The last few months have seen some further development of the Mapping Microbes project. Firstly, the development of a video tracking application that enables users to record instances, frequency and quality of touch onto video footage, producing quantitative data that researchers can use to, for instance analyse critical control points in a hospital ward setting. We are very grateful to Jacqui Prieto, Sandra Wilks and Mat Moyo for their expertise in how we might want to record touch, to Matthew Olden for some of the app development work, to Tim Leighton and Paul White for their data engineering expertise, and to Pina Gruden for her analysis work. We hope to have some figures to share soon.

We have also been working with Matthew Olden and William Datson, a designer in Bristol, to develop an interactive exhibit based on an automatic hand washing machine. Two machines have been kindly donated by Wallgate Ltd., and can play video and record time, to incentivise users to wash their hands. We showed the prototype at the NAMRIP conference and at Cheltenham Science Festival, in early June, where it went down a storm. We’re looking at ways of developing it further and finding new contexts. Watch this space!

We’ve been working with Bristol-based filmmaker Joseph Turp, who has made this beautiful video about the project, based on a beautiful poem by the excellent Michael Rosen. It’s designed as a training tool for healthcare workers, and has been developed in dialogue with nurses at Southampton General and at Southmead Hospital, Bristol. Using some of the techniques of the Mapping Microbes experiment, it tells the story of the spread of simulated pathogens, making visible the effects of hand hygiene and the value of healthcare staff at the front line of infection prevention. Do let us know what you think!

[youtube https://www.youtube.com/watch?v=W7xnaXSJab0&w=560&h=315]

As part of the Eco Bathrooms project, Charlotte Veal and Paul Hurley of the Mapping Microbes team have been working with artists Caleb Parkin and Megan Clark-Bagnall to create an interactive Bathroom Jungle-themed game, communicating some of their work around AMR in the domestic sphere. Aimed at Key Stage two children, the game premiered at Winchester Science Centre during the half term holidays, and engaged hundreds of families in activities and conversations around AMR. Children were taken on a journey through a series of fun challenges – Biofilm Connect Four, Loo Seat Sponge Throw, and Drug Resistance Duck Race – to communicate some of the mechanisms of AMR and to talk to families about their domestic cleaning practices. The team were interested in what alternative metaphors of AMR could be – ecosystems rather than battlefields, colonisation and survival rather than zombie attacks! This is part of a longer NAMRIP-funded research project that Veal and Hurley have been involved in ‘Fighting Superbugs on the Home Front: Becoming an Ecological-Citizen in Your Bathroom’, along with Emma Roe, Bill Keevil, Ian Williams, and with Owain Jones from Bath Spa University, exploring how citizens can connect domestic practices to the global threat of AMR.

In early January we’re restaging the experiment we did in the simulation ward and working with a professional film maker to make a short video about the work, as a training tool for nurses. We’re looking for two (student) nurses / healthcare assistants who can undertake routine tasks (changing a patient’s bed, doing observations, emptying a fake bed pan, etc.) for camera. No acting experience necessary – the focus will be mostly on hands, and so confidence in performing the tasks is what is important.

We’re planning to film on 5th Jan, and would like two (student) nurses / HCAs who could be available between 10am-4pm. It might be that we finish early. Nurses / HCAs will need to bring their own uniform.

Nurses / HCAs will be paid for their time, along with tea and biscuits, and will hopefully have fun!

This opportunity should be of interest to any nursing students, nurses or HCAs, especially those with a curiosity about academic research, collaboration and infection prevention.

Any questions drop me a line below

 

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Research team members Emma Roe (PI) and Paul Hurley (Co-I) attended Camp Bestival at Lulworth Castle, Dorset, with the University’s Public Engagement Roadshow Team. We talked to families about AMR and some of the research taking place at Southampton.

Over the course of the weekend we helped hundreds of children decorate masks of different microbes and to take “cell-fies” in the ‘Microbe Mascquerade’ photo both. This led to great conversations with children and parents about the diversity of the microbiome, and about AMR.

We also used these chats as an opportunity to inform the research questions in the current project, listening to attitudes towards domestic microbes – variously described as ‘germs’, ‘nasties’, and ‘good’ / ‘bad’ bacteria. We also learnt a lot about the diversity of antimbicrobial cleaning products that families use and why, which will feed into the creative interviewing methods and activities we’ll be undertaking with families in Southampton.

Part of the research we have been undertaking in the Eco Bathroom project has been to understand cleaning practices and knowledges (what products people buy and why, and how these products are used) and householders’ understandings of the agency of bacteria in the home. We chose to focus our study on families with children under 10, and selected three households in Southampton and Bristol, with whom to undertake interviews. We were interested in combining ideas from geography and performance studies in qualitative research that took into account place, embodiment and imagination.

We visited research participants in their own houses, and began the interview in their bathroom where we photographed their cleaning products and asked parents about their cleaning practices (how often they clean, what they focus on, what the motivation to clean is, etc.). At the same time, the children in the family were invited to put small Post-it notes on anything that they considered could be dangerous or risky. This performative mapping technique elicited some of the discourses about domestic health and safety practices – around physical hazards like doors, as well as chemical and biological ones, such as areas perceived as prone to pathogenic colonisation.

The interviews continued around the dining table, with more extended conversation about cleaning and pathogens, and activities that the parents and children undertook to visualise different bacteria and their relation to their environment (domestic space and the human body) using colouring and collage on masks, and plasticine modelling. The families were left with a cleaning diary and scrap book, in which to record their next week of living with microbes. The data from these, as well as from the interview transcripts, will be analysed and collated to see how understanding householders cleaning practices and the motivations behind them, might inform future work about AMR and waste water.

