from US public health and regulatory agencies, I investigate how officials have built and used surveillance systems to make foodborne outbreaks visible, reflecting the shape of the industrialized food supply. I describe how, in the course of conducting outbreak investigation work, officials confront the challenges of a "balancing act" of needing to be fast but right, facing dilemmas associated with wanting to protect the public health yet minimize economic impact to commercial entities, while grappling with the highly distributed nature of both the food system and a federalist system of public health governance. In the dissertation, I make three core arguments. First, during foodborne outbreak investigations, public health and regulatory officials manage time and uncertainty through systematization. Second, systematization has helped make visible a new kind of public health problem, rooted in the post World War II industrialization of the US food supply-national, diffuse outbreaks caused by contaminated food moving through interstate commerce. Third, despite the importance of and emphasis on systematization in this domain, the numerous and persistent challenges associated with needing to be fast but right preserves a need for expert judgment amidst formal systematization efforts. In addition to examining broader public health infrastructure, the dissertation features analyses of two surveillance systems for foodborne disease: an historical examination of the National Salmonella Surveillance Program from 1962-1976, and an historical and ethnographic study of the current early-warning, real-time system based on molecular subtyping. Through these analyses, I demonstrate how these systems made outbreaks visible not only from a technical perspective, but also from social, political, and economic perspectives as well

The Ever-Shifting Internet Population

Presents findings from surveys conducted between March and May 2002. Takes a new look at Internet access and the digital divide. Explores factors of cost, lack of technology skills, and physical access (particularly for persons with disabilities)

Biomedical Scientists' Perceptions of Ethical and Social Implications: Is There a Role for Research Ethics Consultation?

Research ethics consultation programs are being established with a goal of addressing the ethical, societal, and policy considerations associated with biomedical research. A number of these programs are modelled after clinical ethics consultation services that began to be institutionalized in the 1980s. Our objective was to determine biomedical science researchers' perceived need for and utility of research ethics consultation, through examination of their perceptions of whether they and their institutions faced ethical, social or policy issues (outside those mandated by regulation) and examination of willingness to seek advice in addressing these issues. We conducted telephone interviews and focus groups in 2006 with researchers from Stanford University and a mailed survey in December 2006 to 7 research universities in the U.S.A total of 16 researchers were interviewed (75% response rate), 29 participated in focus groups, and 856 responded to the survey (50% response rate). Approximately half of researchers surveyed (51%) reported that they would find a research ethics consultation service at their institution moderately, very or extremely useful, while over a third (36%) reported that such a service would be useful to them personally. Respondents conducting human subjects research were more likely to find such a service very to extremely useful to them personally than respondents not conducting human subjects research (20% vs 10%; chi(2) p<0.001).Our findings indicate that biomedical researchers do encounter and anticipate encountering ethical and societal questions and concerns and a substantial proportion, especially clinical researchers, would likely use a consultation service if they were aware of it. These findings provide data to inform the development of such consultation programs in general

“When does it stop being peanut butter?”: FDA food standards of identity, Ruth Desmond, and the shifting politics of consumer activism, 1960s–1970s.

This article uses a historical controversy over the U.S. Food and Drug Administration’s standard of identity for peanut butter as a site for investigating three topics of high importance for historians of technology, consumption, and food activism: how new industrial food-processing technologies have become regulatory problems; how government, industry, and consumer actors negotiate standards development; and how laypeople try to shape technological artifacts in spaces dominated by experts. It examines the trajectory of consumer activist Ruth Desmond, co-founder of the organization the Federation of Homemakers. By following Desmond’s evolving strategies, the article shows how the broader currents of the 1960s–70s consumer movement played out in a particular case. Initially Desmond used a traditional style that heavily emphasized her gendered identity, working within a grassroots organization to promote legislative and regulatory reforms. Later, she moved to a more modern advocacy approach, using adversarial legal methods to fight for consumer protections

Outbreaks and the management of ‘second-order friction’: Repurposing materials and data from the health care and food systems for public health surveillance

In the US, the public health system plays a key role in identifying unsafe food in the food supply. This identification work (public health surveillance) entails piecing together and reworking materials and data from the health care and food sectors to identify the ultimate cause of the problem. As such, the public health system depends heavily on infrastructures built for other purposes to achieve its goals. Using the case of foodborne outbreak detection, this article enhances the ethnographic analysis of second-order systems by incorporating the concepts of ‘repurposing’ and ‘friction’ to analyze this dependent relationship, the challenges it entails, and the broader sociopolitical and ethical consequences of connecting heterogeneous infrastructures. I examine how actors within the second order system of public health conduct the practical work of repurposing materials and data from other sectors, and grapple with the inescapable presence of ‘second-order friction’ between their system and infrastructures built to achieve other goals

Usefulness of a research ethics consultation service.

<p>Usefulness of a research ethics consultation service.</p

Survey respondent population.

<p>Survey respondent population.</p