It’s still a work in progress, but we’ve begin building an interactive timeline of the experiment, which shows how the UV powders have worked to visualise moments of transfer of simulated pathogens. We’ll be adding in some video, as well as tagging and annotating the photos as the data analysis develops. You can see the timeline in different views Hand Hygiene Experiment Timeline

I come to this project with a lot of questions and curiosity. Every conversation | have with others in the research team seems to throw up new knowledge and to shift my thinking. My background is in performance art (as an artist as well as a researcher), in a practice driven by explorations of ritual, of intersubjectivity and of what bodies can do. My research is practice-led, that is to say it concerns knowledge that comes into being through doing, through what Bolt calls “material thinking”, involving “a particular responsiveness to or conjunction with the intelligence of the materials and processes in practice.” (30)

Materiality and process are key to a lot of the work that I do, as is collaboration: collaborating with other academics, other artists, with community and research participants and with organisations. I’m interested in collaboration in a formal sense, but also in the less distinct relationships of meaning making that exist when people come together to view or participate in an artwork (and follow a Barthesian understanding of a text being realised in its encounter with a reader / viewer). A lot of my work is experimental, I don’t know what outcomes will be or even (often, what the reason for doing it is), until after I’ve made an artwork or event. We find out together.

Some of my early artwork, after my MA and in the first couple of years of my PhD was concerned with becoming-animal, with Deleuzo-Guattarian ideas around intersubjectivity and the (non)human. Working with AMR brings me back to some of this, to questions of the agency of microscopic life and our close but peculiarly performed relationship with it. Early meetings with Sandra, Jacqui and Lisette really opened up my eyes to the life of microbes, and to how utterly crucial their presence (or absence) is in healthcare settings. As someone who very rarely visits hospitals, the layers of knowledges, practices, rituals and routines around hand hygiene were a whole new world to me.

In this project, I’m interested in the agency of microbes and in how healthcare workers visualise and perform their own relationship to them. I’m interested in how nurses’ bodies relate to the human and nonhuman life of their patients’ bodies and environments, in how practices of cleaning, protecting, touching and not touching, perform different bodies and relationships. I’m also interested in finding out more about engineering approaches, in how the use of imaging technology might translate the movement of living things (both nurses’ bodies and microbes) into points on a heat or vector map.

What lies ahead is an exciting – if challenging – process of dialogue and exchange across disciplinary practices and languages. I’m confident that this pump priming project will broaden the team’s understanding of AMR and bring us novel practices and knowledges towards improving infection prevention.

Reference:

Barrett. E. and Bolt, B. (eds) (2014), Practice as Research: Approaches to Creative Arts Enquiry, I.B.Tauris

As a cultural geographer, the opportunity of contributing critically to a three-month experimental study on microbial life proposes a series of challenges and possibilities; from negotiating disciplinary-specific languages and knowledges, to differing approaches to conducting research, and a variety of expectations around what experimentation actually means in the context of academia. Collaboration with medical-based specialists, engineers, and performance scholars at the same time brings to light a number of themes and premises that resonate with my own geographical research interests and expertise – albeit in the unusual geographical setting of the hospital ward.

At the heart of my research interest has been a concern with moving bodies and their interrelationship with space, place and objects. While this in the past has tended to focus on the city, the micro-geographical scale of the healthcare ward provides a valuable opportunity to examine how bodies contribute to, and actively produce, the spaces in which they move. Thinking through the lens of microbial life, I am keen to examine how the nurses’ body, and particularly their hands, facilitate and equally deter the trajectories of microbes. In this way, I am interested in what hands are seen to do and what remains unseen, and equally, how a nurse’s body negotiates and respond to a variety of health care procedures (whether this is repulsion, compassion, or desensitisation).

Equally, and interconnected, my research focuses on the geographies of performance and theories of practice. In this respect, I am interested in mundane everyday practices that we train to do and practice doing over time – of learning and enacting ‘appropriate’ forms of behaviour. The tasks, duties and responsibilities of healthcare practitioners thus offer a rich lens into thinking about degrees of conscious and unconscious engagement with patients and a variety of techniques of care needed. Building on Judith Butler’s theories of performativity, I am interested in infection prevention techniques as examples of behavioural practice, which are re-enacted and performed, or iterated, over time. Yet, in addition, I’m equally concerned with the relationship between practice and power. In what ways do perceptions of surveillance and codes of practice actively shape the biopolitics of healthcare workers and the degree to which their practice is coerced into conforming?

Finally, and more broadly, my research has adopted an interdisciplinary perspective, primarily by bringing cultural geography into conversation with debates arising with the performing arts setting. Cross-disciplinary engagement with nurses, microbiologists, engineers and performance scholars in the context of this project thus opens an unusual, yet invaluable, opportunity to think productively about how we share knowledge in mutually beneficial ways, and work collectively toward tackling shared global challenges such as anti-microbial resistance. Essential to this, I would argue, is a geographical perspective. This includes thinking critically about how geography can enrich medical/scientific knowledge; on the differing social-cultural practices that contribute to the spread of disease or determine decision making in the use of antibiotics; the geopolitical context sustaining health inequalities within and often beyond national borders; and making visible the where and how of infection/AMR – which countries and demographics will be most effected, and in what ways do different pathways/routes/everyday trajectories promote or discourage their geographical spread.